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Quality Improvement Project: Impact Of Educational Intervention On Post-Acute And Long-Term Care Staff's Confidence And Accuracy In Aims Screening For Tardive Dyskinesia, Tana Whitt

Doctor of Nursing Practice Projects

Tardive dyskinesia (TD) is a chronic, often irreversible movement disorder associated with prolonged antipsychotic use. In post-acute and long-term care (PALTC) settings, inconsistent Abnormal Involuntary Movement Scale (AIMS) screening practices and limited clinician education contribute to under recognition and delayed treatment. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated whether an educational intervention impacted clinicians’ knowledge, confidence, and perceived importance of AIMS screening among licensed and unlicensed PALTC staff. Guided by Donabedian’s Model of Quality and Kotter’s 8-Step Change Model, the project used a pre-test/post-test design to measure outcomes before and after completion of the Drug-Induced Movement …

Staff Education To Improve Knowledge Of Venous Leg Ulcer Prevention, Bini John

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project implemented a standardized program to strengthen knowledge, confidence, and adherence to venous stasis ulcer (VSU) prevention among staff in an outpatient vascular clinic. The practice problem was the lack of standardized staff education, leading to inconsistent patient teaching and recurrent ulceration. VSUs are a significant public health challenge, increasing morbidity, healthcare utilization, and reducing quality of life (He et al., 2024). The practice-focused question for this project was: In frontline medical staff at a vascular outpatient clinic, does a staff education program on a standardized approach to patient education for VSU …

Staff Education On Antibiotic Stewardship For Urgent Care, Darla Michelle Taylor

Walden Dissertations and Doctoral Studies

This doctoral project focused on a staff education initiative designed to improve antibiotic stewardship among urgent care providers. It evaluated changes in provider knowledge and prescribing intent following an evidence-based educational intervention by asking, “Does staff education on antibiotic stewardship in an urgent care setting enhance knowledge when compared to pre- and post-education assessments?” The purpose was to increase provider knowledge, confidence, and adherence to stewardship principles while influencing prescribing intent. The project consisted of an educational presentation with pre- and post-education surveys. Data was collected using pre- and post-education surveys featuring Likert-scale items that measured provider confidence, knowledge, and …

Relationship Of Job Demands And Perceived Usefulness Of Virtual Nursing Technology Among Bedside Nurses In Acute Care Settings, Oluponle Olubajo

Walden Dissertations and Doctoral Studies

Bedside nurses in acute care settings face intensified job demands amid persistent low nursing staff census and rising patient acuity. The purpose of the study, guided by the job demands–resources (JD-R) model, was to examine the relationship between job demands, years of nursing experience, and perceived usefulness of virtual nursing technology among bedside nurses in acute care settings. A cross-sectional online survey was administered to bedside registered nurses (N = 102) currently using virtual nursing technology. Measures included the Intensification of Job Demands Scale and the Perceived Usefulness Scale. Data analyses indicated that the multiple regression was not statistically significant, …

Improving Cauti Prevention In Long-Term Care: An Educational Intervention To Enhance Staff Confidence And Reduce Infection Rates, Diana Meseha

Doctor of Nursing Practice Projects

Catheter-associated urinary tract infection (CAUTI) is a common preventable healthcare-associated infection in long-term care. knowledge gaps and inconsistent catheter care by staff and increased catheter-associated urinary tract infection rates. The purpose of this quality improvement project aims at testing whether using a structured educational intervention led to improved confidence of staff and reduced catheter-associated urinary tract infection rates. The project employed Bandura's Social Cognitive Theory and Lewin's change model in guiding the behavior and organizational change. A quasi-experimental pretest post-test design was used with the enrolment of nursing employees such as registered nurses, licensed practical nurses and certified nursing assistants …

Educating Emergency Department Nursing Staff: Early Identification Of Sepsis, Cynthia A. Chaney

