Digital Commons Network^™

Quality Improvement Project Integrating Clinical Decision-Making Tools Within An Ehr System For Provider-Enhanced Diagnosis And Treatment Of Depression In Primary Care, Theresa Ojoye

Doctor of Nursing Practice Projects

The inconsistent management of depression in primary care settings persists despite numerous available treatments, which current behavioral health literature frequently addresses.  A review of the project site highlighted the inconsistency in diagnosing and managing depression due to varying levels of provider familiarity with current guidelines and a lack of integrated decision-support tools within the Electronic Health Record (EHR) system. This project aims to evaluate the impact of integrating a clinical decision-making tool and patient outcomes in managing depression. This Quality Improvement (QI) project implemented UpToDate as an evidence-based clinical resource within the EHR system to address inconsistent application of evidence-based …

Assessment Of Faculty Perception Of Flipped Classroom Pedagogy, Jincymol Thomas

Doctor of Nursing Practice Projects

This DNP project assesses the faculty's perception of the flipped classroom (FC) pedagogy, which is an evidence-based teaching strategy to promote active learning and student success. The purpose of this project is to assess faculty members’ perception of implementing FC. The problem identified is the low progression and graduation rates for associate degree nursing (ADN) students at a North Central Texas Community College. This indicates that current teaching strategies need to be revised. As healthcare is constantly evolving and becoming more complex, the traditional methods of teaching nursing students are no longer sufficient. This QI project is aiming to educate …

Dnp Project: Research Study Using Mindfulness Meditation For Stress Reduction In Undergraduate Nursing Students, Jennifer Williams

Doctor of Nursing Practice Projects

Undergraduate nursing students often experience high stress from academic rigor, clinical demands, and personal challenges, contributing to mental health concerns and increased attrition. Unmanaged stress, when met with insufficient coping strategies, may contribute to students failing, leaving, or withdrawing from a nursing program. This research project addressed the need for a structured coping strategy within the curriculum at a State College to promote student resilience and reduce stress. As a quality improvement process change, the project’s purpose was to evaluate the impact of a four-week mindfulness meditation (MM) intervention on perceived stress levels of first-semester Associate Degree in Nursing (ADN) …

Strategies For Sustainable Recruitment, Retention, And Engagement In State Nurse Organization, Carolyn E. Hunter Layne

Doctor of Nursing Practice Projects

Many state nurse organizations are experiencing minimal and stagnant membership, which hinders involvement in policy advocacy, professional development, and workforce stability in healthcare. Policy changes are needed to offer state nurse organization memberships under the umbrella of a single organization that operates multiple medical clinics and employs at least one nurse. This research examined strategic policy interventions designed to increase membership within a state-level nursing organization. The problem is that a minimum number of state-licensed nurses are choosing to join professional nursing organizations, and membership models must be identified. The literature review drew on research from various scholarly sources specific …

Quality Improvement Project Implementing A Structured Communication Program For Academic Clinical Nursing Education, Ashley Daniel

Doctor of Nursing Practice Projects

Effective communication between healthcare professionals is a critical component of safe and high-quality patient care. Structured tools like SBAR (situation, background, assessment, and recommendation) provide a framework to enhance clarity and reduce miscommunication. This quality improvement project implemented SBAR as a structured communication program in debriefing after simulation to improve communication confidence among practical nursing students. The purpose of this project was to evaluate whether the integration of SBAR into debriefing would increase students’ self-reported communication confidence. The problem addressed was the lack of confidence in clinical communication among nursing students, which can impact patient safety and team collaboration. The …

Implementing Education On Music Therapy To Healthcare Professionals In Acute Psychiatric Inpatient Units To Decrease Incidences Of Aggression Among Patients, Judy Murua

