Nursing Commons^™

Improving Compliance With Preoperative Antibiotic Protocols For Cardiac Implanted Electronic Devices: A Quality Improvement Project, James Kaup

DNP Projects

Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Standardizing The Use Of The Sinc Screening Tool In A Rural Clinic, Madison Foss

DNP Projects

Unmet contraceptive need represents a persistent quality gap in rural primary care, where reproductive health discussions are often inconsistently addressed. A rural primary care clinic in Shelbyville, Tennessee lacked a standardized, evidence-based process for screening women of childbearing age (15–44 years) for contraceptive needs. This quality improvement project evaluated the feasibility and effectiveness of implementing the Self-Identified Need for Contraception (SINC) screening tool to support routine, patient-centered care. The SINC tool consists of a single validated question designed to identify patients who wish to discuss contraception or pregnancy prevention during clinical visits. Plan–Do–Study–Act cycles were used to integrate the tool …

Standardizing Syphilis Screening In Tennessee Correctional Facilities: A Policy Analysis, Erin Dernlan

DNP Projects

Background and Rationale

Congenital syphilis in Tennessee rose 227% from 2017-2021, despite being more than 90% preventable with timely diagnosis and treatment. Women of childbearing age entering correctional facilities represent a key intervention population due to disproportionally high rates of sexually transmitted infections, limited or absent prenatal care, and significant unmet health needs. Tennessee’s female incarceration rate is 57% higher than the national average, and nearly one-third of women tested at intake are positive for syphilis. Current intake practices rely heavily on self-report, assumed adequate health literacy, and lack standardized STI screening requirements, contributing to missed diagnoses and preventable infant …

Operationalizing Flourishing In Bsn Nursing Education: A Cipp- Driven Strategy, Kennedy E. Hochstedler, Elizabeth Morse

DNP Projects

Operationalizing Flourishing in BSN Nursing Education: A CIPP- Driven Strategy

Facilitating Timely Initiation Of Hiv Care Through An Interdisciplinary, Algorithm-Guided Approach, Courtney Harris

DNP Projects

ABSTRACT

BACKGROUND: Initiation of antiretroviral therapy (ART) within twenty-four hours of an HIV diagnosis is safe, shortens time to viral suppression, improves retention in care, and contributes to reduced HIV transmission at the community level (Bacon et al., 2021). Despite this evidence, patients across the United States do not universally receive timely HIV care (Bertolino et al., 2023). Barriers to early ART initiation include lack of staff buy-in, logistical challenges, and socioeconomic factors affecting patients (Doshi et al., 2023).

LOCAL PROBLEM: A small HIV care clinic in the southern United States observed a similar discrepancy, noting inconsistent timely initiation of …

Caring For Caregivers: Fostering Empathetic Educational Practices Among Undergraduate Nursing Faculty, Karlee Hedrick

DNP Projects

BACKGROUND: Trauma is highly prevalent among nursing students, and unrecognized responses to that trauma can negatively impact learning, psychological safety, and academic performance (Doughty, 2020). Although trauma-informed care (TIC) principles are described in clinical settings, its use in undergraduate nursing programs remains limited. Faculty often lack formal TIC training, reducing their ability to support students with lived traumatic experiences. TIC education can improve awareness, responsiveness, and educator confidence (Bosse et al., 2021; Doughty, 2020; MacLochlainn et al., 2022). This project aimed to improve faculty knowledge and explore attitudinal shifts following a structured TIC educational intervention.

METHODS: Two Plan-Do-Study-Act (PDSA) cycles …

Advancing University Student Health And Wellbeing Through Peer-Led Health Promotion: A Quality Improvement Project​ ​, Rojeda Merani, Elizabeth Page, Elizabeth Roth

DNP Projects

Background: Peer-led health promotion is widely recognized as an effective strategy for increasing engagement, trust, and health literacy among university students. However, few frameworks guide development and implementation of these programs.

Objective: To evaluate the feasibility, implementation process, and perceived effectiveness of a peer-led health promotion model supported by Doctor of Nursing Practice (DNP) mentorship at a mid-sized private university.

