Health and Medical Administration Commons^™

Evidence-Based Practice Education For Nurses Caring For Oncology Patients With Chemotherapy-Induced Peripheral Neuropathy: A Quality Improvement Project., Natalie N. Ellis, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Nurses are one of the primary sources of information for patients during their healthcare journey. Patient education can mean the difference between a positive and negative outcome. Oncology patients undergoing chemotherapy are an especially vulnerable population and education and preparation for potential side-effects related to chemotherapy is important. There are several ways to control chemotherapy-induced side effects (CISE). One of the debilitating side effects can be chemotherapy-induced peripheral neuropathy (CIPN). While difficult to manage, the support of nursing staff to encourage patients to take an active role in their care could help decrease the risk of CIPN and improve …

Effects Of A Compassion Fatigue Workshop On Psychiatric Mental Health Nurses, Johnnie Elizabeth Bower Bsn, Mary Johnson Dnp

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Compassion fatigue (CF) is a collection of symptoms associated with exposure to traumas experienced by other people. Nursing is one of the professions that experiences CF from recurrent exposure to patient and family distress and from potential acts of abuse at work. Nurses working in behavioral health are one of the highest at risk for CF. Of newly graduated behavioral health nurses, 17.5% leave the field after one year and 33.5% leave after two. Signs of CF include hopelessness, feelings of inadequacy, anxiety, depression, fatigue, and increased absenteeism. Training in self-care techniques and mindfulness builds nurse resilience and …

Initiating Culturally-Directed Education For Hispanic Adults With Type 2 Diabetes Mellitus, Marie Davis, Jennifer Smith, Mandy Horner

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND:

The U.S. Hispanic population has the highest rate of Type 2 diabetes mellitus (T2DM), which is influenced by socio-economic status and language barriers. Current evidence suggests that the delivery of culturally-directed Diabetes Self-Management Education (DSME) with the use of an interpreter can reduce diabetes-associated complications.

LOCAL PROBLEM:

The project took place at a free clinic in North Carolina. The purposes of this project was to create a culturally-directed DSME bundle for Hispanic adults with the use of a Spanish interpreter to improve understanding of T2DM management.

METHODS:

The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was …

Working Under Pressure: Evidence-Based Risk Assessment And Pressure Injury Prevention In The Pediatric Intensive Care Unit, James A. Hutcheson Iv, Allyson M. Neal

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: The hospital-acquired pressure injury (HAPI) can have physiologic, psychologic, and financial sequelae. Children are at increased risk secondary to immature physiology, developmental differences, and severity of illness. Evidence suggests presence of medical devices exponentiates HAPI risk.

Local Problem: Upward trends in HAPIs revealed nearly 50% are device related in the project setting, an urban Pediatric Intensive Care Unit. The Braden QD Scale was identified as best evidence for HAPI risk assessment. This initiative aimed to observe the ability of the Braden QD Scale as a predictor of HAPI risk as compared to current practice utilizing the Braden Q …

Improving Outcomes For Persons With Opioid Use Disorder By Introducing Buprenorphine In The Emergency Department, Emily Caroline Wegenka, Mary Johnson, Thomas Vajen

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Opioid related death is the leading cause of accidental death in adults younger than 50 years old in the United States (US) with approximately 130 opioid related deaths daily. Emergency department (ED) visits for a non-fatal overdose, the one-year mortality is 4.7-5.5%. Studies show increased access to medications for opioid use disorder (MOUD) decrease morbidity and mortality related to OUD. Additionally, there is evidence that initiating MOUD in the ED increases engagement in outpatient follow up, also reducing morbidity and mortality associated with OUD.

LOCAL PROBLEM: The setting for this practice improvement project was a non-profit, rural …

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Antibiotic Stewardship In Patients With Viral Upper Respiratory Illness: Improving Quality Measures In Retail Health, Meredith A. Nolan, Robin Harris, Clay Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Millions of people will die from antibiotic-resistant bacterial infections in the next 30 years. Retail health providers are pivotal in this global epidemiological problem.

