Medicine and Health Sciences Commons^™

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.

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 …

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 …

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 Impacting Provider Self-Efficacy And Use Of Cbt For Depression Treatment, Tony Orafunam

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement project was conducted at a mid-sized outpatient psychiatric clinic in Hempstead, New York, focusing on strengthening providers’ self-efficacy in delivering Cognitive Behavioral Therapy (CBT) to young adults (aged 19–35) diagnosed with Major Depressive Disorder (MDD). Rather than targeting MDD directly, the initiative aimed to impact provider self-efficacy and skill in CBT to improve access to evidence-based treatment and reduce the need for external referrals. Employing Bandura’s Social Cognitive Theory and the ADKAR change model, the project used a quasi- experimental, one-group pre-test/post-test design. Six advanced practice providers participated in a structured, interactive …

Quality Improvement Project Providing Accessible Evidence-Based Education To Nurses Throughout A National Healthcare System, Bailey Wells

Doctor of Nursing Practice Projects

The pursuit of ongoing professional development and learning is crucial to ensure nurses remain well-informed about healthcare trends and have access to the most up-to-date evidence-based materials. This quality improvement project aimed to implement a monthly educational series for nursing personnel within the Veterans Health Administration (VHA) through expansion of the Veterans Administration (VA) – Extension for Community Healthcare Outcomes (ECHO) program. Using Bandura’s Self-Efficacy Theory of Motivation in Psychology, participants’ previous knowledge was linked to continued professional development. The plan, do, study, act (PDSA) framework provided structure for the project, with the awareness, desire, knowledge, ability, and reinforcement (ADKAR) …

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 …

Quality Improvement Project Unlocking Critical Thinking: The Use Of Guided Reflection In Nursing Education, Alissa Wheat

Doctor of Nursing Practice Projects

Nursing education is at a crossroads as the demand for practice-ready nurses increases in a rapidly evolving healthcare environment. Despite high licensure pass rates, graduates often demonstrate gaps in clinical judgment and critical thinking, key competencies for safe nursing practice. This project addressed the problem of limited structured strategies to develop these competencies among pre-licensure nursing students in a Houston-based nursing program. The purpose was to evaluate guided reflection, implemented as a competency-based education (CBE) tool, to determine its effect on faculty perceptions of supporting critical thinking and clinical judgment. A quasi-experimental, one-group pretest–posttest design was conducted with clinical faculty …

Quality Improvement Project Improving Fall Risk Protocol Compliance Through A Structured Fall Prevention Program In A Skilled Nursing Facility, Lakeesha Jenkins

Doctor of Nursing Practice Projects

Falls remain a persistent patient-safety threat in skilled nursing facilities (SNFs). At a Dallas–Fort Worth SNF, a needs assessment identified rising unassisted falls and inconsistent protocol adherence. This quality improvement (QI) project examined whether a structured, evidence-based bundle could improve staff knowledge and fall-prevention processes and reduce falls over four weeks. Guided by Lewin’s Change Theory and implemented with Plan–Do–Study–Act (PDSA) cycles, the pre–post design engaged direct-care staff (registered nurses, licensed vocational nurses, certified nursing assistants; n = 20). The intervention included standardized risk screening with the Morse Fall Scale (MFS), targeted staff education, high-risk visual identifiers, and post-fall huddles. …

Quality Improvement Project Addressing Healthcare Provider Adherence To Diabetic Foot Exams In A Primary Care Clinic, Olaide Akinyinka

Doctor of Nursing Practice Projects

Healthcare providers performing foot examinations are a crucial component in assisting Type II diabetic patients to maintain their health. The purpose of this quality improvement project was to determine how the providers' implementation of Inlow’s 60-second Diabetic Foot screen, compared to current practice standards, impacts the number of foot exams among Type II diabetic patients at a primary care clinic over 12 weeks. Therefore, it was unknown if or to what degree the provider implementing Inlow’s 60-second Diabetic Foot Screen impacts the number of foot exams conducted compared to the current practice among Type II diabetic patients. Wiedenbach’s Helping Art …

Quality Improvement Project Simulation Orientation For Nursing Faculty, Emily Harvey

Doctor of Nursing Practice Projects

Many nursing faculty are expected to teach using SIM without adequate preparation, which can limit competence in SIM-based teaching. A university-level school of nursing identified this gap and initiated a quality improvement project to strengthen faculty readiness through a structured online orientation. The intervention used the Massive Open Online Course (MOOC) Essentials in Clinical SIMs Across the Health Professions and was guided by Benner’s Novice to Expert Model, Lewin’s Change Theory, and the Plan-Do-Study-Act cycle. A quasi-experimental pretest–posttest quantitative design was conducted with nursing faculty participants. The Facilitator Competency Rubric (FCR) assessed competence across five domains: preparation, prebriefing, facilitation, debriefing, …

