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Quality Improvement Project: Improving Nursing Knowledge And Confidence Of Dysglycemia In Pediatric Oncology Patients, Lindley Abrams

Doctor of Nursing Practice Projects

Treatment-induced dysglycemia is a frequently underrecognized complication of pediatric cancer therapy. Pediatric oncology nurses play a critical role in recognizing and managing dysglycemia; however, limited exposure to specialized dysglycemia education may contribute to gaps in knowledge and confidence. A site needs assessment found that 53% of nurses reported discomfort with glycemia-related concepts, supporting the need for targeted education. The purpose of the project was to evaluate changes in pediatric oncology nurses’ knowledge and confidence in recognizing and responding to treatment-induced dysglycemia. The project aimed to provide a structured educational intervention and measure pre- and post-intervention changes. Newman’s Health as Expanding …

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 …

Enhancing Hiv Knowledge And Resource Awareness Among Chief Nursing Officers, Susan Louise Cooper Bailey

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) remains a significant public health concern in rural communities, where limited specialty care, geographic isolation, transportation barriers, and stigma may delay testing and entry into care. The Texas Panhandle is a geographically expansive rural region served by rural hospitals with limited resources. Although area HIV services are available, they are inconsistently utilized. Although chief nursing officers (CNOs) influence practice and care coordination, knowledge gaps regarding HIV guidelines, prevention strategies, and regional resources may limit identification, referral, and continuity of care. The purpose of this doctor of nursing practice (DNP) project was to determine whether a targeted …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Advancing Paternal Perinatal Mental Health: Integrating Qualitative Evidence, Theory, And Measurement Science, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Aim: To advance understanding of paternal perinatal mental health through the integration of qualitative evidence, mid-range theory, and conceptual framework development.

Background: Existing scholarship largely emphasizes prevalence and symptom identification of paternal post partum depression, with limited integration of fathers lived experiences into theory development and assessment frameworks, and mental health nursing practice. Greater integration of qualitative evidence, theory, and measurement science may strengthen the recognition and assessment of paternal distress.

Methods & results: This integrative paper synthesizes findings from a phenomenological study of fathers with postpartum depression, the Reciprocal Adaptation in Postpartum Fathers mid-range nursing theory, and the P- …

Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education project regarding Candida auris, a multidrug-resistant fungus recognized by the Centers for Disease Control and Prevention (CDC) as an urgent global health threat due to its high mortality, environmental persistence, and resistance to common disinfectants. Staff play a crucial role in infection prevention; however, limited awareness and inconsistent knowledge of Candida auris contribute to potential transmission in skilled nursing home settings. The project question was as follows: Among staff members in a skilled nursing facility, does an evidence-based educational intervention improve knowledge of Candida auris infection prevention as compared pre- …

Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening condition that can rapidly lead to organ dysfunction, septic shock, and death if not recognized and treated early. Older adults in skilled nursing facilities (SNFs) are especially vulnerable because of age-related physiological changes, chronic conditions, weakened immunity, and increased exposure to infections. Consequently, sepsis remains a major cause of hospital readmissions, mortality, and healthcare utilization among SNF residents. The SNF serving as the site for this Doctor of Nursing Practice (DNP) project experienced increased hospital readmissions associated with recurrent sepsis, highlighting the need for a standardized, evidence-based approach to sepsis recognition and management. The practice-focused question …

Staff Education To Improve Hand Hygiene And Personal Protective Equipment Compliance, Suliat Oluwa

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to strengthen hand hygiene and personal protective equipment (PPE) practices among interdisciplinary staff in a long-term care (LTC) facility. The practice problem addressed inconsistent hand hygiene and PPE use across shifts and departments, contributing to healthcare-associated infections (HAIs). Because LTC residents are highly vulnerable due to advanced age, multiple comorbidities, and shared living environments, improving adherence to infection prevention practices is essential for enhancing resident safety, reducing preventable infections, and supporting compliance with Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) infection prevention standards. …