LOCAL PROBLEM: Setting included 15 retail health clinics operated by Vanderbilt University Medical Center in Middle Tennessee. Project examined provider education, patient engagement, and commitment to antibiotic stewardship, components of the CDC's Core Elements of Outpatient Antibiotic Stewardship framework. Specific aims were that providers would have a significant reduction in the percentage of antibiotics prescribed for viral illness over the study period.

METHODS: Using the Evidence-Based Practice Improvement Model, a Quality Improvement …

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

How Soon Is Too Soon? A Quality Improvement Approach To Postoperative Length Of Stay Following Transcatheter Aortic Valve Replacement, David Brian Jones, Robin Harris, Paul N. Fiorilli Md, Allyson Neal

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Heart valve disease prevalence is expected to rapidly increase over the next twenty years. Aortic stenosis, the most common valvular disorder, is a significant cause of heart failure hospital admissions and high mortality if left untreated. Treatment options include surgical aortic valve replacement (SAVR) and the more popular transcatheter aortic valve replacement (TAVR). The rapid increase of TAVR procedures generates hospital bed capacity issues, and there is no recommendation defining the minimum length of stay (LOS) following TAVR.

LOCAL PROBLEM: The setting was a 1,100-bed academic medical center in southeastern Pennsylvania with an average annual TAVR volume …

Thermoregulation In Colorectal Patients: Heating Co2 Insufflation Gas, Alejandro Conde, Alieu Jawara, Laura Savage, James Alberding Dnp, Michael Godbold

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: 600,000 colorectal surgeries are performed annually in the United States, with 26-90% experiencing some form of unintended hypothermia. Consequences of hypothermia include surgical site infections (SSIs), delayed wound healing, cardiac dysrhythmias, and increased hospital length of stay. Utilization of the laparoscopic approach to intra-abdominal colorectal surgery uses un-warmed CO₂ gas. Multiple studies demonstrate the addition of heated CO₂, for insufflation, reduces intraoperative hypothermia.

LOCAL PROBLEM: This project was implemented at a facility in Tennessee. On average, 250 laparoscopic colorectal cases are performed at this facility annually. Participants were adult colorectal surgical patients, 18 years …

Implementation Of An Evidence-Based Guideline To Improve Vital Sign Assessment And Documentation In The Emergency Department, Mary Darden Mason, Jennifer Lynn Smith, Laura Sturla

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: The emergency department (ED) is a fast-paced area at risk for medical errors. Studies have found that patients with abnormal vital signs (VS) experience preventable adverse events and worse process outcomes, such as extended length of stay (LOS) times and increased readmission rates. Despite ongoing reports of VS inconsistencies, there remains a lack of evidence-based VS assessment and documentation standards across healthcare, which results in missed opportunities to mitigate deficits in quality of care.

LOCAL PROBLEM: The project site, a 19-bed rural ED in Maryland, lacked a standardized process delineating VS assessment frequency for the ED nurses, …

Implementation Of A Continuing Education Module On Triage Practices For Pediatric Emergency Room Nurses, Catherine Nicholson, Lindsey Lakas, Marian Malone

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: More than 35 million U.S. children visit the emergency department (ED) each year. Triage is the family’s first interaction with the healthcare team and a crucial component of care that directs the course of the ED visit. The use of standardized triage protocols, like the Emergency Severity Index (ESI) algorithm, is shown to improve overall patient health outcomes in the pediatric ED. For triage algorithms to be safe and effective, continuing education for pediatric ED nurses is important.

LOCAL PROBLEM: Patients at a local pediatric emergency department are being inaccurately triaged - assigned a higher or lower acuity level …

Implementation Of A Screening, Brief Intervention, And Referral To Treatment Protocol For Treatment Of Opioid Use Disorder In Post-Carceral Populations, Adaora Ede, Mary Johnson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Opioid use disorder (OUD) is a pressing public health issue in the US affecting marginalized populations the most. Within the correctional setting, 65% of inmates are affected with OUD, worsening health outcomes when untreated.

