Improving Timely Administration Of Scheduled Short-Acting Insulin In Hospitalized Diabetic Patients, Edward S. Qu

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to improve compliance with the administration of scheduled short-acting insulin within 30 minutes of point-of-care blood glucose testing among hospitalized diabetic patients.

Background

This project was implemented in an inpatient hospital unit caring for patients with diabetes who require scheduled short-acting insulin. Internal audit data showed that compliance with administering insulin within 30 minutes of blood glucose testing was approximately 60%, indicating an opportunity to improve workflow and care coordination.

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement method was used to guide the project. Baseline data were collected from electronic health record …

Bridging Gaps In Safety: A Team-Based Approach To Reducing Falls Among Older Adults, Enzali Min

Master's Projects and Capstones

A skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility's fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving 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 …

Improving Chemotherapy Patients' Confidence And Preparedness Through Dual-Format Teaching, Jasmine Esther Aminpour, Harshpreet Kaur, Ana Ruvalcaba, Sarah Muwanas

Master's Projects and Capstones

Section I: Abstract

Objective

Chemotherapy initiation is widely recognized as a period of heightened anxiety and cognitive overload for oncology patients, often limiting their ability to retain essential information during traditional one-time, nurse-led education sessions (Gucuyener & Karabacak, 2025; Howell et al., 2020). This quality improvement (QI) project sought to address gaps in comprehension, preparedness, and digital engagement within an outpatient oncology infusion microsystem by integrating evidence-based digital chemotherapy education with structured follow-up support.

Aim

The project aimed to determine whether a nurse-guided walkthrough of a digital chemotherapy education platform, paired with standardized follow-up calls, would improve patient comprehension, confidence …

Increasing Nursing Staff Confidence And Documentation Compliance For Psychotropic Medication Use, Ei Chit Paing

Master's Projects and Capstones

Objective: Psychotropic medications place a high risk for side effects such as confusion, dizziness, falls, and death in older adults above age 65 (Seifert et al., 2024). Educational training on appropriate psychotropic drug use to nursing staff is linked to a decrease in penalties (Jung et al., 2021), side effects, and an increase in staff knowledge in caring for patients with behavioral and psychological symptoms (Pinazo-Clapés et al, 2020). Aim: Facility A in Northern California is currently non-compliant with the Centers for Medicare and Medicaid Services (CMS) guidelines for appropriate psychotropic use due to limited staff understanding of regulations and …

Nurses’ Voices In Prevention: Evaluating Enhanced Bedside Signage To Reduce Hospital-Acquired Pressure Injuries, Jorge Pinzon Figueroa

Master's Projects and Capstones

Abstract

Objective: Hospital-acquired pressure injuries remain a patient safety concern despite standard practice of nurses’ prevention protocols (National Pressure Injury Advisory Panel, 2022). Barriers include: inconsistent two-hour repositioning, documentation burden, inadequate staffing, lack of visual cues of patient risk level, and inconsistent compliance with the overall comprehensive prevention bundle (Agency for Healthcare Research and Quality, 2023).

Aim: HAPIs occur within two adult medical-surgical and telemetry units at a tertiary hospital. In response, staff were surveyed on potential interventions, resulting in the production of a visual cuing system.

Methods: Pre- and post-surveys were conducted on the two medical-surgical units to assess …

Improving Dka Protocol Adherence In The Emergency Department, Anjolaoluwa Lawani

Master's Projects and Capstones

Problem There was inconsistency in implementation of the DKA protocol by nurses in the emergency department at the Hospital A. Only 58% of the nurses reported feeling comfortable following the DK protocol, and 84% of the nurses described the DKA order set as confusing. Context Hospital A is a large magnet-recognition hospital system in the Bay Area. The emergency department at Hospital A averages about 12 DKA patients per quarter. Intervention Education sessions were held during pre-shift cuddles across day and night shifts to clarify the DKA protocol and answer any questions or nurses may have. Measures Baseline surveys and …

Timely Transfusions In Trauma: Instituting A Transfusion Guideline For Trauma Nurses, Lauren Standiford

Doctor of Nursing Practice Final Project Abstract

PURPOSE This project aims to reduce delays in the blood transfusion process in three non-monitored trauma units at a large academic Level I Trauma Center by decreasing the mean "RN transfusion process times" (RN-TPT) by 20 minutes. The project focuses on optimizing transfusion rates, nursing practices, and electronic documentation integration to enhance transfusion timeliness and improve overall patient care.

