Medicine and Health Sciences Commons^™

Quality Improvement Project: Nursing Education In Relation To The Use And Effect Of Neuromuscular Blockade Agents, Lauren Danielle Bowen

Doctor of Nursing Practice Projects

Neuromuscular blockade agents are a medication class that requires education and knowledge to ensure protocols, assessments, and tools are utilized in acute care facilities. Quality improvement (QI) project focused on the use of neuromuscular blockage agents to ensure nursing staff, who have direct patient contact, received proper education. A quasi-experimental, pre-post project intervention design was used to evaluate evidence-based practice interventions with a literature review, assessment, and tools used by the population studied. Aim and purpose of the QI project was to increase nursing staff educational knowledge on the use of neuromuscular blockade agents in patients who are sedated requiring …

Quality Improvement Project: Standardized Medication Reconciliation Process Training: A Path To Improve Staff Medication Confidence, Christologus Obi

Doctor of Nursing Practice Projects

Medication reconciliation represents a critical safety process in psychiatric healthcare, where medication discrepancies affect up to 67% of hospitalized patients, with 30-40% potentially causing significant harm. This quality improvement project implemented a standardized medication reconciliation training program at a Texas mental health facility to address knowledge and confidence gaps among clinical staff. Using Kotter's 8-Step Change Model and the Iowa Model of Evidence-Based Practice, this quasi-experimental pre-post intervention study delivered three 30-minute interactive sessions to 12 multidisciplinary healthcare professionals. The evidence-based intervention introduced a 3-phase reconciliation model focused on obtaining accurate medication histories, documentation, and discrepancy resolution. Data collection used …

Assessing The Impact Of Cultural Competence Training For Providers Serving Native Americans, Chinazo Obi

Doctor of Nursing Practice Projects

The United States is a culturally diverse nation, yet many healthcare providers report challenges in delivering care that respects cultural values and traditions. Within mental health settings, this gap is especially concerning for Native American populations, who experience disproportionately high rates of mental health conditions and face barriers to culturally responsive care. The purpose of this quality improvement project was to assess the impact of a cultural competence education and training intervention on mental health providers’ knowledge and self-efficacy in delivering culturally competent care to Native American patients. Guided by Leininger’s Culture Care Theory of Diversity and Universality and the …

Quality Improvement Project: The Impact Of Staff Education On Utilization Of The Phq-9 Tool And Follow-Up Management Protocol, Shuntak Jerideau

Doctor of Nursing Practice Projects

Depression is a prevalent mental health disorder that affects daily functioning. Timely screening enables the identification of symptoms, monitoring treatment efficacy, and informs additional treatment such as referrals. The practice site reported low screening rates of patient’s post-psychiatric hospitalization, which was attributed to inadequate knowledge of the PHQ-9 tool. The purpose of this quality improvement project was to evaluate the impact of staff education on the utilization of the PHQ-9 tool and follow-up management protocol in a mental health clinic. A quasi-experimental design method was used in an outpatient mental health clinic. Pretest knowledge of the PHQ-9 was obtained from …

Quality Improvement Project: Impact Of Simulation Training On The Self-Efficacy Of Registered Nurses During A Code Stroke, Kakeya James

Doctor of Nursing Practice Projects

Self-efficacy levels affect decision-making skills and overall confidence in handling critical situations. However, knowledge gaps often hinder the maintenance of high self-efficacy. (Farčić, et al., 2020). The project site provides limited training opportunities that may not adequately prepare registered nurses with the confidence and skills needed to respond to stroke emergencies, potentially causing delays in patient care and adverse health outcomes. As a result, the quality improvement project aims to examine how simulation-based training impacts registered nurses’ self-efficacy in managing stroke emergencies. The project employed a quasi-experimental pretest/posttest design and was guided by the Plan-Do-Study-Act (PDSA) cycle, the Jeffries Simulation …

Quality Improvement Project: Effects Of Ongoing Clinical Education Training On Nursing Faculty’S Self-Efficacy In Clinical Education, Sarah Ferguson

