Medicine and Health Sciences Commons^™

Quality Improvement Project Impacting Healthcare Providers’ Knowledge And Self-Efficacy On Peripheral Artery Disease In An Outpatient Cardiovascular Clinic, Nikki Naphaphone Phanyoraj

Doctor of Nursing Practice Projects

Peripheral artery disease (PAD) affects over 200 million people worldwide and contributes to functional limitations, decline in quality of life, and increased risk of cardiovascular morbidity and mortality. Failure to effectively screen patients for PAD can lead to delayed treatment and poorer health outcomes. Early detection and intervention are key to altering the disease progression, reducing complications, and improving health outcomes. The purpose of the quality improvement project is to impact the knowledge and self-efficacy of the healthcare providers working in the outpatient cardiovascular clinic on PAD. A quasi-experimental design with pre- and post-test PAD knowledge exam and a pre- …

Quality Improvement Project Fall Prevention Among Skilled Nursing Facility Residents Through Staff Education, Reena Mathew

Doctor of Nursing Practice Projects

Falls among older adults in Skilled Nursing Facilities (SNFs) remain a leading cause of injury, hospitalization, and decreased quality of life. Preventing these falls requires awareness and effective staff engagement. This Quality Improvement (QI) initiative is targeted to decrease fall rates in a 90-bed SNF by educating caregivers on the significance and practice of purposeful hourly rounding. The project helped to improve staff knowledge, consistency, and accountability in implementing hourly rounding as a preventive measure. A pre- and post-intervention design was utilized. Staff members received structured educational sessions based on evidence-based guidelines, including interactive modules and printed resources. Twenty staff …

Quality Improvement Project: Faculty Education On Clinical Evaluation Tool Utilization For Outcome-Based Assessment And Readiness In Clinical Competency Evaluation, Catherine Odom

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement initiative addressed the lack of consistency and subjectivity in clinical evaluations of nursing faculty at a community college in the southern United States. The intervention was a structured faculty development program spanning eight weeks, focusing on Objective Structured Clinical Examinations (OSCEs) and performance rubrics. The project was guided by the IOWA Model of Evidence-Based Practice and the Kotter Change Management Framework, aiming to boost faculty confidence and inter-rater reliability in clinical assessment. The PICOT question was whether a structured educational intervention would enhance self-reported faculty confidence in clinical assessments relative to no …

Quality Improvement Project Improving Self-Efficacy Among Urgent Care Staff Through Medication Reconciliation Education, Jana M. Combs

Doctor of Nursing Practice Projects

Medication errors and adverse drug reactions (ADR) are a significant source of preventable harm in healthcare, and failure to complete proper medication reconciliation is a contributing factor. Despite multiple interventions aimed at addressing this issue, no standardized plan has been implemented universally. Outpatient urgent care sites pose as high-risk environments for failed medication reconciliations due to the nature of the setting, but staff are in prime positions to adjust this culture. This project aimed to enhance staff self-efficacy in medication reconciliation over four weeks through an evidence-based educational program, with the goal of improving patient safety and outcomes. Using a …

Quality Improvement Project Data At Risk: The Implications Of Inconsistent Nursing Documentation On Patient Care Interventions, Amber Jones

Doctor of Nursing Practice Projects

Accurate nursing documentation plays a vital role in ensuring high-quality patient care, yet inconsistencies remain a common challenge, particularly with preventive screenings like pediatric tobacco use. Research shows that when documentation is incomplete or incorrect, opportunities to identify and intervene with at-risk adolescents are often missed. This quality improvement project was developed to address a specific gap in documentation practices at a community health clinic, where staff often failed to consistently complete the pediatric tobacco screening tool. The goal of the project was to determine whether evidence-based education, combined with chart audits and feedback, could improve the consistency in which …

Quality Improvement Project Improving Advanced Practice Registered Nurse Self-Efficacy And Retention Through A Structured Mentorship Program, James Caleb Kent

Doctor of Nursing Practice Projects

High turnover among Advanced Practice Registered Nurses (APRNs) creates significant challenges for healthcare delivery, continuity of care, and organizational costs. Despite convincing evidence supporting the use of mentorship programs to improve job satisfaction and retention, structured mentor education remains underutilized in many outpatient settings. This quality improvement project assessed the impact of a structured mentor education program on APRN self-efficacy related to mentoring competence. A single-group, pre-post design was implemented in one primary care department. Six APRNs completed an evidence-based mentor education module. Self-efficacy was measured using the Mentor Competence Assessment (MCA) survey administered immediately before and after education. Paired …

