Medicine and Health Sciences Commons^™

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 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 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 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 …

Improving Patient Outcomes Post-Discharge: Implementing Evidence-Based Discharge Planning For High-Risk Mental Health And Substance Use Disorder Populations, Margaret Phillips

Doctor of Nursing Practice Projects

A significant gap in standardized discharge procedures was identified at a nonprofit, community-based clinic serving male residential patients with substance use disorder (SUD) and co-occurring mental health conditions. The lack of a standardized discharge process led to poor follow-up appointment adherence, poor medication adherence and increased risk of relapse. This quality improvement (QI) project aimed to address these issues through the implementation of a cross-departmental discharge process that produced tailored Individualized Discharge Plans (IDP) or each patient, using the Donabedian and Kotter’s 8-Step Change models as guiding frameworks. Data were collected using custom-built tracking tools over two four-week periods, pre- …

Quality Improvement Project The Introduction Of Gratitude Journaling To Decrease Test Anxiety In Prelicensure Bachelor Of Science In Nursing Students, Jourdan Scoggins

Doctor of Nursing Practice Projects

Test anxiety is a substantial barrier to success among prelicensure nursing students, given the heavy course load and high academic pressure of the educational environment. The purpose of this quality improvement project was to measure the impact of gratitude journaling on levels of test anxiety in first-semester Bachelor of Science in Nursing (BSN) enrolled in a nursing math course at a regional university in Arkansas. Following a quasi-experimental design, students participating in the project completed the Westside Test Anxiety Scale (WTAS) before and after five weeks of gratitude journaling. Thirty-two students participated in the intervention and 24 of those completed …

Quality Improvement Project Building Community Of Practice Through An Affiliate App Virtual Forum, Patricia J. Pease

Doctor of Nursing Practice Projects

Establishing community and support for pediatric hematology and oncology Advanced Practice Providers can be challenging. Asynchronous working schedules, lack of protected time, and geographical distance hinder these efforts. Extending professional support and collaboration to providers is vital to ensure communication, interprofessional teaming, and collaborative care of the high-acuity patient population. Given the availability of virtual forums, this project explores the ability of a virtual, synchronous Community of Practice (VCoP) to enhance interprofessional collaboration for affiliated Advanced Practice Providers (APPs). This project utilizes the validated Assessment of Interprofessional Team Collaboration II (AITCS-II) to assess pre- and post-intervention interprofessional collaboration via a …

Peer Mentor Training Program: A Policy Proposal, Laura Paul

Doctor of Nursing Practice Projects

Peer mentoring is an evidence-based strategy to improve student retention. However, for this approach to be sustainable, the students providing mentoring must be intentionally prepared for this role. This project introduces an evidence-based policy for training Bachelor of Science (BSN) students as peer mentors to enhance student outcomes and retention of first-year students. This policy was created for a small BSN program at a work-study college with a financially disadvantaged student body, which places the students at increased risk of not persisting in their degree. The training policy is intended to be implemented with nursing lab staff who are students …

Quality Improvement Project: Perioperative Recruitment Process Improvement Through Nursing Student Clinical Experience, Traci Boren

Doctor of Nursing Practice Projects

Perioperative nursing is experiencing greater shortages than any other specialty and has been largely removed from undergraduate education. This DNP quality improvement project aimed to impact the recruitment of perioperative nurses through undergraduate nursing clinical exposure and experience. The project addressed the lack of clinical nursing student opportunities in the perioperative department at the partner site to increase interest in perioperative nursing and recruit core staff nurses from the pool of new graduates. Kotter’s Eight-Step Change Model and the Social Career Cognitive Theory framed the project’s design and implementation for two cycles, between January and March 2024 and 2025. Using …

Implementing An Antibiotic Stewardship Program For Acute Respiratory Tract Infections In Urgent Care, John Childree

Doctor of Nursing Practice Projects

Antibiotic overprescription for acute respiratory tract infections (ARTIs) remains a persistent challenge in urgent care, contributing to antimicrobial resistance and increased healthcare costs. This quality improvement project evaluated whether a structured educational intervention an Antibiotic Stewardship Program (ASP) could improve providers’ knowledge and self-efficacy in evidence-based prescribing. A quasi-experimental, single-group pre-post design was used with seven urgent care clinicians. Data were collected through a custom Antibiotic Stewardship Questionnaire and a Self-Efficacy Survey administered before and after the intervention. Results demonstrated a 17% increase in knowledge scores (from 9.3 to 10.6 out of 11) and a statistically significant improvement in self-efficacy …

Quality Improvement Project Education And Implementation Of I-Pass Handoff Between Critical Care Clinicians And Anesthesia Staff, Kimberly Woody