LOCAL PROBLEM: This evidence-based practice (EBP) project targeted justice-involved individuals with co-occurring OUD at a behavioral health clinic in Johnson City, Tennessee. This project aimed to improve outcomes related to recidivism and relapse through clinician education and the implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol.

METHODS: Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was the guiding EBP model for the …

Mindfulness-Based Educational Module For Nurses Caring For Pediatric Mental Health Patients, Brianna Mai Desjardins, Katherine Marie Newnam

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Emergency pediatric nurses have the added stress of not only caring for medical patients but must also care for patients experiencing mental health issues. Many nurses feel unprepared to care for this specialized patient population. To bridge this gap, mindfulness-based interventions (MBIs) have been shown to provide nurses with the skills needed to care for mental health patients. This same concept can be applied to pediatric patients. Pediatric-focused mindfulness-based techniques can be used to help pediatric patients manage their symptoms.

LOCAL PROBLEM: The setting for this project was an urban pediatric emergency department in East Tennessee. At the state …

Evaluation Of Registered Nurses’ Knowledge And Confidence In Encouraging Cardiac Surgery Patients To Participate In Digital Education, Katelin A. Welch, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background: Cardiac surgery remains a necessary means of medical management for cardiac disease. Patient anxiety is a common mental health challenge experienced by cardiac surgical candidates. Preoperative educational videos can reduce anxiety and improve the surgical experience.

Local Problem: This project was conducted for hospital nurses caring for cardiac surgery patients. Cardiac patients are assigned digital education to educate them about their procedures. Regardless of availability, nurse and patient engagement of the material is low. Competing nursing priorities prevent nurses from disseminating education to cardiac surgery patients, thus increasing patient anxiety. Educating nurses on utilizing digital surgery …

Psychosocial Consequences Of Diagnosed Malignant Melanoma, Savanna Eve Smallwood-Corcoran, Mary Johnson, Lindsay Frazier

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Psychosocial consequences frequently accompany the diagnosis of malignant melanoma (MM), such as fear, anxiety, burden, and distress. Patients are not receiving the proper psychiatric care needed to address the psychosocial consequences they are experiencing. Patients diagnosed with MM have expressed a lack of assessment and supportive care by providers to address psychosocial consequences they are experiencing.

LOCAL PROBLEM: The setting for the quality improvement project was a private dermatology clinic in Knoxville, Tennessee. There was no standard procedure for anxiety screening at the site. Comparable to published studies, there is a lack of procedures for screening patients …

Identifying Risk And Improving Outcomes: Application Of The Gad-7 Screening Tool Used Among Patients With Chronic Pain In An Outpatient Setting, Connor J. Cochran

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: It is estimated that chronic pain affects one in every five adults and that one in every three adults will be diagnosed with an anxiety disorder within their lifetime, indicating an overlap in both chronic pain and anxiety. Early identification of anxiety in the outpatient setting has the potential to increase identification and referral rates to specialized care.

Local Problem: An outpatient primary care facility that treats patients with chronic pain located in Philadelphia, Pennsylvania was the project setting. Prior to implementation, there was no standard process for identifying anxiety in patients.

Methods: The Iowa model of Evidence-Based Practice …

Improving Human Papillomavirus (Hpv) Vaccination Rates Through Age-Based Flagging, Savannah Jo Garcia, Karen Lasater

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

DNP SCHOLARLY PROJECT ABSTRACT

BACKGROUND: Over forty million Americans are currently infected with human papillomavirus (HPV). HPV can cause life threatening cancers of the cervix, vagina, vulva, penis, anus, and throat. Only half of U.S. adolescents have completed the HPV vaccine series.

LOCAL PROBLEM: The setting for this evidence-based improvement project is a rural family practice clinic in Texas. Texas has the largest group of teenagers not protected against HPV in the country. The project’s purpose is to investigate the effect of age-based flagging on adolescent vaccination rates in a rural community through evidence-based practice.

