Medicine and Health Sciences Commons^™

Quality Improvement Project: Building Competence And Confidence: Updating Nursing Faculty Knowledge Of The Flipped Classroom Model, Jamie Newman

Doctor of Nursing Practice Projects

The increasing complexity of healthcare requires undergraduate nursing education to move beyond traditional lecture-based instruction toward teaching strategies that promote clinical judgment. Although the flipped classroom model is shown to support these outcomes, faculty at the project site reported uncertainty and inconsistency in flipped classroom implementation. The purpose of this quality improvement project was to evaluate the impact of a structured, evidence-based faculty development intervention on undergraduate nursing faculty confidence, readiness, and competence to implement the flipped classroom model. Guided by Lewin’s Change Theory and the Stetler Model of Evidence-Based Practice, this quality improvement project used a quantitative, pre-experimental one-group …

Quality Improvement Project: Implementation Of The Surgical Safety Checklist To Improve Adherence To Time-Out At In-Office Procedure, Funke Osaremwinda

Doctor of Nursing Practice Projects

Surgical errors in ambulatory and in-office procedural settings continue to rise despite well-established safety standards, such as the time-out (TO) protocol. Literature consistently links non-adherence to the TO protocol to preventable events such as wrong patient, wrong site, or wrong surgery. At the cardiovascular ambulatory clinic where the quality improvement (QI) project was implemented, the baseline needs assessment indicated inconsistent TO practices and the absence of a standardized tool to support TO. The purpose of this project was to improve adherence to the TO safety protocol through staff education and implementation of the evidence-based World Health Organization (WHO) Surgical Safety …

Quality Improvement Project: The Impact Of Hypertension Management Education In Primary Care, Toyin K. Aliu

Doctor of Nursing Practice Projects

Hypertension (HTN) is one of the leading causes of clinic visits and prescription medication use in primary care settings. Despite the availability of evidence-based guidelines to improve HTN management, adherence in clinical practice is often lacking. At the project site, 30% of patients have uncontrolled HTN. This is attributed to providers’ inadequate knowledge of the JNC-8 HTN management guidelines and inconsistent adherence to them. This project aimed to improve hypertension management in a primary care setting by educating providers on the JNC-8 guidelines to enhance adherence to evidence-based practices over six weeks. The purpose was to align medical providers with …

Improving Benzodiazepine Refill Workflow And Communication Via Telehealth Using A Standardized Sbar Protocol, Hendricks Agwu

Doctor of Nursing Practice Projects

The development in telehealth operations in outpatient mental health care has enhanced access to care at the expense of creating challenges in communication and workflow, especially when it comes to dealing with high-risk substances like benzodiazepines. The role ambiguity, inaccurate refill timeline, documentation lapses and high chances of medication errors are caused by inconsistent communication during the process of telehealth refills. This quality improvement project was aimed at assessing the effects of applying a standardized Situation, Background, Assessment, Recommendation (SBAR) communication and documentation protocol to workflow efficiency, interprofessional communication, and medication safety when making benzodiazepine refills in a telehealth outpatient …

Quality Improvement Project: The Influence Of Education On Provider Self-Efficacy And Utilization Of The Columbia Suicide Severity Rating Scale (C-Ssrs), Doreen Nwaogwugwu

Doctor of Nursing Practice Projects

Suicide remains one of the leading causes of death worldwide, underscoring the critical need for consistent, evidence-based suicide risk screening in mental health facilities. Despite being a validated, evidence-based tool, the use of the Columbia Suicide Severity Rating Scale (C-SSRS) is often hindered by inadequate provider training. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of provider education on self-efficacy and utilization of the C-SSRS in an outpatient mental health clinic. This quality improvement project used a quasi-experimental, one-group pretest-posttest design guided by the Health Belief Model, Lewin’s Change Theory, and the …

Quality Improvement Project: Impact Of Evidence-Based Self-Care Practice On Burnout In Nursing Faculty, Lori Boyd