BACKGROUND Delays in the blood transfusion process can negatively affect patient outcomes and increase healthcare costs. In three non-monitored trauma units at a Level I Trauma Center, inefficiencies in transfusion rates, nursing practices, and electronic documentation were identified. Barriers included concerns …

Quality Improvement Project: Enhancing Nursing Documentation Of Patients’ Chief Complaints And Anatomical Site Markings In Radiographic Imaging Requests, Clara Odili

Doctor of Nursing Practice Projects

Incomplete or inaccurate radiographic imaging requests remain a persistent barrier to diagnostic accuracy and patient safety in urgent care settings. The purpose of this quality improvement (QI) initiative was to enhance nursing documentation of patients’ chief complaints and anatomical site markings through an evidence-based educational intervention targeting nurse-trained X-ray technicians. Guided by Benner’s Novice-to-Expert framework and principles of evidence-based practice, this project employed a pre- and post-intervention design over a two-week implementation period. Data was collected using structured knowledge and competency assessments. Post-intervention findings demonstrated substantial improvements in documentation accuracy, with mean knowledge scores increasing by approximately 30% and self-reported …

Quality Improvement Project: The Impact Of Genetic Testing Education For Mental Health Providers In An Outpatient Clinic, Ifeoma Uzoh-Anigbogu

Doctor of Nursing Practice Projects

Despite growing evidence supporting the use of genetic screening in psychiatric medication management, many mental health providers lack the confidence and knowledge to utilize this tool effectively. This quality improvement (QI) project aimed to enhance provider self-efficacy and increase the utilization of genetic screening through a structured education and training program in an outpatient mental health clinic. The purpose of the project was to determine whether provider education on pharmacogenetic testing improves confidence and screening frequency compared to those who do not receive the intervention. The Donabedian Model guided evaluation of structure, process, and outcome measures, while Rogers’ Diffusion of …

Quality Improvement Project: Improving Nurse Competency In Caring For Patients With Dementia With Behavioral Disturbances In Long-Term Care, Lashunta Jackson

Doctor of Nursing Practice Projects

Dementia-related behavioral and psychological symptoms (BPSD) present major challenges for nurses in long-term care settings, often leading to inconsistent care, staff stress, and safety risks. Evidence-based, person-centered interventions are proven to improve outcomes but are frequently underutilized due to limited staff training. The purpose of this Doctor of Nursing Practice (DNP) project was to improve nursing staff competency in managing residents with dementia and behavioral disturbances through structured, evidence-based education. The problem identified was a lack of dementia-specific knowledge and confidence among nurses, which contributed to suboptimal care and increased behavioral incidents. A quasi-experimental pre-/post-intervention design guided by Knowles’ Adult …

Resiliency For Nurse Educators: Incorporating Resiliency Training For Nursing Faculty, Rachael Holder

Doctor of Nursing Practice Projects

Nursing faculty frequently experience high levels of stress, workload demands, and burnout, which can negatively affect teaching effectiveness and retention. Literature supports resilience as a protective factor that enhances well-being and professional sustainability. The purpose of this quality improvement project was to impact resilience levels among full-time undergraduate nursing faculty through a self-paced online resiliency training program. Guided by Pender’s Health Promotion Model and Lewin’s Change Theory, this pre- and post-intervention design used the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to assess changes in resilience. Eleven faculty members completed the pre-survey, and two completed the post-survey. The post-survey mean CD-RISC-10 scores …

Reducing Falls In The Acute Care Setting: A Quality Improvement Project, Elorm M. Adzokpa

Doctor of Nursing Practice Final Project Abstract

Falls remain one of the most common adverse events in acute care settings and are associated with increased morbidity, extended hospital stays, and higher healthcare costs. Orthopedic and trauma patients are particularly vulnerable due to mobility limitations, postoperative recovery, and complex medical conditions. The purpose of this quality improvement project was to reduce inpatient falls on an adult orthopedic and trauma unit by implementing a visual aid to reinforce the 5P fall-prevention framework. A pre–post quality improvement design was used during an eight-week implementation period. The intervention included a standardized fall prevention bundle that reinforced existing Fall TIPS board use …

Quality Improvement Project: Educating Nursing Faculty On Medication Administration Labs To Improve Student Competency, Chelsea Pacheco