Doctor of Nursing Practice Projects

Clinical education is essential for bridging theory and practice in nursing education, yet many clinical instructors transition from expert bedside nurses to novice educators without adequate orientation and training. This quality improvement project examined the effects of ongoing clinical education training on nursing faculty self-efficacy at a satellite nursing school in North Texas. This project, guided by Patricia Benner’s Novice to Expert framework and Lewin’s change model, aimed to determine whether continuous professional development throughout the term would increase clinical faculty confidence compared to standard onboarding alone. A descriptive pre/post design was used, with the Clinical Nursing Teacher Self-Efficacy Scale …

Quality Improvement Project: Improving Providers’ Self-Efficacy In Facilitating Mat Usage Through Educational Training, Joshua W. Moore

Doctor of Nursing Practice Projects

Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD) are common diseases treated in detox facilities around the world. Medication-assisted treatment (MAT) is the most effective treatment for OUD and AUD. Despite the need for MAT, many providers do not prescribe lifesaving medications due to a lack of knowledge and confidence. The purpose of this quality improvement project at a local detox facility is to answer the question: What effect on providers’ self-efficacy in facilitating MAT usage upon discharge does educational training have? Under the Social Cognitive Theory (SCT), self-efficacy was targeted using the Plan-Do-Study-Act (PDSA) change model. The aim …

Quality Improvement Project: Improving Competency Of Behavioral Health Technicians In Vital Sign Technique, Ashley Buescher

Doctor of Nursing Practice Projects

Untreated hypertension or hypotension can lead to serious health problems, including death. Proper technique is essential when obtaining a blood pressure reading to improve patient safety. The goal of the quality improvement project was to improve competency in blood pressure technique by implementing standardized training. The initiative addressed discrepancies in blood pressure readings in the intake unit of a behavioral health hospital. Using the Stetler Model of Evidence-Based Practice and John Kotter’s 8-Step Change Model, a single sample, pre-post design was implemented over 4 weeks. The American Heart Association's blood pressure guidelines and the Teach-Back Observation Tool were used in …

Quality Improvement Project: Improving Patient Appointment Adherence Through Staff Education On Health Literacy, Christine A. Johnson- Nganbou Kamkeu

Doctor of Nursing Practice Projects

Non-adherence to appointments remains an impediment to health continuity. It has been especially pervasive in rural settings. Numerous scholarly articles in the healthcare literature support enhancing health literacy in organizations and training in effective communication to promote patient appointment compliance. Hence, the purpose of the quality improvement (QI) project was not only to encourage appointment compliance but also to enhance the application of the Teach-Back Method through health literacy education. The theoretical perspective and practice application, according to Lewin’s Change Theory and the PDSA approach, included a four-week intervention period, during which the Agency for Healthcare Research and Quality (AHRQ) …

Quality Improvement Project: Responding Effectively With The Use Of A Defibrillator And Crash Cart: An Educational Intervention For Medical-Surgical Nurses, Josilyn Lusk

Doctor of Nursing Practice Projects

Appropriate and timely use of a defibrillator and crash cart is essential for patient survival during cardiac arrest, yet many medical-surgical nurses report limited preparedness due to inconsistent, non-standardized training. The purpose of this DNP project is to evaluate the impact of a structured didactic and simulation-based educational intervention on nurses’ self-assessed preparedness to respond to life-threatening events and their perceptions of educational best practices. The aim of the project is to demonstrate measurable improvements in nurses’ self-reported preparedness in responding to emergent events and their perceptions of effective teaching and learning strategies. Guided by Tanner’s Model of Clinical Judgment …

Enhancing Emergency Department Staff Competency In Ultrasound-Guided Venous Access At A Rural Critical Access Hospital: A Quality Improvement Project, Ryan M. Sand

Doctor of Nursing Practice Projects

Patients meeting difficult intravenous access (DIVA) criteria often experience multiple failed intravenous (IV) access attempts, delayed diagnostics, and treatment initiation, particularly in rural emergency departments with limited resources. This quality improvement (QI) project evaluated whether targeted ultrasound-guided peripheral venous access training would improve staff self-efficacy, confidence, and self-reported procedural execution at a rural critical access hospital. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Theory, a quasi-experimental pre-/post-intervention design was implemented. Nurses and paramedics completed the validated Peripheral Intravenous Insertion Confidence Assessment before and after a didactic and psychomotor training program. Statistical analysis included an independent samples t-test …

