Medicine and Health Sciences Commons^™

Quality Improvement Project Educating Nursing Faculty On The Lasater Clinical Judgment Rubric In Simulation, Tiffany Shivers

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance nursing faculty preparedness in simulation-based education by increasing knowledge and self-efficacy using the Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental, one-group pre-/post-intervention design was used to evaluate outcomes among ten faculty participants. The intervention consisted of an educational session introducing the LCJR and structured debriefing techniques. Data were collected using a knowledge assessment and the General Self-Efficacy Scale. Descriptive statistics and the Wilcoxon Signed-Rank Test were used to analyze changes in scores. Results demonstrated statistically significant improvements in both knowledge (Z = –2.805, p = .005) and self-efficacy (Z = –2.666, p = …

Impact Of A Mentorship Program On School Nurse Confidence, Shanna Groom

Doctor of Nursing Practice Projects

The prevalence of chronic health conditions in children has risen in recent years. As a result, school nurses are now expected to manage medically fragile students while also responding to acute and emergent health issues. This increasing complexity adds extra demands to school nurses, emphasizing the need for strong clinical decision-making skills and confidence. Mentorship programs have been proven to increase the confidence of nurses and are a core essential of the national standards and framework for school nurses. The problems addressed by this project were the lack of a mentorship program in a large school district for newly hired …

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

Doctor of Nursing Practice Projects

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

Purpose: This project aimed to evaluate whether implementing a …

National Patient Safety Goals: Reducing Health Care Disparities In Adult Patients With Alcohol Misuse, Jolie M. Carpenter

Doctor of Nursing Practice Projects

Background: An estimated 76 million people worldwide suffer from alcohol use disorder, accounting for almost two million deaths annually. The Joint Commission has made it a requirement to screen all patients admitted to an inpatient facility for health-related social needs, including alcohol use. By doing so, outpatient resources can be provided appropriately.

Purpose: The facility of interest does not currently have a discharge follow-up protocol. The purpose of this project was to implement an evidence-based protocol to follow-up one week after discharge to determine if patients accessed the community resources provided for alcohol use disorder and to determine whether the …

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …

Implementing A Screening Tool To Increase Palliative Care Referrals For Patients With Metastatic Cancer, Rebecca N. Hegwood

Doctor of Nursing Practice Projects

Background: Palliative care (PC), when prescribed early for patients with metastatic cancer, has proven beneficial to the oncology patient and family by improving quality of life, decreasing stressors, and preventing premature discontinuation of therapy.

Purpose: This Doctor of Nursing quality improvement project aimed to determine if implementing a screening tool for patients newly diagnosed with metastatic cancer would increase PC referrals.

Project Design: The Five Item Palliative Care Screening Tool evaluated patients with a new metastatic cancer diagnosis. Secondary data was used to initiate a PC referral if the patient scored a five or greater on the screening tool. Project …

Implementation Of A Triage Assessment Area To Decrease Left Without Being Seen Rates In The Emergency Department, Margaret Mary T. Steed

Doctor of Nursing Practice Projects

Background: Left without being seen (LWBS) is a concern for emergency departments (EDs) nationwide. LWBS involves patients who sign into the ED and leave prior to being seen by a medical provider. LWBS has been linked to increased wait times in the ED.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project is to aid with decreasing LWBS rates in a local ED. Many tools aid with decreasing LWBS rates, including nurse-initiated protocols and standardized order sets. Despite available tools, LWBS rates remain elevated at 0.95% for the local ED.

Project Design: The evidence-based DNP quality improvement project …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Improving The Detection Of Refractive Errors In First And Third Graders, Tameka J. Bolden

Doctor of Nursing Practice Projects

Background: Vision is a crucial component of the learning process, with academic tasks being heavily dependent on visual acuity. Undetected or diagnosed visual impairments can significantly alter a student’s educational performance and overall development. Currently, in Alabama, kindergarten, second, and fourth grade students are the only students to receive routine vision screenings; therefore, regular screening for visual acuity and eye issues is critical for school health programs. Early screening, diagnosis, and correction of refractive errors prevent permanent visual impairment and support academic success by reducing educational barriers and delayed cognitive impairment.