Doctor of Nursing Practice Projects

Medication administration errors are a leading cause of preventable harm in healthcare. Faculty play a critical role in ensuring nursing students develop the knowledge and confidence to give medications safely. A needs assessment at the project site revealed that only course coordinators were teaching medication administration and dosage calculation, leaving other faculty uncertain about how to teach these skills. This quality improvement project aimed to strengthen faculty confidence and create consistency in first-year instruction through a recorded educational video. Constructivist Learning Theory provided the foundation for active, experience-based learning. Lewin’s Change Theory guided the structured implementation process to support adoption …

A Change In Practice: Improving Uti Management In A Long-Term Care Facility By Implementing Rapid Urinary Culture Collection Protocols To Enhance Timely Treatment And Reduce Hospitalizations, Tania Ojeda

Doctor of Nursing Practice

ABSTRACT

Background: Urinary tract infections (UTIs) remain a leading cause of morbidity among elderly residents in long-term care facilities, where diagnosis is frequently delayed due to atypical presentation, cognitive impairment, and inconsistent urine specimen handling. Purpose: This quality improvement (QI) project aimed to improve the timeliness and accuracy of UTI management in a memory care facility through standardized evidence-based protocols. Objectives: The project sought to ensure that: (a) 100% of staff would be educated on the protocol; (b) 100% of residents with suspected UTIs would have urine sent for urinalysis and culture within 8 hours of symptom onset; (c) 100% …

Shared Decision Making In Women's Health: A Quality Improvement Project, Brittney Butler

Doctor of Nursing Practice Projects

Shared decision-making (SDM) is the best practice in contraceptive counseling, yet it remains underutilized in primary care, particularly within underserved communities. Limited SDM use reduces patient autonomy, weakens satisfaction, and contributes to inconsistent documentation. This quality improvement (QI) project aimed to evaluate whether an educational intervention on SDM for contraceptive counseling improved provider self-efficacy and the electronic medical record (EMR) documentation of SDM practices. Guided by Bandura’s Social Cognitive Theory and Lewin’s Change Management Model, the project sought to enhance provider confidence and foster sustainable behavioral change. A quasi-experimental, one-group pretest–posttest design was implemented at a rural Federally Qualified Health …

Quality Improvement Project: Empowering Nurse Educators: Implementing A Mentoring Program For Professional Growth, Sarah Sugg

Doctor of Nursing Practice Projects

With the ongoing nursing shortage, nursing education plays a vital role in shaping the future of healthcare through the preparation of competent and skilled nurses. Literature supports that a persistent challenge within nursing academia is the lack of structured mentoring programs to support novice nursing faculty transitioning into academic roles. This quality improvement project addressed this gap through the implementation of a structured, evidence-based mentoring program compared to informal mentoring. The purpose of the project was to empower novice nursing faculty with less than three years of teaching experience by enhancing teaching competence, confidence, job satisfaction, and retention. Guided by …

Quality Improvement Project: Increasing Breast Cancer Screening Rates Among Women Ages 40-74 At A Federally Qualified Health Center By Implementing A Provider Alert Tool, Tiny Stephens

Doctor of Nursing Practice Projects

Breast cancer maintains its position as the leading cause of cancer-related death for women worldwide and remains the second deadliest cancer among female patients in the United States (Centers for Disease Control, 2024). The screening rates at Federally Qualified Health Centers (FQHCs), which serve medically underserved communities, remain lower than national benchmarks, thus putting their patients at risk for receiving late-stage cancer diagnoses. This quality improvement project implemented an evidence-based electronic medical record (EMR) provider alert tool at a Northeast Georgia FQHC to address a baseline mammogram order compliance rate falling below national standards at 45%. The project aimed to …

Quality Improvement Project Enhancing Documentation Practices In Community Mental Health Clinics, Carol Parker

Doctor of Nursing Practice Projects

Accurate and timely documentation are essential for safe, high-quality care in community mental health settings. This quality improvement (QI) project addressed inconsistent documentation practices among licensed, unlicensed, and Qualified Mental Health Specialist (QMHS) staff at an outpatient clinic. The purpose of the QI project was to implement and assess a structured in-service training program using the Accountable Health Communities–Health-Related Social Needs (AHC-HRSN) screening and documentation tool to improve staff knowledge, enhance documentation accuracy, and facilitate care coordination. Guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change Management Model, a pre- and post-intervention design was used. Fifteen staff members …

Enhancing Mental Health Providers' Approach To Medication Adherence In Schizophrenia Patients Using Motivational Interviewing Techniques., Jacinta Madu