A Quality Improvement Project Cultural Competency: A Project For Improving Culturally Competent Care Among Mental Health Providers, Lanre Olanrewaju

Doctor of Nursing Practice Projects

Cultural competence, knowledge, and awareness are essential for improving mental healthcare outcomes in diverse populations. Despite the need, the absence of structured cultural competence training contributes to reduced quality of care and health disparities. The purpose of this quality improvement project is to improve cultural awareness and knowledge among mental health providers at an outpatient clinic by implementing structured staff training. A needs assessment identified gaps in cultural competence knowledge, inconsistent practices, and limited provider confidence in addressing diverse patient needs. In the methodology, the model used to answer the PICOT question is Purnell’s Model, guided by a structured process …

Assessing And Improving Provider Knowledge And Comfort With Palliative Care Consultations: A Quality Improvement Project, Summer R. Hess

Doctor of Nursing Practice Projects

Palliative care remains significantly underutilized in the management of heart failure, despite national guidelines supporting its early integration. This underuse limits opportunities for person-centered care in cardiology settings. The purpose of this quality improvement project was to improve provider knowledge and comfort in implementing palliative care consultations. The problem addressed was the low consultation rates for advanced heart failure patients, largely driven by provider misconceptions and a lack of formal training. A quasi-experimental design was initiated by using a brief, evidence-based educational article. Sixteen advanced practice providers at a high-volume cardiology clinic completed pre- and post-intervention surveys using the End-of-Life …

Quality Improvement Project Evaluation Of The Effectiveness Of The Institute For Healthcare Improvement’S Joy In Work Framework On Burnout Experienced By Dialysis Staff, Bernice Jones

Doctor of Nursing Practice Projects

Burnout continues to pose a pervasive and escalating challenge in healthcare, with its severity further amplified in the aftermath of the COVID-19 pandemic. Dialysis professionals are especially vulnerable, facing elevated patient volumes, extended work hours, and frequent encounters with complex clinical needs. These ongoing stressors highlight the critical importance of this quality improvement (QI) project, as there exists an urgent need for evidence-based strategies to alleviate burnout among dialysis professionals. This QI project aimed to enhance joy in the dialysis work setting and reduce burnout experienced by dialysis staff through the implementation of the Institute for Healthcare Improvement’s (IHI) Joy …

Development Of Policy Related To Test Anxiety In High-Stakes Environment, Jancy J. Sabu

Doctor of Nursing Practice Projects

Many nursing students experience test anxiety (TA) due to the highly stressful learning environment and the high-stakes nature of nursing exams. A community college in Texas has experienced an increase in student attrition from 2018 to 2022, primarily due to course failures, which are linked to TA. Expressive writing (EW) is a proven intervention that allows students to write about their anxieties and fears related to exams, helping them to regulate their emotions and manage TA. This project aimed to develop a policy that implements EW as an intervention and incorporates it into the nursing syllabus. Using the Centers for …

The Development Of A Remediation Policy For High-Stakes Standardized Tests, Abigail R. Brundige

Doctor of Nursing Practice Projects

Standardized testing serves as a measure of academic progress and readiness for licensure in nursing programs. Gaps in standardized testing performance emphasize the need for educational support. The problem identified for this Doctor of Nursing Practice (DNP) policy project is the lack of a formal standardized testing remediation policy within a community college nursing program in rural West Tennessee. The DNP project proposes the development and implementation of a standardized testing remediation policy to identify at-risk students early, provide individualized remediation plans, and improve program retention and licensure pass rates. The DNP project employed a quantitative design to assess the …

Enhancing Novice Nurse Educator Success: A Comprehensive Orientation And Mentorship Program, Emily R. Luther

Doctor of Nursing Practice Projects

Nursing education programs face challenges from faculty shortages, high turnover, and limited onboarding support for new educators. This Doctor of Nursing Practice (DNP) project assessed the effectiveness of a structured orientation and mentorship program aimed at improving competency, job satisfaction, and retention among novice nurse educators within a mid-sized nursing program in the southeastern United States. The project addressed gaps in existing onboarding processes that left new faculty unprepared, which contributed to dissatisfaction and attrition. A mixed-methods pre- and post-intervention design was utilized. Quantitative data were gathered through the Self-Assessment of Nurse Educator Competencies (SANE-C), the Minnesota Satisfaction Questionnaire (MSQ), …

Quality Improvement Project Advancing Success In Nursing Education: An Evidence-Based Approach To Remediation, Jessica Wilson