Purpose: This project aims to improve the early detection …

Influenza And Chronic Obstructive Pulmonary Disease: Correlating Adult Immunization With Exacerbation Reduction After Implementation Of The Global Initiative For Obstructive Lung Disease Recommendations In A Rural Clinic, Jessica Semyonova

Doctor of Nursing Practice Projects

Background: Patients with chronic obstructive pulmonary disease (COPD) may experience exacerbations of the disease, leading to disease progression, decreased lung function, increased mortality, and decreased quality of life. However, one of the clinician’s best tools in preventing exacerbations may be the distribution of annual influenza immunizations.

Purpose: This project aimed to determine whether implementing an influenza vaccination protocol would increase influenza vaccination uptake and decrease COPD exacerbation rates.

Project Design: An influenza vaccination protocol was implemented over an eight-week period. During that time, data was gathered and compared to data from the previous year when a vaccination …

Enhancing Patient Outcomes: The Sepsis Navigator Approach, Temeka L. Parker

Doctor of Nursing Practice Projects

Background: Sepsis is the leading cause of hospital mortality, accounting for over $20 billion dollars in total healthcare costs and more than 5 million deaths annually worldwide. The increased burden of sepsis led the Centers for Medicare and Medicaid (CMS) to institute a quality core measure known as the Severe Sepsis and Septic Shock Management Bundle (SEP-1) as a protocol for sepsis treatment. CMS reports national SEP-1 compliance at 62% and 61% for Alabama. The undisclosed project site reports a much lower SEP-1 compliance average of 49% over six months. Compliance with the SEP-1 bundle improves overall patient outcomes and …

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

Doctor of Nursing Practice Projects

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

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

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

Utilizing Text Messaging To Increase Annual Mammogram Screening Compliance, Lacey B. Santa Cruz

Doctor of Nursing Practice Projects

Background: Routine mammography can lessen breast cancer deaths, but many patients do not follow the current screening guidelines. Limited access to mammography and insufficient awareness lead to missed screening appointments.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to improve annual mammogram adherence among women aged 40-74 by implementing an electronic medical record (EMR)-based text reminder system.

Project Design: Secondary patient data was collected from a privately owned, rural family practice clinic. Using the Mobilize-Assess-Plan-Implement-Track (MAP-IT) quality improvement framework, the project implemented a text message reminder intervention through the EMR. Eligible patients received a text reminder …

Decreasing Burdensome Transitions In Hospice Care By Increasing Nursing Visits, Kristin S. Rivers

Doctor of Nursing Practice Projects

Background: Burdensome transitions occur when hospice patients discontinue hospice services to seek hospital treatment, often disrupting end-of-life goals and creating distress for patients and caregivers. These transitions continue to rise throughout the country, highlighting the need for strategies to support patients in remaining at home throughout the dying process.

Purpose: This quality improvement project aimed to decrease hospital transitions by increasing nursing visits for hospice patients at high-risk for burdensome transitions.

Project Design: This quality improvement project used a Plan-Do-Study-Act methodology to form and implement an intervention to reduce burdensome transitions. Patients were already identified as low or high-risk …

Quality Improvement Project Reducing Pediatric Anesthesia In Magnetic Resonance Imaging: The Role Of Preparedness And Education, Rachel Turner

Doctor of Nursing Practice Projects

Pediatric hematology-oncology patients undergo general anesthesia (GA) for various medical procedures, including magnetic resonance imaging (MRI) scans. Overexposure to GA increases the potential for long-term neurocognitive effects in pediatric patients. Despite the growing research literature on GA-related neurotoxicity and the Food and Drug Administration's (FDA) warnings, advanced practice providers (APP) often lack the knowledge to advocate for and support reductions in pediatric GA use. The Doctor of Nurse Practice (DNP) quality improvement (QI) project aimed to reduce unnecessary GA in pediatric hematology-oncology patients undergoing MRI scans by addressing the primary clinic APPs' knowledge deficits through interprofessional education (IPE). Structured in …

