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Quality Improvement Project: Improving Nurse Discharge Competency Through Standardized Education And Discharge Tools In An Inpatient Behavioral Health Hospital, Valina Williams

Doctor of Nursing Practice Projects

Inconsistent discharge education and variable use of structured discharge tools can affect the consistency of transitions from inpatient behavioral health care. The purpose of this Doctor of Nursing Practice quality improvement project was to improve nurse discharge competency by implementing standardized discharge education and reinforcing use of a structured discharge tool in a rural inpatient behavioral health hospital. A quantitative, quasi-experimental one-group pretest-posttest design was used over 12 weeks with 16 eligible registered and licensed practical nurses. Organizational readiness was assessed at baseline, and nurse self-efficacy was measured before and after implementation. Discharge-tool adherence and 30-day readmissions were also evaluated. …

Impacting Provider Knowledge, Attitude, And Practice Care In Adult Autism Spectrum Disorder Through Targeted Educational Interventions, Aganaba Alabi Anike Grace

Doctor of Nursing Practice Projects

Autism spectrum disorder is often considered a pediatric problem. However, undiagnosed autism among adults causes disproportionate healthcare inequities. Conventional ASD research and clinical training focus on pediatric groups, resulting in underdeveloped adult-oriented care and inadequately prepared providers. The project site reported discrepancies in ASD documentation and lack of knowledge in adult autism. The purpose of this project was to evaluate the impact of targeted educational interventions on provider knowledge, attitude, and practice of adult autism. The Iowa Model guided the translation of evidence into practice, whereas Kotter’s eight-step change model guided implementation. A quasi-experimental pretest-posttest design was used among 30 …

Quality Improvement Project: Improving Nurses’ Confidence In Peripheral Intravenous Catheter Assessment Through The I-Decided Framework, Pepe Sanchez

Doctor of Nursing Practice Projects

Peripheral intravenous catheters (PIVCs) remain a patient safety concern because inappropriate management can increase the risk of catheter-related bloodstream infections, prolonged hospitalization, and increased healthcare costs. A vascular access assessment at an acute care hospital identified inconsistent PIVC assessment practices and inadequate documentation, highlighting the need for a standardized approach to vascular access management. This quality improvement project evaluated the impact of education on the I-DECIDED framework on nurses' confidence in PIVC assessment and clinical decision-making. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Lewin's Theory of Planned Change, the project used a quantitative, quasi-experimental, one-group pretest-posttest design. …

Determining Impact On Provider Adherence To Current Diabetes Guidelines: A Quality Improvement Project, Rashemia Suber

Doctor of Nursing Practice Projects

The delivery and documentation of evidence-based adult lifestyle counseling for patients with type 2 diabetes mellitus (T2DM) were found to be inconsistent in a clinic that serves an underserved population. This quality improvement (QI) project assessed whether a provider education program based on the 2025 American College of Lifestyle Medicine (ACLM) Diabetes Guidelines would improve provider confidence and documentation of lifestyle recommendations. A quasi-experimental, pretest-posttest design was guided by both Pender's Health Promotion Model as the theoretical framework and Lewin's Change Theory as the change theory. The Plan Do Study Act (PDSA) cycle guided this project as the implementation framework. …

The Impact Of Provider Medication Reconciliation Education On Hospital Readmissions In A Skilled Nursing Facility, Vivian Nwozu

Doctor of Nursing Practice Projects

Aging causes frailty and multiple comorbidities, necessitating polypharmacy. Complicated drug regimens predispose patients to adverse drug events and hospital readmissions. The practice problem was high rates of medication-related readmissions due to inadequate provider knowledge of medication reconciliation and the lack of a standardized tool. This project aimed at evaluating the impact of provider medication reconciliation education on hospital readmissions in a skilled nursing facility. A pretest-posttest study design was utilized. The Donabedian Model of Healthcare Quality guided the translation of evidence into practice, whereas Lewin’s Change Model and Plan-Do-Study-Act models guided implementation. Eight providers were educated on medication reconciliation using …

Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …

Quality Improvement Project: The Impact Of Self-Assessed Quality Of Sleep On Illness Experience And Job Satisfaction Among Night Shift Nurses, Eunice Ikpekpe