Doctor of Nursing Practice Projects

Aggression in psychiatric inpatient units presents a significant barrier to therapeutic care and staff safety, often resulting in the overuse of pharmacological interventions or restraints. Despite strong evidence supporting music therapy as a non-pharmacological option, limited exposure and confidence among healthcare team members hinder its use in practice. This quality improvement project evaluated whether an educational intervention on music therapy could improve staff‘s confidence in utilizing this technique to manage aggression. A quasi-experimental, one-group pre- and post-test design was employed in an adult inpatient psychiatric unit, involving participation from nurses and behavioral health technicians. A structured 30–45-minute educational session was …

Enhancing Clinical Understanding And Management Of Hypertensive Disorders Of Pregnancy Among Ob-Gyn Providers, Jenelle Camino

Walden Dissertations and Doctoral Studies

Hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and chronic hypertension, are among the leading causes of maternal and neonatal morbidity and mortality globally, affecting approximately 10% of pregnancies. Despite established clinical guidelines, a significant gap remains in provider knowledge and the consistent application of evidence-based practices, particularly during the postpartum period and among marginalized populations. This Doctor of Nursing Practice (DNP) project addressed this gap by implementing a staff education program using the evidence-based California Maternal Quality Care Collaborative (CMQCC, 2021) toolkit. The intervention consisted of a pretest to assess baseline knowledge, an interactive PowerPoint presentation based on …

Quality Improvement Project The Impact Of Targeted Education And Training On The Use Of Rapid Mood Screener Tool On The Rate Of Mood Disorders Detection Among Psychiatric Providers, Oluwatobi Adeleke

Doctor of Nursing Practice Projects

Optimal mood disorder (MD) management outcomes are associated with accurate and timely diagnosis. Yet, MD misdiagnosis, particularly Bipolar I, is an unfortunately common problem. Rapid assessment or screening tools offer effective diagnostic assessment interventions for faster diagnosis without compromising effectiveness. Still, their administration is constrained by providers’ knowledge and competence limitations. The Rapid Mood Screener (RMS) is a rapid screener for MDs, including Bipolar I, with well-established specificity, accuracy, and reliability. Provider training and education on RMS implementation can be effective in addressing the challenges providers encounter in the tool’s administration. Here, through a pre-post quasi-experimental design, this quality improvement …

Quality Improvement Project Implementing Test Anxiety-Reducing Methods In Senior-Level Nursing Students, Ashley Brooke Gray

Doctor of Nursing Practice Projects

Test anxiety is a common occurrence among university students, particularly nursing students. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to address the problem of test anxiety among senior-level nursing students and the lack of faculty intervention in a Bachelor of Science in Nursing (BSN) program. This DNP project aimed to increase awareness of test anxiety among nursing students and provide faculty development training on identifying symptoms, utilizing the Westside Test Anxiety Scale (WTAS), and implementing test anxiety-reducing measures in the classroom. The DNP student provided training to senior-level nursing faculty in integrating relaxation methods, …

Quality Improvement Project Evidence-Based Practice For The Use Of Lower Fio2 Concentration Amongst Pediatric Anesthesia Providers, Brittany Raines

Doctor of Nursing Practice Projects

Hyperoxia during pediatric anesthesia is linked to postoperative pulmonary complications such as atelectasis and oxidative lung injury. Despite strong evidence supporting the use of lower inspired oxygen concentrations (FiO2), many providers habitually administer 100% oxygen during induction and emergence due to tradition and lack of formal guidelines. This quality improvement project aimed to reduce unnecessary hyperoxia by educating pediatric anesthesia providers on evidence-based FiO2 titration strategies. Guided by Kolb’s Experiential Learning Theory and Lewin’s Change Theory, a quasi-experimental one-group pretest/posttest design was employed. Sixteen certified registered nurse anesthetists (CRNAs) and physician anesthesiologists completed baseline surveys, participated in a targeted educational …

Evidence-Based Intervention Proposal For Reducing Intimate Partner Violence Against Jamaican Women, Kimisha K. Campbell

