Medicine and Health Sciences Commons^™

Impact Of Provider Self-Efficacy On Caring For Patients With Prediabetes, David R. Knight

Doctor of Nursing Practice Projects

Prediabetes affects millions of adults in the United States, yet inconsistent provider knowledge and confidence limit evidence-based screening and management in primary care, a gap well-documented in the literature. The purpose of this quality improvement project was to evaluate whether a structured educational intervention improved provider self-efficacy related to prediabetes identification and management. Guided by Social Cognitive Theory and the Transtheoretical Model, with implementation guided by the Plan-Do-Study-Act cycle, this project asked: among family practice providers, how does prediabetes education affect provider self-efficacy over four weeks? A quasi-experimental pre/post design was used. Four asynchronous educational modules focused on evidence-based screening, …

Quality Improvement Project: Faculty Preparedness For Recognition, De Escalation, And Reporting Of Violence In Clinical Education Settings, Dawn "Deedee" D. Moline

Doctor of Nursing Practice Projects

Violence and aggression in healthcare settings present ongoing safety concerns for nursing faculty supervising students during clinical education, particularly when teaching occurs in hospital environments where faculty are not employed. Faculty often rotate across multiple clinical sites and may lack consistent preparation or access to standardized safety education and reporting systems. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effect of a targeted educational intervention on nursing faculty perceived preparedness to recognize, de escalate, and report aggression encountered during clinical instruction. Guided by Bandura’s Social Cognitive Theory and Lewin’s Three Stage Change Model, …

Quality Improvement Project Strengthening Faculty Competence: The Impact Of Structured Debriefing Education On Nursing Faculty Confidence And Competency Compared To Current Practice, Sudaneyse Emmanuel

Doctor of Nursing Practice Projects

Nursing education sometimes struggles to prepare faculty to lead effective simulation-based learning and debriefing. Inconsistent debriefing practices can reduce faculty confidence and competency, limiting student reflection and the development of clinical judgment. This quality improvement project examined whether a structured debriefing education program could enhance nursing faculty confidence and competency in simulation debriefing compared with current practice at a technical college. The project used the Jeffries Simulation Theory and Lewin’s Change Theory as guides. The project used a one-group pretest-posttest design by using the C-Scale to measure confidence and the Facilitator Competency Rubric to measure competency among nursing faculty who …

Quality Improvement Project: Educating Nursing Faculty On Animal-Assisted Therapy: Enhancing Knowledge And Confidence To Improve Program Outcomes, Sarah J. Whitwell

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate whether an educational intervention on animal-assisted therapy (AAT) improved nursing faculty perceived knowledge and confidence in using AAT to improve program outcomes. The problem addressed was the limited knowledge and confidence among nursing faculty regarding the use of non-traditional, evidence-based strategies to support student mental health. This project was guided by the Stetler Model of Evidence-Based Practice and Lewin’s Change Theory and used a quasi-experimental, one-group pre–post design. The project was conducted with nursing faculty teaching in a baccalaureate program at a four-year public university in Oklahoma. A 10-item Likert-scale …

Dexmedetomidine (Precedex) Versus Propofol: In Patients Requiring Sedation While Mechanically Ventilated,, How Does The Use Of Dexmedetomidine (Precedex) Compared To Propofol, Affect Reintubation Within 48 Hours Post Extubation?, Kimberly Barbee, Markela Albright, Malak Amro, Evelyn Caty-Pletcher, Margaret Havey Phd, Aprn, Acnp-Bc, Chfn, Fhrs, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Keywords: dexmedetomidine, propofol, reintubation, sedation2

Abstract Assignment

Background

Sedation management in the ICU plays a key role in extubation readiness and post-extubation outcomes in mechanically ventilated patients. Although both propofol and dexmedetomidine are commonly used in critical care, there is limited evidence comparing their impact on early reintubation. This quality improvement (QI) project examined whether sedative choice was associated with reintubation within 48 hours of extubation.