Participants: Thirteen undergraduate students from a diverse set of academic programs were recruited as Peer Health Ambassadors (PHAs) and paired with DNP student mentors.

Methods: Guided by the Implementation Research Logic Model, the project used a four-phase QI process: targeted …

Enhancing Patient Understanding And Reducing Readmissions: Implementing A Structured Discharge Teaching Protocol In A Medical-Surgical Unit, Jawany Joseph

DNP Projects

Background

Hospital readmissions remain a critical challenge in healthcare, especially in medical-surgical units. The high rates of hospital readmissions are often linked to inadequate patient understanding of discharge instructions. Many patients struggle with deciphering discharge plans, leading to medication errors, missed follow-up appointments, and poor self-care management. A structured discharge teaching protocol has the potential to enhance patient comprehension, improve adherence to port-discharge care, and reduce readmission rates.

Project Goals

This project aimed to improve understanding of discharge instructions, reduce hospital readmissions, and enhance patient satisfaction with the discharge process. Specific objectives included increasing patient comprehension from 65% to 90% …

Establishing Operational Foundations In A Faculty-Led Clinic: Workflow Design, Role Development, And Service Planning, Rebecca Wensmann

DNP Projects

A Central Minnesota College, in collaboration with local community partners, sought to provide access to medical care for an underserved population while offering opportunities for graduate and undergraduate nursing education. They achieved this by establishing a faculty-led clinic in a high-poverty level area in Central Minnesota, where nearly 7% of the population under the age of 65 lacked health insurance (U.S. Census Bureau, 2024). Research was completed on clinic workflows and processes, as well as many interviews with clinics and community members throughout Minnesota. With this data, a clinic workflow, job description list, and services offered were created. This information …

Yo Soy Minnesota: Bridging Health Equity Gaps With Culturally And Linguistically Inclusive Resources For Hispanics In Central Minnesota, Liz Damaris Vincente Berrios

DNP Projects

Health disparities are preventable yet persist due to systemic inequities in social, economic, and healthcare structures. Rooted in historical injustices and social determinants of health, these disparities disproportionately impact minority communities, including Hispanics in Central Minnesota. Barriers such as limited English proficiency (LEP), provider biases, and inadequate health literacy further exacerbate inequitable health outcomes. Culturally and Linguistically Appropriate Services (CLAS) offer a modifiable solution to mitigate these disparities by ensuring healthcare resources align with diverse beliefs, practices, and linguistic needs. This project focuses on CLAS as a modifiable factor affecting Hispanics in Central Minnesota and explores the impact of "Yo …

Barriers To Participation In Follow-Up Services In Oncology, Casey Wagman

DNP Projects

Background
Psychological distress is often seen in cancer patients due to the physical, emotional, and social burdens of diagnosis and treatment. Patient participation in support services remains low despite the readily available psychosocial resources. The Emotional Well-Being Tool (EWBT), a validated psychological distress screening tool, is often used in a Midwest cancer clinic, yet it was noted that its supportive services were underutilized.

Purpose
This quality improvement project aimed to analyze the perspective of cancer patients on the EWBT, their understanding of its purpose and outcomes, and the perceived barriers to utilizing supportive services.

Methods
It was an exploratory design, …

The Use Of Debriefing To Combat Compassion Fatigue Among Cardiac Intensive Care Nurses, Brittany Johnson

DNP Projects

Background:
Compassion fatigue has physical, emotional, and psychological impacts on nurses working in intensive care units. Debriefing sessions can be used to help reduce compassion fatigue by allowing nurses on a cardiac intensive care unit to discuss their thoughts and feelings after the death of a patient who has had a complex hospital stay or traumatic death.

Aim:
The purpose of this project was to assess the perception of compassion fatigue on work life among Cardiovascular Intensive Care Unit (CVICU) nurses and to evaluate whether debriefing sessions following demanding situations enhance nurses' coping abilities and emotional processing.

