Medicine and Health Sciences Commons^™

Quality Improvement Project Reducing Attrition Rates In Nursing Students: Evaluating The Enhanced Student Success Program, Jason Grigg

Doctor of Nursing Practice Projects

The high attrition rate in the Associate of Applied Science in Nursing (AASN) program created an opportunity to develop the enhanced Student Success Program (eSSP). This is a faculty-based quality improvement project designed to increase support for students at risk of withdrawal from the AASN program. The aim of eSSP is to reduce attrition rates, however, this project evaluated only short-term changes in faculty confidence. Using Lewin's Change Model and the Theory of Planned Behavior as a guide, this QI implemented a one-group pre-post experimental design to determine whether a short eSSP training program, combined with a 5-week implementation period, …

Quality Improvement Project : Educating Critical Care Nurses On Braden Scale And Sskin Care Bundle To Impact Pressure Injuries, Andrea Garrett

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) increase patients' risk of infection, prolonged hospitalization, death, and healthcare costs. The Agency for Health Research and Quality (AHRQ) has shown that implementing a standardized skin assessment process and a care bundle helps prevent skin injuries. A critical care unit (CCU) at an acute care 339-bed hospital in Southaven, MS, has seen an increase in HAPIs. This quality improvement project aimed to educate CCU nurses about the Braden Scale and the SSKIN care bundle to impact pressure injuries in the CCU within 8 weeks. Education on the Braden Scale and the Skin, Sensory, Keep Moving, Incontinence, …

Quality Improvement Project: Gpt Prompts As Tools For Cultural Competence In Undergraduate Nursing Education, Elizabeth K. Hobbs

Doctor of Nursing Practice Projects

In rural nursing programs, student exposure to diverse cultures is limited, which can hinder development of cultural competence. Artificial intelligence (AI) simulation is an evidence-based strategy to improve cultural competence and clinical decision-making, a practice gap exists due to lack of structured, accessible tools. This quality improvement project evaluated whether Generative Pre-trained Transformer (GPT)–based structured prompts would increase culturally inclusive simulation activities and improve faculty perceptions of usefulness and ease of use at a rural community college. The guiding PICOT asked: Among nursing faculty, how does the use of GPT-based structured prompts, compared to an unstructured approach, impact perceived usefulness, …

Quality Improvement Project: Faculty Development For Understanding And Utilization Of Exam Data, Deanne Hutchens

Doctor of Nursing Practice Projects

This quality improvement project focused on inconsistent use and understanding of exam data among Associate Degree in Nursing (ADN) faculty, which can influence teaching decisions and student success. Many nursing faculty enter education with strong clinical backgrounds but limited experience working with exam statistics such as item difficulty, discrimination values, and Kuder-Richardson 20 (KR-20) reliability. Without a consistent approach, exam results may not be fully used to guide remediation or adjust instruction. This Doctor of Nursing Practice (DNP) project examined whether a structured faculty development session could improve faculty confidence and ability to interpret and apply exam data. A pre- …

Quality Improvement Project: Impacting Staff Confidence In Recognizing Hiv Medication Adherence, Joy Nwansi-Iro

Doctor of Nursing Practice Projects

Medication adherence to antiretroviral therapy is essential for viral suppression and improved outcomes among individuals living with human immunodeficiency virus (HIV). Despite advances in treatment, healthcare providers lack confidence in recognizing medication adherence challenges and implementing appropriate interventions. Evidence suggests that provider education using standardized adherence assessment tools improves adherence monitoring and clinical decision-making. The purpose of this quality improvement project is to evaluate whether an educational intervention and a standardized workflow using the CASE Adherence Index would impact healthcare staff confidence in recognizing HIV medication adherence. Lewin’s Change Theory guided the project through the stages of unfreezing, change, and …

Quality Improvement Project: Evaluating The Impact Of Provider Education On Sbirt On Screening For Suds, Faith Ogala

Doctor of Nursing Practice Projects

Substance use disorder (SUD) is a serious public health issue in people with psychiatric disorders. However, diagnosis and treatment are often delayed, leading to poor treatment outcomes and increased social and economic costs. The purpose and aim of this Doctor of Nursing Practice (DNP) project was to educate providers on the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model to facilitate the timely diagnosis of SUDs in patients with dual diagnoses. The key outcomes were provider knowledge and SBIRT implementation rates. The Donabedian Model of Healthcare Quality assessed the outcomes, whereas Lewin’s Change Model guided implementation. The project employed …