Methods

A retrospective QI analysis was conducted in a cohort of 38 mechanically ventilated adult patients. Patients received either propofol (n = 31) or dexmedetomidine (n = 7) prior to extubation. Reintubation within …

Quality Improvement Project: Implementation Of A Screening Tool For Postpartum Depression, Yaminah Johnson

Doctor of Nursing Practice Projects

Postpartum depression (PPD) remains underrecognized in clinical practice, with many cases going undiagnosed due to inconsistent or absent screening processes. At the project site, only 60% of postpartum patients reported that their mental health needs were adequately addressed, highlight-ing a critical gap in care. The purpose of this quality improvement project was to implement an evidence-based PPD screening tool and evaluate its impact on provider confidence and patient outcomes. Guided by Lewin’s Theory of Planned Change and Orem’s Self-Care Deficit Theory, the project aimed to improve physician and nursing staff confidence in screening and increase appropriate interventions for patients who …

Promoting Maternal Health Through Community-Based Education: A Quality Improvement Initiative On Hypertension And Pregnancy Complications In An Outpatient Setting, Areli Mendez

Doctor of Nursing Practice Projects

Background

Hypertensive disorders during pregnancy remain one of the leading causes of maternal and fetal complications worldwide, particularly among underserved and minority populations. Spanish-speaking women often experience barriers related to language, limited health literacy, and reduced access to culturally appropriate education, which may delay the recognition of warning signs associated with pregnancy complications. Early education and awareness are essential to improve maternal outcomes and promote timely medical intervention.

Purpose Statement

The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the effectiveness of a culturally tailored educational intervention designed to improve maternal knowledge regarding hypertension during pregnancy …

The Impact Of Simulation-Based Education On Novice Nurses’ Knowledge Of Pressure Injury Prevention, Michelle "Mikki" Cantu

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries remain a significant patient safety concern in acute care settings despite the availability of evidence-based prevention guidelines. Novice nurses, who often have limited clinical experience and exposure to wound care education, may be less prepared to consistently identify risk factors, accurately stage pressure injuries, and implement appropriate preventive strategies. Simulation-based education offers an experiential learning approach that supports the translation of evidence-based knowledge into clinical practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the effectiveness of simulation-based education in improving novice nurses’ knowledge of pressure injury identification and prevention. The …

Quality Improvement Project: Enhancing Self-Efficacy Through Inacsl Standards Training, Amy Bortner

Doctor of Nursing Practice Projects

Simulation-based education (SBE) is a widely used instructional strategy in nursing curricula; however, formal training for faculty and staff who implement it may be inconsistent or limited. Current literature supports the need for structured, evidence-based training to ensure effective use of simulation-based education and promote best practices in teaching and learning. The Doctor of Nursing Practice (DNP) project aims to improve perceptions and self-efficacy regarding the use of the International Nursing Association of Clinical Simulation and Learning (INACSL) standards, which guide simulation education. Driven by Kurt Lewin’s change theory and Jeffries Simulation Theory, twelve volunteers completed the Faculty Attitude and …

Quality Improvement Project: Provider Knowledge Improvement For Care Of The Severely Hypertensive Obstetric Patient, Victoria Abramowitz

Doctor of Nursing Practice Projects

Gaps in confidence among emergency department (ED) and maternal child health services (MCHS) staff negatively impacts effectiveness and timeliness of response to high acuity obstetric emergencies, such as severe obstetric hypertension. The purpose of this quality improvement project was to evaluate the impact on provider self-efficacy with the implementation of evidence-based education and standardized procedures for severe obstetric hypertension management, aimed at evaluating the degree of success of increasing provider confidence. The project was guided by Lewin’s change theory and Donabedian’s structure-process-outcome theoretical framework. With a quasi-experimental design and the PDSA implementation framework, 20 staff from both the ED and …

Quality Improvement Project: Improving Pneumococcal Vaccination Rates Through Provider Education In Primary Care, Leikasha Allen

Doctor of Nursing Practice Projects

Pneumococcal disease remains a major cause of illness and mortality among adults aged 65 years and older, leading to severe pneumonia, bacteremia, and meningitis, particularly in vulnerable populations. Although effective vaccines and clear Centers for Disease Control (CDC) and Advisory Committee Immunization Practice (ACIP) guidelines, vaccination in this age group remains inadequate. This Doctor of Nursing Practice (DNP) quality improvement project aimed to determine the impact of pneumococcal vaccination compliance through evaluating provider knowledge, confidence, and adherence to evidence-based guidelines through targeted education. Guided by Rogers’ Diffusion of Innovation Theory and the Health Belief Model, a 20-minute evidence‑based educational session …