Doctor of Nursing Practice Projects

Medication non-adherence among individuals with schizophrenia remains a persistent challenge that undermines symptom management and increases relapse and hospitalization rates. This quality improvement (QI) project aimed to evaluate the effect of Motivational Interviewing (MI) training on provider knowledge and confidence in promoting medication adherence within an outpatient mental health clinic. Guided by Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) framework, a quasi-experimental pre–post design was used. Six providers, including psychiatric nurse practitioners, therapists, a psychiatrist, and a registered nurse, participated in a structured MI training session incorporating didactic instruction and role-play exercises. Data were collected using pre- and post-intervention surveys …

Enhancing Pediatric Sun Safety: A Parent-Focused Intervention In El Dorado County, Ashley Riley, Calvin Nauer, Alaina Godwin

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background:

Childhood ultraviolet (UV) exposure is the most significant modifiable risk factor for skin cancer, yet proper sun protection remains inconsistently practiced by parents. In El Dorado County, California, where high altitude and intense sun exposure amplify UV risk, knowledge gaps and misinformation persist despite resource availability. This quality improvement (QI) project aimed to strengthen parental knowledge, confidence, and modeling of sun-safe behaviors for their children through an evidence-based community education program.

Aim:
The goal of this QI initiative was to improve parental attitudes, self-efficacy, and photoprotective behaviors by implementing a three-part, nursing-led educational intervention focused on UV risk awareness, …

Hygiene Heroes: Strengthening Oral Hygiene To Reduce Central Line-Associated Bloodstream Infections In Pediatric Hematology/Oncology Patients, Sidney Clymer-Engelhart, Kirstie Shulman

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Central line-associated bloodstream infections (CLABSIs) impact pediatric patient outcomes, increasing mortality, hospital stays, and healthcare costs. At Sutter Medical Center Sacramento (SMCS), the CLABSI prevention bundle includes proper line care, dressing assessments, and hygiene practices, including twice-daily oral care, daily linen changes, and chlorhexidine gluconate (CHG) bathing. Sutter found their CLABSI bundle compliance at approximately 76–78%, with oral hygiene identified as the most frequent gap in care.

Aim: This quality improvement project, partnered with SMCS, targeted oral care compliance to enhance overall bundle adherence, strengthen staff-leadership communication, and ultimately reduce CLABSI rates in the hematology/oncology units. In a wider …

Fall Prevention In The Lobby Of The Emergency Department At Sutter Medical Center Sacramento, Tanya Rodriguez Duarte, Vaneza Espino, Roshni Hayer, Yajari Mendoza

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: In 2024, Sutter Medical Center Sacramento (SMCS) reported 17 patient falls in the Emergency Department (ED) lobby, with 94% (n = 16) occurring in the triage area. Patients awaiting placement after triage are not classified as admitted and thus are not included in CMS’s inpatient fall reporting program. However, due to the known safety risk, SMCS ED leadership began tracking lobby falls locally and partnered with University of the Pacific nursing students to address this issue.. Aim: This quality improvement project aimed to reduce the incidence of falls in the ED lobby through enhanced fall risk identification, timely reassessment, …

The Kangaroo Care Project: Implementation Of Skin-To-Skin (Sts) In Sutter Medical Center, Sacramento, Neonatal Intensive Care Unit, Bianca Wong, Katherine Do, Martha Calero, Lydia Nambala

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Skin-to-skin contact, also known as kangaroo care or kangaroo mother care, is an intervention typically done after birth to promote physiologic stability, bonding, and breastfeeding.

Aim: The Kangaroo Care project aimed to increase the incidence of skin-to-skin contact in the neonatal intensive care unit at Sutter Medical Center, Sacramento.

Methods: A pre-survey was conducted to assess staff comfort with skin to skin. Interventions to increase skin-to-skin rates included staff e-learning, unplanned extubation mock codes, nurse champions, and a policy change to Sutter Medical Center, Sacramento’s handbook.

Results: TBD. Preliminary results indicated use of STS in the NICU and post-results …

Staying Ahead Of The Pressure: A Multimodal Intensive Care Unit Hospital-Acquired Pressure Injury Quality Improvement Project At Sutter Medical Center, Sacramento, Mijung Lim, Daniela Tobler, Raquel Youkhana

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Hospital-acquired pressure injuries (HAPIs) are a major quality and safety concern, particularly in the intensive care units (ICUs) where critically ill and immobile patients face elevated risk. At Sutter Medical Center Sacramento (SMCS), nine confirmed HAPIs and two under investigation were reported within the medical ICU, cardiac ICU, and neurosurgical ICU by May 2025, exceeding the hospital’s target and prompting a system-wide quality improvement initiative.