Establishing A Standardized Suicide Risk Screening Policy For Psychiatric Providers: Closing Gaps In Provider Accountability And Clinical Documentation, Fadekemi Olude

Doctor of Nursing Practice Projects

Psychiatric providers in outpatient settings often experience inconsistent confidence and incomplete documentation when conducting suicide risk screening, contributing to missed opportunities for early identification of at-risk patients. This quality improvement project addressed the need for standardized suicide risk screening at an urban outpatient psychiatric clinic. The purpose was to evaluate documentation using the Columbia-Suicide Severity Rating Scale (C-SSRS). Using a pre-post intervention design guided by Lewin's Change Theory and the Donabedian Model of Quality Improvement, a 60-minute training session was delivered to 31 psychiatric providers. Participants completed pre- and post-intervention General Self-Efficacy Scale (GSES) surveys. Chart audits (N = 1,970) …

Quality Improvement Project Ai-Powered Conversations: Enhancing Nursing Students’ Interview Skills, Judy K. Staley

Doctor of Nursing Practice Projects

Professional communication is an essential skill for nursing students, particularly in job interviews. Deficits in professional communication can negatively impact future employment and accreditation outcomes. Current practices in faculty-led mock interviews can be limited by time constraints and the need for consistent feedback, underscoring the need for a more consistent and effective method supported by current evidence-based literature. The purpose of this quality improvement project is to evaluate whether integrating AI-assisted mock interviews into faculty-led practices influences faculty perceptions of student preparedness. Guided by Kotter’s Change Model and supported by the constructivist framework, the project aimed to enhance the effectiveness …

Quality Improvement Project: Enhancing Staff Delivery Of Non-Pharmacological Interventions In Serious Mental Illness Care, Kimberly Vann

Doctor of Nursing Practice Projects

Serious mental illness places a significant burden on global healthcare systems, increasing hospital utilization and critically impairing patients' functional status. Often crippling, these illnesses are mostly treated with medication therapy despite proven research to show effective outcomes with holistic and non-pharmacological therapies. Non-pharmacological interventions (NPIs) are often underutilized in outpatient mental health settings. The purpose of this quality improvement project was to determine whether structured training impacted staff confidence in delivering NPIs and impacted documentation frequency in the electronic health record (EHR). The project was guided by the Iowa Model of Evidence-Based Practice and implemented using the Plan-Do-Study-Act (PDSA) cycle, …

New Nurse Faculty Mentorship: A Quality Improvement Project, Kimberly B. Porter

Doctor of Nursing Practice Projects

The ongoing nursing faculty shortage limits program capacity and makes it harder to retain novice nurse educators transitioning from clinical practice to academia. The literature highlights issues such as insufficient mentorship, role confusion, and a lack of structured support as key factors contributing to early faculty attrition. This quality improvement (QI) project aimed to implement and evaluate an evidence-based mentorship program to improve perceptions of mentorship effectiveness among new-to-academia nurse faculty in a School of Nursing in Arkansas. The purpose was to implement and evaluate a mentorship program designed to improve perceptions of mentorship among new-to-academia nurse faculty. The project …

Quality Improvement Project: Integrating Depression Screening Into Adult Wellness Visits In A Primary Care Clinic, Nina Denchukwu

Doctor of Nursing Practice Projects

Depression is a prevalent and debilitating mental health condition that remains significantly underdiagnosed in primary care, despite national recommendations for universal adult screening. At the project site, less than 40% of adults completing annual wellness visits had documented depression screening. The purpose of this quality improvement project was to evaluate whether integrating the evidence-based Patient Health Questionnaire (PHQ)-2 and PHQ-9 into the electronic health record (EHR) would improve completion of depression screening, documentation, and referrals to treatment. The project was guided by Rogers' Diffusion of Innovations Theory and the Plan-Do-Study-Act (PDSA) framework. A quantitative pre–post intervention design linked with the …

Quality Improvement Project: Impact Of Faculty Competency And Classroom Application Of Artificial Intelligence (Ai), Clydea Hale

Doctor of Nursing Practice Projects

The rapid integration of artificial intelligence (AI) in healthcare has created a growing need for nursing faculty to develop competency in AI to adequately prepare students for modern clinical practice. Despite this need, limited faculty knowledge and low classroom application of AI persist. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of an evidence-based AI educational intervention on nursing faculty competency and classroom application. Guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory, a quasi-experimental pretest-posttest design was implemented with nursing faculty at a rural community college in …