Walden Dissertations and Doctoral Studies

Sepsis remains a life-threatening health challenge, contributing to significant morbidity and mortality within healthcare systems. This Doctor of Nursing Practice (DNP) project aimed to address knowledge deficits among emergency room nurses regarding the early identification and management of sepsis, mainly through the implementation of the 3-hour sepsis bundle. The practice-focused question guiding this project was whether educating nurses on the 3-hour sepsis bundle would increase their knowledge. This project aimed to educate nurses on how to identify sepsis early and implement the sepsis 3-hour bundle in a timely manner, with the overall goal of improving nursing knowledge. The sources of …

Implementing A Standardized Ssri Tapering Protocol In The Outpatient Setting, Chelsea Sopo-Ngwa

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed antidepressant medications in the outpatient psychiatric setting. Abrupt discontinuation or improper tapering of these medications may result in SSRI withdrawal symptoms. Adverse effects may lead to poor patient outcomes and increase healthcare utilization. A baseline chart review and provider readiness survey within the outpatient psychiatric practice revealed inconsistency in provider documentation related to SSRI tapering plans, patient education, and follow-up planning. The gap in practice highlighted the lack of a standardized SSRI tapering protocol to guide evidence-based medication tapering practices and promote patient safety.

Aim: The …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Quality Improvement Project Impacting Provider Self-Efficacy And Use Of Cbt For Depression Treatment, Tony Orafunam

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement project was conducted at a mid-sized outpatient psychiatric clinic in Hempstead, New York, focusing on strengthening providers’ self-efficacy in delivering Cognitive Behavioral Therapy (CBT) to young adults (aged 19–35) diagnosed with Major Depressive Disorder (MDD). Rather than targeting MDD directly, the initiative aimed to impact provider self-efficacy and skill in CBT to improve access to evidence-based treatment and reduce the need for external referrals. Employing Bandura’s Social Cognitive Theory and the ADKAR change model, the project used a quasi- experimental, one-group pre-test/post-test design. Six advanced practice providers participated in a structured, interactive …

Quality Improvement Project Improving Fall Risk Protocol Compliance Through A Structured Fall Prevention Program In A Skilled Nursing Facility, Lakeesha Jenkins

Doctor of Nursing Practice Projects

Falls remain a persistent patient-safety threat in skilled nursing facilities (SNFs). At a Dallas–Fort Worth SNF, a needs assessment identified rising unassisted falls and inconsistent protocol adherence. This quality improvement (QI) project examined whether a structured, evidence-based bundle could improve staff knowledge and fall-prevention processes and reduce falls over four weeks. Guided by Lewin’s Change Theory and implemented with Plan–Do–Study–Act (PDSA) cycles, the pre–post design engaged direct-care staff (registered nurses, licensed vocational nurses, certified nursing assistants; n = 20). The intervention included standardized risk screening with the Morse Fall Scale (MFS), targeted staff education, high-risk visual identifiers, and post-fall huddles. …

Quality Improvement Project Addressing Healthcare Provider Adherence To Diabetic Foot Exams In A Primary Care Clinic, Olaide Akinyinka

Doctor of Nursing Practice Projects

Healthcare providers performing foot examinations are a crucial component in assisting Type II diabetic patients to maintain their health. The purpose of this quality improvement project was to determine how the providers' implementation of Inlow’s 60-second Diabetic Foot screen, compared to current practice standards, impacts the number of foot exams among Type II diabetic patients at a primary care clinic over 12 weeks. Therefore, it was unknown if or to what degree the provider implementing Inlow’s 60-second Diabetic Foot Screen impacts the number of foot exams conducted compared to the current practice among Type II diabetic patients. Wiedenbach’s Helping Art …

Quality Improvement Project Empowering Nursing Instructors: Faculty Self-Efficacy & Consistency In Simulation Grading, April Guerin

