Nursing Commons^™

Enhancing Cultural Competency Through Training In A Primary Care Clinic, Rogelio Perez Iii

Doctor of Nursing Practice Projects

Cultural competence remains essential in primary care settings serving diverse populations, yet staff at a small Southern Texas primary care clinic reported no previous formal cultural competency training in workplace orientation or school. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a brief, evidence-based cultural competency intervention improved clinician cultural competency scores. Madeleine Leininger’s Culture Care Theory provided the theoretical framework, Lewin’s Change Theory guided the change process, and the Plan-Do-Study-Act cycle directed implementation and evaluation. The problem addressed was the lack of structured training to support culturally responsive communication, patient trust, and …

Impacting Competency In C-Ssrs Suicide Risk Screening On An Inpatient Psychiatric Unit, Fidelis Sangye

Doctor of Nursing Practice Projects

Suicide remains a leading public health concern, and inconsistent application of the Columbia-Suicide Severity Rating Scale (C-SSRS) may contribute to variability in suicide risk assessment and delayed intervention within inpatient psychiatric settings. The purpose of this quality improvement (QI) project was to evaluate the effectiveness of a standardized C-SSRS-guided educational intervention on staff competency in suicide risk screening. Guided by Lewin’s Change Theory and implemented using the Plan-Do-Study-Act (PDSA) framework, this quantitative pretest-posttest QI project was conducted on an adult inpatient psychiatric unit. The intervention consisted of a 25-minute instructor-led PowerPoint presentation on standardized C-SSRS administration and evidence-based suicide risk …

Evaluation Of Implementation Of An Evidence-Based Screening Tool For Genitourinary Syndrome Of Menopause, Anna L. Myers

Doctor of Nursing Practice Projects

Genitourinary syndrome of menopause (GSM) is a prevalent yet underrecognized and undertreated condition despite evidence-based therapies in the urology setting. The purpose of this Doctor of Nursing Practice quality improvement was to provide education on the 2025 American Urological Association/ Society of Urodynamics and Female Pelvic Medicine & Urogenital Reconstruction/American Urogynecological Society GSM guidelines and integrate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire into practice, evaluate outcomes of acceptability, appropriateness, and feasibility of the intervention, and the impact on diagnosis and associated GSM prescribing. The aim was to impact provider screening and treatment of patients with GSM. Kolcaba's Comfort …

Quality Improvement Project From Novice-To-Expert: Training Nurse Faculty On Virtual Simulation, Dae'visha Kinniebrew

Doctor of Nursing Practice Projects

Virtual simulation is an evidence-based teaching strategy that enhances student learning; however, inconsistent faculty preparation limits its implementation in nursing education. A needs assessment identified a practice gap, with 70% of nursing faculty reporting no virtual simulation training within the previous 12 months. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to evaluate the effectiveness of a structured non-immersive virtual simulation training program on nursing faculty confidence, perceived competence, and technology readiness in an Associate Degree Nursing (ADN) program. The aim was to improve faculty preparedness to implement non-immersive virtual simulation. A quantitative, quasi-experimental, …

The Impact Of A Structured Education Program On Artificial Intelligence Use For Nursing Faculty On Teaching Practices, Katy White

Doctor of Nursing Practice Projects

Artificial intelligence (AI) is increasingly integrated into nursing education; however, nursing faculty report inconsistent preparedness, including gaps in AI knowledge and self-efficacy for responsible AI integration. This quality improvement project addressed inconsistent faculty preparedness through an asynchronous AI educational program. The purpose was to address gaps in AI knowledge and self-efficacy, and the aim was to evaluate changes in AI self-efficacy and AI knowledge while supporting AI integration into nursing education. Rogers' Diffusion of Innovations Theory served as the change theory, the Technology Acceptance Model served as the theoretical framework, and the Plan-Do-Study-Act framework guided implementation. A quantitative one-group pretest-posttest …

Quality Improvement Project: Experienced Nurse To Novice Adjunct Educator: Bridging The Gap, Karen Liddy

Doctor of Nursing Practice Projects

A formal mentoring program is an effective approach for enhancing mentee satisfaction and self-efficacy and decreasing turnover rates. Although evidence supports the benefits of mentoring, many universities lack formal mentoring programs for adjunct faculty. Utilizing the PDSA framework, this quality improvement Doctor of Nursing Practice (DNP) project executed and evaluated a structured adjunct faculty mentoring program to improve faculty self-efficacy and mentee satisfaction. The project was led by Bandura's Social Cognitive Theory and the Theory of Change and used a pre- and post-test design involving adjunct nursing faculty members with fewer than three years of academic teaching experience. Mentors and …