Methods:
Nurses working …

Providing An Evidence-Based Miscarriage Care Education Program For Nurses Caring For Women Experiencing An Early Pregnancy Loss, Kailee Draz

DNP Projects

Objective
Women often seek emergency care during an early pregnancy loss. Unfortunately, research shows that women are overwhelmingly dissatisfied with their miscarriage care due to lack of support and guidance, provider knowledge, communication and follow-up care. Mishandled miscarriage situations can cause women to suffer physical and psychological consequences. The purpose of this project was to discover if providing emergency room nursing staff with pregnancy loss bereavement education allows for enhanced support, knowledge, and confidence when caring for women experiencing pregnancy loss. The aim of the project is to measure if perceptions of ER registered nurses support, resources, knowledge, and confidence …

Implications Of Palliative Care Education Amongst Critical Care Nurses And Applicable Screening Criteria For Consultation, Paiten Rask

DNP Projects

Background:
Palliative care is underutilized and/or consulted too late in the patient stay to provide optimal benefits to patients and families. There is a gap in nursing knowledge and confidence surrounding the topic of palliative care and the ability to advocate for specialty involvement for patients.

Objectives:
This project's purpose is to educate registered nurses in critical care about palliative care and introduce the idea of an objective palliative care screening tool. The project involved implementation of pre and post-test analysis of knowledge and confidence following a presentation of educational content. The content also included mock patient scenarios that require …

Implementing A Standardized Education Program To Enhance Nurses' Utilization Of Virtual Nurse Support, Emma Steck

DNP Projects

The rapid expansion of telehealth and virtual nursing support necessitates the development of standardized education programs to optimize the utilization of virtual support systems. This quality improvement project aimed to address the problem of inconsistent and outdated orientation methods for hospital nurses working with virtual registered nurse (ViRN) support staff at a large Midwest hospital. The project engaged over 800 nursing staff across more than 30 inpatient care units, with a focused pilot conducted on three intervention units. The intervention involved the development of an online learning module designed to standardize training and improve utilization of ViRN support. Utilizing the …

Fathers Using Light Touch On Their Infants And Its Effects On Postnatal Paternal Depression, Christopher Dirkes

DNP Projects

Background:
During the postpartum period there are multiple resources available to address maternal postpartum depression. However, there are limited resources available to help fathers during this transition period. Currently, limited data is available for best practice to decrease postnatal paternal depression, and increase paternal bonding and comfortability when caring for the infant.

Method:
Fathers were recruited from a Midwestern Public Health Department. After recruitment, fathers were provided with in-home education on how to perform a light touch intervention. Pre-intervention qualitative and quantitative surveys were provided at this time. Fathers were then asked to record their emotions as well as infant …

Implementation Of Intimate Partner Violence Education To Improve Practice And Attitude Amongst Healthcare Providers, Abigail Nguyen, Breanna Carpenter

DNP Projects

Background
Intimate partner violence (IPV) is a serious and costly public health issue. It is vital that patients are screened at least annually for intimate partner violence. Screening increases disclosure of abuse and allows primary care clinicians to provide comfort, education, and resources to patients experiencing IPV. Evidence strongly suggests that a major barrier to regular screening for IPV is a lack of knowledge and comfort amongst healthcare providers.

Purpose
This project’s purpose was to provide educational tools for healthcare providers related to the importance of screening for IPV, guidelines for most effective screening, common IPV misconceptions, and local resources. …

Implementing Online Evidence Based Educational Program In Diabetics., Michele Lynn Gervase

DNP Projects

Background: Educational online videos about diabetes can significantly improve patient outcomes by enhancing understanding and promoting effective self-management practices. These videos provided by the CDC provide a visually engaging and easily accessible content that simplifies complex medical information, making it more relatable for individuals living with diabetes. Online videos cater to various learning styles and can be watched multiple times to reinforce key diabetes management concepts and strategies. This awareness and competency improve adherence to treatment plans, creates a supportive community, and enhances health outcomes and quality of life.