Doctor of Nursing Practice Projects

Medical errors, specifically communication errors, cause adverse patient outcomes, death, and an estimated annual cost to institutions of over two million dollars. Despite numerous studies highlighting the need for standardized communication during patient transfers and recommendations from regulatory bodies such as the Joint Commission, the gaps in standardized handoffs remain. The Doctor of Nursing Practice's (DNP's) quality improvement project aimed to increase knowledge of the intensive care unit (ICU) and anesthesia clinicians through interprofessional education (IPE) about the illness severity, patient summary, action plan, situational awareness/contingency plan, synthesis by receiver (I-PASS) handoff tool to promote consistent, complete tool use during …

Policy Paper Assessing The Risk Of Obstructive Sleep Apnea In The College Football Player, Joseph C. Archer

Doctor of Nursing Practice Projects

Sleep is a vital yet often overlooked component of athletic performance, particularly in collision sports such as football. Despite growing evidence connecting obstructive sleep apnea (OSA) with cognitive impairment, cardiovascular risk, and injury, standardized screening is rarely implemented in collegiate athletics. This project aimed to assess the risk of obstructive sleep apnea (OSA) in college football players aged 18–25 using the STOP-BANG screening tool and to evaluate the impact of an educational intervention on the knowledge of athletic trainers. The purpose was to identify at-risk athletes early, promote timely intervention, and improve athletic trainers' understanding of OSA. The project addressed …

Quality Improvement Project Promotion Of Policy Adherence Through Education On Shared Governance, Chelsea Baker

Doctor of Nursing Practice Projects

The quality improvement project aimed to enhance compliance with the project site’s policy on participation in shared governance by providing an educational session on the importance of shared governance to faculty roles. Literature reviews revealed that shared governance increases faculty voice and satisfaction with their roles. By educating faculty about the role of shared governance and how to engage in institutional shared governance policies, both the institution and the faculty can benefit from more effective participation, leading to the continuous improvement of the program and incorporation of evidence-based practices into the curriculum. Using a quasi-experimental pre-post design, the principal investigator …

Sugammadex For Reversal Of Neuromuscular Blocking Agents Versus Neostigmine - Safety Comparison, Amanda K. Butler, Daniel Belu, Bailey Accardo, Courtney Ayana Bullard, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Sugammadex and neostigmine are two common drugs used to reverse neuromuscular blockade in anesthesia, but they differ in mechanism of action, side effects, and cost.

Sugammadex provides rapid reversal, has fewer side effects, and has a lower risk of bradycardia than neostigmine. This scoping review examines the frequency of bradycardia in adult surgical patients receiving sugammadex versus neostigmine.

Methods

A scoping review was completed of peer-reviewed articles comparing the incidence of bradycardia in adult surgical patients after the administration of sugammadex and neostigmine for neuromuscular blockade reversal. Findings indicate that sugammadex resulted in fewer adverse events, including bradycardia, than …

Quality Improvement Initiative: Implementing Wellness Visit (Wv) Education To Improve Staff Self-Efficacy, Preston T. Holifield

Doctor of Nursing Practice Projects

Preventive care delivery is a cornerstone of value-based primary care, yet non-provider staff often lack the confidence and training to engage patients in Medicare Annual Wellness Visits (AWVs). Non-provider staff included Registered Nurses (RN’s), Licensed Practical Nurses (LPN/LVN’s), Secretaries, Medical Aids (MA’s), and Practice Managers (PM’s). This quality improvement project aimed to evaluate whether a brief educational intervention could improve self-efficacy among non-provider staff related to AWV discussions and workflow. Conducted in two primary care clinics in Southeast Missouri, this one-group pretest-posttest study involved six participants and utilized the General Self-Efficacy Scale (GSES) and Learning Self-Efficacy Scale (LSES) to measure …

Pulmonary Embolism Response Team In Acute Care Settings: A Scoping Review Of The Evidence, Tia Glover Bsn, Rn, Leslie Asplund Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Pulmonary embolism (PE) is a critical cardiovascular emergency associated with high morbidity and mortality. Despite its prevalence, traditional PE management often lacks cohesion, leading to suboptimal outcomes. Pulmonary Embolism Response Teams (PERTs) offer a multidisciplinary approach aimed at improving patient outcomes by streamlining diagnosis, facilitating timely interventions, and promoting evidence-based treatment. This scoping review evaluates the evidence supporting PERT efficacy across various clinical and resource-related outcomes with the aim to decrease mortality rates, shorten inpatient length of stay, improve cost efficacy, and minimize adverse events from treatment modalities.

Methods

A comprehensive literature search was conducted using PRISMA guidelines across …