Doctor of Nursing Practice Projects

This quality improvement (QI) project aims to evaluate the effectiveness of structured training on the Creighton Competency Evaluation Instrument (C-CEI) in improving nursing faculty self-efficacy and grading consistency in clinical student evaluations. Inconsistent clinical grading practices among nursing faculty create barriers to reliable competency evaluation and undermine student outcomes. Guided by the Donabedian Model and Lewin’s Change Theory, with implementation structured by the Plan-Do-Study-Act (PDSA) cycle, a quasi-experimental pre-post intervention design was used. Participants include nursing faculty responsible for clinical evaluations, who completed structured C-CEI training delivered via self-paced modules in a learning management system. Faculty self-efficacy was measured using …

Quality Improvement Project Diabetes Self-Management Education Training Program, Guylene Lucien

Doctor of Nursing Practice Projects

Diabetes is among the leading causes of morbidity and mortality in the United States; therefore, effective Diabetes Self-Management Education (DSME) is vital in improving patient outcomes. A needs assessment of the Practice site identified gaps in provider confidence and frequency and consistency of delivering DSME that correlated with poor patient adherence and readmissions. The purpose of this quality improvement (QI) project was to implement a structured, evidence-based DSME training program to improve healthcare provider self-efficacy to provide DSME. The project utilized Bandura's Social Cognitive Theory and the ADKAR change model and employed a quasi-experimental, one-group pretest–posttest design. Ten providers (six …

Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying

Journal of Appalachian Health

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize …

A “Re-Imagining The Economic Value Of Nursing” Summit Summary And Recommendations, Olga Yakusheva, Marianne E. Weiss, Tanya Mulvey, Anabel F. Castillo, Marcela Campoli

College of Nursing Faculty Research and Publications

In April 2024, the ANA Enterprise sponsored a “Re-imagining the Economic Value of Nursing” Summit to move the conversation forward on recognizing and leveraging the economic value of nursing within organizations across the US healthcare system. Invited participants engaged in a spirited dialogue about reconceptualizing nurses as critical assets in generating value within the production and financial dynamics of contemporary healthcare systems. This article summarizes the discussion and recommendations emerging from the summit.

In healthcare organizations and systems, nurse executives are the bridge between the production of patient care by the nursing workforce and the organizational financial performance. Historically, nursing …

Utilizing Simulation Training To Understand Maternal Cardiac Arrest Precipitated By Amniotic Fluid Embolism: A Quality Improvement Project, Erica L. Wright, Megan L. Tiernan, Michael W. Neft, Paige Spagiare, Erica Coffin

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Background and Problem: Maternal cardiac arrest precipitated by amniotic fluid embolism is among the leading direct causes of death among laboring women (Enomoto et al., 2022). Because it presents suddenly without any immediate apparent cause and lacks specific diagnostic tests, frontline obstetric caregivers must be vigilant, competent, and prepared to handle this potentially catastrophic emergency. Coordination among multiple disciplines is paramount since two lives, not just one, are at risk. Unfortunately, the rarity of maternal cardiac arrest significantly limits opportunities for staff to learn how to identify and manage these events successfully. Method: This quality improvement project established a simulation-based …

Self-Efficacy And Burnout Of Nursing Faculty: The Mediating Role Of Fear Of Negative Evaluation, Sarah Murray Kelly

Doctoral Dissertations and Projects

The contents of this manuscript include a dissertation of a survey research study using the theoretical models of self-efficacy and burnout. The quantitative study used mediation analysis to explore the relationship between self-efficacy and burnout, with fear of negative evaluation as a mediator. Fear of negative evaluation was measured using the Brief Fear of Negative Evaluation Scale-Revised; self-efficacy was calculated using the General Self-Efficacy Scale; and burnout was measured using the Oldenburg Burnout Inventory. The study drew a sample of 98 academic nurse educators (N = 98) who were evaluated by student evaluations of teaching. The sample included educators who …

