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Quality Improvement Project Improving Self-Efficacy Among Urgent Care Staff Through Medication Reconciliation Education, Jana M. Combs

Doctor of Nursing Practice Projects

Medication errors and adverse drug reactions (ADR) are a significant source of preventable harm in healthcare, and failure to complete proper medication reconciliation is a contributing factor. Despite multiple interventions aimed at addressing this issue, no standardized plan has been implemented universally. Outpatient urgent care sites pose as high-risk environments for failed medication reconciliations due to the nature of the setting, but staff are in prime positions to adjust this culture. This project aimed to enhance staff self-efficacy in medication reconciliation over four weeks through an evidence-based educational program, with the goal of improving patient safety and outcomes. Using a …

Quality Improvement Project Data At Risk: The Implications Of Inconsistent Nursing Documentation On Patient Care Interventions, Amber Jones

Doctor of Nursing Practice Projects

Accurate nursing documentation plays a vital role in ensuring high-quality patient care, yet inconsistencies remain a common challenge, particularly with preventive screenings like pediatric tobacco use. Research shows that when documentation is incomplete or incorrect, opportunities to identify and intervene with at-risk adolescents are often missed. This quality improvement project was developed to address a specific gap in documentation practices at a community health clinic, where staff often failed to consistently complete the pediatric tobacco screening tool. The goal of the project was to determine whether evidence-based education, combined with chart audits and feedback, could improve the consistency in which …

A Quality Improvement Project Cultural Competency: A Project For Improving Culturally Competent Care Among Mental Health Providers, Lanre Olanrewaju

Doctor of Nursing Practice Projects

Cultural competence, knowledge, and awareness are essential for improving mental healthcare outcomes in diverse populations. Despite the need, the absence of structured cultural competence training contributes to reduced quality of care and health disparities. The purpose of this quality improvement project is to improve cultural awareness and knowledge among mental health providers at an outpatient clinic by implementing structured staff training. A needs assessment identified gaps in cultural competence knowledge, inconsistent practices, and limited provider confidence in addressing diverse patient needs. In the methodology, the model used to answer the PICOT question is Purnell’s Model, guided by a structured process …

Quality Improvement Project Evaluation Of The Effectiveness Of The Institute For Healthcare Improvement’S Joy In Work Framework On Burnout Experienced By Dialysis Staff, Bernice Jones

Doctor of Nursing Practice Projects

Burnout continues to pose a pervasive and escalating challenge in healthcare, with its severity further amplified in the aftermath of the COVID-19 pandemic. Dialysis professionals are especially vulnerable, facing elevated patient volumes, extended work hours, and frequent encounters with complex clinical needs. These ongoing stressors highlight the critical importance of this quality improvement (QI) project, as there exists an urgent need for evidence-based strategies to alleviate burnout among dialysis professionals. This QI project aimed to enhance joy in the dialysis work setting and reduce burnout experienced by dialysis staff through the implementation of the Institute for Healthcare Improvement’s (IHI) Joy …

Improving Icu Decolonization Compliance Among Nursing Staff, Sarah J. Moore

Student Scholarly Projects

Practice Problem: Hospital acquired infections (HAIs) burden patients and health care organizations by influencing extended hospital stays, increasing mortality risk, and increasing healthcare spending.

PICOT: The Doctor of Nursing Practice (DNP) Scholarly Project was guided by the PICOT question: In ICU nursing staff (P), how does the implementation of a standardized process with visual reminders and checklists (I) compared to no reminders or checklists (C) impact compliance with the decolonization protocol for HAI reduction (O) over four weeks?

Evidence: A review of evidence-based literature demonstrated efficacy in the reduction of HAIs through once daily bathing with 2% chlorhexidine gluconate (CHG) …

A Workplace Posture Initiative To Reduce Work-Related Musculoskeletal Disorders, Carrie Isaac

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Work-related musculoskeletal disorders (WRMSDs) are a leading cause of occupational injury and discomfort in industrial workplaces. Although an ergonomic program existed at the project site, a formalized process to detect postural misalignments early had not been established. Relying on employee self-reporting, delayed intervention, and limited opportunities to prevent injuries before they progress.

