Nursing Commons^™

Quality Improvement Project High-Quality Simulation Training For High-Quality Nurse Educators, Cherrelle Hawkins

Doctor of Nursing Practice Projects

The Associate of Applied Science in Nursing (AASN) faculty use simulation as a teaching modality to assist nursing students in preparing for their clinical experiences by transitioning knowledge into practice. To successfully facilitate simulations, faculty must possess knowledge and competence in facilitating simulation sessions. Faculty at the practice site lacked these characteristics due to the nonexistence of a simulation training program. This quasi-experimental quality improvement project aimed to implement formal simulation training for faculty to influence self-perceived knowledge and competence in facilitation constructed by the Adult Learning Theory and the Awareness-Desire-Knowledge-Ability-Reinforcement (ADKAR) Change Model. The PI evaluated knowledge and competence …

Quality Improvement Project Impacting Provider Self-Efficacy And Use Of Cbt For Depression Treatment, Tony Orafunam

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement project was conducted at a mid-sized outpatient psychiatric clinic in Hempstead, New York, focusing on strengthening providers’ self-efficacy in delivering Cognitive Behavioral Therapy (CBT) to young adults (aged 19–35) diagnosed with Major Depressive Disorder (MDD). Rather than targeting MDD directly, the initiative aimed to impact provider self-efficacy and skill in CBT to improve access to evidence-based treatment and reduce the need for external referrals. Employing Bandura’s Social Cognitive Theory and the ADKAR change model, the project used a quasi- experimental, one-group pre-test/post-test design. Six advanced practice providers participated in a structured, interactive …

Quality Improvement Project Providing Accessible Evidence-Based Education To Nurses Throughout A National Healthcare System, Bailey Wells

Doctor of Nursing Practice Projects

The pursuit of ongoing professional development and learning is crucial to ensure nurses remain well-informed about healthcare trends and have access to the most up-to-date evidence-based materials. This quality improvement project aimed to implement a monthly educational series for nursing personnel within the Veterans Health Administration (VHA) through expansion of the Veterans Administration (VA) – Extension for Community Healthcare Outcomes (ECHO) program. Using Bandura’s Self-Efficacy Theory of Motivation in Psychology, participants’ previous knowledge was linked to continued professional development. The plan, do, study, act (PDSA) framework provided structure for the project, with the awareness, desire, knowledge, ability, and reinforcement (ADKAR) …

Quality Improvement Project Unlocking Critical Thinking: The Use Of Guided Reflection In Nursing Education, Alissa Wheat

Doctor of Nursing Practice Projects

Nursing education is at a crossroads as the demand for practice-ready nurses increases in a rapidly evolving healthcare environment. Despite high licensure pass rates, graduates often demonstrate gaps in clinical judgment and critical thinking, key competencies for safe nursing practice. This project addressed the problem of limited structured strategies to develop these competencies among pre-licensure nursing students in a Houston-based nursing program. The purpose was to evaluate guided reflection, implemented as a competency-based education (CBE) tool, to determine its effect on faculty perceptions of supporting critical thinking and clinical judgment. A quasi-experimental, one-group pretest–posttest design was conducted with clinical faculty …

Quality Improvement Project De-Escalation Techniques Applied In The Classroom: A Faculty Onboarding Quality Improvement Initiative, Jennifer Lanza

Doctor of Nursing Practice Projects

The nursing shortage persists, and the lack of trained nurse educators exacerbates the issue. Adequate training of novice nurse educators transitioning from bedside to academia is essential for smooth role-transitioning, which impacts intent to stay; however, the content of the mentoring is undefined in literature. Using Bandura’s Social Cognitive theory as the theoretical framework and Havelock’s Process of Change theory, this Quality Improvement project aims to determine how providing de-escalation training adapted for the classroom impacts self-efficacy of novice nurse educators dealing with incivility in the classroom. The method includes incorporating the Plan-Do-Study-Act implementation framework for a quasi-experimental intervention which …

Staff Education And Implementation Of Phq-9 And Gad-7 In An Adult Psychiatric Private Practice, Exta Oppong Tweneboa