Doctor of Nursing Practice Projects

Compromised sleep quality, illness experience, and job satisfaction are important concerns among registered nurses working night shifts. The purpose of this quality-improvement project was to evaluate changes in self-assessed sleep quality, illness experience, and job satisfaction following participation in the six-week Sleep Hygiene and Recovery Program (SHRP) among night-shift registered nurses at a large, urban, Level I trauma academic teaching medical center. The project used a quantitative, quasi-experimental, single-group pretest–posttest design guided by the Plan-Do-Study-Act framework and Lewin’s Change Management Theory, with the Neuman Systems Model and Pender’s Health Promotion Model providing the theoretical foundation. SHRP was a structured, evidence-informed …

Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba

Walden Dissertations and Doctoral Studies

This staff education project addressed the gap in standardized knowledge and implementation of evidence-based sleep hygiene interventions among nursing staff on an inpatient behavioral health unit. Sleep disturbances affect 80%–90% of psychiatric patients and directly impact treatment outcomes and recovery. I developed the practice-focused question to consider whether an evidence-based sleep hygiene education program would enhance the awareness, knowledge, and practices of the nursing staff regarding sleep hygiene interventions. A thorough literature review of 23 high-quality sources formed the background for the development of a structured educational intervention that encompassed assessment methodologies, nonpharmacological interventions, environmental interventions, and patient education interventions. …

Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Peter Mufua Tumenta has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Melanie Braswell, Committee Chairperson, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2026 Executive Summary Falls are a significant patient safety concern among older adults in long-term care (LTC) facilities. This Doctor of Nursing Practice quality improvement project implemented and evaluated a standardized, evidence-based multifactorial fall-prevention staff education program to improve …

Cultivating A Culture Of Feedback: Strengthening Picu Nurses Through Peer-To-Peer Feedback, Alex Ramirez, Reese Reddick, Sydney Usselman

2025

No abstract provided.

More Than Words: Enhancing Caregiver Confidence ​Through Health-Literacy-Informed Discharge Teaching, Madelyn Biad, Rachel Jones, Temi Kalejaiye, Aylana Lindsey, Jennifer Nguyen, Jenny Nguyen, Samantha Wigder

2025

No abstract provided.

Patching The Practice Gap: Standardizing Pediatric Transdermal Medication Administration, Grace Mcreynolds, Jennifer Diaz-Miranda, Raven Davis, Cierra Berry, Womietu Arise, Samantha Onyekwere, Jennifer Lugo, Hasina Barlett

2025

No abstract provided.

Quality Improvement Project: Electronic Consent's Influence On Consent Error Rates, Alexis Fogle

Doctor of Nursing Practice Projects

Surgical consent errors increase the risk of inaccurate documentation, compromise patient safety, and disrupt procedure times. Evidence indicates that adopting electronic consent can optimize workflow, support accurate and complete documentation, improve readability, and enhance record reliability. This project evaluated whether initiating electronic consent, compared with handwriting surgical consent forms, reduced the number of improper surgical consent forms completed over six weeks. Roy’s Adaptation Model guided the change process, and the Theory of the Person as an Adaptation System provided the theoretical basis. The Plan-Do-Study-Act model supported evidence-based implementation of the electronic consent intervention. The quality improvement project was conducted on …

Implementing An Evidence-Based Practice Training Program To Impact Nursing Skills Competency And Self-Efficacy In A Long-Term Care Facility, Angela Mcknight

Doctor of Nursing Practice Projects

Long-term care facilities require nursing staff who can competently perform clinical skills; however, the project site relied primarily on written in-service education and attendance verification without direct validation of psychomotor performance. The purpose of this quality improvement project was to evaluate competency-based nursing education in a long-term care facility. The aim was to strengthen demonstrated urinary catheterization competency and evaluate changes in perceived professional nursing competence and general self-efficacy among licensed nurses. A quasi-experimental, one-group pretest-posttest design included 12 registered and licensed practical nurses. Plan-Do-Study-Act guided implementation, Lewin’s Change Theory guided organizational change, and Social Cognitive Theory supported the educational …

Quality Improvement Project: Implementing A Standardized Psychiatric Handoff Tool To Impact Nurse-To-Nurse Communication In An Acute Care Psychiatric Setting, Andrea Ranglin-Johnson