Aim: The aim of this project was to: (a) reduce ICU-acquired HAPIs to fewer than four cases per quarter by December 2025 and (b) increase nursing compliance with early and ongoing prevention strategies, including …

Improving Maternal Mental Health Awareness And Support In Perinatal Black And Latina Women, Jasman Hans, Lesly Carrillo, Kayla Huynh, Brianna Harrison

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Black and Latina women in California experience disproportionately high rates of perinatal mental health disorders due to limited access to care, stigma, and systemic inequities.

Aim: In collaboration with BeMomAware, this Quality Improvement project aimed to enhance maternal mental health literacy among Black and Latino individuals in the Oak Park community of Sacramento. The project sought to increase awareness, knowledge, and access to culturally appropriate mental health resources through an educational video and community session.

Methods: Interventions included a short educational video and an in-person community session providing culturally relevant information about perinatal depression and anxiety disorders, available resources, …

Implementing Phq-2 In An Outpatient Mental Health Practice, Krishona Poignard

Doctor of Nursing Practice Projects

Depression remains widely underidentified in outpatient behavioral health settings, where variable screening practices limit early recognition and appropriate treatment. This quality improvement project addressed this gap by standardizing screening through targeted clinician education. The purpose was to improve clinician confidence and adherence to validated tools, specifically the Patient Health Questionnaire-2 (PHQ-2) and, when indicated, the Patient Health Questionnaire-9 (PHQ-9). The project aimed to increase consistent tool use through an evidence-based educational intervention guided by Lewin’s Change Theory and the Iowa Implementation for Sustainability Framework. A quasi-experimental, single-group pretest–posttest design was employed with licensed clinical staff, including licensed social workers (LSWs), …

Reducing Emergency Department To Medical Icu Boarding Times: Implementing A Standardized Escalation Protocol At A Large Medical Center Hospital, Taylor A. Robbins-Ethridge

Doctor of Nursing Practice Final Project Abstract

Prolonged emergency department (ED) boarding of critically ill patients awaiting transfer to the medical intensive care unit (MICU) delays access to definitive care and is associated with increased mortality and longer hospital stays. This quality improvement project aimed to reduce ED boarding times for MICU patients by implementing the Bed Ready in 30: Just Say Yes escalation protocol. The Plan–Do–Study–Act (PDSA) framework guided the implementation of a structured escalation process to standardize nurse-to-nurse communication once a MICU bed was marked as ready in the electronic health record. A pre–post observational study was used to evaluate the intervention using electronic health …

Quality Improvement Project: Effects Of Ongoing Clinical Education Training On Nursing Faculty’S Self-Efficacy In Clinical Education, Sarah Ferguson

Doctor of Nursing Practice Projects

Clinical education is essential for bridging theory and practice in nursing education, yet many clinical instructors transition from expert bedside nurses to novice educators without adequate orientation and training. This quality improvement project examined the effects of ongoing clinical education training on nursing faculty self-efficacy at a satellite nursing school in North Texas. This project, guided by Patricia Benner’s Novice to Expert framework and Lewin’s change model, aimed to determine whether continuous professional development throughout the term would increase clinical faculty confidence compared to standard onboarding alone. A descriptive pre/post design was used, with the Clinical Nursing Teacher Self-Efficacy Scale …

Enhancing Emergency Department Staff Competency In Ultrasound-Guided Venous Access At A Rural Critical Access Hospital: A Quality Improvement Project, Ryan M. Sand

Doctor of Nursing Practice Projects

Patients meeting difficult intravenous access (DIVA) criteria often experience multiple failed intravenous (IV) access attempts, delayed diagnostics, and treatment initiation, particularly in rural emergency departments with limited resources. This quality improvement (QI) project evaluated whether targeted ultrasound-guided peripheral venous access training would improve staff self-efficacy, confidence, and self-reported procedural execution at a rural critical access hospital. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Theory, a quasi-experimental pre-/post-intervention design was implemented. Nurses and paramedics completed the validated Peripheral Intravenous Insertion Confidence Assessment before and after a didactic and psychomotor training program. Statistical analysis included an independent samples t-test …