Quality Improvement Project: Advancing Personalized Depression Care In Outpatient Psychiatry, Jillian K. Benoit

Doctor of Nursing Practice Projects

Depression is a leading cause of disability worldwide, yet inconsistent use of evidence-based assessment and treatment strategies contributes to gaps in the quality of psychiatric care. A needs assessment at a community outpatient psychiatric clinic identified inconsistent documentation of measurement-based care (MBC), shared decision-making (SDM), and patient education during depression treatment. The purpose of this quality improvement project was to evaluate whether implementation of MBC and SDM improved depression treatment documentation among psychiatric providers over a 4-week period. Guided by Lewin’s Change Theory and implemented using the Iowa Model of Evidence-Based Practice as the implementation framework, this quantitative one-group pretest-posttest …

Quality Improvement Project Simulating Ethics: Improving Ethical Decision-Making In Nursing Undergraduates Through Simulation And Faculty Training, Shannon Brown

Doctor of Nursing Practice Projects

Nursing faculty often report limited confidence in teaching ethical principles, despite the essential role ethics plays in preparing students for complex clinical decision-making. This quantitative, quasi-experimental pre/post quality improvement project evaluated whether a structured ethics education module incorporating simulation could impact faculty confidence in teaching ethical principles. Guided by Lewin’s Change Theory and the Jeffries Simulation Framework, the project examined how organizational readiness for change and structured simulation design influence faculty development outcomes. Nursing faculty in a baccalaureate program participated in a single simulation-enhanced ethics session. Data were collected through anonymous pre/post Qualtrics surveys, and faculty confidence was measured using …

Improving Exam Scores: Alternative Next Generation Questions In Curriculum, April Morgan

Doctor of Nursing Practice Projects

Evidence identifies clinical judgment deficits among newly licensed nurses, supporting the integration of the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (NCJMM) and Next Generation NCLEX (NGN) strategies. Inconsistent NGN implementation and Assessment Technologies Institute (ATI) Comprehensive Predictor performance established the local problem. This quality improvement project evaluated the impact of implementing NCJMM-aligned NGN instructional strategies, including unfolding case studies and bow-tie questions, on students’ first-attempt achievement of the ATI Comprehensive Predictor benchmark and faculty outcomes. The primary aim was to increase the percentage of students achieving the ATI Comprehensive Predictor benchmark of 76.2% on …

Hypothermia Management In Adult Trauma Patients: Enhancing Nursing Knowledge And Self-Efficacy In The Emergency Department, Shannon M. Rapert

Doctor of Nursing Practice Projects

Trauma-induced hypothermia is a significant, preventable condition that contributes to increased mortality. Evidence suggests that inconsistent recognition and management of hypothermia persist in the emergency department (ED), highlighting the need to strengthen ED nurses’ knowledge and self-efficacy in evidence-based warming strategies. The purpose of this quality improvement project was to evaluate the impact of an educational intervention on ED nurses’ knowledge and self-efficacy in managing trauma-induced hypothermia. Guided by the Iowa Model of Evidence-Based Practice, the ADKAR Change Model, and the Plan-Do-Study-Act framework, this quantitative, quasi-experimental, pretest–posttest project evaluated the effect of an instructor-led educational intervention in ED nurses at …

Standardizing Hypertension Care In An Occupational Medicine Clinic: A Quality Improvement Project, Carolyn Duncan

Doctor of Nursing Practice Projects

Hypertension remains a leading modifiable risk factor for cardiovascular disease, and inconsistent implementation of evidence-based hypertension management may contribute to variability in patient education, documentation, and follow-up care. This quality improvement project evaluated an evidence-based educational program and a standardized hypertension management workflow, based on the 2025 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines, in an occupational medicine clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's 8-Step Change Model, and the Plan-Do-Study-Act framework, the intervention aimed to impact staff self-efficacy, documentation of lifestyle education, and follow-up appointment scheduling. A quantitative quasi-experimental pre-post design was used with …

Quality Improvement Project: Improving Confidence And Clinical Judgment Through Simulation Remediation In Nursing Students, Erica Gillespie

Doctor of Nursing Practice Projects

Simulation is a critical component of nursing education, providing students with a safe environment to develop clinical judgment and confidence before entering clinical practice. However, students may experience anxiety and difficulty meeting competency expectations during simulation. This quality improvement project evaluated whether structured simulation remediation improved confidence and clinical judgment among associate degree nursing students. The project was guided by the NLN Jeffries Simulation Framework, and Kotter’s 8-Step Change Model supported implementation. A quantitative, quasi-experimental pre-/post- intervention design was used. Nine nursing students voluntarily participated. During remediation, students reviewed recordings of their initial simulation experiences and completed guided reflection questions …