Walden Dissertations and Doctoral Studies

The PHQ-9 and the GAD-7 are short screening instruments used for the detection of depression and anxiety symptoms in various settings, including general and mental health care settings (Pranckeviciene, et al., 2022). The purpose of this Doctor of Nursing Practice (DNP) project was to educate staff on the implementation of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) into an adult psychiatric private practice to standardize screening, improve diagnostic accuracy, and support measurement-based care for depression and anxiety. A structured staff education program was conducted with five nurse practitioners, one psychiatrist, two therapists, and two front-end administrative staff. …

Ready Or Not? An Autoethnography Of A Midwife’S Preparedness And Readiness Journey, Kristen Graham

The Qualitative Report

This emotive autoethnography explores my experiences working as an Australian midwife in low- and middle-income countries, which led to a Doctor of Philosophy journey exploring primary care midwives' preparedness and readiness in rural and remote communities in this context. I use the midwifery tradition of storytelling to explore personal experiences of preparedness and readiness as a way towards researcher reflexivity, understanding and meaning. Emerging themes of preparation for practice, resource limitations, heartache, and emotional resilience offer insights to inform midwifery education, research, and practice.

Quality Improvement Project Improving Fall Risk Protocol Compliance Through A Structured Fall Prevention Program In A Skilled Nursing Facility, Lakeesha Jenkins

Doctor of Nursing Practice Projects

Falls remain a persistent patient-safety threat in skilled nursing facilities (SNFs). At a Dallas–Fort Worth SNF, a needs assessment identified rising unassisted falls and inconsistent protocol adherence. This quality improvement (QI) project examined whether a structured, evidence-based bundle could improve staff knowledge and fall-prevention processes and reduce falls over four weeks. Guided by Lewin’s Change Theory and implemented with Plan–Do–Study–Act (PDSA) cycles, the pre–post design engaged direct-care staff (registered nurses, licensed vocational nurses, certified nursing assistants; n = 20). The intervention included standardized risk screening with the Morse Fall Scale (MFS), targeted staff education, high-risk visual identifiers, and post-fall huddles. …

Quality Improvement Project Addressing Healthcare Provider Adherence To Diabetic Foot Exams In A Primary Care Clinic, Olaide Akinyinka

Doctor of Nursing Practice Projects

Healthcare providers performing foot examinations are a crucial component in assisting Type II diabetic patients to maintain their health. The purpose of this quality improvement project was to determine how the providers' implementation of Inlow’s 60-second Diabetic Foot screen, compared to current practice standards, impacts the number of foot exams among Type II diabetic patients at a primary care clinic over 12 weeks. Therefore, it was unknown if or to what degree the provider implementing Inlow’s 60-second Diabetic Foot Screen impacts the number of foot exams conducted compared to the current practice among Type II diabetic patients. Wiedenbach’s Helping Art …

Staff Education For Health Care Providers On Improving Health Care Outcomes For Lgbtq+ Youth And Adolescent Patients, Sheila Shafer

Walden Dissertations and Doctoral Studies

This project was focused on the significant challenges faced by LGBTQ+ adolescents and young adults, specifically those aged 12 to 25 years, who seek mental health care services. Research indicated that discrimination and stigma against this demographic contribute to disproportionately poorer mental health outcomes, underscoring the urgent need for culturally competent health care delivery. The purpose of this project was to educate professionals on the necessary skills and knowledge about the unique needs of LGBTQ+ patients. The question was the following: Would an educational intervention improve providers’ knowledge and confidence in diagnosing and treating the mental health needs of LGBTQ+ …

Educating Correctional Nurses On The Use Of A Mindfulness Program To Reduce Work Stress, Victoria Ngozi Emelogu

Walden Dissertations and Doctoral Studies

Correctional nurses deliver care in environments marked by violent incidents, chronic understaffing, and moral distress. These conditions heighten occupational stress, jeopardize patient safety, and accelerate staff turnover, yet few U.S. jails provide evidence-based training in rapid self-regulation strategies. The purpose of this staff education project was to evaluate whether a 2-week curriculum could increase correctional nurses’ knowledge, attitudes, and self-reported skills (KAS) for on-shift mindfulness use. Pender’s health promotion model framed the intervention, Bloom’s taxonomy and Kirkpatrick’s evaluation model informed learning objectives and outcome levels. Five correctional nurses at a large urban jail completed an anonymous 10‑item KAS survey before …

Implementing Patient Health Questionnaire-9 Screening In Adult Mental Health: A Staff Education Initiative, Precious Nmachi Adaso

