Nursing Commons^™

Homelessness: An Emergency For Many, Casey Almond

Doctor of Nursing Practice Projects

This DNP project implemented nursing staff education on the importance of recognizing homeless individuals early during the initial triage process within the emergency department. Nursing staff were educated on community resources available for homeless individuals. This DNP project helped to promote the collaboration of care by nursing staff with the case management team to help provide resources, which can result in a safer and more effective discharge of homeless patients within the emergency department. Participation consisted of 125 nursing staff who reviewed the online training module and attended one of the 15-minute in-person poster educational sessions. About 53 nursing staff …

Improving The Emotional Wellbeing Of Healthcare Workers In A Homecare Agency, Crystal U. Okafor

Doctor of Nursing Practice Projects

Healthcare workers (HCWs) often have traumatic experiences in the course of care delivery, and these experiences negatively impact their well-being, affecting them emotionally, psychologically, and physically. With the COVID-19 pandemic, healthcare workers have had indelible experiences questioning their choice of profession. This project aimed to teach the factors affecting the emotional well-being of healthcare workers and develop strategies to improve emotional distress in a home care agency. The implementation site was Carolina Homecare Solutions, with 21 participants, including nursing assistants and registered nurses. Sample selection was via a convenient strategy, selecting the most conveniently available participants. The project leader used …

The Use Of Therapeutic Communication To De-Escalate Aggression And Violence In Clients Living In A Homeless Shelter, Tionna S. Felder

Doctor of Nursing Practice Projects

Individuals working at homeless shelters have the daunting task of managing violent/aggressive behaviors with the population they serve. This project focused on educating homeless shelter staff on the use of therapeutic communication to decrease the escalation of aggression and violence when caring for their guests. The DNP Project Leader taught 23 homeless shelter staff members, and the project included three 2-hour educational sessions. The first class focused on understanding what regions in the brain are responsible for aggressive, violent, and emotional behaviors; the second class focused on what the literature says about aggressive behavior in homelessness; and the last class …

Increasing Awareness And Support For Women With Anxiety Disorders In Rural Communities, Candice C. Jones

Doctor of Nursing Practice Projects

Anxiety disorders are among the most common mental health conditions, disproportionately affecting women, particularly those in rural communities with limited access to care. Many women experience perinatal, postpartum, or generalized anxiety, often suffering in silence due to stigma, lack of awareness, and inadequate mental health education. This project focused on increasing awareness and understanding of anxiety disorders among women in rural Randolph County, North Carolina. A comprehensive literature review was conducted to assess the scope of anxiety disorders in women, identify community education needs, and explore evidence-based interventions. Ten relevant studies were analyzed, including randomized controlled trials, cross-sectional studies, and …

Early Recognition In Patient Deterioration: A Quality Improvement Project, Abigail Bell

Doctor of Nursing Practice Projects

This quality improvement project focused on enhancing early recognition of patient clinical deterioration by leveraging a rapid response team to implement targeted strategies that reduce failures in identifying early and subtle signs of physiologic decline. Rapid response teams have been widely adopted across the healthcare system to facilitate efficient interventions and prevent further deterioration in acutely ill patients. Despite their intended purpose, delays in recognizing clinical deterioration continue to exist. Failure to recognize early signs of deterioration contributes to an increased risk of irreversible organ damage, unplanned transfers to the intensive care unit, prolonged hospital stays, and, in severe cases, …

Overdose Response Training For Volunteers In A Homeless Shelter, Heather Lynne Smallwood

Doctor of Nursing Practice Projects

The opioid overdose epidemic is a critical health crisis across the country. The homeless population is substantially more at risk of overdose death compared to the general public. Naloxone is a life-saving medication for reversing opioid overdose and is available to ambulance and emergency care services, but support persons are also in regular contact with opioid users and training (Fine et al., 2022). This DNP Project was created to educate volunteers at a homeless shelter in the event of an opioid overdose. The objective of the project was to increase the knowledge of opioid overdose signs and symptoms and naloxone …

Pantry To Plate: Using Local Food Pantries To Improve Diabetes Self-Care Deficits, Rachelle Zielazienski