Project Goals: To trial online evidence-based educational videos in patients with …

Improving Blood Culture Contamination Rates In The Emergency Department: An Evidence-Based Quality Improvement Project, Kerri Maciejko

DNP Projects

Background/Significance

Blood culture (BC) contamination in the Emergency Department (ED) leads to false-positive results, unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs. Contamination rates at the project site ranged from 2.2% to 6.8%, exceeding the hospital goal of <1%. Addressing this issue is critical for accurate diagnosis, effective treatment, and optimal resource utilization.

Purpose

The purpose of this project was to reduce BC contamination rates in the ED by implementing a modified BC kit, providing staff education, and conducting real-time blind audits with feedback over three months.

Methods

An evidence review, appraisal, and synthesis using Melnyk and Fineout-Overholt’s EBP process confirmed that BC kits and diversion devices are effective interventions to reduce contamination. …

Enhancing Dermatologic Education In A Family Nurse Practitioner Program: A Quality Improvement Project That Promotes Skin Assessment Competency In Diverse Populations, Solonge Schiavone

DNP Projects

Background: Dermatologic education in Nurse Practitioner (NP) programs often lacks adequate representation of skin conditions in patients with darker skin tones, contributing to diagnostic disparities and delayed treatment. This quality improvement (QI) project aimed to integrate culturally competent dermatologic content into the Primary Care I course at Sacred Heart University to enhance diagnostic accuracy and student confidence.

Purpose: The primary goals were to improve NP students’ knowledge and confidence in diagnosing dermatologic conditions across diverse skin tones and to evaluate the effectiveness of an educational intervention using pre- and post-intervention assessments.

Methods: The project utilized the Six Sigma DMAIC framework. …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

Implementation Of A Standardized Discharge Process At A Substance Use Disorder Inpatient Treatment Facility, Katelyn Love Bsn, Rn, Jennifer Sternberg Dnp, Aprn, Fnp-C, Kathryn Dambrino Dnp, Aprn, Fnp-C, David Phillippi Biostatistican

DNP Projects

Project Title: Implementation of a Standardized Discharge Process at a Substance Use Disorder Inpatient Treatment Facility

Background and Rationale: Currently, millions of adults are suffering from substance use disorder. For those in recovery, 45-55% of these adults will relapse within the first 6 months of leaving rehab, and due to loss of tolerance to their preferred drug of choice, these clients are at higher risk of mortality. This transition of care phase is a critical time period for clients to avoid relapse while navigating recovery challenges independently, and evidence supports standardized, intentional, client-centered discharge planning to improve transitional care outcomes. …

Navigating Graduate Nursing Education: The Effect Of Peer Mentorship On Academic Self-Efficacy At Shu: A Quality Improvement Project, Deborah Olujimi

DNP Projects

Background

Academic self-efficacy plays an essential role in the success of graduate nursing students, influencing their confidence, persistence, and ability to navigate complex coursework. Graduate nursing education is rigorous, and many students struggle with self-doubt, stress, and academic pressures that can impact their performance and retention in programs. Peer mentorship programs have been identified as an effective intervention to support students by cultivating collaboration, providing guidance, and enhancing academic self-efficacy. This project implemented a peer mentorship program for graduate nursing students at a university in Northeast U.S. to evaluate its impact on academic self-efficacy over 10 weeks.

Purpose

The primary …

Launching A Neonatal Resuscitation Escape Room To Combat High Infant Mortality Rates In South India: A Quality Improvement Project, Ellen M. Campos, Kathryn L. Dambrino Dr., Jennifer Sternberg Dr., Taryn Mccoy, Shelby L. Garner Dr., Kendell Natt, Lyn S. Prater Dr., R. David Phillippi Dr., Weiming Ke Dr., Leena Lourduswamy Dr., Sheela Victor Dr., Vernonsiya Kirubha, Beth Hallmark Dr., Julie Honey Dr.

DNP Projects

Background: In South India, infant mortality rates are high, and nurses require advanced training to respond to infants in fetal distress. Evidence shows that improved nurse competency in neonatal resuscitation and the ability of students to recognize and respond to distressed infants have led to decreased infant mortality rates.

Purpose: The purpose of this quality improvement project was to design and implement a simulated escape room to improve neonatal resuscitation outcomes among undergraduate students in South India.