Quality Improvement Project Impact Of Weekly Mentorship On Compassion Fatigue In Critical Care Nurses, Susan Livengood

Doctor of Nursing Practice Projects

Compassion fatigue is defined as the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period. Without proactive intervention, compassion fatigue will continue to affect healthcare workers, leading to dissatisfaction in the workplace. Mentorship is an intervention that has been identified for improving the incidence of compassion fatigue. This quality improvement project implemented and evaluated a mentorship program for critical care nurses in a 227-bed acute care facility that has a 36-bed intensive care unit. The project evaluated the impact of weekly mentoring sessions on compassion fatigue in critical …

Quality Improvement Project Educating Family Of Patients Dealing With Substance Use Disorder, Emmanuella Edekobi

Doctor of Nursing Practice Projects

Substance Use Disorder (SUD) creates significant hardships for individuals and their families. Although families play a vital role in recovery, they may not know how to provide effective support. To address this, a Doctor of Nursing Practice (DNP) quality improvement project introduced a structured educational program for non-professional caregivers at an outpatient psychiatric clinic. The goal was to enhance caregivers' confidence and readiness to support their loved ones during recovery (Filiz & Polat, 2022). Participants completed the General Self-Efficacy Scale (GSE) before and after the intervention. Statistical analysis showed a significant improvement in confidence (t(9) = -26.00, p < .001, Cohen's d = 8.22), supported by the Wilcoxon Signed-Rank Test (z = -2.88, p = .004) (Rezaie et al., 2022). The project was grounded in Bandura’s Social Cognitive Theory, using observational learning, reinforcement, and real-life examples. Caregivers gained practical strategies, emotional support, and a clearer understanding of their role (Mardani et al., 2023). Initial uncertainty gave way to increased comfort through group support. These findings suggest that even low-cost, brief interventions can strengthen caregiver self-efficacy. Incorporating family education into addiction treatment may improve outcomes in outpatient mental health settings (Kellar & Kelvin, 2020).

Quality Improvement Project Improving Nurse Self-Efficacy In Completing Person-Centered Care Plans, Divya Iype

Doctor of Nursing Practice Projects

Person-centered care planning (PCCP) is a cornerstone of psychiatric nursing practice, yet many nurses lack the training and confidence to implement it effectively. This quality improvement project addressed a practice gap in nurse self-efficacy regarding PCCP completion at an acute psychiatric hospital. A care plan completion rate of 88%, below the institutional benchmark of 100%, prompted an intervention. This project’s purpose was to enhance nurse self-efficacy in implementing PCCP by providing focused training on trauma-informed care, cultural competence, and person-centered care planning. The project used a pre-post intervention design to assess the impact of the intervention, with self-efficacy measured using …

Quality Improvement Project Implementing A Hand Hygiene Compliance Program, Daisy Jean-Pierre

Doctor of Nursing Practice Projects

Hand hygiene remains a cornerstone of infection prevention in healthcare, yet gaps in compliance persist among nursing staff, contributing to preventable healthcare-associated infections (HAIs) and patient harm. The purpose of this Doctor of Nursing Practice (DNP) project, conducted at Piedmont Henry Hospital, was to implement and evaluate an educational intervention targeting nurse managers, with the aim of enhancing their knowledge, self-efficacy, and leadership in promoting hand hygiene compliance. The project addressed the identified problem of inconsistent hand hygiene practices among frontline staff, which was linked to insufficient leadership engagement and ongoing barriers such as time constraints and resource limitations. The …

Quality Improvement Project The Impact Of Increased Use Of High-Fidelity Nursing Simulation On Transfer Of Knowledge And The Correlation With Course Pass Rates, Debra Kilcrease

Doctor of Nursing Practice Projects

Ongoing nursing shortages and limited clinical preceptor availability have made it increasingly difficult for nursing programs to secure traditional clinical placements. In response, simulation-based learning (SBL) has gained support as an evidence-based strategy to supplement clinical education while maintaining transfer of knowledge. This quality improvement project examined whether increasing SBL hours, as a partial replacement for traditional clinical hours, impacted course pass rates in a practical nursing program. Course pass rates served as an indicator of knowledge transfer. Guided by the Jeffries Simulation Theory, the intervention emphasized learner engagement, structured simulation design, and debriefing to support clinical reasoning. A retrospective, …