Walden Dissertations and Doctoral Studies

Domestic violence (DV) is a significant public health concern that negatively impacts women’s health, yet gaps in trauma-informed screening and referral processes persist within nursing practice. In Jamaica, DV remains underreported, highlighting the need for enhanced provider competency in identifying and supporting survivors. The doctoral project was used to examine how implementing the trauma-informed care (TIC) model and the Identification and Referral to Improve Safety (IRIS) program could improve healthcare staff’s ability to recognize, assess, and support DV survivors. Guided by the TIC framework and the IRIS program, a mixed-methods approach was used, incorporating pre- and posttraining assessments, staff surveys, …

Impacting Atherosclerotic Cardiovascular Disease Risk Screening In The Primary Care Setting, Rosalyn Primus

Doctor of Nursing Practice Projects

Cardiovascular disease continues to be the leading cause of death worldwide. Despite the availability of evidence-based guidelines recommending routine cardiovascular risk screening, tools such as the atherosclerotic cardiovascular disease (ASCVD) Risk Estimator are underutilized in primary care settings. This quality improvement project implemented an evidence-based educational intervention to enhance healthcare providers' knowledge, self-efficacy, and consistent utilization of the ASCVD Risk Estimator within a primary care setting. The project employed a quasi-experimental design involving four primary care providers. Data was collected through various methods, including a knowledge questionnaire, the Evidence-Based Nursing Practice Self-Efficacy (EBPSE) Scale, a retrospective chart review, and a …

Evaluating The Impact Of Auscultation Task Trainer On Faculty Teaching Health Assessment Course In A Bsn Program, Marie Leonie Tampus

Doctor of Nursing Practice Projects

Simulation-based education continues to transform nursing pedagogy by enhancing instructional effectiveness and clinical competency through experiential learning. In undergraduate Bachelor of Science in Nursing (BSN) programs, faculty often face challenges when teaching complex skills such as respiratory system assessment due to variability in lung sound exposure and reliance on peer-based instruction. The project aimed to evaluate whether the implementation of a high-fidelity auscultation task trainer could improve faculty knowledge and self-confidence in teaching respiratory assessment in a BSN Health Assessment course. Using a pre- and post-intervention quality improvement design, five faculty members teaching the course participated in a six-week intervention. …

Quality Improvement Project Structured Faculty Mentorship Program: A Quality Improvement Project, Nikki R. Pearson

Doctor of Nursing Practice Projects

The increasing issue of untrained faculty stepping into teaching roles poses a challenge in nursing education. This shift often causes stress and a period of disorientation. One evidence-based solution to enhance role clarity involves mentorship, which is defined as a professional relationship whereby a more experienced faculty member aids in the growth of a novice. The purpose of this project was to help novice nursing faculty by offering them structured, consistent mentorship as they moved into academia. The goal was to increase job satisfaction by clarifying roles, building a sense of support, and ultimately helping to retain faculty. The intervention …

Protecting Sleep To Reduce Delirium In Patients 65 Years And Older In The Icu, Jessica L. Thomas

Doctor of Nursing Practice Final Project Abstract

Protecting Sleep to Reduce Delirium in Patients 65 Years and Older in the ICU

PURPOSE

This quality improvement (QI) project aimed to reduce the incidence of delirium by 30% through a nurse-initiated, non-pharmacological sleep improvement protocol in the ICU.

BACKGROUND

This project was implemented in a large healthcare organization in Houston, Texas, in a 16-bed Intensive Care Unit.