Methods: A quantitative descriptive design was used. N=310 undergraduate nursing students from six schools in India participated in a simulated neonatal resuscitation (NNR) …

Improving Same-Day Access To Highly Effective Contraceptives In Middle Tennessee, Jillian Gunderson, Elizabeth Morse, David Phillippi

DNP Projects

Project Title: Improving Same-day Access To Highly Effective Contraceptives In Middle Tennessee

Background and Rationale: Long-acting reversible contraceptives (LARC) are highly effective at preventing pregnancy at 99%. A two-visit protocol is a known barrier to access. The American College of Obstetricians and Gynecologists recommends same-day placement to increase access to LARC. A Step Ahead Middle Tennessee (ASA) is a non-profit organization partnered with Belmont University that provides free, long-acting reversible contraceptives. However, most ASA clinical partners offer services with a two-visit protocol, and there is no process to identify patient preference for same-day placement.

Purpose: The primary purpose of this …

Food Allergies On The College Campus: Increasing Awareness, Kelly Wagner

DNP Projects

Project Title: Food Allergies on the College Campus: Increasing Awareness

Background and Rationale: The prevalence of food allergies in the United States is high and continues to increase, affecting approximately 32 million people (10.8% of the population). Food allergies are a chronic disease, and students transitioning to college are in the age group that experiences the highest rate of lethal anaphylactic reactions related to food allergies. Current best practice guidelines recommend that colleges should have a comprehensive, campus-wide approach to food allergy awareness, management, and emergency protocol. At a midsize southeastern university, there was no campus-wide approach to addressing the …

Implementing A Validated Screening Tool For Intimate Partner Violence In A Women’S Primary Care Setting: A Quality Improvement Project, Alexis Senu

DNP Projects

Background: Intimate partner violence (IPV) is a significant public health crisis, disproportionately affecting individuals identifying as women, with lifelong physical and psychological consequences. Despite recommendations from the U.S. Preventive Services Task Force (USPSTF) for routine IPV screening, many primary care settings lack standardized tools to perform this screening. The Modern Woman Health and Wellness Center (MWHWC), a women’s only primary care clinic in Connecticut, identified the need for a validated screening tool to increase detection of IPV, improve patient outcomes and align with national screening guidelines.

Objective: This quality improvement (QI) project aimed to implement the HARK (Humiliation, …

Optimizing Care For Heart Failure Patients With Reduced Ejection Fraction: A Quality Improvement Project On Guideline Directed Medical Therapy Adherence, Leonie Campbell-Williams

DNP Projects

Significance and Background: Heart failure with reduced ejection fraction (HFrEF) remains a major cause of hospital readmissions, increasing both healthcare utilization and patient morbidity. Guideline-Directed Medical Therapy (GDMT) has been proven to reduce mortality and hospitalizations; however, adherence to these evidence-based guidelines remains inconsistent (Yancy et al., 2022).

Purpose: This quality improvement project aimed to evaluate whether enhancing GDMT adherence in an outpatient heart failure clinic could reduce emergency room (ER) admissions among patients with HFrEF.

Methods: A structured intervention was implemented at a local healthcare system Cardiology Clinic, focusing on optimizing adherence to GDMT in 60 patients with HFrEF. …

Monitoring Weight Loss Management And Patient Satisfaction By Utilization Of Phone-Based Check-Ins: An Evidence-Based Quality Improvement Project, Katie O’Neill

DNP Projects

Background

Obesity is one of the fastest growing public health issues across the nation. Obesity is a critical factor in prevention of obesity-related non-communicable diseases (OR-NCDs) such as diabetes, hypertension and coronary artery disease. The increase in obesity creates a global burden on chronic disease prevention for future healthcare systems. With the increasing popularity of Glucagon-like peptide-1 (GLP-1’s) being prescribed, the level of provider communication should be evaluated and encouraged for successful weight management outcomes.

Project Goals

1.) Implement a phone call to patients on a GLP-1 to provide education on healthy lifestyle habits from October 2024 to December 2024. …