Doctor of Nursing Practice Projects

This project aimed to improve food pantry participants’ diabetes self-management and understanding of diabetes nutrition education through a collaborative approach. Over the course of 2 months, the project provided educational resources on diabetes nutrition at a food pantry. The target population included individuals with diabetes, pre-diabetes, and those responsible for preparing meals for diabetic individuals. A certified diabetes specialist was enlisted to ensure the delivery of culturally sensitive, evidence-based educational support tailored to participants’ diabetes health goals. Orem’s Self-Care Deficit Theory served as a framework for this project. A mixed-methods approach was utilized through pre-and post-test design to gather qualitative …

Addressing Physical Inactivity In Cabarrus County, Amy S. Hicks

Doctor of Nursing Practice Projects

Background: 21% of Cabarrus County, North Carolina, residents report complete physical inactivity during their leisure time, contributing to various health problems affecting 29% to 33% of Cabarrus County residents aged 40 to 84.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate a 3-week community walking challenge (Trim Before the Turkey Walking Challenge) to increase physical activity and social connectedness among Cabarrus County residents aged 50 and older.

Methods: A pre- and post-program survey design was used to evaluate participant-reported physical activity levels and sense of social engagement. Participants were recruited through the …

Hand Hygiene Education For Personal Care Staff In Congregated Care Settings: A Quality Improvement Initiative, Saunders Noel

Doctor of Nursing Practice Projects

For many years, proper hand hygiene has been emphasized as one of the most important defenses in helping to prevent illnesses. The World Health Organization (WHO) is a major organization that stresses the importance of proper hand hygiene and disease prevention. However, hand hygiene education and knowledge must be acquired to successfully utilize the correct steps in combating illnesses and diseases. Hand hygiene is a learned behavior and emphasizing education and awareness is important to successful adoption. This DNP project was implemented to personal care staff in a congregated care setting located in the southeastern part of Virginia. The project …

On The Frontline: Stop The Bleed© Training For School Staff, Mary Michaela Hinson

Doctor of Nursing Practice Projects

The American College of Surgeons’ Stop the Bleed© course was introduced in 2015 following an outcry from the community surrounding the Sandy Hook Elementary School shooting. The Stop the Bleed© course was developed as a tool for training that any person could participate in, despite their medical background or knowledge. The course is comprised of a 30-minute didactic portion followed by a 30-minute hands-on portion where participants can practice applying tourniquets, packing a wound, and applying manual pressure. This DNP project aimed to educate school staff in a high school located in North Carolina on Stop the Bleed© in an …

Quality Improvement Project: Improving Tardive Dyskinesia Detection And Management Through Aims Scale Utilization In Outpatient Psychiatry Clinic, Judeline Docteur

Doctor of Nursing Practice Projects

Tardive dyskinesia (TD) is a debilitating movement disorder commonly associated with prolonged antipsychotic medication use. The disorder results in functional impairment and reduced quality of life for those affected. Frequent TD screening using scales such as the Abnormal Involuntary Movement Scale (AIMS) for those on antipsychotic medication is recommended. However, its underutilization due to a lack of awareness, confidence, and knowledge of its applicability contributes to delayed detection and management, resulting in poor patient outcomes. The purpose of this quality improvement project was to improve TD detection and management through healthcare provider training to affect their self-efficacy and knowledge and …

Quality Improvement Project - Test Anxiety In Nursing Students: Reducing Stress And Anxiety In The Testing Environment, Aaron Gann

Doctor of Nursing Practice Projects

Nursing student retention is a critical issue due to limited clinical placements and faculty shortages, with many students citing test anxiety as a barrier to success in high-stakes National Council Licensure Examination (NCLEX) testing. The problem the Doctor of Nursing Practice (DNP) project identified is the lack of targeted interventions for test anxiety at the project site, a two-year community college’s associate degree nursing (ADN) program. The DNP project aimed to evaluate the efficacy of an Assessment Technologies Institute (ATI) test anxiety module on students’ course quiz scores and self-reporting of emotional barriers as measured by the depression, anxiety, and …

Building Confidence In Critical Thinking Through Faculty Implementation Of Simulation, Melissa Morris

