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Enhancing Cultural Competency Through Training In A Primary Care Clinic, Rogelio Perez Iii

Doctor of Nursing Practice Projects

Cultural competence remains essential in primary care settings serving diverse populations, yet staff at a small Southern Texas primary care clinic reported no previous formal cultural competency training in workplace orientation or school. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a brief, evidence-based cultural competency intervention improved clinician cultural competency scores. Madeleine Leininger’s Culture Care Theory provided the theoretical framework, Lewin’s Change Theory guided the change process, and the Plan-Do-Study-Act cycle directed implementation and evaluation. The problem addressed was the lack of structured training to support culturally responsive communication, patient trust, and …

Quality Improvement Project: Development And Implementation Of A Structured Certification Support Program And The Impact On Nurses’ Confidence And Medical Surgical Certification Rates, Mary Tran

Doctor of Nursing Practice Projects

Professional nursing certification is an important criterion of Magnet designation, and increased certification rates have been associated with positive patient outcomes. The literature supports peer support and group study as beneficial strategies to assist nurses in preparing for certification exams. A quality improvement project among medical-surgical (med-surg) nurses at a community hospital pursuing Magnet redesignation addressed the lack of formal processes and nursing perceived barriers to certification that may contribute to low certification rates. The purpose of this project was to develop and implement a structured medical-surgical certification support program following the Plan-Do-Study-Act (PDSA) cycle utilizing evidence-based strategies, including a …

Quality Improvement Project: Effect Of Multi-Level Student Collaboration On Clinical Judgment In High-Fidelity Simulation, Jillian Carroll

Doctor of Nursing Practice Projects

There is a gap in undergraduate nursing curriculum on incorporating collaboration and communication into patient care, leading to a lack of competence and confidence in novice practice. Using collaboration in high-fidelity simulation, students gain real-world exposure and opportunities to communicate and make independent decisions. Using Kotter’s eight-step change theory, this project addresses the limited exposure to collaboration by implementing purposeful interdisciplinary collaboration within high-fidelity simulation to improve undergraduate nursing students’ confidence and competence in nursing practice. This will build on Patricia Benner’s novice-to-expert theory and help advance Associate Degree Nursing (ADN) students into a safe and effective novice year of …

Educating Nurse Practitioners On Music-Based Interventions: An Evidence-Based Project, La’Keshia Henderson

Doctor of Nursing Practice Projects

Background: Arts-based interventions (ABIs) harness the transformative power of art to enhance processes or situations, particularly those related to physiological, emotional, and psychological well-being. There are three types of arts-based interventions: visual, literary, and performing arts. Among these, music therapy, a form of performing arts intervention, has gained recognition as an effective approach for addressing mental health challenges. Music therapy has shown promise in reducing anxiety symptoms, offering a non-invasive and accessible form of support within ABI strategies. Purpose: This project assessed changes in nurse practitioners' knowledge, attitudes, and practices, as well as their intentions to utilize music-based interventions in …

Implementing A Team-Based Approach To Reduce Blood Culture Contamination Rates In The Emergency Department: A Quality Improvement Initiative, Melissa Lockhart

Doctor of Nursing Practice Projects

Background: Blood culture contaminations (BCC) present significant risks to patients, including adverse drug reactions and the exacerbation of antibiotic resistance. BCC can also result in millions of dollars in financial burdens for hospitals due to the need for follow-up testing, treatment complications, and antibiotic stewardship efforts. At this facility, the contamination rate in the emergency department (ED) consistently exceeds the national benchmark of 3%. Contributing factors include high patient turnover and increased nursing workloads, which can lead to shortcuts in essential practices such as hand hygiene and skin disinfection before collection.

Purpose: This project aimed to evaluate whether implementing a …

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 …

Commit To Sit: Does Purposefully Sitting With Adult Medical-Surgical Patients At A Rural Hospital Impact Patient Satisfaction?, Jolie A. Puckett

Doctor of Nursing Practice Projects

Background: Patient satisfaction surveys encourage patients to provide feedback about their experiences with healthcare organizations, and the surveys also play a critical role in identifying gaps in care that may contribute to patient harm. Effective communication between nurses and patients is crucial for delivering high-quality healthcare; therefore, initiatives to enhance this communication should be explored and implemented.

Purpose: This quality improvement project aimed to evaluate whether sitting with patients improved patient satisfaction scores for a medical-surgical unit within a Northwest Georgia inpatient facility.

Project Design: A pre- and post-design method was utilized to compare patient satisfaction scores before and after …

Preserving Memories, Building Relationships, Jamie H. Cochran

Doctor of Nursing Practice Projects

Loneliness among adults aged 65 and older is a significant health concern linked to negative physical and mental outcomes, especially in rural communities. This DNP project implemented a 4-week scrapbooking intervention within a faith-based rural community in North Carolina to reduce feelings of loneliness. Guided by Watson’s Theory of Human Caring, participants engaged in collaborative arts activities designed to foster social connection and emotional expression. The potential results of this project are multifaceted, including improved social engagement, emotional well-being, and strengthened community bonds. The findings support integrating creative, relationship-centered strategies into community nursing practice to enhance well-being among older adults.

Assessing Pain In People With Dementia Using The Pacslac-Ii Scale, Audrey L. M. Breton, Pardeep Singh

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice project aimed to educate caregiving staff on the use of the PACSCLAC-II, a validated pain tool, for residents with advanced dementia unable to selfreport pain. It also evaluated whether training the staff to use the PACSLAC-II enhanced pain assessment accuracy compared to the staff’s clinical judgement when detecting the presence of pain. Participants included on-site caregivers – a nurse, certified nursing assistants, and licensed medical technicians – who provide direct care to residents with dementia. Staff completed an assessment form featuring a Likert scale for staff clinical judgement on one side of the paper and …

Pain Versus Neuropsychiatric Symptoms In Residents With Dementia: A Nursing Staff Educational Training, Rebecca Hildreth

Doctor of Nursing Practice Projects

BACKGROUND: Pain assessment in patients with dementia is challenging due to cognitive and communication impairments, making the older adult population highly susceptible to poor pain assessment and treatment.

AIM: The purpose of this project is to accurately identify the cause of agitation in residents with dementia. Specific aims include 1) to collect background demographic data on residents, 2) to educate nursing staff on pain assessment in dementia patients, and 3) to educate nursing staff about the risks associated with antipsychotic medications to prioritize using non-pharmacologic interventions to treat agitation.

METHODS: A chart review of residents residing in a suburban, Pacific …

High-Consequence Infectious Disease Transport Protocols And Guidelines: Procedures And Simulation Evaluation, Charles J. Svela

Doctor of Nursing Practice Projects

Introduction: High-consequence infectious diseases (HCIDs) such as Ebola virus disease (EVD) and other viral hemorrhagic fevers (VHFs) require interdisciplinary teamwork and collaboration, communication, and adherence to protocols in order to safely transport patients between agencies. Despite national preparedness efforts, standardized transport protocols for HCID patients remain limited and inconsistently applied nationally. This quality improvement (QI) project aimed to develop and assess evidence-based interfacility transport protocols for a regional Biological Isolation Care Unit (BICU) using a multidisciplinary, simulation-based learning activity.

Methods: A quantitative semi-structured survey was utilized to evaluate the effectiveness of newly developed HCID interdisciplinary transport protocols utilized in a …

Improving Dementia Literacy In Direct Care Workers In Independent Senior Communities, Rachael Kauffung, Rosalie Monkono

Doctor of Nursing Practice Projects

No abstract provided.

The Use Of Music Therapy And Various Mechanisms Of Diversion To Aid Caregivers Of Those With Alzheimer’S Disease And Dementia, Sarah Elizabeth Kane

Doctor of Nursing Practice Projects

Background: Alzheimer’s Disease and Dementia inhabit an increasingly alarming number of individuals within the United States with the majority of their caregivers being loved ones with limited to no healthcare education. This DNP project was designed to specifically educate caregivers of those with Alzheimer’s Disease and Dementia. The goal of this project was to increase the knowledge of the disease while also increasing the ability and confidence to better care for their loved ones. In using the resources outlined in this project, such as music therapy and diversional tools, the caregiver would see a decrease in emotional outbursts and …

Navigating Change: Cultivating Faculty Support For Curriculum Revision Through The 4ms Framework, Sarah Dearing

