Medicine and Health Sciences Commons^™

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Quality Improvement Project: Improving Pneumococcal Vaccination Rates Through Provider Education In Primary Care, Leikasha Allen

Doctor of Nursing Practice Projects

Pneumococcal disease remains a major cause of illness and mortality among adults aged 65 years and older, leading to severe pneumonia, bacteremia, and meningitis, particularly in vulnerable populations. Although effective vaccines and clear Centers for Disease Control (CDC) and Advisory Committee Immunization Practice (ACIP) guidelines, vaccination in this age group remains inadequate. This Doctor of Nursing Practice (DNP) quality improvement project aimed to determine the impact of pneumococcal vaccination compliance through evaluating provider knowledge, confidence, and adherence to evidence-based guidelines through targeted education. Guided by Rogers’ Diffusion of Innovation Theory and the Health Belief Model, a 20-minute evidence‑based educational session …

Implementation Of A Mentoring Toolkit: A Quality Improvement Project, Joshlyn Neu

Doctor of Nursing Practice Projects

Nursing faculty mentorship is an essential component of professional development, job satisfaction and faculty retention. However, many schools lack a structured approach to preparing their faculty members to act as mentors. This quality improvement project set out to determine whether the implementation of a formal mentoring toolkit would improve nursing faculty members perceived competency to act as mentors. Guided by Bandura’s Social Cognitive Theory (SCT), Lewin’s Change Theory, and the latest evidence-based research, this project sought to answer the following question: In full-time nursing faculty members teaching in a BSN program at a small, private college (P), how does the …

Quality Improvement Project: Empowering Nurses And Medical Assistants To Improve Medication Adherence: A Screening-Based Quality Improvement Initiative, Maria Garcia

Doctor of Nursing Practice Projects

Medication nonadherence is a persistent challenge in clinical settings that negatively influences patient outcomes and is often driven by cost, access, and patient-related barriers, as widely documented in the literature. Nurses and medical assistants play a critical role in identifying these barriers; however, inconsistent screening and limited staff confidence may hinder intervention. The purpose of this quality improvement project was to evaluate the impact of implementing the Brief Medication Questionnaire (BMQ) on staff confidence in addressing medication adherence and to assess clinic-wide utilization of the tool. The project was guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change …

Optimizing Patient Adherence Through Improved Technology-Based Communication By Enhancing Staff Efficiency At An Opiate Treatment Program Clinic, Jennifer Parsons

Doctor of Nursing Practice Projects

High rates of missed appointments and unreliable follow-up remain a problem in outpatient opioid treatment clinics. This project improved the communication workflow at a methadone maintenance clinic by strengthening reminder systems and staff coordination. A needs assessment found several problems: appointment reminders were inconsistent, tracking was unreliable, and staff communication often relied on manual handoffs. The project was to test a technology-based workflow designed to improve staff communication and reduce missed appointments. The Technology Acceptance Model and Lewin’s Change Theory guided the change. The clinic implemented automated reminders, secure messaging, and clearer documentation to support daily communication. A pre-post evaluation …

Addressing Faculty Gaps In The Psychiatric Mental Health Nurse Practitioner Program, Shea Brock

Doctor of Nursing Practice Projects

Graduate nursing programs increasingly rely on adjunct faculty to sustain enrollment growth; however, inconsistent onboarding processes may contribute to variability in faculty preparedness and job satisfaction. The purpose of this quality improvement project was to implement a standardized adjunct faculty education program and evaluate its impact on adjunct faculty knowledge and job satisfaction within an online Psychiatric–Mental Health Nurse Practitioner (PMHNP) program. A quantitative, quasi-experimental one-group pre–post design was utilized. Six adjunct faculty members (n = 6) completed a 10-item EXXAT Knowledge Survey and a 10-item Faculty Satisfaction Survey before and after participation in a structured one-hour education session focused …

Quality Improvement Project: Integrating Modified Early Warning Score (Mews) Criteria Into A Local Community College's Nursing Curriculum, Breanna C. Bell