Doctor of Nursing Practice Projects

Simulation provides nursing students with experiences that are as effective as clinical experiences in a non-threatening environment. Clinical experiences such as obstetrics, pediatrics, and mental health have been observation only at the project site. With observation-only clinicals, students do not have opportunities to master skills specific to nursing, which bridge theory to practice. The purpose of this Quality Improvement (QI) project focuses on educating nursing faculty who may not be simulation experts to learn the skills to build and implement simulations that align with the International Nursing Association Clinical and Simulation Learning (INACSL) simulation standards. The Primary Investigator (PI) utilized …

Enhancing Faculty Confidence And Candidate Selection: Evaluation Of A Standardized Holistic Interview Rubric In Nursing Program Admission, Jennifer M. Bray

Doctor of Nursing Practice Projects

Nursing programs continue to struggle with high attrition rates, which impact student success, program outcomes, and the development of a competent nursing workforce. National data show that associate degree nursing programs report attrition rates as high as 50% in the first year, highlighting the urgency for more effective admission strategies. The problem addressed in this quality improvement project was the use of traditional academic metrics, such as grade point average (GPA) and standardized test scores, as primary admission criteria, which often overlook essential non-cognitive attributes linked to student persistence and success. The purpose of the project was to improve faculty …

The Impact Of Staff Education On Menopausal Care, Oluwatoyosi Olumide

Doctor of Nursing Practice Projects

Natural menopause typically occurs around the age of 51. During this transition, many women experience a variety of vasomotor symptoms, with hot flashes and night sweats being the most common. As women age, diminishing levels of estrogen, progesterone, and testosterone can lead to various health complications. Without proper assessment, diagnosis, and treatment, many may suffer in silence. This quality improvement project sought to evaluate the impact of staff education on menopausal care. The symptom checklist, or the Menopause Rating Scale (MRS), is a standardized, evidence-based tool for assessing menopause symptoms and serves as an essential component of the admission process …

Educating Caregivers And Parents On Infant Safe Sleep Guidelines In A Rural Community, Melody Hill

Doctor of Nursing Practice Projects

Sudden Infant Death Syndrome (SIDS) remains a leading cause of infant mortality, highlighting the need for effective, safe sleep education for caregivers and parents. Key safe sleep guidelines have been shown to reduce SIDS risk by placing infants on their backs to sleep, using firm mattresses, and avoiding soft bedding. However, misconceptions about safe sleep practices persist, making education for caregivers and parents essential. The desired outcome of this project was to significantly enhance the knowledge and behaviors related to infant sleep practices, ensuring that caregivers and parents understand and follow safe sleep guidelines. This project aimed to evaluate the …

Providing Community Education On Opioid Addiction And Emergency Intervention, Chasity Vargas

Doctor of Nursing Practice Projects

Introduction: The opioid crisis remains a significant public health concern, with opioid-related overdoses continuing to rise. Naloxone (Narcan) is a life-saving medication that can reverse opioid overdoses, yet many community members lack awareness and training on its use. This Doctor of Nursing Practice (DNP) project aimed to implement and evaluate a community-based Narcan education program to improve knowledge, accessibility, and confidence in administering Narcan.

Method: Using a quality improvement framework, the project targeted community members servicing the homeless population. Pre- and post-education surveys assessed changes in participants' knowledge and attitudes toward opioid overdose response.

Results: Findings demonstrated a significant increase …

The Path To Zero Clabsis: The Benefits Of Central Line Care Teams, Supplemental Checklist, Increased Education And Utilizing Clabsi Bundles, Lauren A. Bondurant

Doctor of Nursing Practice Projects

Central line-associated bloodstream infections (CLABSIs) result in a plethora of deaths each year and cost the U.S. healthcare system billions of dollars (Centers for Disease Control and Prevention, 2024). CLABSIs have been a type of bloodstream infection that has affected a plethora of individuals for years and one that does not discriminate patient type. Many articles were reviewed, but they all inferred that CLABSIs bundles,supplemental checklists, and central line care teams all showed the most significant data and resulted in the most decreased CLABSI rates. Upon assessment of the project unit, it was noted that the issue that most impacted …

Recognizing Opioid Withdrawal: An Educational Intervention To Increase Nurses' Knowledge And Improve Quality Of Patient Care, Keyannah L. Glover