Weekly Team Validation Rounding Focused On Chlorhexidine Gluconate Bathing And Bath Completion And Documentation Compliance, La-Toya Therese Fong

Walden Dissertations and Doctoral Studies

This quality improvement project evaluated whether weekly team validation rounding improved chlorhexidine gluconate (CHG) bath completion and documentation compliance among eligible adult inpatients, with particular attention to differences in compliance outcomes between Pod 5C and Pod 4B. Background. Hospital-acquired infections continue to increase morbidity, mortality, length of stay, and healthcare costs. Although CHG bathing is an evidence-based strategy for reducing infection risk and the transmission of multidrug-resistant organisms, inconsistent documentation at the practicum site limited accurate monitoring of compliance across validation data, electronic medical record documentation, and DOMO reports. Method. Participants included eligible adult inpatients admitted within the previous 24 …

Closing The Loop: Strengthening Cauti Prevention With Urinary Catheter Management, Erika N. Braun

Master's Projects and Capstones

Objective: Catheter-associated urinary tract infections (CAUTIs) are among the most common preventable healthcare-associated infections and are associated with significant patient harm and increased healthcare costs. Baseline assessment across five adult cardiovascular and critical care units within a community-based acute care hospital identified four CAUTI events during the first half of 2026 and revealed important nursing knowledge deficits related to bladder scanning protocols and urinary catheter management practices. Aim: This Quality Improvement (QI) Project aimed to improve nursing knowledge of evidence-based bladder scanning protocols and urinary catheter management practices through targeted educational interventions implemented over a 10-week period, with …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Implementation Of A Standardized Antibiotic Order Set To Improve Evidence-Based Antibiotic Prescribing In Oral Surgery, Lashundra Miles

Walden Dissertations and Doctoral Studies

Inconsistent antibiotic prescribing practices in an oral surgery clinic contributed to variation in antibiotic selection, timing, dosing, redosing when indicated, and duration. This variation limited adherence to evidence-based prescribing recommendations and highlighted the need for a workflow-based strategy to support antibiotic stewardship. The purpose of this quality improvement project was to increase use of a standardized antibiotic order set through reminder-based reinforcement and to improve evidence-based prescribing practices. The practice-focused question examined whether implementing the standardized antibiotic order set, supported by workflow-integrated reminders and ongoing performance feedback, would improve order-set utilization during a 6-week implementation period. The project was guided …

Draining The Risk, Holding The Line: A Nurse-Driven Approach To Catheter-Associated Urinary Tract Infection Prevention, Thy Nguyen

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over …

Improving Rsv Vaccination Uptake Through Nurse-Led Educational Intervention, Lawrence Onuorah

Walden Dissertations and Doctoral Studies

In this quality improvement project, the DNP scholar explored the impact of a nurse-led staff education approach on improving respiratory syncytial virus (RSV) vaccine uptake. RSV disease results in negative health outcomes and even death among vulnerable individuals. Despite the availability of U.S. Food and Drug Administration (FDA)-approved vaccines, uptake remains low due to limited provider knowledge and inconsistent vaccine recommendations. Therefore, the project question addressed whether a staff education program would increase providers’ perceived knowledge of RSV vaccine recommendation and confidence to engage in patient education. The purpose of this quality improvement project was to implement a nurse-led staff …

Confidence Versus Competence: Addressing Nursing Knowledge Gaps In Catheter Care To Reduce Catheter-Associated Urinary Tract Infections, Leslie Anne Villanueva Bautista

Master's Projects and Capstones

Catheter-associated urinary tract infections (CAUTIs) remain among the most prevalent and preventable healthcare-associated infections (HAIs), contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare expenditures. Most hospital-acquired UTIs are related to urinary catheters, and this burden costs the United States alone an estimated $340 to $450 million annually (Yang et al., 2022). CAUTIs are UTIs that occur in patients with indwelling urinary catheters. This quality improvement project aimed to increase adherence to existing bladder scanning protocols and strengthen urinary catheter care to prevent CAUTI. Baseline staff nurse knowledge was obtained, and reinterpretation of the facility’s existing protocols and bundles …