Quality Improvement Project Improving Employee Satisfaction And Retention Through A Structured Training Process, Dawn Lundgren

Doctor of Nursing Practice Projects

The DNP project aimed to evaluate the impact of a structured new-hire training program on employee retention and job satisfaction within a hospice organization. Insufficient training for new employees can lead to a high staff turnover rate, stress, decreased job satisfaction, and poor quality of care. The quality improvement project utilized a pre-post intervention design over an eight-week period, comparing retention rates and job satisfaction scores before and after project implementation. Employee retention was measured as a binary outcome (retained or left), and job satisfaction was assessed through a seven-item survey rated on a five-point Likert scale. A total of …

Quality Improvement Project Impacting Provider Efficiency And Burnout With Standardized Ordering Tools, Carly Meredith

Doctor of Nursing Practice Projects

The adoption of electronic health record (EHR) systems promises better interoperability, transparency, patient safety, and care quality. However, concerns about increased provider stress and burnout are rising, suggesting a link between burnout and EHR use. This project aimed to evaluate whether improving EHR efficiency could reduce burnout rates. While literature highlights the need for enhanced training, effective methods remain unclear and challenge whether there is data supporting improvements or merely the perceived usefulness of these activities as identified through the Technology Acceptance Model. For this project, a preference list was created for commonly used orders with pre-selected defaults to streamline …

Quality Improvement Project Improving The Management Of Diabetes In A Primary Care Setting Through Staff Education, Chibuzo Okereke

Doctor of Nursing Practice Projects

Managing chronic disease, such as type 2 diabetes, requires effective patient education. This quality improvement project aimed to improve staff knowledge and confidence in delivering diabetes education using the evidence-based teach-back method. Eight staff members (physicians, nurse practitioners, nurses, medical assistants, and a clinic manager) of a suburban primary care clinic in Houston, Texas, were involved in the project by participating in structured educational sessions. The Always Use Teach-Back Conviction and Confidence Scale (CCS) and a Diabetes Knowledge Test 2 (DKT2) were validated instruments to measure data pre- and post-intervention. A quasi-experimental pre- and post-test design was used, and the …

Enhancing Pre-Licensure Bsn Students' Clinical Knowledge And Confidence In Blood Transfusion Via Postpartum High-Fidelity Simulation, Tresia Rouse

Doctor of Nursing Practice Projects

Blood transfusion administration is a complex nursing skill registered nurses require in bedside settings, regardless of experience level. Nursing students are expected to be practice-ready upon graduation. A significant concern in nursing academia is the insufficient exposure to administering blood products, which many pre-licensure nursing students lack in clinical and educational environments. This gap in nursing curricula can compromise students’ preparedness to perform this skill in real-world scenarios. The core purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to enhance clinical knowledge and impact self-confidence regarding blood transfusion administration and management, specifically by implementing a …

Quality Improvement Project Evaluating The Impact Of Specialized Blood Pressure Measurement (Bpm) Training On Nursing Faculty's Knowledge And Self-Efficacy In Teaching Bpm, Heba Sadaka

Doctor of Nursing Practice Projects

Accurate blood pressure measurement (BPM) is crucial for the proper diagnosis and management of hypertension. However, BPM errors are common and may lead to under- or overtreatment, negatively impacting patients. The purpose of this quality improvement (QI) project was to retrain nursing faculty on BPM practices based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) clinical guidelines. A quasi-experimental pre-/post-intervention design was used. The intervention consisted of an online specialized training video developed by the Idaho Diabetes, Heart Disease, and Stroke Prevention Program. Nursing faculty’s BPM knowledge and self-efficacy were measured before and after the training using the …

Quality Improvement Project Enhancing Self-Efficacy In Managing Patient No-Shows: A Staff-Focused Intervention, Aaron Wabang