Conceptual Model And Design Of An Initiative To Build Nurses’ Resilience And Ethical Practice, Cynda Hylton Rushton, Sandra M. Swoboda, Nancy Reller, Laura C. Sarver, Erin M. Wright, Krysia Warren Hudson, Robie Victoria Hughes, Ginger C. Hanson, Rita D’Aoust

College of Nursing Faculty Papers & Presentations

Background: Healthcare faces a nursing crisis with high turnover, burnout, and faculty shortages, which requires innovative educational approaches that bridge the gap between education and practice. Purpose: To present the conceptual model and design of a statewide, trans-institutional academic-practice collaboration that holistically builds nurses' resilience and ethical practice across the education-to-practice continuum. Method: Development of the Renewal, Resilience, and Retention (R³) Initiative based on adaptation of the Mindful Ethical Practice and Resilience Academy (MEPRA), social ecological framework, and stakeholder input across eight schools of nursing and five hospitals in Maryland. Results: The R³ Initiative created a scalable …

An Integrated Literature Review Examining Nurse Burnout Interventions, Wislande Joseph

DNP Qualifying Manuscripts

Nurse burnout has detrimental consequences for patients, nurses, and organizations and can negatively impact patient outcomes, nurse quality of life, and organizational costs. This integrated literature review aimed to examine interventions for nurse burnout in order to identify what characterizes effective interventions, whether evidence supports implementing such interventions, and how the most commonly-implemented intervention type (mindfulness-based) in particular impacts signs and symptoms of nurse burnout. A two-part search was conducted of CINAHL, PubMed, Google Scholar, and APA PsychInfo. Part one investigated burnout interventions broadly using the primary search terms nurse burnout and interventions; part two focused specifically on mindfulness-based interventions …

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 …

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, …

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 …

The Effects Of A Breastfeeding Educational Program On Nurses’ Self-Efficacy And Knowledge, Amanda Quinn

Doctor of Nursing Practice Projects

Breastfeeding, a cornerstone of maternal and infant health, faces barriers due to inadequate healthcare provider education, contributing to low exclusive breastfeeding rates. The purpose of this quality improvement project was to evaluate the impact of a four-week educational program on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. This project evaluated a four-week educational program’s effect on clinical staff’s knowledge and self-efficacy in supporting breastfeeding in a rural OB/GYN clinic in central Florida. Using a quasi-experimental pre-post design, nine licensed/certified staff (medical assistants, licensed practical nurses, registered nurses, advanced practice registered nurses) …

Quality Improvement Project Implementing Comprehensive Foot Exams In Pediatric Patients With Diabetes, Jimmy Penn

Doctor of Nursing Practice Projects

Pediatric patients with diabetes face many of the same long-term complications as adults, including neuropathy. Yet screenings are often overlooked in this population. Research shows that pediatric patients with diabetes experience neuropathy symptoms, yet screening in this population remains underperformed. The purpose of this quality improvement project was to implement a comprehensive foot exam for eligible pediatric patients with diabetes and improve provider adherence through education. The project addressed the question: “Among providers in a pediatric endocrinology clinic, how does implementing education on foot exams, compared to no education, impact provider knowledge and compliance with performing pediatric foot exams over …

Empowering Medical-Surgical Nurses To Conquer Burnout: Building Resilience And Wellness, Catherine P. Morante

Master's Projects and Capstones

Problem: In the healthcare industry, nurse burnout is a well-documented issue that affects the well-being of both healthcare professionals and their patients. Burnout manifests as intense exhaustion, depersonalization, and diminished personal accomplishment (Okoniewski & Verni, 2024).

Context: Burnout affects patient outcomes and drives up costs (Dall’Ora et al., 2020). When nurses are overwhelmed, attendance is affected (Unpublished confidential document; 2024). Resilient nurses are essential to a healthy, reliable workforce (Unjai et al., 2024).