Doctor of Nursing Practice Projects

Evidence supports that inconsistent nurse-to-nurse handoff communication may contribute to omitted information, workflow inefficiencies, and patient safety concerns in acute psychiatric settings. The practice problem was the absence of a standardized psychiatric handoff process, which contributed to inconsistent shift report communication. This quality improvement project examined whether the PSYCH (Patient Profile, Situation, Your Clinical Assessment, Care Plan/ Critical Information, and Hindrance for Discharge) standardized handoff tool impacted nurses' perceptions of nurse-to-nurse communication over six weeks. Lewin's Change Theory guided implementation, while the Donabedian Structure-Process-Outcome Model provided the theoretical framework. The Plan-Do-Study-Act cycle supported implementation. A pre- and post-implementation design was …

Quality Improvement Project: Empowering Change: Evidence-Based Strategies To Improve Ai Use In Pedagogy, Amanda Boyle

Doctor of Nursing Practice Projects

Artificial intelligence (AI) continues to integrate into healthcare and higher education; however, Health Science faculty at the project site lacked formal training to operate or teach AI responsibly. This Doctor of Nursing Practice quality improvement project evaluated whether computer-based AI literacy education improved Health Science faculty members’ self-reported AI literacy. It was predicted that faculty AI literacy scores would improve after completing the intervention. Kotter’s change model and Benner’s novice-to-expert framework informed implementation of change and faculty professional development. The Plan–Do–Study–Act model supported evaluation. In a one-group, quasi-experimental preintervention–postintervention study design at a North Texas two-year college, 19 eligible Health …

A Quality Improvement Project: Impacting Communication Perceptions Among Nursing Staff And Providers Regarding Perioperative Medication Management Impacting Anesthesia Care, Demetria Jefferson

Doctor of Nursing Practice Projects

Medication-related surgical cancellations disrupt patient care, increase healthcare costs, and contribute to inefficient use of perioperative resources. Evidence supports standardized education and communication to improve perioperative medication safety. This quality improvement project aimed to improve staff self-efficacy in communicating medication instructions and reduce surgical cancellations associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and phentermine. Bandura’s Social Cognitive Theory and Lewin’s Change Model guided the project. A quasi-experimental one-group pretest-posttest design included perioperative staff who provided medication instructions across two settings within an academic health sciences center. Using the Plan-Do-Study-Act framework, interventions included standardized staff education, patient …

Training Faculty For Skills Evaluation: A Quality Improvement Project, Shelley Leezer

Doctor of Nursing Practice Projects

There is an identified gap between nursing knowledge learned in academic settings and application of clinical skills in practice settings. Literature contributes this gap to poor knowledge retention, lack of constructive feedback, and inability to apply knowledge to clinical practice. The purpose of this project was to address skill mastery and retention in nursing students within a university. The project aim was to improve faculty feedback and evaluation to best support skill mastery in the skills laboratory. Lewin’s Change Management Model and Dr. Patricia Benner’s Novice-to-Expert Theory guided project design and progress. This pre- and post-intervention study followed a PDSA …

Quality Improvement Project Stress First Aid: Equipping Nurse Leaders, Bethany Russell

Doctor of Nursing Practice Projects

Stress among nurses can negatively affect well-being, workforce stability, and the quality of patient care, highlighting the need for nurse leaders to effectively recognize and respond to stress within their teams. The purpose of this quality improvement project was to evaluate whether education on the 7 Cs of Stress First Aid (SFA) improved leadership self-efficacy among nurse leaders at an urban acute-care hospital. Watson’s Theory of Human Caring provided the theoretical foundation, while Lewin’s Change Theory guided implementation of the practice change. A one-group pretest-posttest design was used, with the Plan-Do-Study-Act framework supporting project implementation. Participating nurse leaders completed an …

Integrating Interprofessional Education To Strengthen Team-Based Mental Health Care, Adebisi Tijani

Doctor of Nursing Practice Projects

Fragmented interprofessional collaboration in outpatient mental health settings compromises care coordination and patient engagement. This quality improvement (QI) project implemented a structured interprofessional education (IPE) workshop series to improve team collaboration and reduce patient no-show rates in an outpatient mental health clinic. Guided by Bandura's Social Cognitive Theory and Lewin's Change Management Model, the project used a pre-post, single-group design with 12 licensed mental health professionals. The team measured collaboration with the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II) and collected aggregate patient no-show rates from the electronic health record. The intervention consisted of four monthly, one-hour workshops covering role …

Quality Improvement Project: Impacting Clinical Competency Through Faculty Preparation: A Standardized Teaching Guide Initiative, Caroline White