Quality Improvement Project: Debriefing In Simulation With Improved Knowledge And Confidence, Rebecca Walker

Doctor of Nursing Practice Projects

Debriefing is a vital part of simulation and is critical to the students' learning in the simulation environment. It is essential for faculty that debriefers receive training in simulation concepts and in structuring debriefings. The purpose is to improve the simulation program at the project site by implementing a training course, and the project aims to enhance the faculty's confidence and address any knowledge gaps. The project design is a quasi-experimental study that features pre- and post-intervention surveys. Fifteen full-time nursing educators were surveyed, excluding faculty who do not teach in simulation. The intervention includes launching a SBL course and …

Quality Improvement Project Assessment Of Emergency Department Staff Knowledge On Use Of Emergency Severity Index In A Critical Access Hospital: Implementation Of Emergency Department-Based Education Program., Amanda Taylor

Doctor of Nursing Practice Projects

In rural emergency departments, accurate triage is vital to ensuring patient safety and maximizing limited resources. This quality improvement project aimed to strengthen triage practices by enhancing nurses’ understanding and confidence in using the Emergency Severity Index (ESI), a standardized tool for assessing patient acuity. Ten registered nurses at a seven-bed critical access hospital participated in a structured educational program, guided by Lewin’s Change Theory and Benner’s Novice to Expert Theory. The intervention included hands-on training, real-world scenarios, and self-assessment surveys. After the program, nurses showed significant gains in both knowledge (mean scores rose from 70.0 to 88.9, p < .001) and confidence (from 13.5 to 23.2 out of 25). While the small sample size and short timeline were limitations, the results highlight the value of ongoing education in improving triage accuracy and patient care. This project offers a practical model for rural hospitals seeking to enhance emergency nursing practice and promote consistent, evidence-based decision-making.

Policy Project: Creating An Animal Assisted Therapy Policy For A College Of Nursing, Brooke Peyton

Doctor of Nursing Practice Projects

Nursing students experience high levels of academic stress, anxiety, and burnout, which can negatively impact learning, professional development, and overall health. Evidence indicates that Animal-Assisted Therapy (AAT) has the potential to impact stress levels, improve community connection, and enhance overall well-being among nursing students. Many academic institutions lack structured policies to guide AAT programs into educational settings. The purpose of this Doctor of Nursing Practice project was to develop a formal AAT policy for the College of Nursing with standardized procedures to implement an AAT program. Rogers’ Diffusion of Innovations theoretical framework was used to guide the development of the …

Simulation Education Program For Medical Emergencies: Improving Facilitator Simulation Proficiency, Cari Kent

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project, Simulation Education Program for Medical Emergencies: Improving Facilitator Simulation Proficiency, addressed a critical gap in outpatient emergency preparedness among nursing leaders and facilitators. Despite established policies, many ambulatory care staff reported feeling unprepared to respond effectively to medical emergencies. Guided by the PICOT question, among nursing leaders and facilitators (P), how does a simulation education program in emergency care scenarios (I), compared to current education practices (C), impact simulation proficiency and effectiveness (O)? This quality improvement project evaluated the impact of structured simulation-based education on the competence of facilitators. Using a pre- and …

Quality Improvement Project Step Into Serenity: How Walking Can Ease Stress For Nursing Faculty, Stefanie Martinez

Doctor of Nursing Practice Projects

This quality improvement project explored whether incorporating scheduled walk breaks could help reduce perceived stress among accelerated Bachelor of Science in Nursing (ABSN) faculty. High levels of stress and burnout continue to affect nursing educators and contribute to faculty turnover and workforce shortages. The goal of this project was to promote physical activity as a simple and accessible approach to supporting well-being and fostering a healthier work environment. Grounded in George Engel’s Biopsychosocial Model of Health, this project introduced an educational session on faculty stress, burnout, and the benefits of walking. Participants completed the Perceived Stress Scale (PSS-10) before and …

Quality Improvement Project: Creation Of An Ebp Healthy Lifestyle Program: An Evidence-Based Development Program, Devanee Ray