Quality Improvement Project Improving Provider Confidence For Medication Adherence Screening Through Use Of The Medication Adherence Rating Scale (Mars), Tamara Cheek

Doctor of Nursing Practice Projects

Medication nonadherence affects 50% to 70% of individuals with serious mental illness. This contributes to symptom relapses, hospitalization, poor treatment outcomes, and higher healthcare costs. The purpose of this quality improvement project was to evaluate the impact of a competency-based Medication Adherence Rating Scale (MARS) training program on provider confidence and standardized adherence screening in a psychiatric clinic, to improve confidence and increase use of a standardized assessment. Guided by Bandura's Self-Efficacy Theory and Lewin's Change Management Model and implemented using the Plan-Do-Study-Act framework, the project used a quantitative quasi-experimental pre-post design with eight psychiatric mental health nurse practitioners. Data …

Quality Improvement Project: Addressing Appointment Non-Adherence Through Social Needs Screening, Dorathy Anderson

Doctor of Nursing Practice Projects

Mental health care access in the US faces systemic barriers that delay treatment and disrupt care, often worsening patient outcomes. Unmet social needs of health, such as transportation, financial, and housing issues, lead to missed appointments and fragmented care, thereby increasing health disparities. This quality improvement project evaluated whether targeted staff education improved the identification and response to social needs that affect appointment adherence. Adult Learning Theory guided the training, while Lewin’s Theory of Change and the Plan-Do-Study-Act framework informed implementation and evaluation. The intervention population consisted of five clinic staff members. A quasi-experimental pretest-posttest design was used to evaluate …

The Impact Of Telephonic Versus Video Platforms On Nurses’ Intrinsic Motivation: An Evidence-Based Practice Project, Brittney Saldierna

Doctor of Nursing Practice Projects

Ambulatory pediatric nurses frequently rely on telephone-only encounters for telehealth triage and patient education despite the availability of video-enabled technology. Literature demonstrates that the inability to visually assess patients limits clinical assessment accuracy, communication effectiveness, and nurse confidence. The purpose of this evidence-based practice project was to evaluate whether educating ambulatory pediatric nurses on the integration of video-enhanced telehealth encounters impacts intrinsic motivation and perceived competence compared with telephone-only encounters. Guided by the Iowa Model of Evidence-Based Practice and the ADKAR Change Management Model, this quantitative, quasi-experimental project was applied utilizing the PDSA cycle implementation framework in ambulatory pediatric specialty …

Quality Improvement Project: The Impact Of Standardized Handoff Communication In A Home Acute Care Setting, Antonius Devon Speed

Doctor of Nursing Practice Projects

Effective nurse-to-nurse handoff communication is essential in hospital-at-home telehealth care, where remote nurses depend on accurate electronic health record documentation and structured shift-to-shift communication. This quality improvement project evaluated whether education and implementation of a standardized Situation, Background, Assessment, Recommendation (SBAR) workflow improved staff-reported handoff quality and reduced communication-related near-miss events over 8 weeks. Lewin's Change Theory, Rogers's Diffusion of Innovations, and the Plan-Do-Study-Act framework guided implementation and sustainability. A quantitative, quasi-experimental one-group pretest-posttest design was used. The intervention included SBAR education, a workflow checklist, and a handoff template. Outcomes were selected Handover Evaluation Scale (HES) responses and aggregate near-miss …

Quality Improvement Project: Implementation Of Trauma-Informed Care Education In An Outpatient Psychiatric Clinic, Ornela Claude Ika

Doctor of Nursing Practice Projects

Trauma-informed care (TIC) is an evidence-based approach that promotes safe, patient-centered care for individuals with a history of trauma. Many patients receiving services in psychiatric settings have experienced trauma, placing them at risk for retraumatization during healthcare encounters. Despite the recognized benefits of TIC, the outpatient psychiatric clinic involved in this project lacked a formal trauma-informed care education program for staff. The purpose of this quality improvement project was to determine whether implementation of a structured trauma-informed care educational intervention improved staff attitudes toward trauma-informed care. Lewin’s Change Theory and the Plan-Do-Study-Act framework guided project implementation. A quantitative pre-intervention and …

Quality Improvement Project: Impact Of Adjunct Clinical Faculty Mentorship On Self-Confidence: A Quality Improvement Project, Fairah Solomon