Interventions: From May to July 2025, a 12-week initiative was launched to reduce the effects of nurse burnout in the workplace. Evidence-based interventions were implemented, incorporating educational …

Enhancing Client Intake Efficiency In The Removal Defense Program: A Nursing-Led Quality Improvement Initiative, Johnny Linares, Julia Tran Ngo, Daniel Orea, Atheana Yadira Lopez

Master's Projects and Capstones

This quality improvement project focuses on optimizing the intake process for the Removal Defense Program at a nonprofit immigration legal office serving asylum-seeking clients. The existing intake relied on unstructured, phone-call-based intake interviews that gathered incomplete information, leading to inconsistent documentation, reduced efficiency, and significant client processing delays. A structured, multilingual, and multiplatform new-client admission protocol coupled with the implementation of a client-facing resource guide for waitlist clients were co-developed and implemented using the Lippitt Change Theory framework. Utilizing a mixed methods approach, the study involved staff interviews and observational assessments with staff members from the program. Baseline intake process …

Kid Power: Mastering Asthma Management To Keep Hospitals Away!, Kriste L. Moret

Master's Projects and Capstones

Problem: Pediatric asthma remains a leading cause of preventable hospitalizations, particularly in California’s Central Valley, where environmental and health disparities worsen symptoms. Many children are discharged without understanding their Asthma Action Plan (AAP) or feeling confident in symptom management.

Context: On a unit in a community hospital in this high-risk region, asthma-related admissions persisted. Gaps in discharge education highlighted the need for a structured intervention. The Institute for Healthcare Improvement (IHI) Model for Improvement (MFI) guided this effort.

Intervention: A nurse-led, developmentally appropriate asthma education bundle was implemented. Teaching began on admission and was reinforced using teach-back, color-coded AAPs, culturally …

Enhancing Patient Safety: Fall Prevention Through Video Education, Fithawit T. Zere

Master's Projects and Capstones

Abstract

Problem: Globally, hospital falls remain a leading cause of injuries, increased costs, short and long-term disability and emotional impact on patients/families. Despite required prevention measures, a local hospital experienced rising fall rates during 2024 (n=71);13 of these occurred in the Med-telemetry microsystem. Although multiple strategies and financial investments occurred, nursing compliance with the fall prevention “bundle” remained suboptimal.

Context: Thirteen falls resulted in $182,000 in 2024. A quality improvement (QI) project was initiated over 12 weeks after routine audits revealed inconsistency in application of several components of the required bundle: particularly, the fall prevention video upon admission.

Interventions: A …

Enhancing Nurse Well-Being Through Mandatory Rest Breaks At A Hospital, Elise Njang

Doctor of Nursing Practice Projects

Nurses are essential to the healthcare system, yet their demanding 12-hour shifts in hospital settings often leave little opportunity for adequate rest. The absence of structured rest breaks not only endangers nurses' well-being but may also compromise the quality of patient care. This quality improvement (QI) project aimed to evaluate the effects of implementing structured, mandatory 15-minute rest breaks on nurse burnout and job satisfaction. The initiative addressed a critical gap at the project site, where nurses typically received only one 30-minute lunch break per shift, despite evidence supporting the benefits of more frequent rest breaks. A quasi-experimental pre- and …

Quality Improvement Project Fall Prevention Among Skilled Nursing Facility Residents Through Staff Education, Reena Mathew

Doctor of Nursing Practice Projects

Falls among older adults in Skilled Nursing Facilities (SNFs) remain a leading cause of injury, hospitalization, and decreased quality of life. Preventing these falls requires awareness and effective staff engagement. This Quality Improvement (QI) initiative is targeted to decrease fall rates in a 90-bed SNF by educating caregivers on the significance and practice of purposeful hourly rounding. The project helped to improve staff knowledge, consistency, and accountability in implementing hourly rounding as a preventive measure. A pre- and post-intervention design was utilized. Staff members received structured educational sessions based on evidence-based guidelines, including interactive modules and printed resources. Twenty staff …