Doctor of Nursing Practice Projects

Nursing education is the foundation of healthcare itself. However, several things influence nursing students’ academic success. A lack of overall health habits is a significant contributor. Generally, this lack is due to a lack of education. The goal of this quality improvement Doctor of Nurse Practice (DNP) project was to develop an educational program that addresses the identified knowledge gaps. The aim was to develop the program to promote student success and pilot-test the program to determine its impact among masters-level nursing faculty. Using Lewin’s Change Theory and Orem’s theory of self-care, the educational program was piloted over a seven-week …

Quality Improvement Project: Impact Of An Onboarding Program On Novice Nursing Clinical Adjunct Faculty Self-Efficacy, Tonie Metheny

Doctor of Nursing Practice Projects

Many nursing colleges rely on adjunct faculty to deliver the clinical curriculum (i.e., skills lab, clinical instruction, simulation, etc). Without a structured approach to orienting novice adjunct clinical nursing faculty to their roles and responsibilities, educational outcomes may be negatively impacted. Nursing literature documents the impact of a structured orientation program on novice self-efficacy. The purpose of this quality improvement project is to evaluate the impact of an orientation program on novice nursing adjunct clinical faculty self-efficacy with the Academic Clinical Nurse Educator (ACNE) core competencies. Self-efficacy was assessed using the Academic Clinical Nurse Educator Skills Acquisition Tool (ACNESAT). The …

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

Doctor of Nursing Practice Projects

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

Impact And Effectiveness Of Phq-9 Training For School Counselors On Mental Health Referrals For High School Students, Sherikee Dorice Grim Bsn, Rn, Ja’Quay Brister Dnp, Pmhnp-Bc, Margaret Harvey Phd, Aprn, Acnp, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Adolescents' mental health has worsened and become a public health issue, with depression being a primary concern. There is an urgent need for early screening, school-based referral pathways, and interventions to address common problems in high schools. Patient Health Questionnaire-9 (PHQ-9) is a validated, evidence-based tool for detecting depression; however, its systematic use in school-based counseling settings through organized training has not been studied for implementation in high schools. This review assesses the current literature on the impact and effectiveness of PHQ-9 training for school counselors on mental health referrals among high school students, with a focus on early …

Hypertension Prevention Program And Its Effects On Blood Pressure Levels Among Young Adults In A Christian Community In Southwest Michigan, Cindel Hollancid

Doctor of Nursing Practice Projects

Background

Although the majority of patients who present are adults over the age of 40 years old; with blood pressures ranging from 140/88 – 190/110 and many times higher readings, it was intriguing and important to assess whether a direct intervention, teaching young adults ages 18 – 39 years the benefits of lifestyle choices would be beneficial as a preventative measure to implement for hypertension reduction patterns as one ages. According to Hinton et al. (2019), hypertension affects 1 in 8 adults between the ages of 20 and 40 years old and is thus common among young people; with the …

Assessing The Efficacy Of The Cam-Icu Scale In Reducing Length Of Stay In The Icu: A Scoping Review, James Ray Davis Mph, Bsn, Rn, Donna Lynch-Smith Dnp, Aprn, Acnp-Bc, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

No abstract provided.

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

Doctor of Nursing Practice Projects

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

Quality Improvement Project: The Impact Of A Dedicated Education Unit On The Self-Efficacy Of First-Year Associate Degree Nursing Students, Danita Broussard

Doctor of Nursing Practice Projects

Nursing education continues to face challenges in preparing students to meet the complex demands of modern healthcare, particularly due to limited clinical placements and faculty shortages. This quality improvement project addressed the gap between classroom instruction and clinical practice by implementing a Dedicated Education Unit (DEU) model designed to impact students' self-efficacy. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether participation in a DEU impacted the self-efficacy of the first-year associate degree nursing students compared to the traditional clinical model. Guided by Bandura’s Self-Efficacy Theory and grounded in Evidence-Based Practice (EBP) principles, the project …

Implementing A Pap Smear Tracking Tool For Increased Compliance, Meghan Marie Madea Msn, Cnm, Whnp-Bc, Katherine Ferrell Fouquier Phd, Cnm, Facnm, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

The Papanicolaou “pap” smear screens for cervical cancer in women ages 21-65 with a cervix. Inconsistent locations for lab results lead to a decrease in provider efficiency, and patients are unaware of results or recommended follow-up. This quality improvement project implemented a tracking tool within the electronic medical record (EMR) in a busy midwifery clinic. The outcomes are the identification of patients overdue for pap smears, scheduling the procedure, recording of results, and patient notification with recommended follow-up.