Doctor of Nursing Practice Projects

Novice adjunct clinical faculty transitioning from expert clinicians to nurse educators face many challenges, particularly in understanding their roles, responsibilities, and educational frameworks. Despite an established orientation at the project site, a structured mentorship program to support the role transition is lacking. This quality improvement (QI) project aimed to improve novice adjunct clinical faculty’s self-confidence through the implementation of a structured mentorship intervention. Guided by Lewin's Change Theory and Constructivist Learning Theory, the project utilized a quasi-experimental pre- and post-test design. Implementation was guided by the Plan-Do-Study-Act framework. A purposive sample of seven novice adjunct clinical faculty with less than …

Quality Improvement Project The Impact Of The Interact “Stop And Watch Tool” In A Skilled Nursing Facility, Lorraine Hicks

Doctor of Nursing Practice Projects

Avoidable hospitalizations from skilled nursing facilities (SNF) contribute to increased healthcare costs, resident distress, and adverse health outcomes. Many readmissions result from delays in identifying and communicating early signs of resident deterioration. The purpose of this project was to implement an evidence-based intervention to recognize early changes in residents’ conditions, empower nursing staff to detect and promptly communicate concerns, and impact 30-day hospital readmission rates. Problems identified included delayed recognition of early changes in residents’ conditions, fragmented staff communication, and the absence of standardized reporting practices, which were associated with preventable hospital readmissions. A quasi-experimental pre-/post-intervention design guided by Jean …

Enhancing Teaching Effectiveness Through Professional Development For Part-Time Nursing Faculty, Amanda Moss

Doctor of Nursing Practice Projects

Part-time nursing faculty play a vital role in nursing education; however, many institutions lack standardized professional development opportunities for part-time faculty, resulting in inconsistent preparation and teaching practices. This Doctor of Nursing Practice policy change project examined whether revising an institutional professional development policy to include part-time faculty and implementing a structured faculty development program would improve faculty preparedness, confidence, and comfort with evidence-based teaching practices and instructional strategies that support ACEN faculty development expectations. Guided by the Iowa Model–Revised of Evidence-Based Practice, Kotter’s Organizational Change Theory, and the Plan-Do-Study-Act (PDSA) framework, this quantitative policy change project was conducted over …

Quality Improvement Project: The Impact Of A Safety Coach Program In A Pediatric Intensive Care Unit, Royanne Lickliter

Doctor of Nursing Practice Projects

Patient safety remains a critical concern in healthcare, with hospital-acquired conditions (HACs) contributing to preventable harm, mortality, and increased costs, particularly in high-acuity settings such as Pediatric intensive care units (PICUs). A recent safety culture survey at a tertiary pediatric hospital identified gaps in proactive safety behaviors, communication, and psychological safety. The primary problem identified was inconsistent engagement in proactive safety practices and limited frontline empowerment to identify and mitigate risks in real time. The purpose of this quality improvement (QI) project was to evaluate the impact of implementing a structured Safety Coach Program in the PICU on HAC rates, …

Quality Improvement Project: Impact Of Formalized Debriefing On Correctional Health Emergency Response, Angel Woody

Doctor of Nursing Practice Projects

Structured debriefing following medical emergencies has been identified as an evidence-based strategy to improve communication, reflective learning, and staff confidence within high-acuity healthcare settings. Inconsistent debriefing practices within correctional healthcare environments contributed to a gap in emergency response support and staff preparedness. The purpose of this quality improvement project was to evaluate whether implementation of a formalized debriefing protocol following medical emergencies impacted staff confidence during emergency response situations within a correctional healthcare setting. The project was guided by Bandura’s Self-Efficacy Theory and Lewin’s Change Theory. A quantitative one-group pretest-posttest quality improvement design was implemented in a county correctional healthcare …

Preparing Adjunct Clinical Instructors For Success: The Impact Of A Structured Orientation Program On Perceived Capabilities As Measured By The Capabilities Of Nurse Educators (Cone) Questionnaire, Amanda Stone

Doctor of Nursing Practice Projects

Adjunct clinical instructors are essential in helping nursing students connect classroom learning to real-world patient care. A needs assessment within an associate degree nursing (ADN) program identified that adjunct clinical instructors received only a brief overview of policies, contributing to role uncertainty and inconsistent preparation for clinical teaching responsibilities. Current literature supports the use of structured orientation and mentorship to better prepare nurses as they transition into clinical educator roles. The purpose of this quantitative, quasi-experimental quality improvement project was to evaluate the impact of a structured orientation program on adjunct clinical instructors’ perceived capabilities. Guided by the Plan-Do-Study-Act change …

Quality Improvement Project: Impact Of An Escape Room Simulation Tool On Nursing Confidence, Farren M. Moore