Quality Improvement Project: Impact Of National Culturally And Linguistically Appropriate Services (Clas) Standards Education On Behavioral Health Providers’ Self-Efficacy, Zita Anigbou

Doctor of Nursing Practice Projects

Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners …

Implementation Of A Standardized Suicide Risk Screening Protocol Using The Columbia-Suicide Severity Rating Scale (C-Ssrs) In An Outpatient Mental Health Clinic, Kemisola Ebietomiye

Doctor of Nursing Practice Projects

The outpatient mental health clinics across the United States lack consistent suicide risk assessment methods. This project developed standardized procedures which used Columbia-Suicide Severity Rating Scale (C-SSRS) assessment together with provider education and electronic health record systems to evaluate how these elements impacted provider self-efficacy and their ability to record screening results. The project used a pre-post design to examine (n=24) psychiatric providers at an urban outpatient clinic through the combined methods of Lewin's Change Theory and the Plan-Do-Study-Act framework. The General Self-Efficacy Scale measured provider self-efficacy, and structured EHR audits tracked documentation rates pre- and post-implementation over six weeks. …

Quality Improvement Project: Empowering Nurses And Medical Assistants To Improve Medication Adherence: A Screening-Based Quality Improvement Initiative, Maria Garcia

Doctor of Nursing Practice Projects

Medication nonadherence is a persistent challenge in clinical settings that negatively influences patient outcomes and is often driven by cost, access, and patient-related barriers, as widely documented in the literature. Nurses and medical assistants play a critical role in identifying these barriers; however, inconsistent screening and limited staff confidence may hinder intervention. The purpose of this quality improvement project was to evaluate the impact of implementing the Brief Medication Questionnaire (BMQ) on staff confidence in addressing medication adherence and to assess clinic-wide utilization of the tool. The project was guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change …

Quality Improvement Project Standardizing Simulation In Nursing Education: A Faculty Training Initiative, Andrea Reyes

Doctor of Nursing Practice Projects

Simulation-based education is essential in nursing programs as clinical placement opportunities decline. However, inconsistent faculty preparation can compromise the quality of simulation delivery. The purpose of this quality improvement project was to implement and evaluate a standardized simulation faculty training initiative to determine its impact on nursing faculty's confidence in simulation facilitation. Guided by the Jeffries Simulation Framework and Lewin’s Change Theory, a quasi-experimental pre-post design was used to examine changes in faculty confidence following participation in a training program aligned with national standards and guidelines. Faculty confidence was measured using the Simulation Educator Needs Assessment Tool (SENAT) administered pre- …

Improving Diabetes Care: Staff Training On Updated Ada Guidelines, Jeffrey Wilson

Doctor of Nursing Practice Projects

The incidence of diabetes is rising, requiring clinical staff to stay current with the American Diabetes Association (ADA) Standards of Care. A lack of knowledge and outdated practices were revealed during the needs assessment at the project site. This quality improvement (QI) project sought to determine whether ADA‑centered educational training could impact staff members' knowledge of diabetes. Orem’s Self‑Care Deficit Nursing Theory and Lewin’s Change Theory served as the theoretical frameworks to promote provider competence and adherence to evidence‑based diabetes treatment. Quasi‑experimental pre–post design was used with a convenience sample of four clinical staff at a rural outpatient clinic. Study …

Quality Improvement Project: Protecting Young Kidneys: Optimizing Albuminuria Management In Youth With Diabetes, Mili Vakharia

Doctor of Nursing Practice Projects

Diabetic nephropathy is a major microvascular complication and the leading cause of chronic kidney disease (CKD) among individuals with diabetes. Children and adolescents with type 1 and type 2 diabetes face a higher risk of developing CKD earlier in life due to longer disease duration, poor glycemic control, and delayed CKD diagnosis. Guidelines emphasize timely detection and intervention to slow disease progression. Albuminuria is an early marker of glomerular injury and signals the need to initiate CKD treatment. Despite evidence supporting early detection and treatment, standardized management of albuminuria in pediatric diabetes care remains inconsistent. This Doctor of Nursing Practice …

Quality Improvement Project: Use Of The Behavioral Risk Assessment Tool To Enhance The Utilization Of The Behavioral Emergency Response Team, Joseph Sindhu