Doctor of Nursing Practice Projects

Opioid abuse, prescription and illicit use, remain a problem in the United States. Recognizing signs and symptoms is important because lack of recognition can lead to misdiagnosis and mismanagement. The target population for this study was nurses in the emergency department. This quality improvement project was developed to provide education to the nurses in the emergency department to recognize opioid withdrawal signs and symptoms. This project evaluated the baseline knowledge of nurses working in the emergency department. The project was implemented over a 3-week time frame. The pre-test was sent out to participants via email to test their baseline knowledge. …

Providing Safe Care For Mental Health Patients Through Ongoing Education Of Non-Psychiatric Nurses And Staff, Amy Kilpatrick

Doctor of Nursing Practice Projects

Nurses care for many individuals with medical conditions, but also those who suffer from mental illness and are in an acute mental health crisis. Nonpsychiatric nurses often lack adequate knowledge and training while caring for individuals with mental health disorders and those in acute crisis, which can be a barrier to providing safe, effective care for this vulnerable population. When individuals are in crisis and present to the emergency departments, their first contact is with emergency room nurses who may lack the necessary skills to conduct a thorough assessment when evaluating for mental health disorders, including the presence of suicidal …

Heart Of An Athlete: Educating On The Importance Of Cardiovascular Screening Of High School Athletes, Tiffany Michelle Haley

Doctor of Nursing Practice Projects

There is a lack of education regarding cardiovascular screening and the incidence of sudden cardiac arrest (SCA) in high school athletes. The target population needing improved education is primarily school faculty, staff, trainers, and coaches. Effective cardiovascular screening and education will aid in the prevention of a catastrophic injury, including SCA and sudden cardiac death (SCD). Educating high school faculty and staff will bring forth awareness of signs and symptoms of SCA and aid in proper care and treatment for high school athletes who are at higher risk. The goal of this project was to educate faculty and staff on …

Teaching With Confidence: Strengthening Nurse Education On Heart Failure Using The Teach-Back Method, Melany Boyd

Doctor of Nursing Practice Projects

Heart failure remains one of the leading causes of hospital readmissions, often due to poor patient understanding of self-care instructions provided at discharge. Nurses play a critical role in patient education, yet many lack confidence and competence in delivering effective education. Additionally, inconsistencies and discharge materials, such as outdated or excessive documentation, can overwhelm patients and hinder their ability to retain vital information. Standardized education enhances the learning experience and ensures consistent messaging across the healthcare system. This project aimed to improve nurses’ confidence and competence in educating heart failure patients at discharge by 10% through the implementation of the …

Recognizing Adult Male Mental Health Needs: An Intervention Looking At Education In Rural Communities, Eugene W. Winans Jr

Doctor of Nursing Practice Projects

This DNP Project examined the role of student nurses and their confidence levels when assisting adult male patients experiencing a mental health crisis. The majority of suicide acts are attributed to men. Thus, this subject requires specific insight and instructions when it comes to proper ways to assist these patients. Incorporating evidence from a pre-test and post-test survey, this project demonstrates that student nurses lack confidence in how to deal with men who are experiencing a mental health crisis. The analysis gained from this project demonstrates the important role nurses play in recognizing, speaking to, and assisting in the treatment …

Preserving Memories, Building Relationships, Jamie H. Cochran

Doctor of Nursing Practice Projects

Loneliness among adults aged 65 and older is a significant health concern linked to negative physical and mental outcomes, especially in rural communities. This DNP project implemented a 4-week scrapbooking intervention within a faith-based rural community in North Carolina to reduce feelings of loneliness. Guided by Watson’s Theory of Human Caring, participants engaged in collaborative arts activities designed to foster social connection and emotional expression. The potential results of this project are multifaceted, including improved social engagement, emotional well-being, and strengthened community bonds. The findings support integrating creative, relationship-centered strategies into community nursing practice to enhance well-being among older adults.