Doctor of Nursing Practice Projects

There is an international priority for early recognition of patient deterioration with adequate responses to facilitate patient safety. The modified early warning score (MEWS) tool is commonly used to identify and respond to acute patient deterioration, so it is effective to educate nursing students on its use to influence their future practice. However, there is a lack of a curriculum to integrate MEWS criteria for associate degree in nursing (ADN) students at a local community college. This quality improvement project aimed to enhance ADN faculty’s self-efficacy and ability to integrate MEWS criteria into the didactic curriculum at a community college …

Quality Improvement Project: Leveling Pharmacology: A Faculty Development Initiative, Allison Berg

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to address limited faculty self-efficacy in developing higher-level, competency-based pharmacology questions for clinical quizzes within an Associate Degree in Nursing (ADN) program. A faculty needs assessment identified an overreliance on recall-based pharmacology assessments, contributing to gaps in students’ clinical reasoning and medication competency. Guided by Bandura’s Theory of Self-Efficacy and Lewin’s Change Theory, a structured faculty development session was implemented to improve faculty confidence and skills in writing application-based pharmacology questions. A pre- post intervention design was used with ADN faculty participants (N = 5) at a …

Improving Lunch Break To Enhance Nurse Happiness And Job Satisfaction, Evelyn O. Dumkwu

Doctor of Nursing Practice Projects

Nurses frequently forgo scheduled lunch breaks due to high workload demands, inadequate staffing, and organizational cultures. Consistently skipping breaks has been associated with reduced happiness and lower job satisfaction, which may ultimately compromise the quality of patient care. This quality improvement (QI) project examined whether the structured observance of scheduled lunch breaks enhances nurses’ subjective happiness and job satisfaction. Guided by Lewin’s Change Theory and the Donabedian Theoretical Framework and implemented using the Plan–Do–Study–Act (PDSA) framework, the project employed a quasi-experimental pre–post design during a six-week implementation period. Ten full-time nurses participated in the project. Investigator-designed Subjective Happiness and Job …

Quality Improvement Project: Effectiveness Of Staff Education On Fall Prevention, Theresa Oahre Okoyomo

Doctor of Nursing Practice Projects

Falls increase injury and mortality rates and decrease patients' quality of life. Hospital falls also incur enormous financial burdens on hospitals. In 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for fall-related injuries. The problem addressed in this quality improvement project was staff confidence in fall prevention and hospital fall rates. The purpose is to improve staff confidence and reduce fall rates by 95 % within six weeks. The 2025 CDC/STEADI Algorithm for Fall Risk Screening, Assessment, and Intervention was the program of choice because it aligns with the hospital's fall-prevention policy. This project design is …

Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish

Doctor of Nursing Practice Projects

Medication administration errors remain a persistent threat to patient safety in emergency department settings, where high acuity, rapid throughput, and workflow interruptions increase vulnerability to preventable adverse events. The purpose of this Doctor of Nursing Practice quality improvement project was to increase medication-safety knowledge scores by at least 10% and reduce medication administration error rates by 20% within eight weeks among registered nurses in a freestanding emergency department in South Texas. The project was grounded in Lewin’s Change Theory as the theoretical framework and implemented using the Plan–Do–Study–Act quality improvement model. A quasi-experimental, single-group pretest–posttest design was used with a …

Quality Improvement Project: Reducing Test Anxiety: Faculty Training For Supporting Students, Chichi Markham

Doctor of Nursing Practice Projects

Test anxiety significantly affects nursing students’ academic performance and well-being. Emotional Freedom Techniques (EFT) offer a non-pharmacological method for alleviating anxiety; however, research on faculty-centered approaches in nursing education is limited. The purpose of this quality improvement project is to evaluate the impact of EFT training on nursing faculty’s knowledge, attitudes, and confidence regarding test anxiety, as well as on student exam performance. Guided by Lewin’s Change Theory, Stetler’s Model, and the Plan-Do-Study-Act (PDSA) cycle, the initiative aimed to enhance faculty capacity to identify and address test anxiety within a prelicensure nursing program. A pre-post quality improvement design involved faculty …

Quality Improvement Project: Enhancing Nurse Communication, Courtesy, And Respect At The Bedside, Rachel Kemp