Doctor of Nursing Practice Projects

Nursing faculty burnout is a national concern supported by literature, which compromises faculty well-being, creativity, retention, and sustainability of nursing programs. Burnout is characterized by the subscales of emotional exhaustion, depersonalization, and feelings of reduced personal accomplishment. At the project site, leaders reported that faculty often left their roles due to increased workload and being overwhelmed by the rigorous expectations of the role, underscoring the need for a process to support nursing faculty burnout. This quality improvement (QI) project aimed to evaluate the impact of evidence-based self-care practices on nursing faculty burnout using Maslach's Burnout Inventory Toolkit, a valid and …

Quality Improvement Project: Improving Transitional Care Management (Tcm) Follow-Up Through Medical Assistant Education, Oben Assick

Doctor of Nursing Practice Projects

The underutilization of Transitional Care Management (TCM) services in primary care significantly contributes to preventable hospital readmissions and revenue loss. Despite established Centers for Medicare & Medicaid Services (CMS) guidelines, execution often fails due to knowledge gaps among frontline staff. This quality improvement project addressed low TCM task completion rates by implementing a structured educational intervention for medical assistants (MAs). The purpose was to evaluate whether targeted training improves timely patient follow-up, visit scheduling, and billing accuracy. The project utilized Kotter’s 8-Step Change Model to guide organizational change and the Health Belief Model to address behavioral barriers. A quantitative, quasi-experimental …

Dexmedetomidine Versus Propofol For Reducing Emergence Delirium In Pediatric Anesthesia: A Scoping Review, Hannah Laxton Bsn, Rn, Hannah Mclain Bsn, Rn, Robert Mohr Bsn, Rn, Sarah Rocha Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Dwanye Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background 

Propofol is widely regarded as the standard anesthetic agent for preventing and treating emergence delirium, particularly in pediatric patients. Emergence delirium presents as postoperative agitation that may escalate to self-injurious behavior that can lead to disruption of critical lines or equipment. Since its approval in 1999, dexmedetomidine has gained attention for its sedative and sympatholytic properties, offering potential advantages over propofol. This study compares the postoperative effects of propofol and dexmedetomidine in reducing emergence delirium in pediatric surgical patients.

Methods 

A scoping review was conducted using PRISMA guidelines to identify relevant literature published between 2000 and 2025. Databases searched …

Opioid Abuse: Community Education, Meggan N. Wolff-Jackson

Doctor of Nursing Practice Projects

The opioid epidemic in the United States has persisted for over two decades and has become one of the leading causes of accidental deaths nationwide (Robert et al., 2022). The opioid crisis represents a widespread public health emergency that extends beyond individual and community boundaries, imposing burdens on both the national economy and the healthcare system (Kyei et al., 2024). Although the opioid epidemic is a global concern, it is particularly concerning in the target community located in the western part of North Carolina. This region has some of the highest rates of opioid overdoses within the state, with 118 …

Improving Overall Morale Of Nurses By Implementing A Serenity Room, Ruth B. Clarke-Johnson

Doctor of Nursing Practice Projects

Nursing, while a highly respected profession grounded in research and scientific practice, continues to face persistent challenges related to staff retention and morale. Key contributors include burnout related to high workloads, challenging staffing ratios, lack of supportive leadership, and an aging workforce. Together, these factors hinder healthcare organizations’ ability to sustain a stable and experienced staff. The implementation of a serenity or relaxation room is supported by growing evidence highlighting its positive effects on nurse morale and stress reduction. A review by Mileski et al. (2022) found wellness spaces significantly reduced burnout, emotional exhaustion, and stress while improving resilience, job …

Integrating Lactation Education Into Centering Pregnancy To Enhance Maternal Confidence And Lactation Initiation Rates, Courtney Barbee

Doctor of Nursing Practice Projects

Introduction: Breastfeeding remains the gold standard for infant nutrition providing physical and psychological benefits for both mother and baby. The inadequacy of lactation education and support continue to hinder breastfeeding initiation in the rural areas of North Carolina. Integrating a board-certified lactation consultant into the Centering Pregnancy model provides an evidence-based strategy to improve maternal confidence and increase lactation initiation rates within the target community.

Method: Using a quality improvement framework, the project targeted expecting mothers participating in Centering Pregnancy. Pre- and post-surveys assessed confidence levels after receiving two educational sessions with a board-certified lactation consultant.