Doctor of Nursing Practice Projects

Public campaigns have increased awareness of Alzheimer’s disease and other dementias, however, education for healthcare providers concerning brain health and appropriate screenings to identify elderly patients at risk is not present. This curricular policy change project outlines the need for faculty buy-in to complete a curriculum change that addresses the lack of geriatric-evidence based education within an Associate of Applied Science in Nursing (AASN) program. Qualitative data identifies the amount of geriatric-evidence based education present in the current AASN curriculum map. Using Lewin’s change management theory (CMT) and the Cognitive-Affective-Social Theory of Learning Environments (CASTLE), an educational module teaching the …

Enhancing Family Nurse Practitioner Education Through End-Of-Life Simulation: A Quality Improvement Project, Deborah Jamison

Doctor of Nursing Practice Projects

Providing compassionate and effective end-of-life care is a crucial skill for Family Nurse Practitioners (FNP) students (Collins & Small, 2019). However, many students experience significant anxiety and lack confidence in such challenging situations. The problem identified for the Doctor of Nursing Practice (DNP) Quality Improvement (QI) project is the lack of training focused on end-of-life care in the FNP program at a College of Nursing (CON) within an academic clinical center. The project’s purpose was to improve confidence and anxiety levels among FNP students in providing end-of-life care. The project aimed to create an inventive and immersive end-of-life simulation with …

The Implementation Of Comfort Medication Kits In Hospice Patients’ Homes To Reduce Hospice Revocations, Brandi J. Parker

Doctor of Nursing Practice Projects

Background: When hospice patients experience a symptomatic crisis at the end of life, unmanaged symptoms can lead to unwanted hospitalizations and the revocation of their hospice benefits. Strategies to reduce the incidents of hospice revocation are needed to improve patient care and quality of life.

Purpose: The quality improvement project aimed to reduce hospice revocation rates by implementing comfort medication kits in eligible hospice patients’ homes.

Methods: The project’s intervention included identifying patients at high risk for revocation, patients with a cancer diagnosis, and patients with a prognosis of two weeks or less. Comfort medication kits were placed in the …

Implementing Delirium Prevention Strategies To Reduce The Need For 1:1 Observation In A Palliative Care Unit, Natalyn Finley

Doctor of Nursing Practice Projects

Background: Delirium is a common complication within the palliative care community that is preventable. Delirium is a condition characterized by confusion and disturbed thought processes. One to one observation was the facility’s intervention used to prevent delirium. The best intervention is non-pharmacological interventions.

Purpose: This quality improvement (QI) project aimed to reduce 1:1 observation hours without increasing patient safety issues.

Methods: The Doctor of Nursing Practice (DNP) student educated nursing staff about the American Nurses Association’s (ANA) evidence-based interventions to help decrease delirium. The staff received the ANA interventions form and the Confusion Assessment Method (CAM) tool. The DNP student …

Reducing The Incidence Of In-Hospital Cardiac Arrests (Ihca) By Utilizing Infographics, Alexis Morgan Pope

Doctor of Nursing Practice Projects

Background: In-hospital cardiac arrests (IHCA) have negative outcomes on patients and can prolong hospitalization or lead to death. The rate of IHCA has been increasing over the past few years in the United States. A medical intensive-care stepdown unit in a level three trauma center has an incidence of IHCA above the national average and a survival-to-discharge rate less than the national average.

Purpose: The project aimed to improve patient outcomes and reduce the rate of IHCA by placing infographics containing evidence-based practice in the unit with the highest incidence.

Methods: A pre-post implementation quality improvement design was used to …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

Reducing No-Show Rates In An Outpatient Gi Endoscopy Lab, Mwaba Chisela

Doctor of Nursing Practice Projects

Background: Patients who do not attend their scheduled appointments cost the healthcare industry approximately $150 billion annually. They are at higher risk of missed diagnoses, delay in care, and increased morbidity and mortality.

Purpose: This quality improvement project aimed to determine the effectiveness of serial reminders using phone calls and electronic messaging to reduce no-shows for patients scheduled for gastrointestinal (GI) endoscopy.