Walden Dissertations and Doctoral Studies

This project was a staff education program aimed at the use of the Patient Health Questionnaire-9 (PHQ-9) as a universal depression screening instrument within a mental health facility. The project was conducted in an urban area of the United States at an outpatient behavioral health facility and was focused on addressing the stagnation in the staff’s correct use of evidence-based measures of depression screening that inhibits the prompt detection and treatment of major depressive disorder (MDD). The practice focused question was: Following participation in a staff education program, will staff demonstrate increased knowledge on depression screening and use of the …

Quality Improvement Project Simulation Orientation For Nursing Faculty, Emily Harvey

Doctor of Nursing Practice Projects

Many nursing faculty are expected to teach using SIM without adequate preparation, which can limit competence in SIM-based teaching. A university-level school of nursing identified this gap and initiated a quality improvement project to strengthen faculty readiness through a structured online orientation. The intervention used the Massive Open Online Course (MOOC) Essentials in Clinical SIMs Across the Health Professions and was guided by Benner’s Novice to Expert Model, Lewin’s Change Theory, and the Plan-Do-Study-Act cycle. A quasi-experimental pretest–posttest quantitative design was conducted with nursing faculty participants. The Facilitator Competency Rubric (FCR) assessed competence across five domains: preparation, prebriefing, facilitation, debriefing, …

Quality Improvement Project Enhancing Provider Education On Phq-9 Depression Screening To Improve Compliance, Obianuju Okafor

Doctor of Nursing Practice Projects

Depression is a leading cause of disability worldwide; however, screening in primary care remains inconsistent. Even though the Patient Health Questionnaire-9 (PHQ-9) is a validated screening tool, its use is often limited by insufficient provider training. This quality improvement (QI) project aimed to evaluate the impact of structured provider education on PHQ-9 screening practices, with the purpose of improving provider knowledge, confidence, and adherence to screening guidelines in a primary care setting. Guided by Donabedian's Model of Quality Care and Lewin's Change Theory and implemented using the Plan-Do-Study-Act (PDSA) framework, the project used a one-group pre/post design at an outpatient …

Staff Education To Increase Nursing Staff Knowledge On Handoff Tool Kit For Medication Reconciliation, Mode Hilaire

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project aimed to enhance medication safety by implementing a structured staff education initiative focused on standardized handoff communication using a medication reconciliation tool kit. Medication errors during transitions of care contribute to adverse drug events and patient harm. A lack of consistency in handoff processes was identified as a critical gap in practice. The practice-focused question guiding this project was: In an inpatient hospital setting, how does implementation of a standardized handoff tool kit affect nursing staff knowledge and communication practices related to medication reconciliation? The purpose was to educate nurses on utilizing a …

A Novel Scaffold-Based Model For Stage Ii Pressure Injury Simulation: Protocol Development And Future Directions In Tissue Engineering, Skyler B. Wrubleski

Undergraduate Research and Scholarship Symposium

This study developed a 3D tissue-engineered scaffold to mimic human sacral skin for modeling pressure injuries. The scaffold consisted of a composite hydrogel of sodium alginate, gelatin, and tannic acid, crosslinked with calcium chloride. Swelling tests showed moderate hydration capacity, while wound mimic formation using a custom 3D-printed apparatus produced consistent morphology and dimensions comparable to human dermal tissue. The scaffold maintained structural integrity under prolonged compressive forces, demonstrating viability for pressure injury studies. Future work will incorporate a bilayer model with keratinocytes and fibroblasts and introduce elastin to enhance elasticity and mechanical properties. This approach aims to improve in …

Quality Improvement Project Empowering Nursing Instructors: Faculty Self-Efficacy & Consistency In Simulation Grading, April Guerin

Doctor of Nursing Practice Projects

This quality improvement (QI) project aims to evaluate the effectiveness of structured training on the Creighton Competency Evaluation Instrument (C-CEI) in improving nursing faculty self-efficacy and grading consistency in clinical student evaluations. Inconsistent clinical grading practices among nursing faculty create barriers to reliable competency evaluation and undermine student outcomes. Guided by the Donabedian Model and Lewin’s Change Theory, with implementation structured by the Plan-Do-Study-Act (PDSA) cycle, a quasi-experimental pre-post intervention design was used. Participants include nursing faculty responsible for clinical evaluations, who completed structured C-CEI training delivered via self-paced modules in a learning management system. Faculty self-efficacy was measured using …