Methods

A one-month chart review was performed of fifty gynecology patients within a midwifery clinic. Results of pap smears were located …

Quality Improvement Project Improving Faculty Support For First-Generation Rural Nursing Students, Charlotte Dowdy

Doctor of Nursing Practice Projects

The barriers to academic success among first-generation rural nursing students are substantial, including a lack of knowledge of academic resources, ineffective study strategies, and difficulty navigating the higher education system. These challenges are documented in the literature as resulting in higher attrition rates and lower graduation rates. This quality improvement project was intended to implement and analyze a faculty training module designed to increase faculty awareness and confidence in supporting first-generation rural nursing students at the project site. The project adopted a pre-post intervention design based on High-Reliability Organization principles and Lewin’s Change Model, to determine the effectiveness of targeted …

Quality Improvement Project Implementing Teamstepps 3.0: Impact On Perception Of Teamwork, Angela Allen

Doctor of Nursing Practice Projects

The clinical practice site is a rural health clinic that has experienced 28% staffing turnover in the last year, and opportunities for improvement in communication and teamwork were identified. The principal investigator (PI) used the Iowa Model Revised (IMR) as a theoretical framework and Lippitt’s change theory to promote change for the identified priority issue. TeamSTEPPS is an evidence-based program designed to improve communication and teamwork in healthcare teams with the goal of improving patient outcomes and safety. The quality improvement project utilized a quasi-experimental design with pre- and post-intervention surveys to answer the question: among staff at a rural …

Quality Improvement Project Improve Staff Knowledge On Spravato For Treatment Resistant Depression, Cynthia Barraza Guerra

Doctor of Nursing Practice Projects

Treatment-resistant depression (TRD), defined as major depressive disorder unresponsive to at least two adequate antidepressant trials, is linked to higher morbidity, diminished quality of life, and increased healthcare utilization. Spravato (intranasal esketamine), approved by the U.S. Food and Drug Administration, provides a novel mechanism of action through N-methyl-D-aspartate (NMDA) receptor modulation but requires strict safety oversight due to risks including dissociation and hypertension. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated whether a targeted educational intervention improved staff knowledge and confidence in Spravato safety protocols. Guided by Lewin’s Change Theory, Bandura’s Social Learning Theory, and implemented with …

Quality Improvement Project High-Quality Simulation Training For High-Quality Nurse Educators, Cherrelle Hawkins

Doctor of Nursing Practice Projects

The Associate of Applied Science in Nursing (AASN) faculty use simulation as a teaching modality to assist nursing students in preparing for their clinical experiences by transitioning knowledge into practice. To successfully facilitate simulations, faculty must possess knowledge and competence in facilitating simulation sessions. Faculty at the practice site lacked these characteristics due to the nonexistence of a simulation training program. This quasi-experimental quality improvement project aimed to implement formal simulation training for faculty to influence self-perceived knowledge and competence in facilitation constructed by the Adult Learning Theory and the Awareness-Desire-Knowledge-Ability-Reinforcement (ADKAR) Change Model. The PI evaluated knowledge and competence …

Quality Improvement Project De-Escalation Techniques Applied In The Classroom: A Faculty Onboarding Quality Improvement Initiative, Jennifer Lanza

Doctor of Nursing Practice Projects

The nursing shortage persists, and the lack of trained nurse educators exacerbates the issue. Adequate training of novice nurse educators transitioning from bedside to academia is essential for smooth role-transitioning, which impacts intent to stay; however, the content of the mentoring is undefined in literature. Using Bandura’s Social Cognitive theory as the theoretical framework and Havelock’s Process of Change theory, this Quality Improvement project aims to determine how providing de-escalation training adapted for the classroom impacts self-efficacy of novice nurse educators dealing with incivility in the classroom. The method includes incorporating the Plan-Do-Study-Act implementation framework for a quasi-experimental intervention which …