METHODOLOGY

A pre- and post-intervention study was conducted in the ICU over a period using Plan-Do-Study-Act (PDSA) cycles. Baseline delirium (CAM-ICU) and sleep quality (RCSQ) assessments were obtained during Phase 1. Environmental adaptations, such as low lighting, noise reduction, staff education, and …

Digital-Based Nutrition Interventions Employing The Dietary Approaches To Stop Hypertension (Dash) Diet: A Systematic Scoping Review, Elizabeth Dodge, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing the DASH dietary pattern. Methods: A search was conducted using 14 databases to include relevant studies from 1997 to January 2025 using PRISMA guidelines for scoping reviews. Results: The review included 24 studies with almost 7000 participants, including randomized controlled trials and cohort studies conducted in several countries. Interventions using the DASH dietary pattern positively affected blood pressure (BP), nutrition behavior, and weight. Some studies also reported secondary outcomes such as reduced healthcare …

Chlorhexidine Bath Procedures To Increase Clabsi Maintenance Bundle Compliance And Decrease Clabsi And Clambi Incidence Rates., Michael Jabituk

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of the quality improvement (QI) project was to increase the Chlorhexidine (CHG) bath compliance, to decrease Central Line-Associated Bloodstream Infections (CLABSI and Central Line-Associated Mucosal Barrier Injury Infections (CLAMBI) rates in a transplant oncology unit.

Background

CLABSI and CLAMBI are hospital-acquired infections causing morbidity and mortality worldwide. A project targeting CHG bath compliance was developed to address the increased rates of these infections at a 32-bed transplant oncology unit at a hospital in Dallas, Texas.

Methodology

Two simulation-based videos were created on the importance of CHG baths and demonstration of CHG wipe application at bedside and administered …

Impact Of Primary Preventive Initiatives To Reduce Burnout And Compassion Fatigue In Emergency Department Nurses, Kelley Molandes

Doctor of Nursing Practice (DNP) Manuscripts

Background and significance: It is estimated that 20% of nurses leave the profession within the first year due to an onset of burnout (Henson, 2020). Prior to the pandemic of 2020, workforce projected models estimated large-scale shortages in full time employee (FTE) registered nurses as demand continued to outpace supply (Lauer, 2022). Researchers estimate projections from 2024 into the year 2032 are now skewed, as pandemic-related contributors and their effects on burnout in the nursing profession have not been thoroughly assessed (Saravanan et al., 2022). When considering the data, an underlying need for burnout prevention amongst nurse residents emerges. Interventions …

Bridging Evidence With Community: Five Routes To Diabetes Prevention In Latino Adults, Ann M. Maliackal

Doctor of Nursing Practice Final Project Abstract

Bridging Evidence with Community: Five Routes to Diabetes Prevention in Latino Adults

Background: This project used the Eightfold Path policy analysis approach to identify and recommend an evidence-based diabetes prevention program (DPP) for Latino adults in the Rio Grande Valley (RGV). The aim was to reduce diabetes prevalence by selecting an intervention that is culturally appropriate and effective for this population.

Methodology: The Eightfold Path policy analysis approach guided this project. A comprehensive literature review identified diabetes prevention programs (DPPs) tailored for Latino adults, and the Critical Appraisal Skills Programme (CASP) was used to assess study quality. Five DPPs were …

Dietary, Behavioral, And Psychosocial Factors Related To Cardiovascular Disease Risk Among South Asian Americans: A Scoping Review, Lakshmi Meyyappan, Peggy A. Ursuy, Olivia S. Anderson

Internet Journal of Allied Health Sciences and Practice

Purpose: South Asian Americans disproportionately represent the world’s prevalence of cardiovascular disease. This scoping review assessed the dietary and psychosocial factors associated with cardiovascular disease risk that South Asian Americans encounter and concluded with considerations for health professionals who encounter this population in practice. Method: Inclusion criteria included studies with the primary population as South Asian Americans and investigated diet or psychosocial factors as variables and cardiovascular disease as an outcome variable. Results: Thirteen studies were included. Analysis of nutritional factors showed that South Asian Americans have high dietary quality yet eating non-vegetarian diets and high alcohol consumption is associated …