METHODS: Project …

Implementation Of Standardized Contraceptive Education To Improve Larc Initiation In Postpartum Individuals, Gracie E Clayton, Melissa M. Hessock, Amanda Flood

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Approximately 50% of pregnancies in the United States are unintended, leading to negative health, psychosocial, and financial outcomes. Supported methods for preventing unintended pregnancies are promoting education and access to highly effective contraceptive methods, including long-acting reversible contraceptives (LARCs). Studies demonstrate counselor knowledge and bias contribute to underutilization of LARCs, highlighting the need for standardized education.

LOCAL PROBLEM: The setting for this practice improvement project was a rural obstetrical unit in Tennessee where there was no standardized postpartum contraceptive education. Rates of contraceptive use at postpartum discharge were low. The purpose of this project was to implement …

Pediatric Vaccine Pain Management & Perceptions Of Caregivers And Nursing Staff: An Evidence-Based Project, Madison K. Bears, Tami H. Wyatt

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: In an age with many diseases controlled through immunization and herd immunity, the significance of immunization can wane in public memory. In children, injection pain is an obstacle to vaccination and can cause anxiety around medical visits, healthcare avoidance, delayed immunizations, and needle fear (McMurty et al., 2015; Shah & Sui, 2019; Taddio et al., 2022). Evidence-based vaccine pain relief techniques are described in the literature (Shah et al., 2009; Wu et al., 2022; Taddio et al., 2015), yet their use in practice is minimal (Taddio et al., 2022).

Local Problem: An evaluation of a pediatric clinic …

Acute Stress Disorder And Post-Traumatic Stress Disorder Screening In Pediatric Trauma Patients, Samantha Irizarry, Marian Malone, Megan Waddell

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.

LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD …

Reducing Iatrogenic Opiate Withdrawal In The Picu: An Evidence-Based Practice Improvement Project, Kaitlin Kirk Ogle, Marian Malone, Will Guider

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Current recommendations to reduce pain associated with mechanical ventilation is the administration of opiate and benzodiazepine infusions for Pediatric Intensive Care Unit (PICU) patients. If these infusions are weaned too quickly, iatrogenic withdrawal syndrome (IWS) often occurs. IWS symptoms include tachycardia, hypertension, diaphoresis, fever, irritability, tremors, clonus, hyperactive reflexes, vomiting, and diarrhea. Untreated IWS can lead to life-threatening complications.
LOCAL PROBLEM: The PICU at the project site contains fourteen beds and treats critically-ill pediatric patients. There was no standardized withdrawal assessment tool in practice. The purpose of this project was to implement the Withdrawal Assessment Tool-Version 1 …

The Effect Of Focused Client Education On Case Management & Readmission Rates In Homeless Individuals With Co-Occurring Disorders Admitted To A Jail Diversion Program, Pallavi Rao, Mary Johnson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Individuals with both mental illness(es) (MI) and substance use disorder (SUD) occurring simultaneously are known as having co-occurring disorders (COD). The rates of COD found among homeless individuals (H-COD) are higher than in the general population. The presence of both conditions prevents H-COD individuals from overcoming their hardships and places them at a higher risk of being involved in the criminal justice system.

Local Problem: Jail diversion programs (JDPs) admit a high rate of H-COD clients nationally and locally at the project site in Knoxville (JDP-K). The Office on Homelessness reported about 80% of those admitted to JDP-K are …

Initiating A Skin-Care Bundle In The Emergency Department To Decrease Hospital-Acquired Pressure Injuries In Geriatric Patients, Suzanne Babcock, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Adults 65+ comprise 15.2% of the United States (U.S.) population and 17.9% of Emergency Department (ED) visits. Aging causes changes to skin, including thinning and loss of elasticity. Annually, in the U.S., 2.5 million individuals develop Pressure Injuries (PI), causing 60,000 deaths. Hospital acquired PIs in the U.S. cost $26.8 billion annually, over $10,000/patient and increase the length of stay by greater than four days.