Predictors Of Success Among Accelerated Bachelor Of Science In Nursing Students: A Retrospective Study, Alison H. Davis, Jennifer Manning, Todd Tartavoulle, Adele Harrell, Kathleen Brennan, Mickey Pigg, Mary Dioise Ramos

School of Nursing Faculty Publications

Background: Accelerated second-degree Bachelor of Science in Nursing (BSN) programs attract students with diverse academic backgrounds and experiences. Understanding the factors that contribute to student success is essential for improving retention and program effectiveness. While prior research has explored predictors of success in traditional BSN programs, limited data exists on accelerated BSN students. Aim: This study aimed to describe the factors predicting the success of students enrolled in an accelerated second-degree BSN program. Methods: A retrospective analysis was conducted on 273 accelerated BSN students. Descriptive statistics summarized demographic and academic characteristics. Multiple logistic regression analyses were performed to assess predictors …

The Relationship Between Nursing Faculty Sense Of Belonging And Faculty Intent To Stay, Heather M. Bowers

Doctoral Dissertations and Projects

The purpose of this quantitative causal-comparative and correlational study was to evaluate the relationship between workplace sense of belonging and intent to stay in the current nursing faculty role among full-time nursing faculty. The shortage of nursing faculty impacts the ability to prepare the next generation of nurses needed to meet worldwide nursing demands. Strategies to effectively recruit and retain nursing faculty are important considering the current shortage and increasing retirements of nursing faculty. While sense of belonging has been studied for student retention and studies are beginning to explore the importance of workplace belonging, the impact of organizational sense …

The Lived Experiences Of Micu Nurses During The Covid-19 Pandemic: A Qualitative Study, Thomas Hopkins

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the lived experiences of MICU nurses during the COVID-19 pandemic and how these experiences may inform disaster preparedness in the nursing curriculum. This research is guided by Watson’s (1979) theory of human caring. The theory emphasizes the importance of interpersonal relationships and emotional support in nursing practice, and how these elements can be integrated into disaster preparedness training. Using interpretive phenomenological analysis, data were collected through semi-structured interviews, field notes, and guided journaling. The interviews were conducted via digital conferencing software over the internet. Field notes were recorded during the interviews. …

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% …

Quality Improvement Project Using Standardized Teaching Tools To Improve Skills Proficiency, Katrina Walker

Doctor of Nursing Practice Projects

Studies show that inconsistencies in teaching and evaluating skills proficiency in nursing programs can lead to student failure, delayed progression, and decreased faculty satisfaction. The purpose and aim of this quality improvement project was to determine whether the use of an evidence-based, standardized tool for teaching and evaluating Foley catheter insertion improved faculty satisfaction and teaching confidence compared to faculty-created checklists. The project utilized a quasi-experimental design guided by the Iowa Model of Evidence-Based Practice and Kotter’s 8-Step Change Model. The Bachelor of Science in Nursing (BSN) faculty implemented the standardized tool and completed pre- and post-intervention Likert-scale surveys measuring …

Improving Staff Knowledge On Hourly Rounding Using The 4ps To Reduce The Fall Rate, Chukwuemeka Igboanugo

Walden Dissertations and Doctoral Studies

I designed this Doctor of Nursing Practice (DNP) project to develop an educational program that increases staff knowledge of hourly rounding using an evidence-based approach, specifically pain, position, potty, and possession (the 4Ps), to prevent falls among residents in a long-term care facility. According to facility leadership, the observed gap in practice was the nursing staff members’ lack of knowledge in performing hourly rounding. The facility’s fall records for the lockdown units indicated a surge in fall rate, with 32 falls among 62 residents per month, reflecting a need for action. The practice-focused question guiding the project was: For staff …

Active Learning And Nclex-Rn Pass Rate On First Attempt In Bsn And Adn Programs, Janette Tingson

Walden Dissertations and Doctoral Studies

Failing the NCLEX-RN on the first attempt affects not only the students and their families but also nursing programs. To increase NCLEX-RN pass rates, nursing programs are shifting from traditional teaching to active learning in their aim to produce nursing graduates who will pass the NCLEX-RN exams on the first attempt. The purpose of this descriptive, correlational study, guided by theory of constructivism, was to determine if there is a relationship between faculty’s use of active learning strategies (ALS) and nursing students’ NCLEX-RN pass rates on the first attempt in bachelor of science in nursing (BSN) and associate degree in …