Doctor of Nursing Practice Projects

No-shows are widely reported in behavioral health venues. They hinder continuity of care, decrease clinic efficiency, and compromise patient care. The solution requires addressing patients’ behavior and internal facility processes. This quality improvement (QI) project aimed to reduce no-show rates by providing staff with tools and enhancing their self-efficacy in managing appointments. The project was conducted in a rural East Texas behavioral clinic. Clinic staff reported challenges with patient reminders, scheduling, and follow-up issues that cause increased no-shows. The QI project aimed to empower staff by providing evidence-based scheduling strategies and decision support resources to enhance their confidence and attendance …

Quality Improvement Project Enhancing Communication Perceptions Among Nursing Staff In The Operating Room, Denis Awu

Doctor of Nursing Practice Projects

Effective communication in the operating room (OR) is crucial for ensuring patient safety and optimal surgical outcomes. Communication breakdowns among surgical teams are a leading cause of sentinel events and procedural errors. This quality improvement (QI) project aimed to enhance communication perception among OR nursing staff through a structured training program focused on verbal, non-verbal, active listening, and communication under pressure. Grounded in Social Cognitive Theory and implemented using both Kotter’s 8-Step Change Model and the Plan-Do-Study-Act (PDSA) cycle, the intervention included interactive workshops and simulation exercises delivered over a six-week period. A total of 50 registered nurses participated in …

Quality Improvement Project Enhance Self-Efficacy And Knowledge In Pediatric Emergency Care For Nurses In An Adult Acute Care Facility, Tiffany Daniel

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project addresses the significant gap in emergency nursing preparedness for managing pediatric emergencies in adult-focused emergency departments. A quasi-experimental pre/ post intervention design was used to implement a pediatric-specific training intervention consisting of didactic education and simulation-based learning. A total of 87 night shift ED nurses participated. Knowledge and self-efficacy were measured using pre- and post-intervention surveys and assessments. The training equipped nurses with critical skills to manage pediatric emergencies more confidently and competently, addressing both clinical and emotional barriers. Knowledge scores significantly improved, t = -20.45, p < 0.001, with post-test means rising from 5.56 (SD = 1.58) to 9.03 (SD = 0.32). Post-intervention self-efficacy scores also increased significantly, t(86) = -21.57, p < .001, indicating greater confidence in pediatric emergency care. These findings validate the effectiveness of structured pediatric emergency training in enhancing nurse competency and self-efficacy. Lewin's change theory and Newman’s systems model guided this quality improvement project. The results support the continuation of the program in population-specific education and simulation as part of annual competency development. This project demonstrated that targeted pediatric training improves nurse preparedness and has the potential to enhance patient outcomes in a setting traditionally focused on adult care.

Quality Improvement Project Supporting Novice Nurse Faculty Through Mentorship, Lorna Deardeuff

Doctor of Nursing Practice Projects

Current literature suggests that a lack of support to assist novice faculty in their socialization to academia can lead to increased attrition among faculty members. However, novice nursing faculty, when transitioning from the role of clinical expert, require much support to successfully meet the demands of preparing nursing students. This quality improvement project aimed to develop and implement a structured novice nurse faculty mentorship program, with the use of a mentorship toolkit, to improve job satisfaction levels and the intent of the novice faculty members to remain in their current positions. This quasi-experimental project utilized a pre-and-post intervention survey designed …

Enhancing Education In Nursing Skills: The Impact Of Simulation Use On Faculty Self -Efficacy, Annie Kyle

Doctor of Nursing Practice Projects

This quality improvement (QI) project aimed to improve nursing faculty self-efficacy in teaching nursing skills using medium- and high-fidelity simulation. The problem addressed was the increasing number of students requiring multiple attempts to pass skills checkoffs, with some ultimately being withdrawn from the program. Faculty at the project site reported a lack of training and confidence in utilizing simulation technology effectively. A quasi-experimental design was used with a single group of full-time faculty (n=6), who received simulation training and completed the Self-Efficacy Towards Teaching Inventory for Nurse Educators (SETTI-NE) before and after the intervention. The data analysis was conducted using …