Aim of the Project: A proactive posture screening program using PostureScreen® was implemented to identify postural deviations that could contribute to WRMSDs. Emphasis was placed on supporting employees through early awareness of posture-related issues and evaluation of alignment improvements following individualized intervention.

Review of the Evidence: Evidence …

Policy Review Of The Aha Clinical Practice Guideline For Congestive Heart Failure: Evaluating Best Practices, Brenda E. Garcia

Student Scholarly Projects

Practice Problem: Congestive heart failure (CHF) is a significant public health challenge that impacts various populations and contributes to rising hospital admission rates.

PICOT: The PICOT question that guided this scholarly project was: For healthcare policymakers and interprofessional teams (P), how does a policy review of the American Heart Association’s Clinical Practice Guidelines for Heart Failure (I), guided by the CDC’s Polaris Framework (C), conducted over a 12-week period (T), evaluate alignment with evidence-based practices and potential for adoption in the care of patients with congestive heart failure (O)?

Evidence: This scholarly project focused on reviewing the current clinical guidelines …

Emergency Nurses’ Perceptions Of A Trauma-Informed Organizational Climate: A Cross-Sectional Study, Audrey Kobina

Nursing Theses and Dissertations

Healthcare leaders face numerous challenges in today’s complex healthcare environment. The most pressing issues are staffing shortages and burnout among healthcare workers. By 2025, the U.S. healthcare system could experience a shortfall of up to 450,000 nurses, or 20% fewer nurses than needed to provide adequate patient care. High job dissatisfaction and burnout levels are significant factors driving many nurses away from the profession. This three-paper dissertation portfolio addressed how trauma-informed approaches and practices can enhance the work environment by establishing trauma-informed organizational climates to mitigate burnout. Understanding the impact of trauma-informed practices within healthcare systems supports the nursing workforce. …

The Impact Of Trauma-Informed Care Education On Healthcare Providers And Staff In An Outpatient Clinic: A Holistic Approach To Diversity, Equity, And Inclusion, Ngozi Azu

Doctoral Dissertations and Projects

Trauma is an emotional response that an individual may experience due to exposure to an event beyond their ability to manage. Trauma-informed care (TIC) is essential in health care for creating a supportive and safe atmosphere for individuals with a trauma history, but many health providers and staff lack proper training in TIC. The purpose of this project was to design, implement, and evaluate a comprehensive education program focused on TIC for health care providers and staff in an outpatient clinic setting. A quasi-experimental methodology and the Iowa Model of Evidence-Based Practice were used. Quantitative and qualitative data were collected …

Enhancing Medication Communication In The Acute Care Setting To Strengthen Patient Comprehension And Retention, Ashleigh C. Christensen

Student Scholarly Projects

Practice Problem: Research has shown that breakdowns in communication, especially in the context of medication education, play a critical role in the delivery of safe and effective patient care. These findings underscore the need to prioritize effective communication in medication education. In the acute care setting, effective communication is essential for ensuring patient safety, adherence, and improved patient-centered outcomes.

PICOT: In clinical staff providing direct patient care in the acute care setting (P), does the implementation of the evidence-based teach-back method (I), as compared to current practice (C), improve patient knowledge, understanding, and self-management upon discharge (O), over ten weeks …

Controlling Hypertension In The African American Population Through Dash Diet Education, Tanya K. Mccaskill

Doctor of Nursing Practice Projects

Hypertension disproportionately affects African Americans, contributing to elevated risks of stroke, cardiovascular disease, and kidney failure. Despite the well-established benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, its adoption remains limited due to cultural, socioeconomic, and health literacy barriers. This Quality Improvement (QI) project aimed to evaluate the effectiveness of a culturally tailored DASH diet education intervention in improving nutritional knowledge among African American adults with hypertension (HTN). Using a quasi-experimental pre-post intervention design, 50 participants received a structured educational session during a single clinic visit, which included counseling, printed materials, and sample menus. The intervention was guided …

Best Practice Toolkit For Burnout Prevention In Emergency Department Nurses, Moises A. De Oleo

Student Scholarly Projects

Practice Problem: Burnout Syndrome (BS) is a serious problem in emergency department (ED) nurses and is associated with higher nurse turnover rates. A burnout prevention toolkit is needed.