Quality Improvement Project: Improving Provider Workflow And Documentation For Routine Mental Health Screening In An Outpatient Psychiatric Clinic, Sharon Uchechi Joshua

Doctor of Nursing Practice Projects

Depression and anxiety are leading causes of disability and are frequently underdiagnosed in outpatient psychiatric settings due to inconsistent screening and documentation practices. Evidence supports the use of standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to improve early detection and clinical outcomes. This quality improvement (QI) project evaluated whether implementing standardized electronic health record (EHR) templates and provider education would improve documentation of PHQ-9 and GAD-7 screenings. The aim was to increase the consistency of screening and documentation among psychiatric providers. The project was guided by the Plan-Do-Study-Act (PDSA) framework and Lewin’s Change …

Promoting Trauma-Informed Practices Through Staff Education, Ediomi Enebong Oduwole

Doctor of Nursing Practice Projects

Front office staff in outpatient psychiatric settings are often the first point of contact for patients experiencing anxiety and emotional distress. However, existing evidence indicates that non-clinical, front office staff often lack formal training in trauma-informed care (TIC). This gap may limit early recognition and response to patient distress. This quality improvement project addressed this gap by evaluating the impact of a trauma-informed educational intervention of staff confidence and documentation of patient distress. The project was guided by Pender’s Health Promotion Model and Lewin’s Change Theory. It used a pre-and post-intervention quantitative design with sample of five front office staff …

Quality Improvement Project: Improving Adn Faculty Professional Development Through Simulation Training, Sharon Haley Peace

Doctor of Nursing Practice Projects

Lack of structured simulation training for nursing faculty, which has been identified as a gap in the literature, can negatively impact the quality of simulation-based education and student learning outcomes. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to develop, implement, and evaluate an evidence-based training intervention aimed at improving faculty self-efficacy and competence in simulation facilitation. The project was guided by Lewin’s Change Theory and Kolb’s Experiential Learning Theory to support faculty development. A quantitative, quasi-experimental pre-post design was used with a convenience sample of nine associate degree nursing faculty at a rural community …

Embedding Social Determinants Of Health Into Maternal Simulation Scenarios: Enhancing Nursing Staff Awareness Of Equity-Based Education, Sherina Evans

Doctor of Nursing Practice Projects

Despite growing evidence emphasizing the importance in addressing disparities in maternal health outcomes, maternal health simulations often lack integration of social determinants of health (SDOH) and cultural considerations. The purpose of this Doctor of Nursing Practice quality improvement project was to enhance nursing faculty cultural awareness through simulation scenarios that incorporate SDOH and culturally responsive elements. This project was guided by Lewin’s Change Theory and the Jeffries Simulation Framework. The aim was to strengthen faculty awareness and skills to support the development of culturally inclusive simulation experiences. Descriptive statistics were utilized to analyze results which was a limitation. Nursing faculty …

Improving Monitoring And Documentation Of Long-Acting Injectable Antipsychotic Adherence In Patients With Schizophrenia Through Staff Education And Refill History Review, Stacy Ann Bruce

Doctor of Nursing Practice Projects

Schizophrenia is a chronic psychiatric disorder associated with relapse, hospitalization, and poor outcomes when medication adherence is suboptimal. Nonadherence increases morbidity and healthcare utilization (World Health Organization, 2022; Zhao et al., 2025). Long-acting injectable (LAI) antipsychotics improve adherence and reduce hospitalization, but inconsistent monitoring and documentation in outpatient settings hinder early identification of missed doses (Lieslehto et al., 2022). This Doctor of Nursing Practice (DNP) quality improvement project aimed to evaluate whether staff education and structured refill-monitoring processes improve identification and documentation of nonadherence to LAI antipsychotics. Using Kotter’s Change Management Model and the Plan-Do-Study-Act framework, the project focused on …

Quality Improvement Project: Emergency Preparedness In Urgent Care: Impacting Competency Among Medical Assistants, Sarah Pettyjohn

Doctor of Nursing Practice Projects

Urgent care settings present significant challenges, including limited staffing and resources, unpredictable patient acuity, and training deficiencies. These factors contribute to a competency gap among medical assistants, limiting their ability to recognize and respond to medical emergencies. The purpose of this quality improvement project is to impact emergency medical preparedness through a formal educational intervention. Grounded in Lewin’s Change Model and the Kirkpatrick Model, the project aims to improve emergency medical competency, consistent with evidence supporting structured training approaches. Using American Heart Association guidelines, medical assistants participated in a six-week educational program implemented through the Plan-Do-Study-Act framework, with assessments administered …