Quality Improvement Project Supporting The Novice Nurse Educator Through Onboarding Orientation Practices, Samantha Fouts

Doctor of Nursing Practice Projects

There is a growing concern about a nursing faculty shortage. Many reasons exist, but one primary reason is a lack of support. Literature supports the argument that there is a lack of support for novice nursing faculty during their transition from expert clinician to novice educator. Literature also supports the need for formalized mentor programs, but gaps exist in determining successful models. This quality improvement project aimed to measure the impact on novice nursing faculty skill acquisition in a revised mentor program. The previous mentor program was outdated and lacked consistency. The program was updated using Benner’s novice-to-expert theory and …

Quality Improvement Project Enhancing Nursing Faculty Competency In Dimensional Analysis: A Quality Improvement Initiative, Kimberly Mcdonald

Doctor of Nursing Practice Projects

Medication dosage calculation errors remain a persistent concern in nursing education and practice, often tied to inconsistent teaching methods that leave students unsure and underprepared. Dimensional analysis (DA) has been shown to improve accuracy and confidence in solving dosage problems, yet many faculty have not received structured training in this method. To address that gap, a quality improvement (QI) project introduced a six-week DA training program for nursing faculty in a pre-licensure program. The initiative was guided by the Roy Adaptation Model and Bandura’s Self-Efficacy Theory, with change supported through Kotter’s 8-Step Model and the Plan-Do-Study-Act framework. Using a quasi-experimental, …

Quality Improvement Project Integration Of Mentoring Into A Registered Nurse Transition To Practice Program, Sherry L. Roberson

Doctor of Nursing Practice Projects

New graduate nurses (NGNs), who constitute the majority of the nursing workforce, face significant challenges due to high patient acuity, staffing shortages, and long shifts, resulting in risks of burnout, turnover, and impaired patient care. Transition to practice programs, or nurse residency programs (NRPs), are evidence-based solutions designed to support NGNs effectively in their transition to the profession. A key component of NRPs is mentoring, which provides longitudinal support to ease this transition. Research shows that mentorship is associated with increased feelings of support, self-confidence, resilience, and competence among NGNs, while also reducing stress. A needs assessment at the project …

Ask Me 3® In Action Advancing Health Literacy In Pediatric Acute Care, Yaseming Medina

EBP Fellowship

Background: Parents and caregivers’ understanding of how to provide safe and effective care at home is vital. However, elevated levels of stress and limited health literacy face significant challenges in understanding discharge instructions.

For parents of pediatric patients seen in an acute perioperative setting, how will the use of the Ask Me 3® health literacy tool impact understanding of medical information and communication with healthcare providers?

Literature Evidence: Patients who understand heath instructions make fewer mistakes when they take their medicine, follow treatment plans, and prepare for medical appointments (Six-Means, Amy, et al, May 2012). Patients have reported …

Empowering Nurses: A Training Initiative On Essential Oils For Pediatric Neurosurgery Patients, Sheri Sacks

EBP Fellowship

PICO Question: In pediatric neurosurgical bedside nurses, does education on lavender essential oil, compared to no education, improve knowledge, confidence and intent to integrateit as a complementary therapy for TBI patients?

Literature Review: Pediatric neurosurgery patients often face increased anxiety and agitation. Nurses may lack knowledge of non-pharmacological interventions to reduce agitation and anxiety in their patients. Literature review used MeSH Headings and keywords to find recent English articles. Evidence shows EO reduces anxiety. Lavender inhalation lowers anxiety, pain, and vital signs in pediatric dental patients. In adults, aromatherapy decreases anxiety, pain, blood pressure, and improves sleep, also …

Fierce And Focused - Virtual Reality Support For Pediatric Oncology Patients, Javarius Barber-Esparza

EBP Fellowship

Practice Problem: Pediatric oncology patients often experience anxiety during needle procedures. Even with anesthetic pain management in place, visually encountering the needle can be more distressing than the procedure itself. Virtual Reality (VR) has emerged as a nonpharmacological tool that provides immersive distraction, effectively lowering pain perception and anxiety. Studies show VR reduces anxiety during medical procedures, including accessing Implanted venous access devices (IVAD). Yet, its adoption in pediatric oncology settings remains limited.

Literature/Evidence: Search strategy in the CINAHL (EBSCOhost) database used MeSH headings and keywords, including English articles published within the last five years. Studies show that …