LOCAL PROBLEM: This project occurred in a 27-bed Geriatric Accredited Emergency Department in a southeastern U.S. city where patients 65+ comprise 40% of the patient volume annually. PIs can begin developing within two hours. …

Sleep Hygiene Interventions For Hospitalized Pediatric Patients, Courtland E. Kunz, Marian Malone

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

ABSTRACT

BACKGROUND: Adequate sleep is found to improve overall physical and mental health. Unfortunately, hospitalized children receive significantly less sleep than what is recommended by the National Sleep Foundation.

LOCAL PROBLEM: Patient and family feedback at the project site demonstrated inadequate sleep and a noisy hospital environment. The objective of this EBP project is to improve sleep for the hospitalized pediatric patient.

METHODS: The Johns Hopkins Evidence Based Practice Model for Nurses and Healthcare Providers was used as the framework for this project. The PROMIS Sleep Disturbance 4a questionnaire was the tool used to measure pediatric patients’ …

Reducing Hopelessness In Patients With Parkinson’S Disease: Educational Intervention, Kara R. Callear, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Reducing Hopelessness in Patients with Parkinson’s Disease: Educational Intervention

BACKGROUND: Parkinson’s disease (PD), features several non-motor manifestations, including cognitive dysfunction, which impacts patients and their families. Depression, hopelessness, and anxiety are all prevalent in the psychiatric conditions of PD. In fact, at least 50% of those diagnosed with PD will experience some sort of depression, hopelessness, or anxiety disorder after diagnosis (Ray & Agarwal, 2020). The specific purpose of this project was to help patients with PD diagnosis feel less hopeless and more resilient when coping with their symptoms of PD.

LOCAL PROBLEM: The project setting was a …

Improving Oncofertility Discussions And Referrals: Implementation Of A Formal Fertility Preservation Program, Mackenzie Danielle Browning, Melissa Marie Hessock

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Impaired fertility is a risk of life-saving cancer treatment in adolescents and young adults (AYAs). Despite this known risk and clinical practice guidelines that stress their importance, treatment-associated fertility risk education and preservation referrals are often neglected in this population.

LOCAL PROBLEM: The site of this evidence-based practice improvement project is an outpatient hematology-oncology clinic serving adults with varying cancer diagnoses. The site did not have a standardized approach to ensure treatment-associated fertility risk education and fertility preservation referrals were provided to AYAs with newly diagnosed cancer. The purpose of this project was to implement a formal fertility preservation …

Ultrasound-Guided Intravenous Access As A First-Line Approach By Nurses: A Quality Improvement Project, James Austin Burkhart, Pamela Hardesty, Melissa Mcdonald

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Up to 9% of patients admitted to EDs (Emergency Departments) have difficult intravenous insertion access issues (DIVA). This creates delays in patient care that includes interruptions for physicians providing medical emergency care. Often the utilization of RNs to perform US (ultrasound) IV insertions is limited related to lack of training and supportive policies.

Local Problem: The site for this project was an ED Level 1 Trauma Center associated with a large teaching hospital located in the southeastern U.S. Prior to the implementation of the process improvement project, there was no formal education of RNs in the use of US …

Implementation Of Standardized Patient Education To Improve Adherence With Colonoscopy For Colorectal Cancer Screening, Melissa Leal Hearn, Melissa M. Hessock, Tara L. Hahn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths among men and women in the U.S. CRC is preventable and manageable when detected early. Approximately 30% of average-risk Americans are overdue for colonoscopy screening. Colonoscopy screenings can reduce death by 67%. Current evidence suggests CRC screening education improves screening uptake among men and women at average-risk age.

LOCAL PROBLEM: The setting of this practice improvement project was a private colorectal surgery practice in South Texas, serving primarily Hispanic/Latino and Caucasian patients. Cancellation rates before colonoscopy were 16.8%, and there was no standardized education for CRC …

Decreasing Perioperative Medication Errors With Standardized Labeling Education, Stephanie Mccain, Emily Almond, Anna Wong, Julie Bonom

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016).

LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site.

METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, …