From Novice To Effective: Strengthening Clinical Education In Nursing, Stephanie Campbell

Doctor of Nursing Practice Projects

The professional transition from clinician to educator is often complicated by a lack of formal training and professional development. This gap in training and support compromises the delivery of nursing education and leads to feelings of inadequacy, diminished confidence, and higher rates of attrition. This quality improvement (QI) project seeks to improve the quality of clinical education by evaluating the impact of a structured onboarding process on a novice nurse educator’s self-efficacy and perceived support. Guided by Lewin’s Change Theory and Bandura’s Social Cognitive Theory, the project aims to enhance the onboarding process for novice nurse educators. The Find, Organize, …

Improving Cultural Competence Among Healthcare Professionals Through A Targeted Staff Training Program, Oyindamola Akinkugbe

Doctor of Nursing Practice Projects

Limited culturally competent care for Hispanic patients worsens existing health disparities, creates misunderstandings, leads to poor health outcomes, and reduces satisfaction with the quality of care. In an outpatient clinic, more than 70% of patients are Hispanic, yet healthcare providers reported a lack of confidence in caring for culturally diverse patients. Extensive literature supports staff training to improve provider cultural competence, but implementation remains inconsistent across healthcare settings. This quality improvement project addressed this gap by implementing a targeted staff training program grounded in the Culturally and Linguistically Appropriate Services (CLAS) in Nursing framework. The purpose of this project was …

Quality Improvement Project: Reimplementation Of Bedside Reporting, Veronicah Banga

Doctor of Nursing Practice Projects

Communication breakdown during nursing shift handoffs is a major patient safety challenge in healthcare today. At the project site, 85% of handovers occurred at the central nursing station, and most staff nurses expressed dissatisfaction with the quality of the bedside reporting. In psychiatric nursing, unique barriers exist that make bedside reporting challenging, including patient confidentiality and an individual's diagnosis. Such barriers eroded bedside reporting (BSR) over time, leading to measurable safety risks and nursing dissatisfaction. The purpose of this quality improvement project was to reintroduce bedside handoffs using the Situation, Background, Assessment, and Recommendation (SBAR) framework and to maintain BSR …

Enhancing Shared Decision-Making In Mental Health Care: A Quality Improvement Initiative, Joanna L. Hysler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is an evidence-based approach that enhances patient engagement, treatment adherence, and clinical outcomes in psychiatric care. Despite strong support in the literature, SDM remains inconsistently implemented in mental health settings due to limited provider training, time constraints, and organizational barriers. The purpose of this Doctor of Nursing Practice quality improvement project was to implement and evaluate an educational intervention designed to improve SDM utilization and provider confidence within a private outpatient psychiatric practice. The project was guided primarily by the Plan-Do-Study-Act framework to support structured practice change, with Lewin’s Change Theory providing additional conceptual support. The intervention …

Mapping The Evidence On The Maternal–Fetal Triage Index (Mfti): A Scoping Review, Taylor Harris, Kelsey Downie, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Maternal morbidity and mortality remain persistent challenges in the United States, with obstetric triage serving as a critical point of entry for timely recognition and management of high-acuity maternal-fetal conditions. Despite recommendations for acuity-based triage models, many obstetric units continue to rely on non-specific emergency triage tools, such as the Emergency Severity Index (ESI), which inadequately account for pregnancy-specific physiological changes and fetal status. To address these limitations, the Association of Women’s Health, Obstetric and Neonatal Nurses developed the Maternal-Fetal Triage Index (MFTI), a five-level obstetric-specific triage tool. Although the MFTI has been increasingly adopted in clinical practice, the …

Quality Improvement Project: Improving The Clinical Teaching Experience Through Clinical Adjunct Orientation, Elissa Saunders

Doctor of Nursing Practice Projects

Clinical adjunct nursing faculty often transition into academic roles without formal preparation, leading to role insecurity and high turnover rates that negatively impact student clinical experiences. The purpose of this quality improvement (QI) project was to implement a structured orientation checklist to improve perceived clinical teaching competency among novice clinical adjunct faculty. The project aimed to standardize onboarding and support the transition from clinical practice to academia. A quantitative pre-post intervention design was used with a convenience sample of clinical adjunct faculty employed for less than one year at a rural university nursing program. The project was guided by Kotter’s …