Doctor of Nursing Practice Projects

Workplace violence is a global challenge, and nurses often encounter patient aggression. The purpose of this quality improvement project was to enhance the use of a behavioral assessment tool derived from the Brøset Violence Checklist and the Behavioral Emergency Response Team (BERT) to de-escalate workplace violence. This project aimed to improve behavioral assessment documentation and BERT use in a critical care unit by 30% within 5 weeks. Guided by the Donabedian Model theoretical framework and Lewin's Change Theory, the project employed a quasi-experimental, pretest-posttest design in an advanced heart failure unit with full-time nurses as participants. The Plan-Do-Study-Act (PDSA) framework …

Standardizing Patient-Centered And Trauma-Informed Communication Practices Among Staff In A Behavioral Health Setting, Jayla Brown

Doctor of Nursing Practice Projects

The purpose of this quality improvement project was to evaluate the effect of an evidence-based educational intervention on staff attitudes toward trauma-informed and patient-centered communication in an outpatient behavioral health clinic. Guided by Lewin’s Change Theory and Jean Watson’s Theory of Human Caring, the project aimed to improve staff knowledge, attitudes, and confidence in applying trauma-informed communication strategies across all clinic roles. An eight-week educational intervention based on the SAMHSA Trauma-Informed Care Toolkit was implemented for clinical and administrative staff. A quantitative pretest–posttest quasi-experimental design was used, with outcomes measured using an adapted Attitudes Related to Trauma-Informed Care scale. All …

Implementation Of A Mentoring Toolkit: A Quality Improvement Project, Joshlyn Neu

Doctor of Nursing Practice Projects

Nursing faculty mentorship is an essential component of professional development, job satisfaction and faculty retention. However, many schools lack a structured approach to preparing their faculty members to act as mentors. This quality improvement project set out to determine whether the implementation of a formal mentoring toolkit would improve nursing faculty members perceived competency to act as mentors. Guided by Bandura’s Social Cognitive Theory (SCT), Lewin’s Change Theory, and the latest evidence-based research, this project sought to answer the following question: In full-time nursing faculty members teaching in a BSN program at a small, private college (P), how does the …

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Addressing Faculty Gaps In The Psychiatric Mental Health Nurse Practitioner Program, Shea Brock

Doctor of Nursing Practice Projects

Graduate nursing programs increasingly rely on adjunct faculty to sustain enrollment growth; however, inconsistent onboarding processes may contribute to variability in faculty preparedness and job satisfaction. The purpose of this quality improvement project was to implement a standardized adjunct faculty education program and evaluate its impact on adjunct faculty knowledge and job satisfaction within an online Psychiatric–Mental Health Nurse Practitioner (PMHNP) program. A quantitative, quasi-experimental one-group pre–post design was utilized. Six adjunct faculty members (n = 6) completed a 10-item EXXAT Knowledge Survey and a 10-item Faculty Satisfaction Survey before and after participation in a structured one-hour education session focused …

Optimizing Patient Adherence Through Improved Technology-Based Communication By Enhancing Staff Efficiency At An Opiate Treatment Program Clinic, Jennifer Parsons

Doctor of Nursing Practice Projects

High rates of missed appointments and unreliable follow-up remain a problem in outpatient opioid treatment clinics. This project improved the communication workflow at a methadone maintenance clinic by strengthening reminder systems and staff coordination. A needs assessment found several problems: appointment reminders were inconsistent, tracking was unreliable, and staff communication often relied on manual handoffs. The project was to test a technology-based workflow designed to improve staff communication and reduce missed appointments. The Technology Acceptance Model and Lewin’s Change Theory guided the change. The clinic implemented automated reminders, secure messaging, and clearer documentation to support daily communication. A pre-post evaluation …

Quality Improvement Project: Integrating Modified Early Warning Score (Mews) Criteria Into A Local Community College's Nursing Curriculum, Breanna C. Bell

Doctor of Nursing Practice Projects

There is an international priority for early recognition of patient deterioration with adequate responses to facilitate patient safety. The modified early warning score (MEWS) tool is commonly used to identify and respond to acute patient deterioration, so it is effective to educate nursing students on its use to influence their future practice. However, there is a lack of a curriculum to integrate MEWS criteria for associate degree in nursing (ADN) students at a local community college. This quality improvement project aimed to enhance ADN faculty’s self-efficacy and ability to integrate MEWS criteria into the didactic curriculum at a community college …

