Nursing Commons^™

Evaluation Of A Peer Mentoring Program In Baccalaureate Nursing Students: A Quality Improvement Project, Leigh E. Swartzendruber

Doctor of Nursing Practice Projects

Nursing school can be rigorous, stressful, and anxiety-producing for students trying to progress to graduation, with students leaving the program if they encounter barriers. Academia must consider strategies to support students; peer mentoring is an evidence-based approach. The project evaluated an existing peer mentoring program to understand the benefits and barriers entry-level sophomore students experience with the program, comparing survey results from 2022 and 2024 cohorts—a mixed-methods descriptive statistical study was conducted with the spring 2024 peer mentoring program. Using a PDSA cycle, the program was transformed from an in-person to a hybrid format. At the end of the program, …

Quality Improvement Project Integrating Telemedicine To Reduce Patient No-Shows, Ferdinand Akoko

Doctor of Nursing Practice Projects

No-show among psychiatric outpatient clinic patients is a major problem due to disrupted clinical flow, reduced productivity, and financial losses. This quality improvement project implemented telehealth services to decrease the no-show rates in an outpatient psychiatric clinic in Texas. This project employed quantitative methods to compare the no-show rates pre- and post-intervention for 90 days. The quantitative data were analyzed by paired t-tests. A total of 1,790 appointments were sampled during the implementation period. The obtained results are statistically significant in decreasing the rates of no-shows for all adult appointments from 18% to 13% (p ≈ 0.0067). New appointment no-shows …

Quality Improvement Project: Incivility In Nursing Education: Utilizing An Educational Module And Professionalism Guide To Address Incivility In A Nursing Students, Jennifer Schadler

Doctor of Nursing Practice Projects

Incivility is a well-documented issue in the nursing profession that begins in nursing education and follows graduates into nursing practice. Nursing academia has a responsibility to address incivility to prevent inappropriate behaviors from becoming embedded into the culture. The problem addressed in this quality improvement project is incivility among nursing students at a private college. The purpose of this project was to apply evidence-based incivility interventions to address uncivil behaviors of nursing students. The hypothesis was that the implementation of a civility mentor module and professionalism guide would impact perceived incivility among nursing students. The project was conducted using the …

Health Policy: Food Allergy Restaurant Education Law, Joanna Ko

Doctor of Nursing Practice Projects

Food allergies are a rising public health concern with no indication of deceleration. The purpose of this Doctor of Nursing Practice (DNP) project is to enact an Arkansas state law to protect the food allergy community in dining out at restaurants to increase quality of life and decrease adverse allergic reactions. The current Arkansas state legislation for restaurant food allergy employee training is absent and action needs to be taken to safeguard the food allergy community from life-threatening reactions. The methodology involved contacting the six states that have previously implemented similar food allergy legislation. It encompassed performing a thorough search …

The Implementation Of Comfort Medication Kits In Hospice Patients’ Homes To Reduce Hospice Revocations, Brandi J. Parker

Doctor of Nursing Practice Projects

Background: When hospice patients experience a symptomatic crisis at the end of life, unmanaged symptoms can lead to unwanted hospitalizations and the revocation of their hospice benefits. Strategies to reduce the incidents of hospice revocation are needed to improve patient care and quality of life.

Purpose: The quality improvement project aimed to reduce hospice revocation rates by implementing comfort medication kits in eligible hospice patients’ homes.

Methods: The project’s intervention included identifying patients at high risk for revocation, patients with a cancer diagnosis, and patients with a prognosis of two weeks or less. Comfort medication kits were placed in the …

Implementing Delirium Prevention Strategies To Reduce The Need For 1:1 Observation In A Palliative Care Unit, Natalyn Finley

Doctor of Nursing Practice Projects

Background: Delirium is a common complication within the palliative care community that is preventable. Delirium is a condition characterized by confusion and disturbed thought processes. One to one observation was the facility’s intervention used to prevent delirium. The best intervention is non-pharmacological interventions.

Purpose: This quality improvement (QI) project aimed to reduce 1:1 observation hours without increasing patient safety issues.

Methods: The Doctor of Nursing Practice (DNP) student educated nursing staff about the American Nurses Association’s (ANA) evidence-based interventions to help decrease delirium. The staff received the ANA interventions form and the Confusion Assessment Method (CAM) tool. The DNP student …

Reducing The Incidence Of In-Hospital Cardiac Arrests (Ihca) By Utilizing Infographics, Alexis Morgan Pope

Doctor of Nursing Practice Projects

Background: In-hospital cardiac arrests (IHCA) have negative outcomes on patients and can prolong hospitalization or lead to death. The rate of IHCA has been increasing over the past few years in the United States. A medical intensive-care stepdown unit in a level three trauma center has an incidence of IHCA above the national average and a survival-to-discharge rate less than the national average.

