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From Incomplete To Impactful—Finalizing Unfinished Nursing Projects In Nart And Polypharmacy For Lasting Improvement, Paula Thanh Nhat Pham, Armine Lianna Chamichyan, Anastasia Yerofeyeva, Stelene Alexis Tragus

Master's Projects and Capstones

This quality improvement project addressed the problem of incomplete or unsustained clinical initiatives at a long-term care facility by introducing Kotter’s Change Model, an evidence-based framework designed to support and sustain lasting improvements in clinical practice. Within the context of a religious-based residential community for older adults with complex chronic needs, the objective was to strengthen the facility’s capacity to implement and sustain change more effectively. By using two previously unfinished initiatives, the NaRT triage tool and Polypharmacy management process, the project applied Kotter’s model to evaluate how structured change strategies can improve staff engagement, leadership alignment, and long-term project …

Improving Pressure Injury Prevention With Educational Programs For Caregivers And Nurses, Michella B. Kahanding

Master's Projects and Capstones

Problem: Pressure injuries are preventable with adequate interventions and knowledge by healthcare staff; however, skilled nursing facilities struggle with pressure ulcer prevention (PUP). Patient suffering and associated costs with treating these injuries are considerable.

Context: Staff education in knowledge regarding PUP is lacking, and annual PUP education is ineffective in reducing the number of pressure injuries in these facilities.

Interventions: Staff education on prevention strategies includes education, pre- and post-knowledge assessments, return demonstration and product use will be implemented

Measures: Results from the baseline knowledge of appropriate PUP in caregivers, pre- and post-test for knowledge retention, teach back techniques to …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Implementing A Standardized Doula Awareness Tool To Improve Team Collaboration And Patient Understanding, Stephanie Wong

Master's Projects and Capstones

Setting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently …

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …

Evaluating Fall Prevention Outcomes: Fall Rates, Staff Fall Knowledge, And Perceptions On Safety Culture, Priscilla Greco

Student Scholarly Projects

Practice Problem: The practice problem addressed in this project was the elevated fall rates on a 46-bed medical–surgical unit with a reported sentinel fall event, prompting the need to evaluate the current fall prevention program.

PICOT: The PICOT question that guided this project was: In nursing staff on a medical–surgical unit (P), how does the implementation of an evidence-based fall prevention program evaluation using AHRQ tools (I), compared with no formal program evaluation (C), influence staff knowledge, perceptions of safety culture, and fall rates (O) over 8-weeks (T)?

Evidence: Evidence supporting this project emphasized that structured staff education, strong communication, …

Enhancing Sepsis Prevention In Long-Term Care Facilities: Development Of An Infection Prevention Sepsis Toolkit, Emmalyn A. Tuhin

Student Scholarly Projects

Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to create, validate, and refine an Evidence-Based Sepsis Prevention Toolkit to enhanced early sepsis recognition and interprofessional coordination of care within long-term care facilities (LTCFs).

Background: Sepsis remains a leading cause of mortality and preventable transfer to the hospital for the elderly residents within the LTCFs. A significant practice gap persists because sepsis in this population often presents atypically, resulting in delayed or inaccurate diagnosis and treatment.

Methods: This project was guided by the following PICOT question: For healthcare professionals caring for patients aged 65 years and older …

Facilitating Timely Initiation Of Hiv Care Through An Interdisciplinary, Algorithm-Guided Approach, Courtney Harris

DNP Projects

ABSTRACT

BACKGROUND: Initiation of antiretroviral therapy (ART) within twenty-four hours of an HIV diagnosis is safe, shortens time to viral suppression, improves retention in care, and contributes to reduced HIV transmission at the community level (Bacon et al., 2021). Despite this evidence, patients across the United States do not universally receive timely HIV care (Bertolino et al., 2023). Barriers to early ART initiation include lack of staff buy-in, logistical challenges, and socioeconomic factors affecting patients (Doshi et al., 2023).