Doctor of Nursing Practice Projects

Effective communication is key to the nurse-to-patient relationship, patient outcomes, and patient satisfaction. The literature widely shows that barriers such as increased workplace violence and fear and biases within patient interactions hinder communication. This quality improvement project aimed to enhance nurse-to-patient communication, using an evidence-based tool, and leveraged Foli’s Theory of Nurses’ Psychological Trauma to explain and predict barriers. Success is measured by improvement of patient experience in the three nursing domains; courtesy and respect, listen to you, and explain in a way you understand. Lewin’s Change Theory and the plan, do, study, act (PDSA) framework was used to promote …

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 …

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 …

Reducing No-Show Rates In A Rural Family Medicine Clinic Through Personal Phone Call Reminders, Joyce Bumgardner

Doctor of Nursing Practice Projects

Background: Missed patient appointments cost the healthcare industry billions annually, reducing provider accessibility and practice revenue. At a rural family medicine office in western Lincoln County, North Carolina, new patient no-show rates exceeded 10%, surpassing the healthcare system’s goal of 5% or less. Automated appointment reminders via text, phone, and email were already in place, but did not adequately address the problem. New patient appointments occupy a 40-minute time slot, twice that of established patients, increasing the impact of each missed appointment.

Purpose: The purpose of this quality improvement project was to determine whether personal phone call reminders made with …

Gratitude Journaling And Mindfulness To Mitigate Burnout In Mental Health Staff, Jennifer Davis

Doctor of Nursing Practice Projects

Burnout among mental health professionals in inpatient behavioral health settings negatively affects staff well-being, job satisfaction, and patient care quality. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the effectiveness of an 8-week mindfulness and gratitude journaling program implemented on a rural behavioral health unit in North Carolina. Guided by Jean Watson’s Theory of Human Caring, the intervention aimed to enhance resilience and workplace wellness through daily mindfulness and reflective journaling practices. A repeated cross-sectional design using anonymous pre- and post-intervention surveys was conducted with 30 staff participants. Thirty participants enrolled in the study, and 24 completed the …

Enhancing Clinical Judgement In Pre-Licensure Nursing Students Through Active Learning Strategies Of Unfolding Case Studies And Simulations For Postpartum Hemorrhage, Lisa M. Alley

Doctor of Nursing Practice Projects

New graduate nurses lack the appropriate clinical judgement to provide optimal, safe, quality care, as evidenced by the report of errors in health care (Rodziewicz et al., 2024). The purpose of this project was to provide an evidence-based intervention that used an unfolding case study and simulation to further develop clinical judgement among undergraduate nursing students in a rural ADN program. The project used a pre-test and post-test to measure students' improvement prior to versus after the learning experience and debrief. This project also introduced a DASH tool, which is a debriefing assessment for simulations in healthcare, to help students …

Enhancing Mass Casualty Incident Preparedness: Bridging The Gap Between Education And Practice, Emily M. Coggins

Doctor of Nursing Practice Projects

The increasing amount of mass casualty incidents (MCIs), such as natural disasters, large-scale emergencies, and active shooter events, has emphasized the need for healthcare professionals to respond effectively. Traditional undergraduate nursing curriculum often offers limited opportunities for students to practice disaster preparedness through simulated experiences. This DNP project was created to evaluate the effectiveness of implementing an MCI training simulation to increase the confidence and competence of senior pre-licensure nursing students when responding to a mass casualty event. The project implemented a 1-day, simulation-based MCI event for senior nursing students enrolled in an Adult Health II course. The event included …

Senior Heart Health Facilitating Hypertension Management, Heather Hodgens Lupo

Doctor of Nursing Practice Projects

Hypertension affects approximately 70% of adults aged 65 years and older and remains a leading contributor to cardiovascular morbidity and mortality in the United States, highlighting the need for effective community-based hypertension management interventions. Despite the availability of evidence-based guidelines, gaps in education and self-management persist among older adults. This Doctor of Nursing Practice (DNP) quality improvement project, Senior Heart Health: Facilitating Hypertension Management, was designed to improve hypertension-related knowledge among adults aged 55 years and older through a structured, community-based health coaching intervention.

The project was implemented in a rural community and consisted of four weekly educational sessions delivered …

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 …

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 …

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 …