Preventing Nurse Burnout Through Self-Care Strategies, Doris Iwuh

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Preventing Nurse Burnout through Self-Care Strategies by Doris Iwuh MS, Walden University, 2022 BSN, Grand Canyon University, 2020 ADN, Radiance College, 2016 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2025 Summary An outpatient mental health clinic identified a rise in burnout among psychiatric nurse practitioners, licensed therapists, and social workers. A gap in practice revealed that staff lacked knowledge of self-care strategies to manage burnout, leading to the project question: Does implementing an educational program for nurses and mental health specialists on …

Improving Intraoperative Antibiotic Stewardship To Reduce Surgical Site Infections: A Quality Improvement, Allyson Nichelle Heard

Doctor of Nursing Practice (DNP) Manuscripts

Purpose: Surgical site infections (SSIs) have been associated with poor pre-surgical incision antibiotic and intraoperative redosing practices and are the leading cause of postoperative readmissions and healthcare-acquired infections. A Quality Improvement (QI) project was developed to evaluate SSIs rates and pre-surgical incision antibiotic dosing and intraoperative redosing practices of anesthesia providers at a Level 1 trauma center in the Midwest. Methods: A pre- and post-intervention knowledge, attitudes, and practices (KAP) survey addressing intraoperative antibiotic stewardship was administered to 138 anesthesia providers. Interventions included education, a reference sheet, and a clinical pathway. Data analysis for surgical procedures involving anesthesia services, …

Increasing Gonorrhea And Chlamydia Testing By Using Universal Trauma-Informed Care And Offering Self-Collected Vaginal Swabs To Patients At A Non-Profit Independent Reproductive Healthcare Center, Dana M. Bloomburg

Doctor of Nursing Practice (DNP) Manuscripts

Background & Significance: The sexually transmitted infection (STI) epidemic in the United States remains a public health concern, with over 2.4 million cases in 2023 (Centers for Disease Control and Prevention [CDC], 2024). Increased screening can help prevent complications and enable treatment for the sexual partners of these asymptomatic infections (CDC, 2024). The American College of Obstetrics and Gynecology recommends that obstetrician-gynecology offices aim to provide universal trauma-informed care (TIC) to all patients (McNicholas et al., 2021). Purpose: Universal TIC practices were used to improve acceptance of gonorrhea and chlamydia (GC/CT) testing among at-risk individuals by adding a self-collected vaginal …

Addressing Medical Errors In Nursing Practice Through An Evaluation Of The Barcode Medication Administration Program, Alma Trigg

Doctor of Nursing Practice (DNP) Manuscripts

The barcode medication administration (BCMA) process is complex. When a step is omitted or altered, the risk of a medication error reaching the patient increases, which subsequently increases the chance of the patient experiencing an adverse drug event. A BCMA program evaluation was implemented to address questions related to policy and practice. Dr. Harrington's BCMA checklist provided the framework for the assessment. The Medication Administration System—Nurses Assessment of Satisfaction (MAS-NAS) scale, developed by Hurley et al. (2006), and the BCMA perceived usefulness scale, adopted by Darawad et al. (2019), measured nurses' perception of the program, including technology integration and ease …

Enhancing Care Coordination And Expedited Appointment Scheduling By Structured Workflow Process In Oncology Clinics: A Quality Improvement Initiative, Jasmine Lassiter

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Delays in oncology appointment scheduling can negatively impact timely cancer treatment, care coordination, and patient outcomes. Inefficiencies often stem from inconsistent workflows, communication breakdowns, and limited visibility into provider availability, contributing to scheduling inaccuracies, and treatment delays (Fletcher et al., 2023; Johnson et al., 2020). Purpose: This quality improvement project aimed to implement and evaluate a structured workflow for expedited oncology appointment scheduling in an outpatient setting to improve scheduling accuracy, care coordination, and healthcare team vitality. Intervention and Implementation Plan: Guided by the Institute for Healthcare Improvement (IHI) Model for Improvement and the Johns Hopkins Evidence-Based …