LOCAL PROBLEM: A small HIV care clinic in the southern United States observed a similar discrepancy, noting inconsistent timely initiation of …

Improving Lung Cancer Screening Rates Through Low-Dose Computed Tomography, Pauline Adhoch

Doctor of Nursing Practice Projects

Tobacco use is the leading cause of lung cancer and one of the most preventable causes of morbidity and mortality worldwide. The World Health Organization estimates that 1.25 billion people smoke, resulting in significant social, economic, and health burdens. Despite this, opportunities to screen and refer eligible patients for lung cancer screening are often missed in primary care, contrary to the recommendations of the United States Preventive Services Task Force (USPSTF). This quality improvement (QI) project educated clinical staff about the USPSTF guidelines for lung cancer screening to increase referral rates. Lewin’s Change Model guided behavior change, and the Iowa …

Quality Improvement Project: Nursing Faculty Mental Health Literacy Assessment And Evaluation, Elesha Roberts

Doctor of Nursing Practice Projects

Mental illness is a major healthcare concern affecting young adults enrolled in college. College students enrolled in nursing programs in particular face intense academic pressure due to the demands and rigor of the program. Students commonly report symptoms associated with depression, anxiety, and suicide. Nursing faculty often do not feel comfortable approaching students about these concerns and other related mental health issues. Many faculty members lack the knowledge and skill to identify mental health issues and provide resources to support students in need. Faculty should be mental health literate and aware of campus resources. The purpose of this quality improvement …

Quality Improvement Project, Communicating With The Dying Patient: A Simulation Experience For Nursing Students, Jason Weger

Doctor of Nursing Practice Projects

Effective communication with patients near the end of life is a crucial yet often underdeveloped skill among nursing students. Previous research highlights a persistent gap in training for end-of-life communication in nursing schools. This quality improvement project implemented a simulation-based educational intervention to improve end-of-life communication skills among first-semester nursing students at a community college in Oklahoma. A needs assessment identified significant gaps in students' readiness for emotionally charged patient interactions. Guided by Prosci’s Change Model and Jeffries Simulation Theory, the project used a faculty-led simulation experience to teach evidence-based communication strategies, including appropriate word choice, therapeutic presence, and active …

Improving Self-Efficacy Among Clinical Instructors: The Impact Of Communication Education On Handling Lateral Violence, Emma Guidry

Doctor of Nursing Practice Projects

The quality improvement (QI) project aims to determine if clinical instructors perceive changes in self-efficacy in communication skills specific to lateral violence (LV) situations secondary to an educational intervention. Currently, clinical nurse instructors lack education specifically addressing communication strategies to utilize when LV occurs in the clinical setting. Banduras Social Cognitive Theory, Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) were employed as frameworks in the development of this project. Methods used in this quasi-experimental design project include administration of the Self Efficacy to Address Disruptive Behaviors Scale (SADBS) survey to project participants, nursing clinical instructors. The evidence-based practice (EBP) intervention …

Resiliency For Nurse Educators: Incorporating Resiliency Training For Nursing Faculty, Rachael Holder

Doctor of Nursing Practice Projects

Nursing faculty frequently experience high levels of stress, workload demands, and burnout, which can negatively affect teaching effectiveness and retention. Literature supports resilience as a protective factor that enhances well-being and professional sustainability. The purpose of this quality improvement project was to impact resilience levels among full-time undergraduate nursing faculty through a self-paced online resiliency training program. Guided by Pender’s Health Promotion Model and Lewin’s Change Theory, this pre- and post-intervention design used the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to assess changes in resilience. Eleven faculty members completed the pre-survey, and two completed the post-survey. The post-survey mean CD-RISC-10 scores …

Quality Improvement Project: Educating Nursing Faculty On Medication Administration Labs To Improve Student Competency, Chelsea Pacheco