Doctor of Nursing Practice Projects

Nursing education requires intense academic work, which creates specific obstacles for learner achievement. The improvement of academic results in BSN 346 and similar high-stakes courses remains essential for maintaining learner retention, graduation success, and practice readiness. This quality improvement project assessed how evidence-based remediation with structured implementation compared to traditional voluntary remediation methods. The research investigated whether faculty-led evidence-based remediation meetings would enhance BSN 346 learner success through concept map score assessment. A retrospective pre-/post-intervention study analyzed concept map performance between two learner groups from Spring 2025, who received standard remediation, and Summer 2025, who received structured remediation. The researchers …

Enhancing Postpartum Depression Screening Rates: An Educational Intervention For Primary Care Pediatric Providers: A Quality Improvement Project, Jasmine Shaterra Jones

Doctor of Nursing Practice Projects

This quality improvement (QI) project sought to increase postpartum depression (PPD) screening rates at a single pediatric primary care practice setting by implementing an educational intervention for pediatric providers. Postpartum depression is a common and debilitating mental health condition affecting many mothers worldwide. Postpartum depression impacts many women in the United States and affects all ethnicities, although rates may vary based on demographic and socioeconomic factors. Despite the American Academy of Pediatrics' recommendations for maternal PPD screening at one, two, four, and six months, well-child visits, national screening rates remain low, with a large number of cases undiagnosed. The current …

Improving Hiv Pep Patient Follow-Up Appointment And Laboratory Testing In A Telehealth Setting: A Quality Improvement Project, Ralston Lockett

Doctor of Nursing Practice Projects

The ongoing HIV epidemic in the United States highlights the need for innovative prevention strategies, including non-occupational post-exposure prophylaxis (nPEP). This Doctor of Nursing Practice (DNP) project evaluated a telehealth-based intervention aimed at increasing HIV PEP follow-up appointments and laboratory completion rates, while also enhancing provider knowledge. Dual interventions included a patient reminder system and provider education. While provider knowledge significantly improved post-intervention, based on Cohen’s d effect size of 0.62, clinical significance was demonstrated by follow-up appointment rates declining from 44% pre-intervention to 41% post-intervention. Laboratory completion rates also decreased, with 53% of patients completing labs pre-intervention compared to …

Evaluation Of A Nurse Practitioner-Led Preoptimization Care Management Program’S Impact On Patient Satisfaction For Total Hip And Knee Arthroplasty, Bryttany Chambers

Doctor of Nursing Practice Projects

This evaluation project aimed to assess whether the nurse practitioner-led preoptimization care management program can increase patient satisfaction by improving the quality metrics, such as same-day ambulation post-surgery, discharge to home, and compliance in preoperative education. The evaluation retroactively reviewed 46 charts of primary total knee and hip arthroplasty patients, male (38%) and female (62%), aged 43 to 84. Using Fisher’s exact test to examine the Net Promoter Scores (NPS) for six months of the PCM program, there was no significant increase in patient satisfaction scores, despite PCM patients averaging 89% compared to non-PCM patients at 83%, based on an …

Educating Nurse Practitioners On Music-Based Interventions: An Evidence-Based Project, La’Keshia Henderson

Doctor of Nursing Practice Projects

Background: Arts-based interventions (ABIs) harness the transformative power of art to enhance processes or situations, particularly those related to physiological, emotional, and psychological well-being. There are three types of arts-based interventions: visual, literary, and performing arts. Among these, music therapy, a form of performing arts intervention, has gained recognition as an effective approach for addressing mental health challenges. Music therapy has shown promise in reducing anxiety symptoms, offering a non-invasive and accessible form of support within ABI strategies. Purpose: This project assessed changes in nurse practitioners' knowledge, attitudes, and practices, as well as their intentions to utilize music-based interventions in …

Controlling Hypertension In The African American Population Through Dash Diet Education, Tanya K. Mccaskill

Doctor of Nursing Practice Projects

Hypertension disproportionately affects African Americans, contributing to elevated risks of stroke, cardiovascular disease, and kidney failure. Despite the well-established benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, its adoption remains limited due to cultural, socioeconomic, and health literacy barriers. This Quality Improvement (QI) project aimed to evaluate the effectiveness of a culturally tailored DASH diet education intervention in improving nutritional knowledge among African American adults with hypertension (HTN). Using a quasi-experimental pre-post intervention design, 50 participants received a structured educational session during a single clinic visit, which included counseling, printed materials, and sample menus. The intervention was guided …

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 …