PICOT: The project was guided by the following PICO question: "For emergency department nurses (P), how does the development of the best practice burnout prevention toolkit (I), compared to the absence of a structured intervention (C), support the establishment of nurse burnout best practices when evaluated using the CDC Program Evaluation Framework? (O)".

Evidence: The analysis of the literature supported the implementation of active interventions in the form of workshops.

Intervention: A …

Quality Improvement Project Educating Nursing Faculty On The Lasater Clinical Judgment Rubric In Simulation, Tiffany Shivers

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance nursing faculty preparedness in simulation-based education by increasing knowledge and self-efficacy using the Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental, one-group pre-/post-intervention design was used to evaluate outcomes among ten faculty participants. The intervention consisted of an educational session introducing the LCJR and structured debriefing techniques. Data were collected using a knowledge assessment and the General Self-Efficacy Scale. Descriptive statistics and the Wilcoxon Signed-Rank Test were used to analyze changes in scores. Results demonstrated statistically significant improvements in both knowledge (Z = –2.805, p = .005) and self-efficacy (Z = –2.666, p = …

National Patient Safety Goals: Reducing Health Care Disparities In Adult Patients With Alcohol Misuse, Jolie M. Carpenter

Doctor of Nursing Practice Projects

Background: An estimated 76 million people worldwide suffer from alcohol use disorder, accounting for almost two million deaths annually. The Joint Commission has made it a requirement to screen all patients admitted to an inpatient facility for health-related social needs, including alcohol use. By doing so, outpatient resources can be provided appropriately.

Purpose: The facility of interest does not currently have a discharge follow-up protocol. The purpose of this project was to implement an evidence-based protocol to follow-up one week after discharge to determine if patients accessed the community resources provided for alcohol use disorder and to determine whether the …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Enhancing Patient Outcomes: The Sepsis Navigator Approach, Temeka L. Parker

Doctor of Nursing Practice Projects

Background: Sepsis is the leading cause of hospital mortality, accounting for over $20 billion dollars in total healthcare costs and more than 5 million deaths annually worldwide. The increased burden of sepsis led the Centers for Medicare and Medicaid (CMS) to institute a quality core measure known as the Severe Sepsis and Septic Shock Management Bundle (SEP-1) as a protocol for sepsis treatment. CMS reports national SEP-1 compliance at 62% and 61% for Alabama. The undisclosed project site reports a much lower SEP-1 compliance average of 49% over six months. Compliance with the SEP-1 bundle improves overall patient outcomes and …

Enhancing Diabetes Care In Adult Patients With Type 2 Diabetes In An Outpatient Setting, Osayanmo Ojo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition associated with significant morbidity, particularly among underserved populations. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to improve diabetes care among adult patients with poorly controlled T2DM (A1C > 9%) in an outpatient primary care clinic by increasing referrals to the Diabetes Self-Management Education (DSME) program. Guided by the Plan-Do-Study-Act (PDSA) cycle and the OhioHealth Change Management (OHCM) model, the project implemented structured interventions including standardized DSME referral workflows, electronic health record (EHR) prompts, provider education, and culturally tailored communication strategies.

The 12-week initiative targeted 68 eligible patients. …

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Implementing An Evidence-Based Transitional Care Toolkit To Reduce Postpartum Readmissions In Women With Chronic Conditions, Cassidy La Fleur

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postpartum women with preexisting chronic conditions are at increased risk of hospital readmissions due to fragmented care transitions and poor follow-up adherence. At the project site, the 30-day postpartum readmission rate was 10%, exceeding the national benchmark of 7.15%. Gaps in standardized discharge planning and limited patient engagement were identified as contributing factors.

Aim of the Project: The aim of this quality improvement (QI) project was to reduce 30-day postpartum readmissions in women with chronic health conditions by implementing an evidence-based transitional care toolkit within a women’s outpatient clinic.

Review of the Evidence: Evidence supports the use of structured, …

Improving Provider Documentation For Procedure Authorizations: A Nursing Perspective On Enhancing Outcomes And Compliance, Juli Legg

All Doctor of Nursing Practice (DNP) Scholarly Projects

Insurance denials resulting from non-standardized documentation and communication gaps in the prior authorization process adversely impacted financial performance and patient care within the electrophysiology (EP) department of a large Midwest academic medical center. High denial rates for costly procedures revealed a need for improved alignment with payer medical necessity criteria. This quality improvement (QI) project aimed to enhance provider documentation, reduce denials, improve care delivery, and increase revenue by implementing standardized documentation templates. A review of the literature supports that standardized documentation and clinical decision support tools enhance consistency, reduce errors, and improve prior authorization success rates. Guided by the …

Quality Improvement Project Improving Nurse Self-Efficacy In Completing Person-Centered Care Plans, Divya Iype

Doctor of Nursing Practice Projects

Person-centered care planning (PCCP) is a cornerstone of psychiatric nursing practice, yet many nurses lack the training and confidence to implement it effectively. This quality improvement project addressed a practice gap in nurse self-efficacy regarding PCCP completion at an acute psychiatric hospital. A care plan completion rate of 88%, below the institutional benchmark of 100%, prompted an intervention. This project’s purpose was to enhance nurse self-efficacy in implementing PCCP by providing focused training on trauma-informed care, cultural competence, and person-centered care planning. The project used a pre-post intervention design to assess the impact of the intervention, with self-efficacy measured using …

Quality Improvement Project Improving Employee Satisfaction And Retention Through A Structured Training Process, Dawn Lundgren

Doctor of Nursing Practice Projects

The DNP project aimed to evaluate the impact of a structured new-hire training program on employee retention and job satisfaction within a hospice organization. Insufficient training for new employees can lead to a high staff turnover rate, stress, decreased job satisfaction, and poor quality of care. The quality improvement project utilized a pre-post intervention design over an eight-week period, comparing retention rates and job satisfaction scores before and after project implementation. Employee retention was measured as a binary outcome (retained or left), and job satisfaction was assessed through a seven-item survey rated on a five-point Likert scale. A total of …

Identifying And Exploring Successful Leadership Strategies To Improve Nurse Retention, Jennifer Triggs Rickerson

Walden Dissertations and Doctoral Studies

Nurse turnover has become a critical concern in healthcare, as low retention rates lead to decreased patient care quality and increased operational costs. A critical issue for hospital stakeholders is that many nursing leaders lack strategies to improve nursing retention. Grounded in the leader-member exchange theory, the purpose of this qualitative pragmatic inquiry was to identify and explore successful leadership strategies used by nurse managers in the Pacific South region of the United States to improve nurse retention. The study included interviews with six nurse managers who successfully implemented retention strategies. Data were collected through semistructured interviews and publicly available …

Quality Improvement Project Reducing Pediatric Anesthesia In Magnetic Resonance Imaging: The Role Of Preparedness And Education, Rachel Turner

Doctor of Nursing Practice Projects

Pediatric hematology-oncology patients undergo general anesthesia (GA) for various medical procedures, including magnetic resonance imaging (MRI) scans. Overexposure to GA increases the potential for long-term neurocognitive effects in pediatric patients. Despite the growing research literature on GA-related neurotoxicity and the Food and Drug Administration's (FDA) warnings, advanced practice providers (APP) often lack the knowledge to advocate for and support reductions in pediatric GA use. The Doctor of Nurse Practice (DNP) quality improvement (QI) project aimed to reduce unnecessary GA in pediatric hematology-oncology patients undergoing MRI scans by addressing the primary clinic APPs' knowledge deficits through interprofessional education (IPE). Structured in …

Quality Improvement Project Enhancing Communication Perceptions Among Nursing Staff In The Operating Room, Denis Awu

Doctor of Nursing Practice Projects

Effective communication in the operating room (OR) is crucial for ensuring patient safety and optimal surgical outcomes. Communication breakdowns among surgical teams are a leading cause of sentinel events and procedural errors. This quality improvement (QI) project aimed to enhance communication perception among OR nursing staff through a structured training program focused on verbal, non-verbal, active listening, and communication under pressure. Grounded in Social Cognitive Theory and implemented using both Kotter’s 8-Step Change Model and the Plan-Do-Study-Act (PDSA) cycle, the intervention included interactive workshops and simulation exercises delivered over a six-week period. A total of 50 registered nurses participated in …

Enhancing Education In Nursing Skills: The Impact Of Simulation Use On Faculty Self -Efficacy, Annie Kyle

Doctor of Nursing Practice Projects

This quality improvement (QI) project aimed to improve nursing faculty self-efficacy in teaching nursing skills using medium- and high-fidelity simulation. The problem addressed was the increasing number of students requiring multiple attempts to pass skills checkoffs, with some ultimately being withdrawn from the program. Faculty at the project site reported a lack of training and confidence in utilizing simulation technology effectively. A quasi-experimental design was used with a single group of full-time faculty (n=6), who received simulation training and completed the Self-Efficacy Towards Teaching Inventory for Nurse Educators (SETTI-NE) before and after the intervention. The data analysis was conducted using …

Improving Patient Outcomes Post-Discharge: Implementing Evidence-Based Discharge Planning For High-Risk Mental Health And Substance Use Disorder Populations, Margaret Phillips

Doctor of Nursing Practice Projects

A significant gap in standardized discharge procedures was identified at a nonprofit, community-based clinic serving male residential patients with substance use disorder (SUD) and co-occurring mental health conditions. The lack of a standardized discharge process led to poor follow-up appointment adherence, poor medication adherence and increased risk of relapse. This quality improvement (QI) project aimed to address these issues through the implementation of a cross-departmental discharge process that produced tailored Individualized Discharge Plans (IDP) or each patient, using the Donabedian and Kotter’s 8-Step Change models as guiding frameworks. Data were collected using custom-built tracking tools over two four-week periods, pre- …

Quality Improvement Project: Perioperative Recruitment Process Improvement Through Nursing Student Clinical Experience, Traci Boren

Doctor of Nursing Practice Projects

Perioperative nursing is experiencing greater shortages than any other specialty and has been largely removed from undergraduate education. This DNP quality improvement project aimed to impact the recruitment of perioperative nurses through undergraduate nursing clinical exposure and experience. The project addressed the lack of clinical nursing student opportunities in the perioperative department at the partner site to increase interest in perioperative nursing and recruit core staff nurses from the pool of new graduates. Kotter’s Eight-Step Change Model and the Social Career Cognitive Theory framed the project’s design and implementation for two cycles, between January and March 2024 and 2025. Using …

Strengthening Communication Between Staff And Health Providers In A Mental Health Setting, Michael Tricoli

Doctoral Dissertations and Projects

Communication between nursing staff and providers is essential for supporting optimum patient outcomes. Each component of the communication process needs to be clearly defined to create an environment of safety for both patients and caregivers. The SBAR (situation, background, assessment, recommendation) is a nurse-driven protocol that is widely used as a communication and documentation template in health care organizations. This format is currently not being used effectively on the mental health units where the evidence-based project was implemented. Recognizing and reiterating the value of SBAR as a communication tool is necessary when communication deficits are noted. The purpose and scope …

Weight Recidivism Post-Bariatric Surgery: A Lifestyle Modifications Educational Intervention, Kimeshia N. Johnson

Electronic Theses and Dissertations

Weight recidivism after bariatric surgery is a frustrating phenomenon for bariatric surgery patients and healthcare professionals. A 90-day lifestyle modification intervention for patients at least 18 months postsurgery was performed in the primary care setting to determine if a structured program could promote or maintain weight loss. The intervention aimed to investigate if participation in a structured lifestyle modification program would impact the body mass index of bariatric patients at least 18 months postsurgical intervention. In coordination with a nutritionist specializing in addiction and obesity education, a booklet detailing the guidelines for a 12-week program was provided to 41 bariatric …