Doctor of Nursing Practice Projects

Medication administration errors are a leading cause of preventable harm in healthcare. Faculty play a critical role in ensuring nursing students develop the knowledge and confidence to give medications safely. A needs assessment at the project site revealed that only course coordinators were teaching medication administration and dosage calculation, leaving other faculty uncertain about how to teach these skills. This quality improvement project aimed to strengthen faculty confidence and create consistency in first-year instruction through a recorded educational video. Constructivist Learning Theory provided the foundation for active, experience-based learning. Lewin’s Change Theory guided the structured implementation process to support adoption …

Shared Decision Making In Women's Health: A Quality Improvement Project, Brittney Butler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is the best practice in contraceptive counseling, yet it remains underutilized in primary care, particularly within underserved communities. Limited SDM use reduces patient autonomy, weakens satisfaction, and contributes to inconsistent documentation. This quality improvement (QI) project aimed to evaluate whether an educational intervention on SDM for contraceptive counseling improved provider self-efficacy and the electronic medical record (EMR) documentation of SDM practices. Guided by Bandura’s Social Cognitive Theory and Lewin’s Change Management Model, the project sought to enhance provider confidence and foster sustainable behavioral change. A quasi-experimental, one-group pretest–posttest design was implemented at a rural Federally Qualified Health …

Improving Pharmacovigilance Via Systematic Gass Screening And Interdisciplinary Collaboration In The Outpatient Setting, Dustin Bower

Doctor of Nursing Practice Projects

The goal of this Doctor of Nursing Practice (DNP) quality improvement project was to enhance pharmacovigilance practices among non-medical mental health providers (NMMHPs) in an outpatient psychiatric setting. The project addressed the issue of limited recognition and reporting of adverse drug reactions (ADRs) by NMMHPs, which can lead to delays in clinical intervention and compromise patient safety. To tackle this problem, a quasi-experimental, pre–post intervention design was employed. Two evidence-based strategies were implemented: (a) eight weekly collaborative training sessions that focused on identifying, documenting, and communicating ADRs, and (b) the integration of the Glasgow Antipsychotic Side-Effect Scale (GASS) into the …

Quality Improvement Project Nursing Student Retention Strategies: A Focus On Peer Mentoring, Anh Vittoria

Doctor of Nursing Practice Projects

The nursing shortage remains a concern in healthcare. Increasing the number of students who complete nursing programs and enter the profession can help with the demand for nurses in the workforce. Nursing programs face challenges with student retention, which limits the number of nurses entering the profession. The quality improvement project aimed to examine the effects of a peer mentorship program on first-year associate degree nursing students’ perception of support and course completion rates. The purpose is to impact student retention and sense of support in an Associate Degree Nursing Program (ADN) through peer mentorship. The project was guided by …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Quality Improvement Project: Impact Of A Brief Mindfulness-Based Stress Reduction Program For Healthcare Providers Who Evaluate Veterans, Peng Anderson

Doctor of Nursing Practice Projects

Long-term stress can lead to healthcare provider burnout. Mindfulness-based interventions, even when shortened, may provide a promising and innovative method to reduce stress and prevent burnout. Research on mindfulness programs has demonstrated significant benefits for both providers and patients. This quality improvement project aims to evaluate the effect of a brief mindfulness-based stress reduction program (MBSR) for providers who evaluate veterans on the variable of mindfulness awareness compared to current site practice. Lewin’s change management model and Peplau’s Interpersonal Relations Theory were used. Plan-Do-Study-Act was the implementation framework applied. The design was pretest-posttest using the Mindful Attention Awareness Scale (MAAS). …

Reduction In Patient Falls: A Quality Improvement Project, Jotis J. Lee

Doctor of Nursing Practice Projects

Patient falls remain one of the most frequent adverse events in hospital settings, leading to injury, prolonged hospital stays, and increased healthcare costs. The identified problem was high fall rates at a specialty hospital. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to evaluate the effectiveness of an evidence-based (EB) educational intervention, using the Fall TIPS (Tailoring Interventions for Patient Safety) toolkit, in improving direct care nursing staff’s knowledge, confidence, and perceived ability to implement fall prevention strategies for high-risk patients. The aim was to improve the nursing staff’s knowledge, confidence, and perceived ability …