Purpose: The project aimed to improve patient outcomes and reduce the rate of IHCA by placing infographics containing evidence-based practice in the unit with the highest incidence.

Methods: A pre-post implementation quality improvement design was used to …

Implementation Of Depression Screening For The Puerperal Woman During The Fourth Trimester, Ashley Tidwell Bowlin

Doctor of Nursing Practice Projects

Background: Postpartum depression is a mental illness that most commonly develops in the first twelve weeks postpartum, known as the “fourth trimester.” Nationally, one in five women suffers from postpartum depression, with 50 percent going undiagnosed and untreated due to fear of stigmatization and lack of consistent screenings among healthcare providers.

Purpose: The evidence-based Doctor of Nursing Practice quality improvement project included screening for postpartum depression between seven to 14 days postpartum to increase the identification of women likely to have postpartum depression before their scheduled postpartum visit over six weeks.

Methods: The project used a quantitative design as the …

Implementing Bedside Shift Reporting On An Adult Medical-Surgical Unit: An Evidence-Based Intervention For Inpatient Fall Reduction, Halie Blackerby

Doctor of Nursing Practice Projects

Background: Patient falls are a continuous issue in healthcare facilities because they increase patient length of stay and hospitals receive no reimbursement for these falls from insurance providers. Falls are a patient safety issue and can result in long-lasting damage for patients in the healthcare facility, including fear of ambulation. Falls in a facility can impact a facility’s ability to meet strategic planning goals and receive state and federal funding.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce inpatient falls during shift change by implementing an evidence-based bedside shift reporting (BSR) protocol.

Methods: Quantitative data …

Strengthening Medication Adherence In African Americans Diagnosed With Hypertension, Daphne James

Doctor of Nursing Practice Projects

Background: African Americans have a high rate of hypertension, which varies by region. Additionally, African Americans struggle to understand the risks of uncontrolled high blood pressure and the necessity of medication adherence in lowering strokes, heart attacks, and quality of life.

Purpose: The project aims to implement a patient education program to improve medication adherence and blood pressure control for African American patients in a primary care setting.

Methods: Twenty African Americans ages 18–65 with hypertension (130/80 mm Hg or above) and six months of nonadherence participated in this project. The pre-, mid-, and post-questionnaires assessed medication adherence and blood …

Nutric: Enhancing Surgical Intensive Care Unit Patient Nutrition Consultations, Misty Armstrong

Doctor of Nursing Practice Projects

Background: Daily nutritional screenings in the critical care population can identify patients in need of nutritional modifications during hospital admission. Inadequate nutritional assessments of critically ill patients lead to poor outcomes. Daily nutritional assessments result in the early identification of patients at risk for nutritional compromise compared to weekly assessments.

Purpose: The purpose of this project was to incorporate a daily nutritional assessment using the Nutrition Risk in the Critically Ill (NUTRIC) scores for patients in a surgical intensive care unit to identify patients in need of a referral to a registered dietician.

Methods: The method for this project used …

Improving Early Detection And Treatment Of Chlamydia By Implementing A Routine Chlamydia Screening And Testing In Females Between The Ages Of 18–24, Isabelle Vikumitsi

Doctor of Nursing Practice Projects

Background: Chlamydia Trachomatis is the most frequently reported bacterial sexually transmitted infection in the United States. One in 20 sexually active females between the ages of 15 and 24 have chlamydia. Most people with the infection are asymptomatic and do not seek treatment. Chlamydial infections in women, especially if untreated, increase the risk of infertility and ectopic pregnancy, leading to higher medical costs.

Purpose: The project aimed to implement early screening for chlamydial infections in the young adult population to increase early detection of the disease.

Methods: A pre-post design was used for this project to compare chlamydia diagnosis rates …

Standardization Of Chlorhexidine Gluconate Bathing: A Quality Improvement Project In Central Line Bloodstream Infection Prevention, Faustina Muruako

Doctor of Nursing Practice Projects

Background: Central Line-Associated Bloodstream Infections (CLABSIs) are severe healthcare-related infections that can lead to sepsis, organ failure, and even death. Several healthcare agencies provide guidelines to prevent CLABSIs, with Chlorhexidine Gluconate Bathing (CHGB) as one of the preventive measures for individuals with central venous lines (CVL).

Purpose: The Doctor of Nursing Practice (DNP) project aims to standardize CHGB procedures for maintaining CVLs on a specific unit for CLABSI prevention through evidence-based practice.