Results: …

Beat By Beat: Empowering Communities With Lifesaving Cpr Skills, Allyssa Mb Hutchins

Doctor of Nursing Practice Projects

Introduction: This doctoral project was created to increase bystanders' willingness and ability to perform CPR by building their confidence in performing it effectively. A total of 13 participants participated in this project to increase knowledge and confidence in CPR interventions.

Background: Cardiac arrests remain a leading cause of death, yet research indicates that rural communities have lower rates of bystanders trained and willing to assist. Increasing CPR awareness and eliminating barriers to care for classes can improve CPR confidence and have a positive community impact.

Methods: Three 4-hour CPR classes were held in Zirconia, NC, at no …

Safe And Effective Injection Practices For Insulin And Glp-1 Users, Lydia A. Anderson

Doctor of Nursing Practice Projects

Improper insulin and GLP-1 injection techniques can reduce treatment effectiveness in patients diagnosed with diabetes mellitus. This quality improvement project aimed to improve patients' knowledge and safety regarding insulin and GLP-1 medications by conducting an educational session and demonstration of proper injection techniques. The project took place at a community senior center where individuals reported not receiving instruction or education on correct injection practices when prescribed these medications. Pre- and post-intervention surveys assessed changes in patient knowledge, confidence, and understanding of proper injection methods. Results demonstrated clear improvements in patient knowledge, confidence, and technique. This project highlights the significance of …

Enhancing Uncontrolled Hypertension Compliance And Self-Management In A Senior Center, Kimberly D. Strickland

Doctor of Nursing Practice Projects

Hypertension is a complicated, chronic condition that affects individuals worldwide. The prevalence of this condition has increased nearly 48% in the last decade in America. This project served to determine if participants in a targeted area/community would show increased knowledge and awareness of hypertension after implementation of educational sessions. A post-session survey was provided to determine if the educational sessions were effective. Data was collected and analyzed that showed an increase in awareness and knowledge regarding the prevalence of hypertension, diet modification, lifestyle, and compliance.

Increasing Awareness Of Obesity And Its Associated Risks In Adults, Esther E. Bayode

Doctor of Nursing Practice Projects

Obesity is a significant and growing public health concern in a metropolitan area of North Carolina, reflecting statewide and national trends. With 36% of adults in North Carolina classified as obese, the condition contributes to chronic diseases such as hypertension, diabetes, heart disease, and certain cancers. This project targeted adults aged 18 and older within a local faith-based community, where preliminary findings showed a strong association between elevated body mass and increased chronic disease burden. To address this issue, a two-session educational intervention was implemented in partnership with a religious organization to increase knowledge about obesity, its causes, associated risks, …

The Essentials Of Heart Failure Management, Emily W. Greene

Doctor of Nursing Practice Projects

Heart failure remains a leading cause of hospitalization among older adult women, often due to delayed recognition of symptom exacerbation and limited knowledge of self-management strategies. The purpose of this quality improvement project was to evaluate whether a brief educational intervention could improve knowledge of heart failure management among older adult women at a community senior center. The DNP project leader conducted two educational sessions focusing on early recognition of heart failure symptoms, heart-healthy diet, and when to contact a healthcare provider. Participants completed a pre- and post-test survey containing four knowledge questions and one Likert-scale question on perceived knowledge …

Spreading Awareness To College Athletes About Skin Cancer And Improving Sun Protection Habits, Baylee B. Whiteside

Doctor of Nursing Practice Projects

Introduction: The intention of this Doctor of Nursing Practice evidence-based project was to provide education on improving awareness of skin cancer to potentially improve sun protection habits. A total of 100 college athletes participated in this project. The goal was to increase educational knowledge and practice intentional sun protection habits.