Doctor of Nursing Practice Projects

Variability in clinical teaching practices can contribute to inconsistent faculty preparation and student learning experiences. This quality improvement project addressed the absence of a standardized clinical teaching resource within an Associate Degree Nursing (ADN) program at a public technical college in the southeastern United States. The purpose was to implement a standardized, evidence-based clinical teaching guide to improve faculty confidence and clinical educator skill acquisition. Social Cognitive Theory provided the theoretical framework, and Lewin’s Change Theory guided practice change. A quantitative, quasi-experimental one-group pretest-posttest design was used. Fourteen eligible nursing faculty and clinical instructors were invited to participate; 10 participated, …

Nurse-Led Remote Patient Monitoring In Outpatient Heart Failure, Jackline Ukadike

Walden Dissertations and Doctoral Studies

Chronic heart failure (HF) remains a leading cause of avoidable hospital readmissions and emergency department visits due to delayed recognition of early symptom exacerbation between routine outpatient encounters. This doctoral quality improvement project evaluated whether the implementation of an evidence-based, nurse-led remote patient monitoring (RPM) standard operating procedure (SOP) improved early identification of symptom exacerbation compared to standard episodic care among adult heart failure patients (NYHA Class II–III) in an outpatient primary care setting over a 10-week period. Guided by the Plan-Do-Study-Act (PDSA) framework, an evidence-based clinical practice guideline (CPG) and escalation protocol were developed and appraised by a 3-member …

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Enhancing Early Detection Of Suicide Risk In Outpatient Settings Through Standardized Implementation Of The Ask Suicide Screening Questions Tool, Shayla Lee

Doctor of Nursing Practice Projects

Suicide is a leading cause of death in the United States, highlighting the need for routine suicide risk identification. Evidence supports standardized suicide screening can promote early identification of suicide risk. A needs assessment at an outpatient mental health clinic identified the absence of a standardized suicide screening and referral process. The purpose of this quality improvement project was to implement the Ask Suicide-Screening Questions (ASQ) Tool and a standardized referral protocol. The aim was to evaluate ASQ documentation, referral rates, and staff self-efficacy over four weeks. Peplau’s Interpersonal Relations Theory, Lewin’s Change Theory, and the Plan-Do-Study-Act (PDSA) framework guided …

Development Of An Evidence-Based Clinical Practice Guideline For Glp-1 Medication Management And Weight-Loss Monitoring In Adults, Jeannette Mariela Pena

Walden Dissertations and Doctoral Studies

This doctor of nursing practice project addressed the lack of a standardized clinical practice guideline for glucagon-like peptide-1 (GLP-1)-based medication management and weight-loss monitoring in an outpatient functional health setting. The purpose was to develop an evidence-based guideline to improve provider consistency, patient education, monitoring, documentation, and treatment safety for adults receiving GLP-1-based weight-management therapy. The Johns Hopkins Evidence-Based Practice Model guided question development, evidence appraisal, synthesis, translation, and implementation planning. The guideline incorporated evidence related to adult obesity management, GLP-1-based pharmacotherapy, lifestyle intervention, eligibility assessment, medication selection and titration, adverse-effect monitoring, follow-up, and documentation. Three content experts—a nurse practitioner …

Implementation Of Asynchronous Mentor Education Modules To Improve Mentoring Competency, Elvira Sayfutdinova

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Structured mentorship supports new CRNAs as they transition to practice, fostering confidence, job satisfaction, and professional growth. The WashU Medicine Department of Anesthesiology (WUDA) launched a CRNA Mentorship Program in 2022, but it lacked standardized mentor education, leading to inconsistent mentor preparation and variable mentoring practices.

Review of Literature Findings: Structured mentor education improves mentoring competency across healthcare settings, yet the literature specific to CRNAs remains limited. Asynchronous, self-paced formats reduce barriers to participation for busy clinicians, but no prior study has evaluated a fully asynchronous, prerecorded mentor-education format for CRNAs.

Methods: This pre-/post quality improvement (QI) …

Palliative Care Consults In The Intensive Care Unit, Kyra Zimmer

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Intensive care unit (ICU) patients often face serious illness or terminal diagnoses requiring invasive monitoring and life-sustaining treatments. Palliative care (PC) supports patients and their families by focusing on improving quality of life, goals of care, and symptom management. It is estimated that 14-20% of ICU patients in the United States could benefit from palliative care consults (PCCs) with potential savings of $6 billion per year. Nurses caring for these patients face unique ethical challenges and may develop secondary post-traumatic stress, emotional strain, burnout, and compassion fatigue.

Review of Literature: The review of literature supported a structured …