Methods: A quality improvement project was implemented at a Central Alabama hospital to standardize CHGB procedures for CVL patients utilizing a CLABSI unit champion monitoring system to establish …

Ekg Is Key: A Quality Improvement Project To Decrease Door-To-Ekg Time In A Rural Emergency Department, Amanda Southwell

Doctor of Nursing Practice Projects

Background: Electrocardiograms (EKGs) are the priority when evaluating patients with chest pain who present to the Emergency Department (ED). The American Heart Association and other governing bodies suggest a 10-minute door-to-EKG (DTE) time. The target facility displayed a delay in DTE times.

Purpose: The Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to decrease the average DTE time for patients over 18 years old with chest pain who presented to the ED registration area.

Methods: The DNP project consisted of an EKG suite to perform EKGs near the ED registration/triage area. Registration and ED staff were educated on …

Increasing Lung Cancer Screenings In A Family Medicine Clinic, Ashley Williams

Doctor of Nursing Practice Projects

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Although lung cancer screening is an established guideline for intervention in primary care, eligible patients do not receive it. Patients at high risk of developing lung cancer are aged 50 to 80 and currently smoke or have quit smoking within the last 15 years. Obtaining an annual low-dose computed tomography for patients at high risk of developing lung cancer helps detect lung cancer earlier and, therefore, improves patient outcomes.

Purpose: The Doctor of Nursing (DNP) project aimed to increase lung cancer screenings in patients at high risk of developing …

Implementing A Comprehensive Tobacco-Cessation Program For Patients With Tobacco Use Disorder, Jalen Eaton

Doctor of Nursing Practice Projects

Background: Individuals who use tobacco are at an increased risk for the development of heart disease, congestive heart failure, and chronic obstructive pulmonary disease. Tobacco use is one of the most preventable causes of death in the world.

Purpose: The focus of the quality improvement project was to improve access to tobacco cessation resources in patients with tobacco use disorder at a primary care clinic.

Methods: Weekly stakeholder meetings were held to ensure the validity of the project. The plan, do, study, act (PDSA) model of continuous quality improvement guided the project. A comprehensive tobacco-cessation program including informational materials and …

A Quality Improvement Project: Improving The Clinical Practice For Assessing Hemoglobin A1c On Admission In Diabetic Ketoacidosis Patients Admitted To The Intensive Care Unit, Tiara Lawson

Doctor of Nursing Practice Projects

Background: Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. Early treatment and adherence to guidelines are crucial in preventing DKA. The American Diabetes Association (ADA) publishes annual guidelines for effective DKA management, and the Education Recognition Program National Benchmarks program can help maintain adherence to the published guidelines. Improving the intensive care unit (ICU) admission process enhances the quality of care to DKA patients and improves progress towards national benchmarks.

Purpose: This quality improvement project aimed to improve Hemoglobin A1C (HbA1c) evaluations in DKA patients admitted to the ICU.

Methods: The intervention of triggering HbA1c orders …

Reducing No-Show Rates In An Outpatient Gi Endoscopy Lab, Mwaba Chisela

Doctor of Nursing Practice Projects

Background: Patients who do not attend their scheduled appointments cost the healthcare industry approximately $150 billion annually. They are at higher risk of missed diagnoses, delay in care, and increased morbidity and mortality.

Purpose: This quality improvement project aimed to determine the effectiveness of serial reminders using phone calls and electronic messaging to reduce no-shows for patients scheduled for gastrointestinal (GI) endoscopy.

Methods: No-show data was retroactively analyzed from June 2023 to December 2023 and compared to post-implementation data from February 2024 to March 2024. For eight weeks, a trained staff team called patients scheduled for endoscopic procedures seven days …

Decreasing Anxiety During Nursing Skills Evaluation In First-Semester Nursing Students, Terri Davis

Doctor of Nursing Practice Projects

Nursing students experience moderate to severe anxiety related to the rigor of nursing programs. Anxiety often leads to poor performance on exams and skills evaluations. When anxiety is not limited, it can contribute to nursing students being unable to progress in the nursing program and high attrition rates. The National League of Nursing (2021) estimates the attrition rate for nursing students in the United States at 20%. Attrition rates for associate degree programs are even greater and estimated to be around 50% (Kubec, 2017, as cited in Priode et al., 2020). This DNP quality improvement project looks to examine the …

Transition To Success: Development Of A Nursing Faculty Orientation Program, Christine Kaiser

Doctor of Nursing Practice Projects

Nursing faculty transitioning from clinical expert into the novice educator role face the dilemma of learning a new professional role while simultaneously meeting the demands of developing students to become competent nurses. A literature review suggested informal orientation programs lack the guidance necessary to assist novice nursing faculty in the transition to academia. This quality improvement project aims to develop and implement a formal, guided orientation program for nursing faculty with less than three years of experience. The project was implemented using a qualitative pre-post intervention design. Nursing faculty with less than three years of experience completed a Likert scale …