Methods: No-show data was retroactively analyzed from June 2023 to December 2023 and compared to post-implementation data from February 2024 to March 2024. For eight weeks, a trained staff team called patients scheduled for endoscopic procedures seven days …

Ketamine Infusion Protocol & Patient Education Pamphlet For Complex Regional Pain Syndrome, Ricardo Aranda, Giles Howard

Doctor of Nursing Practice Projects

Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD) and causalgia, is a debilitating neurological disease accounting for 1.2% of all chronic pain conditions, with eighty percent being severely disabled (Zhao et al., 2018). Altered pain pathways in CRPS patients result in resistance to traditional methods of analgesia, contributing to poor quality of life and unanticipated hospitalizations. Multiple meta-analysis studies suggest ketamine infusions effectively lower chronic pain scores in CRPS patients. Despite the evidence, a lack of standardized ketamine infusion protocols creates a barrier to provider implementation. This Doctor of Nursing Anesthesia project aimed to develop a …

A Behavioral Intervention Checklist To Reduce Re-Hospitalizations In Residents With Mental Illness, Jeffery Davis

Doctor of Nursing Practice Projects

Skilled nursing facilities are an essential component of the continuum of care and, with the rapidly aging population, represent an increasing cost to the healthcare system. The policies beginning in the 1960s promoting the deinstitutionalization of mental health institutions have resulted in increasing numbers of individuals with serious mental illnesses now residing in skilled nursing facilities. The complex needs of individuals with mental illness have been associated with an even greater cost of care, deficient quality, and safety concerns. This quality improvement project analyzed the impact of an evidenced-based, structured behavioral intervention checklist on rehospitalization rates in individuals with mental …

Taps-Top Active Pre-Screening And Education: A Pre-Kidney Transplant Quality Improvement Initiative, Stacie Myers Bsn, Rn

Doctor of Nursing Practice Projects

Background: Due to the large number of patients waiting for a kidney transplant and the prolonged wait times, once a kidney becomes available some patients may not be medically ready. For this reason, some patients may miss out on a kidney transplant.

Objective: To assess the effects and outcomes of a one-to-one touch point interview and education seminar for pre-kidney transplant patients who are currently waitlisted for a kidney transplant.

Method: This quality improvement project evaluated the effectiveness of one-to-one interviews and an education seminar with a nurse navigator for approximately 60 adult pre-kidney transplant patients on …

Reducing 30-Day Hospital Readmission Rates By Addressing Social Determinants Of Health In The Home Health Care Setting, Kelly-Ann Federle Reilly

Doctor of Nursing Practice Projects

Background: In 2013, Medicare penalties for high hospital readmission rates spurred initiatives to reduce these figures. Despite efforts, 25% of elderly patients are readmitted within 30 days post-discharge, often due to unaddressed Social Determinants of Health (SDoH) like food, housing, and medication access.

Objectives: The project aimed to assess the effectiveness of interventions targeting SDoH for patients over 65 receiving home care services. It specifically sought to evaluate the impact of these interventions on 30-day readmission rates, focusing on addressing food, housing, and medication insecurities.

Methods: This project evaluated interventions targeting SDoH in-home care among patients over 65 to reduce …

Does A Case Study Based Intervention About Return To Play After A Mild Traumatic Brain Injury Increase Knowledge And Confidence In Dnp Students, Courteney Lam

Doctor of Nursing Practice Projects

No abstract provided.

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Mental Health And The Black Church: Decreasing The Division In Divinity, Latonya Gray

Doctor of Nursing Practice Projects

Racial disparities in mental health care persist for Black Americans, with only one in three who need treatment receiving it. The care they do receive is often of a poorer quality than that of other groups. Faith communities serving Black members could help address this gap by partnering with mental health professionals to meet congregants' needs. With mental health now at the forefront of public discourse, considering the specific needs of the Black community is critical. Black Americans face disproportionate mental health burdens but are more likely to seek counsel from clergy due to cultural stigma. Educating clergy on mental …

Utilization Of Modified Early Warning Scores (Mews) To Decrease In-Hospital Cardiac Arrests (Ihca), Ashley Bryan

Doctor of Nursing Practice Projects

Background: Less than 25% of patients survive to discharge after an in-hospital cardiac arrest (IHCA). The American Heart Association (AHA) aimed to increase the survival to discharge after IHCA to 35%, according to the AHA Get with the Guidelines (GWTG). Pre-implementation of MEWS-based rapid response rounding the facility had a 24% survival to discharge rate after IHCA.

Purpose: The Doctor of Nursing Practice (DNP) project aimed to improve the survival to discharge percentage after IHCA by implementing MEWS-based rapid response rounding on all patients with a MEWS of four or greater.

Methods: The quality improvement project consisted of having rapid …