Background: One in 5 people will develop a type of skin cancer by age 70 (Skin Cancer Foundation, 2024). Several studies have proven that young adults, ages 15-25, are at an increased risk of sun exposure due to decreased knowledge about skin cancer. Teaching and improving the knowledge in this …

Increasing Teens' Knowledge On The Health-Related Effects Of Vaping, Anteja Gore

Doctor of Nursing Practice Projects

Vaping in teens has become an increasing public health issue related to the growth in the number of teens who are using vapes. Many teens are not aware of the potential associated risk of using vapes, as they perceive them to be a safer alternative to smoking cigarettes. The purpose of this project was to increase the middle school teens’ knowledge of the potential health risks associated with vaping through an educational awareness session. This project was implemented in the middle school setting, targeting students aged 12-14 years. The students who participated completed anonymous pre- and post- questionnaires that evaluated …

Spreading Awareness To Adults About Cardiovascular Disease And Improving Healthy Lifestyle Habits, Madison L. Eldridge

Doctor of Nursing Practice Projects

Introduction: The intention of this Doctor of Nursing Practice evidence-based project was to evaluate if providing education to the target community would increase awareness and knowledge of cardiovascular disease and healthy lifestyle habits. The goal was to increase educational knowledge and promote awareness of cardiovascular disease and healthy lifestyle habits.

Background: Cardiovascular disease (CVD) is a critical health issue that prevails across the state of North Carolina, while continuing to remain one of the leading causes of death across the south-center Piedmont area of North Carolina. Several studies have proven that increasing knowledge on cardiovascular risks, promoting healthy exercise, and …

Effects Of Educational Programs On Reducing Sexually Transmitted Infection Rates, Phierica D. Gardin

Doctor of Nursing Practice Projects

Sexually transmitted infections (STIs) remain a significant public health concern in the United States, with increasing rates reported in many states, including North Carolina. Limited sexual health education, stigma surrounding sexual health discussions, and lack of awareness regarding prevention and screening contribute to ongoing transmission, delayed diagnosis, and potential long-term complications associated with untreated STIs. The purpose of this Doctor of Nursing Practice (DNP) project was to implement a sexual health education program aimed at increasing knowledge of STI transmission, prevention strategies, and the importance of screening among adults aged 18 years and older. Two educational sessions were completed within …

Combating Pressure Injuries In Critical Care: A Dnp Project On Nursing Education And Prevention Strategies In The Icu, Tijuana M. Johnson

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) are preventable complications that significantly increase patient morbidity, mortality, length of stay, and healthcare costs, particularly in intensive care units (ICUs). At a rural 146-bed hospital, the ICU pressure injury rate of 1.17 per 1,000 discharges exceeded the national benchmark of 0.58 per 1.000 discharges, identifying a critical gap in prevention practices. This Doctor of Nursing Practice (DNP) project aimed to improve ICU nurses' knowledge of pressure injury prevention and reduce unit-based educational intervention grounded in Patricia Benner’s Novice to Expert Theory and implemented using the Plan-Do-Study-Act (PDSA) quality improvement framework.

A pre-and post-intervention design was …

Building Clinical Competency In Central Line Care: A Nurse-Focused Initiative To Prevent Clabsis, Glenda A. Robbins

Doctor of Nursing Practice Projects

Central line-associated bloodstream infections (CLABSIs) are a significant yet preventable source of increased morbidity, mortality, and healthcare costs in acute care settings. Despite established evidence-based prevention bundles, inconsistent nursing adherence remains a primary contributor to elevated CLABSI rates. A 241-bed acute care hospital reported CLABSI rates above the national benchmark. This Doctor of Nursing Practice (DNP) project utilized Neuman’s Systems Model. The intervention consisted of a structured educational module on central line care and maintenance, including pre- and post- knowledge assessments. Additionally, standardized daily central line visual audits were reinforced by the Vascular Access Team. A total of 363 bedside …

Diabetes Education In Buncombe County, Deonna Nicole Blount

Doctor of Nursing Practice Projects

The growing number of Americans living with diabetes has reached an all-time high. According to the Centers for Disease Control and Prevention (CDC) (2026), there are 40.1 million people diagnosed with or underdiagnosed with diabetes. Evidence has shown that with education tailored to the patient's lifestyle, changes can be made and healthier lifestyles exhibited. Understanding the why of the patients can assist in changes that are feasible and can be implemented for the now and the future. Several studies outlined by Alonso-Carril et al. (2024), Lander et al. (2022), and Hodges et al. (2019) showed that education was implemented and …