Quality Improvement Project: Leveling Pharmacology: A Faculty Development Initiative, Allison Berg

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to address limited faculty self-efficacy in developing higher-level, competency-based pharmacology questions for clinical quizzes within an Associate Degree in Nursing (ADN) program. A faculty needs assessment identified an overreliance on recall-based pharmacology assessments, contributing to gaps in students’ clinical reasoning and medication competency. Guided by Bandura’s Theory of Self-Efficacy and Lewin’s Change Theory, a structured faculty development session was implemented to improve faculty confidence and skills in writing application-based pharmacology questions. A pre- post intervention design was used with ADN faculty participants (N = 5) at a …

Improving Lunch Break To Enhance Nurse Happiness And Job Satisfaction, Evelyn O. Dumkwu

Doctor of Nursing Practice Projects

Nurses frequently forgo scheduled lunch breaks due to high workload demands, inadequate staffing, and organizational cultures. Consistently skipping breaks has been associated with reduced happiness and lower job satisfaction, which may ultimately compromise the quality of patient care. This quality improvement (QI) project examined whether the structured observance of scheduled lunch breaks enhances nurses’ subjective happiness and job satisfaction. Guided by Lewin’s Change Theory and the Donabedian Theoretical Framework and implemented using the Plan–Do–Study–Act (PDSA) framework, the project employed a quasi-experimental pre–post design during a six-week implementation period. Ten full-time nurses participated in the project. Investigator-designed Subjective Happiness and Job …

Quality Improvement Project: Effectiveness Of Staff Education On Fall Prevention, Theresa Oahre Okoyomo

Doctor of Nursing Practice Projects

Falls increase injury and mortality rates and decrease patients' quality of life. Hospital falls also incur enormous financial burdens on hospitals. In 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for fall-related injuries. The problem addressed in this quality improvement project was staff confidence in fall prevention and hospital fall rates. The purpose is to improve staff confidence and reduce fall rates by 95 % within six weeks. The 2025 CDC/STEADI Algorithm for Fall Risk Screening, Assessment, and Intervention was the program of choice because it aligns with the hospital's fall-prevention policy. This project design is …

Quality Improvement Project: Reducing Test Anxiety: Faculty Training For Supporting Students, Chichi Markham

Doctor of Nursing Practice Projects

Test anxiety significantly affects nursing students’ academic performance and well-being. Emotional Freedom Techniques (EFT) offer a non-pharmacological method for alleviating anxiety; however, research on faculty-centered approaches in nursing education is limited. The purpose of this quality improvement project is to evaluate the impact of EFT training on nursing faculty’s knowledge, attitudes, and confidence regarding test anxiety, as well as on student exam performance. Guided by Lewin’s Change Theory, Stetler’s Model, and the Plan-Do-Study-Act (PDSA) cycle, the initiative aimed to enhance faculty capacity to identify and address test anxiety within a prelicensure nursing program. A pre-post quality improvement design involved faculty …

Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish

Doctor of Nursing Practice Projects

Medication administration errors remain a persistent threat to patient safety in emergency department settings, where high acuity, rapid throughput, and workflow interruptions increase vulnerability to preventable adverse events. The purpose of this Doctor of Nursing Practice quality improvement project was to increase medication-safety knowledge scores by at least 10% and reduce medication administration error rates by 20% within eight weeks among registered nurses in a freestanding emergency department in South Texas. The project was grounded in Lewin’s Change Theory as the theoretical framework and implemented using the Plan–Do–Study–Act quality improvement model. A quasi-experimental, single-group pretest–posttest design was used with a …

Quality Improvement Project: Enhancing Nurse Communication, Courtesy, And Respect At The Bedside, Rachel Kemp

Doctor of Nursing Practice Projects

Effective communication is key to the nurse-to-patient relationship, patient outcomes, and patient satisfaction. The literature widely shows that barriers such as increased workplace violence and fear and biases within patient interactions hinder communication. This quality improvement project aimed to enhance nurse-to-patient communication, using an evidence-based tool, and leveraged Foli’s Theory of Nurses’ Psychological Trauma to explain and predict barriers. Success is measured by improvement of patient experience in the three nursing domains; courtesy and respect, listen to you, and explain in a way you understand. Lewin’s Change Theory and the plan, do, study, act (PDSA) framework was used to promote …