Improving Post-Resuscitation Debriefing Completion Rates In An Acute Care Community Hospital: A Quality Improvement Project, Tiffany Tolden

Doctor of Nursing Practice Projects

Background: Post-resuscitation debriefing improves team dynamics and CPR quality and can identify systemic barriers to quality care delivery. However, completion rates remain low in acute care settings. Purpose: This quality improvement project evaluated whether a one-hour training session for rapid response nurses and charge nurses, combined with weekly reminder emails, would increase completion rates of post-resuscitation debriefings and influence nurses’ perceptions of their usefulness in an acute care community hospital. PICOT Questions: Will a one-hour training session (I) with rapid response nurses and unit charge nurses (P), along with a weekly reminder system (I), increase the completion rate (O) of …

Implementing Phq-2 In An Outpatient Mental Health Practice, Krishona Poignard

Doctor of Nursing Practice Projects

Depression remains widely underidentified in outpatient behavioral health settings, where variable screening practices limit early recognition and appropriate treatment. This quality improvement project addressed this gap by standardizing screening through targeted clinician education. The purpose was to improve clinician confidence and adherence to validated tools, specifically the Patient Health Questionnaire-2 (PHQ-2) and, when indicated, the Patient Health Questionnaire-9 (PHQ-9). The project aimed to increase consistent tool use through an evidence-based educational intervention guided by Lewin’s Change Theory and the Iowa Implementation for Sustainability Framework. A quasi-experimental, single-group pretest–posttest design was employed with licensed clinical staff, including licensed social workers (LSWs), …

Quality Improvement Project: Standardized Medication Reconciliation Process Training: A Path To Improve Staff Medication Confidence, Christologus Obi

Doctor of Nursing Practice Projects

Medication reconciliation represents a critical safety process in psychiatric healthcare, where medication discrepancies affect up to 67% of hospitalized patients, with 30-40% potentially causing significant harm. This quality improvement project implemented a standardized medication reconciliation training program at a Texas mental health facility to address knowledge and confidence gaps among clinical staff. Using Kotter's 8-Step Change Model and the Iowa Model of Evidence-Based Practice, this quasi-experimental pre-post intervention study delivered three 30-minute interactive sessions to 12 multidisciplinary healthcare professionals. The evidence-based intervention introduced a 3-phase reconciliation model focused on obtaining accurate medication histories, documentation, and discrepancy resolution. Data collection used …

Quality Improvement Project: Improving Patient Appointment Adherence Through Staff Education On Health Literacy, Christine A. Johnson- Nganbou Kamkeu

Doctor of Nursing Practice Projects

Non-adherence to appointments remains an impediment to health continuity. It has been especially pervasive in rural settings. Numerous scholarly articles in the healthcare literature support enhancing health literacy in organizations and training in effective communication to promote patient appointment compliance. Hence, the purpose of the quality improvement (QI) project was not only to encourage appointment compliance but also to enhance the application of the Teach-Back Method through health literacy education. The theoretical perspective and practice application, according to Lewin’s Change Theory and the PDSA approach, included a four-week intervention period, during which the Agency for Healthcare Research and Quality (AHRQ) …

Simulation Education Program For Medical Emergencies: Improving Facilitator Simulation Proficiency, Cari Kent

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project, Simulation Education Program for Medical Emergencies: Improving Facilitator Simulation Proficiency, addressed a critical gap in outpatient emergency preparedness among nursing leaders and facilitators. Despite established policies, many ambulatory care staff reported feeling unprepared to respond effectively to medical emergencies. Guided by the PICOT question, among nursing leaders and facilitators (P), how does a simulation education program in emergency care scenarios (I), compared to current education practices (C), impact simulation proficiency and effectiveness (O)? This quality improvement project evaluated the impact of structured simulation-based education on the competence of facilitators. Using a pre- and …