Mental Health First Aid Training In The Community, Vester Agbley Gideon

Doctor of Nursing Practice Projects

Mental health issues impact one in five adults in the United States; however, many individuals lack the requisite knowledge and skills to effectively respond to mental health crises. Mental Health First Aid (MHFA) training empowers individuals to recognize and address mental health concerns, thereby fostering early intervention and support. This review analyses the efficacy of MHFA training, best practices for its implementation, and its influence on mental health outcomes. Empirical evidence indicates that MHFA training enhances mental health literacy, diminishes stigma, and encourages supportive behaviors. Customized approaches for targeted populations, such as youth and older adults, have also shown significant …

Improving Timeliness Of Extubation Post-Cabg: An Educational Intervention Utilizing A Nurse-Driven Checklist, Christy Scott

Doctor of Nursing Practice Projects

Background: Timely extubation following coronary artery bypass graft (CABG) surgery is associated with improved patient outcomes. In a rural six-bed cardiovascular intensive care unit (CVICU) in North Carolina, extubation times were previously reported at approximately 15 hours. A lack of a standardized nurse-driven process and inconsistent familiarity with extubation readiness criteria contributed to variation in practice.

Purpose: The purpose of this DNP project was to implement and evaluate an educational intervention using a nurse-driven extubation checklist to improve nurses' knowledge, confidence, communication, and role clarity related to post-CABG extubation readiness in the CVICU.

Methods: The staff education …

Musical Measures: Nurse Education On Music-Based Interventions To Reduce Patient Restraints, Crystal D. Tucker

Doctor of Nursing Practice Projects

The use of physical restraints in acute psychiatric settings poses significant risks to patient safety, including physical injury and psychological distress. Evidence supports the need for alternative, non-pharmacologic interventions to reduce reliance on restraints. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of an educational intervention on nurses’ knowledge and confidence in implementing music-based interventions, specifically binaural beats, to manage patient anxiety and agitation.

The project was conducted on a medical observation and behavioral health holding unit and utilized a pre- and post-intervention design. Registered nurses participated in educational sessions on music-based interventions and were …

A Quality Improvement Project: Faculty Education On Diversity, Equity, And Inclusion Principles, Ashley Mcdoulett

Doctor of Nursing Practice Projects

According to the literature, social injustices, inequities, and implicit bias influence health outcomes in marginalized populations. To eliminate health disparities, nurses should be prepared to provide care that addresses these issues, and faculty should be able to effectively integrate diversity, equity, and inclusion (DEI) principles into the nursing curriculum. A literature review suggests the integration of DEI into nursing education is lacking, and by offering an educational session for faculty on best practices for curriculum incorporation, this project aimed to address that gap. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) model guided this project. RE-AIM emphasizes targeting a population to …

Quality Improvement Project: Trauma-Informed Care For Nurse Faculty, Nicke R. Wilson

Doctor of Nursing Practice Projects

Recent research in nursing education highlights trauma-informed care, noting that nurse faculty often understand the concept but lack formal training to apply it consistently. The Doctor of Nursing Practice (DNP) project aimed to address this gap by developing an evidence-based Trauma-Informed Care training module to help faculty acquire the skills needed for psychologically safe and inclusive learning environments. This initiative aligned with the priorities of the American Association of Colleges of Nursing. Trauma-informed care is especially important in high-stress fields like nursing, where trauma can impact the performance, engagement, and well-being of both students and faculty. The project, conducted at …

Quality Improvement Project: Enhancing Nursing Documentation Of Patients’ Chief Complaints And Anatomical Site Markings In Radiographic Imaging Requests, Clara Odili

Doctor of Nursing Practice Projects

Incomplete or inaccurate radiographic imaging requests remain a persistent barrier to diagnostic accuracy and patient safety in urgent care settings. The purpose of this quality improvement (QI) initiative was to enhance nursing documentation of patients’ chief complaints and anatomical site markings through an evidence-based educational intervention targeting nurse-trained X-ray technicians. Guided by Benner’s Novice-to-Expert framework and principles of evidence-based practice, this project employed a pre- and post-intervention design over a two-week implementation period. Data was collected using structured knowledge and competency assessments. Post-intervention findings demonstrated substantial improvements in documentation accuracy, with mean knowledge scores increasing by approximately 30% and self-reported …

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 …