Doctor of Nursing Practice Projects

This quality improvement project aims to address the need for innovative teaching strategies to meet the demands of licensure exams and the increasing complexity of patient care. Evidence supports simulation-based learning as an effective method to enhance critical thinking and clinical judgment; however, faculty members lack confidence in implementing innovative strategies in their courses. The purpose of this project is to determine whether a standardized escape room simulation tool would impact faculty’s self-confidence in developing and implementing simulation-based activities. Guided by the National League for Nursing (NLN) Jeffries Simulation Theory and Lewin’s Change Theory, the project evaluates the change in …

Evaluating The Impact Of Evidence-Based Education On The Utilization Of Preoperative Gastric Ultrasound For Patients On Glp-1 Agonists, Rachel K. Gibbons, Wesley Johnson, Rachel Cartillar

Create@State

Abstract

Patients taking glucagon-like peptide-1 (GLP-1) receptor agonists have a 30.5% higher prevalence of retained gastric contents at the time of surgery despite being held according to ASA and AANA recommendations, highlighting the need for enhanced preoperative assessment to reduce aspiration risk (Sen et al., 2024; Willson et al., 2024). Although an effective, noninvasive tool for assessing gastric contents and reducing the risk of pulmonary aspiration, gastric ultrasound remains underutilized in anesthesia practice (Pan et al., 2024). This evidence-based project evaluated whether an educational intervention could improve anesthesia providers’ knowledge, attitudes, and readiness to adopt point-of-care gastric ultrasound (POC-GUS) into …

Impact Of Provider Confidence And Psychiatric Referrals Through Education And Implementation Of The Gad-7 Anxiety Screening Tool In An Outpatient Family Clinic, Maceline E. Check

Doctor of Nursing Practice Projects

Gaps in provider and nurse confidence in identifying and managing anxiety disorders in outpatient family clinic settings contribute to underdiagnosis, delayed intervention, and reduced psychiatric referrals. This quality improvement project evaluated the impact of provider education and implementation of the Generalized Anxiety Disorder-7 (GAD-7) screening tool on provider and nurse confidence and appropriate psychiatric referral rates, with the goal of improving clinical decision-making and standardizing anxiety screening practices. The project was guided by Lewin’s Change Theory and the Iowa Model of Evidence-Based Practice. Using a quasi-experimental pre- and post-intervention design, providers and nurses in an outpatient family clinic received structured, …

Quality Improvement Project: Evaluating The Effectiveness Of Chlorhexidine Gluconate Bathing Education On Staff Perceived Knowledge, Kaonta Spencer

Doctor of Nursing Practice Projects

A community hospital set strategic goals to achieve Vizient top-decile performance and drive continuous improvement by reducing surgical site infection (SSI) rates. The purpose of this quality improvement project was to support this goal by implementing an evidence-based educational intervention to improve nurses' perceived knowledge and self-reported ability with the chlorhexidine gluconate (CHG) bathing protocol for hysterectomy patients. Guided by Lewin's Change Theory, the Iowa Model Revised, and the Iowa Implementation Framework, the educational intervention applied a structured approach to address behavioral and organizational barriers contributing to protocol noncompliance. A quantitative, quasi-experimental pre- and post-intervention design was used to evaluate …

Quality Improvement Project: Improving Interdisciplinary Care In Nursing Education Through Simulation, Anna Williams

Doctor of Nursing Practice Projects

Interprofessional education (IPE) is essential in preparing nursing students for effective teamwork and communication in clinical practice and is supported by the literature as improving these outcomes. However, limited faculty training in interprofessional simulation design contributes to reduced IPE opportunities within nursing curricula. A needs assessment at the project site identified a lack of structured, hands-on training for simulation faculty, resulting in decreased faculty confidence and limited implementation of IPE simulations. The purpose of this quality improvement project was to evaluate whether a structured training intervention improved simulation faculty self-efficacy in developing and implementing IPE simulations. Bandura’s Self-Efficacy Theory guided …

Implementation Of A Nurse-Led Discharge Protocol To Impact Nurse Confidence And Optimize Transitional Care Management, Jessi-Ann Elrod

Doctor of Nursing Practice Projects

Heart failure (HF) remains a leading cause of hospitalization and readmission, with the transition from hospital to home representing a vulnerable period for patients. Variability in discharge education and follow-up scheduling contributes to poor self-management and adverse outcomes. This quality improvement (QI) project evaluated whether implementing a standardized nurse-led HF discharge protocol impacted nurses' confidence and the rate of 7–14-day transitional care management (TCM) follow-up appointments. Guided by Meleis’ Transitions Theory and Lewin’s Change Theory, a one–group pretest–posttest QI design was implemented on a cardiac step-down unit. Twelve discharge nurses participated. The intervention included a structured education session and the …

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, …