Enhancing Provider Self-Efficacy And Documentation In Hypertension Management, Stephanie Nsiah

Doctor of Nursing Practice Projects

Primary care providers often experience inconsistent confidence and incomplete documentation when managing hypertension, contributing to suboptimal blood pressure control. This quality improvement project addressed the need for structured provider education at an outpatient family clinic. The purpose was to evaluate the impact of a structured educational intervention on provider self-efficacy and documentation completeness. Using a quasi-experimental pre-post design guided by the Plan-Do-Study-Act model and Lewin's Change Theory, a 60-minute educational session was delivered to 12 licensed providers. Participants completed pre- and post-intervention self-efficacy surveys using the Acceptability of Intervention Measure (AIM) and Intervention Appropriateness Measure (IAM) and Feasibility of Intervention …

Strengthening Evaluation For Student Success, Hollan Scrivner

Doctor of Nursing Practice Projects

Student evaluation is an important factor in guiding students to develop self-confidence and gain competency in nursing skills. For evaluation to be effective, it must be consistent. The purpose of this quality improvement project is to implement a training program to improve consistency and interrater reliability among faculty conducting skill evaluations. The impact of the training program will be measured by a pre- and post-grading exercise using a skills rubric. Data will be extracted from the rubrics and entered into a codebook for data analysis. The project was guided by the theoretical framework of Stephens’ Star Model of Knowledge Transformation …

Quality Improvement Project Enhancing Maternal Health Outcomes: Evaluating The Impact Of Universal Social Determinants Of Health (Sdoh) Screening In An Interdisciplinary Pregnancy Care Model, Shannon Morgen

Doctor of Nursing Practice Projects

Social determinants of health (SDOH), including housing instability, food insecurity, transportation barriers, and interpersonal violence, significantly influence maternal outcomes and contribute to disparities such as preterm birth and maternal morbidity. Despite national recommendations for universal SDOH screening, implementation in prenatal care remains inconsistent, limiting opportunities to identify and address social needs. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a standardized SDOH screening and documentation process to improve referral completion and examine its impact on hospital readmissions among obstetric patients. Guided by Bronfenbrenner’s Socio-Ecological Model and the Plan-Do-Study-Act framework, the project …

Quality Improvement Project: Enhancing Efficacy And Reducing Urine Contamination Through Simulation In The Ed, Kimberley Strong

Doctor of Nursing Practice Projects

Urine specimen contamination in emergency department settings contributes to diagnostic inaccuracies, unnecessary antibiotic use, increased healthcare costs, and decreased patient satisfaction. This quality improvement project evaluated the impact of a simulation-based educational intervention on staff knowledge, self-efficacy, and urine specimen contamination rates among emergency department nurses and patient care technicians with less than six years of clinical experience in a rural Texas hospital. The aim of this project was to enhance knowledge and self-efficacy while reducing contamination rates over a six-week period. The project was guided by Knowles’ Adult Learning Theory as the theoretical framework, supported by Lewin’s Change Theory, …

Quality Improvement Project: The Impact Of The Clinical Judgment Measurement Model In Nursing Faculty, Lamia Zeidan

Doctor of Nursing Practice Projects

Clinical judgment is essential for nursing practice and can be taught using the Clinical Judgment Measurement Model (CJMM). A needs assessment conducted at the project site revealed that students had limited clinical judgment skills, there was no emphasis on clinical judgment in nursing skills courses, and the faculty had a limited understanding of the CJMM. In response to the findings of the needs assessment, the quality improvement (QI) project was developed using a quasi-experimental design. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Educator theoretical framework, the project aimed to provide faculty with education on the CJMM and …

Quality Improvement Project: The Critical Role Of Provider Knowledge In The Golden Hour, Kimberly Mcglothan

Doctor of Nursing Practice Projects

Maternal and infant mortality rates in the Southern United States remain disproportionately high, and inconsistent implementation of the Golden Hour, defined as uninterrupted skin to skin contact for at least the first hour after birth, continues to limit its evidence based maternal and neonatal benefits. The aim of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of a structured provider education intervention on Golden Hour compliance and provider confidence. Guided by Benner’s Novice to Expert Theory and implemented using Kotter’s 8-Step Change Model, a quantitative, quasi experimental pre-post design was used. The project was …