Increasing Health Literacy To Improve Cardiovascular Risk Factors In Patients With Low Socioeconomic Status In The Appalachian Region: A Quality Improvement Project, Kara M. Dougherty

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Improving health literacy is one of the main goals of Healthy People 2030. However, there are no evidence-based guidelines as health literacy is still in research status (Office of Disease Prevention and Health Promotion, n.d.). Vulnerable populations are especially at risk of having low health literacy skills. Social determinants of health, such as poverty, lack of access to care, few community resources, and low health literacy, are common issues throughout Appalachia, which includes West Virginia. These disparities negatively impact the success of primary and secondary prevention for cardiovascular disease (Mangini et al., 2018). This quality improvement project utilized the …

Evalutaing The Effectiveness Of A Two-Year Nurse Residency Program On Reducing Nursing Turnover In The One To Three Years Tenure, Nancy J. Plum

Doctor of Nursing Practice (DNP) Manuscripts

Background: First-year turnover for new registered nurses continues to take the lead in all tenured categories, accounting for 59% of turnover, carrying with it a financial impact averaging $88,000 per staff nurse lost. A synthesis of the literature finds the research to be ambiguous and anecdotal, with a narrow focus on understanding the causes of turnover, while an underwhelming amount of rigorous research has been conducted on identifying effective solutions. Solutions to mitigate nursing turnover will require an innovative approach.

Purpose: This program evaluation aimed to examine the impact of a two-year nurse residency program (NRP) on registered nurse turnover …

Enhancing Nurses’ Joy And Meaningful Work In A Military Treatment Facility: A Quality Improvement Project, Ann M. Uetz

Doctor of Nursing Practice (DNP) Manuscripts

Background: Prior to the pandemic, there was growing concern regarding nurse burnout and retention – concern which still exists today in healthcare organizations. Purpose and happiness in work ensures staff engagement, positive patient outcomes, improves nurses’ well-being, and decreases burnout. The Institute of Healthcare Improvement’s (IHI) Quadruple Aim emphasizes improving the work life and well-being of healthcare teams. IHI’s white paper, Joy in Work, outlines nine components to guide interventions for enhancing joy and meaningful work. Purpose: This project’s purpose is to determine the impact of implementation of the Joy in Work’s framework on registered nurses and nursing leadership …

The Implementation Of A Pilot Program On Puberty And Menstruation Education For Adolescent Females And Youth Development Specialists For A Gender-Specific Community Organization: A Quality Improvement Project, Cassandra Tavares

Doctor of Nursing Practice (DNP) Manuscripts

Background & Significance: Adolescent girls in the United States (U.S.) often lack adequate education and support regarding puberty and menstruation, despite the importance of this knowledge for healthy development (Schmitt et al., 2022). Only 21% of school systems serving ages 8–12 provide puberty education, and many educators feel unprepared to teach it (Schmitt et al., 2022). Purpose: This quality improvement project aimed to equip youth development specialists (YDS) at a community organization with a structured curriculum and educational tools to confidently educate adolescent females (ages 8–13) on the physical, emotional, and social aspects of puberty and menstruation. Intervention: A four-day …

Staff Education To Reduce Medication Errors In An Outpatient Mental Health Clinic, Oluwatoyin Rotimi

Walden Dissertations and Doctoral Studies

Summary Medication errors are a common concern within the healthcare industry, increasing healthcare costs and harming patients. The Doctor of Nursing Practice (DNP) project focuses on a staff education initiative to improve knowledge regarding using the Bar Code Management System (BCMS) to reduce medication errors in an outpatient mental health clinic. The identified gap in practice was the lack of knowledge on using the BCMS in outpatient mental health. The guiding practice-focused question was “Does educating the intake nurses on the barcode management systems improve knowledge, as evidenced by pre- and post-surveys?” The Analysis, Design, Development, Implementation, and Evaluation (ADDIE) …