Enhancing Health Literacy Using Video Education And The Teach-Back Method For Hypertension And Diabetes Mellitus Type 2, Shelly-Ann M. Malcolm-Padilla

Doctor of Nursing Practice Projects

Diabetes type 2 and hypertension are chronic illnesses that have both physical and psychological impacts on an individual. Primary care providers play an important role in the management of chronic illness, specifically type 2 diabetes and hypertension. Changing behavior with a commitment to compliance with the treatment plan and living a healthy lifestyle can decrease disease complications for both diabetes and hypertension. With the use of educational videos and the teach-back method to confirm understanding of disease management, the goal of this quality improvement project was to contribute to positive health and lifestyle change for patients, their caregivers, clinical staff, …

Using Educational Intervention To Impact Provider And Nurse Knowledge And Self-Efficacy In Contingency Management At An Sud Clinic, Chinwe Egwudo

Doctor of Nursing Practice Projects

The US opioid epidemic crisis led to 700,000 deaths in 2019 alone. Poor adherence to medications for opioid use disorder (MOUD) strains individuals, families, and the healthcare systems, with rising relapses at the project site highlighting the need for evidence-based intervention. Studies show that contingency management (CM), a behavioral intervention that incentivizes desired behaviors, improves adherence to MOUD. Despite its effectiveness, CM remains underutilized in clinical settings due to healthcare providers’ lack of knowledge and self-efficacy. This project aimed to bridge the knowledge gap by implementing an educational intervention to impact healthcare providers’ knowledge and self-efficacy in applying CM protocols …

Enhancing Nursing Education: A Quality Improvement Project To Mitigate Incivility Among Faculty, Rebecca Mitschele

Doctor of Nursing Practice Projects

Incivility among nursing faculty poses a significant challenge, adversely affecting job satisfaction, mental health, and communication within academic and clinical settings. This Quality Improvement (QI) project addressed this pervasive issue by identifying faculty incivility as a key contributor to high turnover rates and burnout in faculty and students. A mixed-methods approach assessed the prevalence and types of incivility displayed, including surveys and focus group discussions with faculty. The intervention included conflict resolution training, the establishment of an anonymous reporting mechanism, and the development of a framework to revise the faculty handbook specifically to address incidents of incivility. Post-intervention results indicated …

Promoting Student Retention Through Mandatory Remediation, Randi Mccoy

Doctor of Nursing Practice Projects

This DNP Project seeks to identify and evaluate among associate degree nursing (ADN) faculty, will implementing a pilot remediation policy, compared to the current remediation policy, impact faculty perception regarding exam remediation? Exam remediation is important as it helps students understand why they missed questions, how to improve on their next exam, provides guidance and confidence. It is also essential to determine whether required remediation for students after failing an exam promotes student retention, growth, and expansion at a local university in Oklahoma in the setting of an unprecedented program. Does adding required remediation after a failed exam offer students …

Improving Nursing Faculty's Self-Efficacy For Pre-Brief In High Fidelity Simulation: A Quality Improvement Project, Jamie Herron

Doctor of Nursing Practice Projects

High-fidelity simulation (HFS) effectively allows students to practice nursing care in a safe and controlled environment with fewer chances of error or harm. The Society of Simulation in Healthcare (2021) states that best practice standards include pre-briefing, evaluation during simulation, and debriefing. A standardized pre-briefing for faculty during nursing students' high-fidelity simulation was needed in an Oklahoma associate degree nursing (ADN) program. The Society of Simulation in Healthcare (SSH) evidence-based standards of practice include providing a pre-brief before starting a high-fidelity simulation, which decreases the student's anxiety and improves learning. The PICOT question, “How does education about pre-briefing in high-fidelity …

Quality Improvement Project: Reducing Ventilator Days: Evaluating The Effectiveness Of A Nurse-Led Mechanical Ventilation Liberation Protocol In Critical Care Units, Joseph Duncan

Doctor of Nursing Practice Projects

The present study investigated the effect of intensive care unit (ICU) nurses’ knowledge and confidence in managing mechanically ventilated patients’ weaning trials, and whether innovative education can improve these clinical interventions. Current practice relies on an antiquated provider-led protocol that does not account for the nurses’ skill level or practice autonomy. This oversight consistently leads to ventilator associated complications including prolonged ventilation time, increase sedation infusion use and increase ICU length of stay. This study’s aim was to determine if innovative education could improve nursing knowledge and confidence related to ventilated patient care. Nurse participants (N=100) were randomly selected to …