An Interprofessional Organization Change Process To Reduce Catheter-Associated Urinary Tract Infections, Bolatito Owolabi

Walden Dissertations and Doctoral Studies

This organization change process initiative addressed a critical safety practice gap regarding catheter-associated urinary tract infection (CAUTI) prevention in a 450-bed acute care facility. This gap was recognized based on evidence that the facility’s CAUTI Standardized Infection Ratio (SIR) was above the national benchmark—and daily necessity assessment compliance of only approximately 50%. This gap was attributed to an organizational interprofessional culture, which hindered timely device removal. Prolonged catheter dwell times increase patient morbidity, extend hospital stays, and expose the organization to severe financial penalties. The project aimed to safely reduce device dwell times by structurally empowering bedside nurses. I used …

Improving Chlamydia Testing For Females Through Universal Screening In Outpatient Pediatric Primary Care: An Adolescent Quality Improvement Initiative, Christina Howard

Doctor of Nursing Practice (DNP) Manuscripts

Chlamydia is the most common sexually transmitted infection in the United States in adolescents and young adults (Dutra & Lazenby, 2023). Per Smith, Reirden, and Nyquist (2022), adolescents and young adults between the ages of 15 and 24 account for more than 60% of new chlamydia infections each year. Testing for chlamydia is not standardized, and it is estimated that only 50% of those who qualify receive a yearly screening American Sexual Health Association. (2021). If outpatient testing and treatment is not improved these asymptomatic cases will be missed, infections in general will increase, and reinfections may occur leading to …

Know Your Birth, Jasmine Mckelvey, Reagan L. Hunt, Michaela M. David

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Maternal mortality remains a significant public health concern in rural Kenya because of limited healthcare resources, inadequate emergency obstetric training, and barriers to accessing timely, high-quality maternal care. This quality improvement project evaluated the implementation of the Know Your Birth educational intervention, a culturally responsive, simulation-based training program designed to improve healthcare providers' knowledge, confidence, and competency in evidence-based maternal and newborn care. The project was conducted at Sega Dispensary in Sega, Siaya County, Kenya, and included 26 healthcare staff members. Guided by the Plan-Do-Study-Act framework, participants completed a brief educational presentation followed by three interactive skills stations focused on …

Improving Clostridioides Difficile Prevention Practices Through Standardized Stool Collection And Hand Hygiene, Dunya Khateeb, Laura Martin, Jessica Zhang

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Healthcare-associated Clostridioides difficile (C. diff) infections increase patient morbidity, length of stay, and healthcare costs (Simor, 2010). Our quality improvement project seeks to reduce C. diff infection rates and enhance prevention practices on the Med-Acute Unit at Sutter Medical Center Sacramento (SMCS) by utilizing the Plan-Do-Study-Act (PDSA) framework. Interventions will be implemented between March 2026 and July 2026. The project examined whether introducing a standardized stool collection tote and improving hand hygiene compliance would reduce C. diff infection rates. Participants included all nursing staff on the unit. Data is being collected through observational hand hygiene audits, collaboration with the SMCS …

Increasing Human Papillomavirus Vaccination Rates Among Adolescents In The Primary Care Setting: A Quality Improvement Project, Chioma Rosemary Ike

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is the most common viral infection of the reproductive system, and it is responsible for most cervical cancer cases worldwide. Many HPV-related cancer deaths can be prevented simply through vaccination. The vaccine is most effective when administered before exposure to the virus. Despite the HPV vaccine’s proven safety and efficacy, its uptake remains suboptimal. Purpose: This quality improvement (QI) project trained providers at a pediatric and family clinic in an effective communication strategy to increase HPV vaccination uptake among adolescents. It encouraged providers to …

Bridging The Gap In Science Research: Preparing Students For College- Level Research In The Sciences, Victoria Helwig, Yaoguang Li

UConn Library Presentations

Many first-year students enter college unprepared to fully engage with scientific literature and academic library resources. Drawing on experiences from academic librarians working with STEM students, this session explores common gaps in science research skills, including navigating databases, identifying scholarly sources, and understanding the structure of scientific literature. Participants will be introduced to practical strategies and classroom-ready activities to better prepare students for college-level research. Discussion questions: What science research skills do students struggle with most when entering college? How can high school instruction better support these skills? Where can librarians and educators collaborate to support student success?

Evaluating An Educational Intervention On Penicillin Allergy De-Labeling Among Graduate Nursing Students, Allison Desmond

DNP Projects

Background
Approximately 10% of patients report a penicillin allergy; however, up to 90% of these individuals are not truly allergic. Inaccurate penicillin allergy labels contribute to inappropriate antibiotic use, increased healthcare costs, and antimicrobial resistance. Education on penicillin allergy testing remains limited among future Family Nurse Practitioners (FNPs).

Methods
A quantitative quality improvement project using a pretest-posttest design was conducted among second- and third-year Doctor of Nursing Practice–Family Nurse Practitioner (DNP-FNP) students enrolled in Pharmacology II or Advanced Practice Nursing III at a Midwestern liberal arts college. Participants completed a 15-minute voiceover PowerPoint educational intervention on penicillin allergy testing and …

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

Nurses’ Knowledge And Practices Regarding Infection Prevention Measures In Cardiac Intensive Care Unit, Marwa G. Abouheiba, Maha Adel Salem, Jean Bertin Mudenge

Nursing

Abstract: Background: Healthcare-associated infections (HAIs) remain a major global patient safety challenge, contributing substantially to morbidity, mortality, prolonged hospitalization, antimicrobial resistance, and increased healthcare costs. Patients admitted to cardiac intensive care units (ICUs) are particularly vulnerable because of their critical illness, frequent exposure to invasive devices, and complex cardiovascular interventions. Nurses play a pivotal role in preventing HAIs through the consistent implementation of evidence-based infection prevention and control (IPC) measures. Therefore, assessing both nurses' knowledge and their observed clinical practices is essential for identifying strengths, potential gaps, and opportunities for quality improvement. Aim: To assess nurses' knowledge and observed practices …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Optimizing Daily Central Line Review: A High-Reliability Qi Project, Heather Khan

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Prolonged central line use increases the risk of infection. At baseline, central line utilization in a 21-bed medical intensive care unit exceeded organizational goals and the national median. Gaps in the central line review process and variation in staff knowledge contributed to overutilization.

 Aim of the Project: The project team aimed to improve patient outcomes by reducing the central line standardized utilization ratio (SUR) from 0.93 to the national median of 0.79 over 12 weeks.

Review of the Evidence: Evidence supports standardization, use of decision-support tools, measurement, and auditing to reduce central line utilization. Leadership engagement, safety culture, and …

Reducing Emergency Department Boarding Using Pull-Based Throughput Intervention: Quality Improvement Project, Eunice Dundu

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Emergency department (ED) boarding increases overcrowding and delays care. A 200-bed acute care hospital in the southeastern United States has a median time from inpatient bed readiness to ED departure that exceeds its hospital benchmarks, resulting in prolonged boarding and delays. Hospital data showed a median bed-ready-to-departure time of 76 minutes, exceeding the target of less than 45 minutes. Workflow analysis identified delays in transport activation, communication, and accountability as major contributors to inefficiency.

Aim of the Project: ED throughput quality improvement project aimed to reduce the median time from when an inpatient bed is marked ready to …

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

Reducing Catheter-Associated Urinary Tract Infections In Progressive Care, Kelli S. Bylsma

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.

Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.

Review of the Evidence: Recent …