Quality Improvement Project Enhancing Provider Education On Phq-9 Depression Screening To Improve Compliance, Obianuju Okafor

Doctor of Nursing Practice Projects

Depression is a leading cause of disability worldwide; however, screening in primary care remains inconsistent. Even though the Patient Health Questionnaire-9 (PHQ-9) is a validated screening tool, its use is often limited by insufficient provider training. This quality improvement (QI) project aimed to evaluate the impact of structured provider education on PHQ-9 screening practices, with the purpose of improving provider knowledge, confidence, and adherence to screening guidelines in a primary care setting. Guided by Donabedian's Model of Quality Care and Lewin's Change Theory and implemented using the Plan-Do-Study-Act (PDSA) framework, the project used a one-group pre/post design at an outpatient …

Quality Improvement Project Empowering Nursing Instructors: Faculty Self-Efficacy & Consistency In Simulation Grading, April Guerin

Doctor of Nursing Practice Projects

This quality improvement (QI) project aims to evaluate the effectiveness of structured training on the Creighton Competency Evaluation Instrument (C-CEI) in improving nursing faculty self-efficacy and grading consistency in clinical student evaluations. Inconsistent clinical grading practices among nursing faculty create barriers to reliable competency evaluation and undermine student outcomes. Guided by the Donabedian Model and Lewin’s Change Theory, with implementation structured by the Plan-Do-Study-Act (PDSA) cycle, a quasi-experimental pre-post intervention design was used. Participants include nursing faculty responsible for clinical evaluations, who completed structured C-CEI training delivered via self-paced modules in a learning management system. Faculty self-efficacy was measured using …

Quality Improvement Project Using Standardized Teaching Tools To Improve Skills Proficiency, Katrina Walker

Doctor of Nursing Practice Projects

Studies show that inconsistencies in teaching and evaluating skills proficiency in nursing programs can lead to student failure, delayed progression, and decreased faculty satisfaction. The purpose and aim of this quality improvement project was to determine whether the use of an evidence-based, standardized tool for teaching and evaluating Foley catheter insertion improved faculty satisfaction and teaching confidence compared to faculty-created checklists. The project utilized a quasi-experimental design guided by the Iowa Model of Evidence-Based Practice and Kotter’s 8-Step Change Model. The Bachelor of Science in Nursing (BSN) faculty implemented the standardized tool and completed pre- and post-intervention Likert-scale surveys measuring …

Quality Improvement Project Supporting The Novice Nurse Educator Through Onboarding Orientation Practices, Samantha Fouts

Doctor of Nursing Practice Projects

There is a growing concern about a nursing faculty shortage. Many reasons exist, but one primary reason is a lack of support. Literature supports the argument that there is a lack of support for novice nursing faculty during their transition from expert clinician to novice educator. Literature also supports the need for formalized mentor programs, but gaps exist in determining successful models. This quality improvement project aimed to measure the impact on novice nursing faculty skill acquisition in a revised mentor program. The previous mentor program was outdated and lacked consistency. The program was updated using Benner’s novice-to-expert theory and …

Quality Improvement Project Enhancing Nursing Faculty Competency In Dimensional Analysis: A Quality Improvement Initiative, Kimberly Mcdonald

Doctor of Nursing Practice Projects

Medication dosage calculation errors remain a persistent concern in nursing education and practice, often tied to inconsistent teaching methods that leave students unsure and underprepared. Dimensional analysis (DA) has been shown to improve accuracy and confidence in solving dosage problems, yet many faculty have not received structured training in this method. To address that gap, a quality improvement (QI) project introduced a six-week DA training program for nursing faculty in a pre-licensure program. The initiative was guided by the Roy Adaptation Model and Bandura’s Self-Efficacy Theory, with change supported through Kotter’s 8-Step Model and the Plan-Do-Study-Act framework. Using a quasi-experimental, …

Quality Improvement Project Integration Of Mentoring Into A Registered Nurse Transition To Practice Program, Sherry L. Roberson

Doctor of Nursing Practice Projects

New graduate nurses (NGNs), who constitute the majority of the nursing workforce, face significant challenges due to high patient acuity, staffing shortages, and long shifts, resulting in risks of burnout, turnover, and impaired patient care. Transition to practice programs, or nurse residency programs (NRPs), are evidence-based solutions designed to support NGNs effectively in their transition to the profession. A key component of NRPs is mentoring, which provides longitudinal support to ease this transition. Research shows that mentorship is associated with increased feelings of support, self-confidence, resilience, and competence among NGNs, while also reducing stress. A needs assessment at the project …