Quality Improvement Project: Impact Of An Onboarding Program On Novice Nursing Clinical Adjunct Faculty Self-Efficacy, Tonie Metheny

Doctor of Nursing Practice Projects

Many nursing colleges rely on adjunct faculty to deliver the clinical curriculum (i.e., skills lab, clinical instruction, simulation, etc). Without a structured approach to orienting novice adjunct clinical nursing faculty to their roles and responsibilities, educational outcomes may be negatively impacted. Nursing literature documents the impact of a structured orientation program on novice self-efficacy. The purpose of this quality improvement project is to evaluate the impact of an orientation program on novice nursing adjunct clinical faculty self-efficacy with the Academic Clinical Nurse Educator (ACNE) core competencies. Self-efficacy was assessed using the Academic Clinical Nurse Educator Skills Acquisition Tool (ACNESAT). The …

Executive Summary: Multi-Departmental Resilience And Stress Reduction Program, Joy Adeyemi

Walden Dissertations and Doctoral Studies

Background: Primary care nursing faces an escalating burnout crisis threatening patient safety and organizational sustainability. Internal data reveals 68% of primary care nurses report high emotional exhaustion scores on the Maslach Burnout Inventory (MBI), significantly exceeding the national average of 45%. Annual voluntary turnover of 28% results in direct replacement costs exceeding $750,000, with associated increases in absenteeism (15% higher) and overtime costs (22% higher) compared to regional benchmarks. Purpose: This quality improvement project implemented a comprehensive multi-departmental resilience and stress reduction program to reduce nurse burnout, improve retention, and enhance patient safety outcomes in a primary care setting serving …

Enhancing Ptsd Diagnostic Accuracy Among Immigrant Patients Through Staff Education On The Harvard Trauma Questionnaire, Elijah Machogu Mabururu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project is a staff education initiative addressing the underdiagnoses of post-traumatic stress disorder (PTSD) among immigrant patients. The project was developed in response to inconsistent screening practices, lack of standardized tools, and limited provider confidence in assessing PTSD in culturally diverse populations. The purpose is to equip clinical staff with the knowledge and skills to apply the HTQ appropriately and consistently, thereby improving diagnostic accuracy and supporting equitable access to mental healthcare. The practice-focused question guiding this project was: Can an educational intervention using the HTQ improve staff’s ability to identify PTSD symptoms among …

Stress First Aid Implementation To Address Stress Among Acute Care Nurses, Obioma Maryann Asiegbu

Walden Dissertations and Doctoral Studies

Acute care nurses face persistent occupational stress that contributes to burnout, anxiety, depression, and high turnover rates within healthcare systems. The Stress First Aid (SFA) framework offers a proactive, evidence-based approach to identifying and managing psychological distress among healthcare workers. The purpose of this Doctor of Nursing Practice project was to implement and evaluate the SFA program as a structured, early-intervention model to improve nurse well-being, retention, and patient care outcomes in an acute care setting. Guided by the Stress Continuum Model and organizational change theory, this project emphasized early recognition of stress, peer support mechanisms, and continuous outcome monitoring. …

Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross

Walden Dissertations and Doctoral Studies

Summary This doctoral, practice-focused quality improvement project used a mixed-methods design to evaluate the usability, acceptability, and clinical integration of a nutrition screening tool in a mental health outpatient clinic. The project addresses a key practice gap, the lack of evaluation of the implementation of a systematic nutrition screening for individuals with severe mental illness (SMI), which contributes to worsening psychiatric symptoms and delayed recovery. Aligning with nursing’s holistic and patient-centered framework, the initiative aimed to strengthen interprofessional collaboration and preventive care. The guiding practice-focused questions addressed: How usable and acceptable is the clinical practice guideline (CPG) tool among clinic …