The Effectiveness Of Pressure Injury Prevention Through Educational Intervention Within The Long-Term Care Setting, Ashley Nunley

Doctor of Nursing Practice Projects

The prevalence of pressure injuries, particularly in older adults, continues to be disturbingly high, especially in those suffering from chronic diseases and frailty, bringing a higher awareness of applied preventive and therapeutic measures (Jaul et al., 2019). In long-term care nurses, will an educational, evidenced-based pressure ulcer prevention program impact health outcomes by increasing nurses’ knowledge, compared to no intervention over four weeks? The Pieper-Zulkowski Pressure Ulcer/Injuries Knowledge Test was used to evaluate the nurse's pressure injury knowledge pre- and post-educational intervention. The paired t-test was used to analyze the pre-and post-test data from the educational intervention. This DNP project …

Determining The Impact Of A Diabetes Logbook In Improving Self-Care Among African Americans With Type 2 Diabetes, Winifred Moore

Doctor of Nursing Practice Projects

Type 2 diabetes is a prevalent chronic disorder that is associated with defects in the metabolism of glucose. The management of type 2 diabetes depends on patients’ adherence to self-care activities. However, patients at the project site reported poor glycemic control, which increased their risk of diabetes complications. The purpose of this quality improvement project was to educate nursing staff on the use of diabetes logbooks to improve self-care among African Americans with type 2 diabetes and thereafter have the nursing staff educate diabetic patients. A quasi-experimental pre-post-intervention design involving 30 African American adults (mean age 43.70 years) with uncontrolled …

Determining The Effectiveness Of Deep Breathing Exercises In Alleviating Stress In Veterans With Post-Traumatic Stress Disorder (Ptsd), Lovette Okoh

Doctor of Nursing Practice Projects

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that affects veterans following deployment from combat. Medication side effects and re-exposure to trauma while undergoing psychotherapy hinder the effectiveness of recommended treatments. There is evidence supporting the effectiveness of deep breathing exercises in stress management, which is a common feature among PTSD patients. The purpose of this quality improvement (QI) project was to evaluate the effectiveness of deep breathing exercises in alleviating stress among veterans with PTSD. Nursing staff at the project site were educated about the benefits of deep breathing exercises and how to perform them and educated veterans …

From Knowledge Gap To Empowerment: Patient-Operated Insulin Pump Management For Bedside Nurses, Bernadette J. Amao

Doctor of Nursing Practice Projects

Acute care nurses often struggle with the complexities of managing patient-operated insulin pumps (PIPs) due to limitations in training. With the rising prevalence of insulin pumps, equipping nurses with the necessary skills to navigate these devices effectively is essential. This quality improvement project addressed this critical gap by enhancing bedside nurses' self-efficacy in PIP management. Drawing upon Bandura's self-efficacy theory, this project hypothesized that targeted educational interventions could significantly improve nurses' confidence in managing PIPs. A four-week educational program was implemented to cover basic knowledge, troubleshooting, and patient interaction aspects of insulin pump management. The intervention tool was designed to …

Impact Of Gamification In An Online Rn To Bsn Program, Deosha Anderson

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance student engagement in an online RN to BSN program by incorporating gamification strategies into the curriculum. Traditional teaching methods often fail to maintain student interest, leading to low engagement and reduced program completion rates. This project sought to determine the impact of gamification on student engagement compared to no gamification. The intervention involved integrating gamified elements into the online RN to BSN program to create a more interactive learning environment. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data on student engagement metrics, including login frequency, time spent …

Improving Student Perceptions Of Collaboration By Using Interprofessional Education, Valerie L. Beshears

Doctor of Nursing Practice Projects

Educators must include interprofessional education (IPE) in the healthcare provider curriculum. Including IPE is the first step in changing the healthcare culture toward interprofessional practice. The project aims to increase nursing students' perceived ability to collaborate with patients, nurses, and other healthcare professionals by introducing IPE to first-semester nursing students. The students will participate in an IPE activity and score a pre-test/post-test survey to assess their perceived ability to collaborate before and after the IPE activity. The data collected from this activity answered the quality improvement question: Among first-semester nursing students in a BSN program, how does incorporating an IPE …

Enhancing Student Simulation Debriefing Using Video Recording, Lisa Hall

Doctor of Nursing Practice Projects

This quality improvement project aimed to show how video recording can increase vivid feedback by expanding the students' memory by reviewing the recording to recall and reflect on their roles during the simulations. This project sought to help the learner understand how well the simulation ran and what was done to improve its performance. The interventions involved video recording each simulation scenario. The recording was used during the debriefing session to help the students recall and reflect on their actions during the scenario. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data was collected using …

Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel

Doctor of Nursing Practice Projects

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …