Quality Improvement Project: Faculty Education On Clinical Evaluation Tool Utilization For Outcome-Based Assessment And Readiness In Clinical Competency Evaluation, Catherine Odom

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) quality improvement initiative addressed the lack of consistency and subjectivity in clinical evaluations of nursing faculty at a community college in the southern United States. The intervention was a structured faculty development program spanning eight weeks, focusing on Objective Structured Clinical Examinations (OSCEs) and performance rubrics. The project was guided by the IOWA Model of Evidence-Based Practice and the Kotter Change Management Framework, aiming to boost faculty confidence and inter-rater reliability in clinical assessment. The PICOT question was whether a structured educational intervention would enhance self-reported faculty confidence in clinical assessments relative to no …

Assessing And Improving Provider Knowledge And Comfort With Palliative Care Consultations: A Quality Improvement Project, Summer R. Hess

Doctor of Nursing Practice Projects

Palliative care remains significantly underutilized in the management of heart failure, despite national guidelines supporting its early integration. This underuse limits opportunities for person-centered care in cardiology settings. The purpose of this quality improvement project was to improve provider knowledge and comfort in implementing palliative care consultations. The problem addressed was the low consultation rates for advanced heart failure patients, largely driven by provider misconceptions and a lack of formal training. A quasi-experimental design was initiated by using a brief, evidence-based educational article. Sixteen advanced practice providers at a high-volume cardiology clinic completed pre- and post-intervention surveys using the End-of-Life …

Quality Improvement Project Evaluation Of The Effectiveness Of The Institute For Healthcare Improvement’S Joy In Work Framework On Burnout Experienced By Dialysis Staff, Bernice Jones

Doctor of Nursing Practice Projects

Burnout continues to pose a pervasive and escalating challenge in healthcare, with its severity further amplified in the aftermath of the COVID-19 pandemic. Dialysis professionals are especially vulnerable, facing elevated patient volumes, extended work hours, and frequent encounters with complex clinical needs. These ongoing stressors highlight the critical importance of this quality improvement (QI) project, as there exists an urgent need for evidence-based strategies to alleviate burnout among dialysis professionals. This QI project aimed to enhance joy in the dialysis work setting and reduce burnout experienced by dialysis staff through the implementation of the Institute for Healthcare Improvement’s (IHI) Joy …

Abstract Prevention Of Hospital-Acquired Pressure Injuries In Older Adults In Acute Care Settings, Evelyn Yegella

Doctor of Nursing Practice Final Project Abstract

INTRODUCTION:

Hospital-acquired pressure injuries (HAPIs) are a significant risk for older people in acute care, leading to increased morbidity,

Healthcare costs and fragility in senior patients result in higher HAPI rates. This quality improvement (QI) project aimed to reduce HAPI incidence by 40% within four months, utilizing evidence-based nursing interventions tailored to this vulnerable population.

METHODOLOGY:

The project followed the Plan-Do-Study-Act (PDSA) methodology, implementing staff training, periodical skin assessments, and repositioning schedules. Data were collected monthly using skin evaluation checklists and HAPI incidence reports from 30 patient days, and chi-square tests and control charts were used to examine the results. …

A Quality Improvement Project To Improve Touch Exposures In The Neonatal Intensive Care Unit., Jeremi Tricia Braga

Doctor of Nursing Practice Papers

Introduction: Premature infants in the NICU are exposed to many noxious stimuli that could cause negative effects on development. The SENSE® program has been developed to provide developmentally appropriate sensory stimulation for neonates. This project will focus on sense of touch primarily with KC or also referred to as skin-to-skin.

Environment: This QI project took place in to a Level III NICU at a tertiary medical center in Louisville, Kentucky. The facility has a total of 421 beds including the NICU that is licensed for 34 beds and caring for infants born prematurely as early as 22 weeks to term …

Enhancing Nurse Competence And Self-Efficacy In Delivery Of Medication Education At Discharge: A Quality Improvement Project Using The Teach-Back Method., Quinesia James

Doctor of Nursing Practice Papers

Medication nonadherence in pediatric psychiatric care contributes to worsening symptoms, delayed developmental progress, and increased hospitalizations. Adherence rates remain as low as 30–60%, accounting for up to $300 billion in avoidable healthcare costs annually. Low health literacy and inconsistent education strategies further complicate adherence. This quality improvement project took place on the child and adolescent psychiatric units at the project site, a large teaching hospital in a metropolitan area in the south-central United States, which serves patients aged 5–17 with complex mental health needs. The initiative aimed to improve nurses’ competence, self-efficacy, and time efficiency in delivering medication discharge education …

Measuring The Impact Of The Australian National Placement Evaluation Centre To Enhance Nursing And Midwifery Student Clinical Placements: A Multimodal Evaluation, Colleen Ryan, Robyn Cant, Areum Hyun, Debbie Procter, Louise Alexander, Dianne Bloxsome, Lynda Hughes, Fiona Bogossian, Simon Cooper

Research outputs 2022 to 2026

Aim: To evaluate the early impact of the Centre. Background: The educational quality of nursing and midwifery student clinical placement learning varies. The National Placement Evaluation Centre has a pivotal role in quality improvement by systematically collecting student and supervisor feedback on placement experiences. Design: Multimodal impact evaluation. Methods: Data were collected from website analytics and a survey shared via stakeholder registration emails and social media. The Impact Management Planning and Evaluation Ladder model was used to understand impact. Data were analysed using a sequential, hybrid inductive/deductive approach. Descriptive statistics summarised participant characteristics and qualitative data were themed. Results: Website …

A Pilot Structured Mentorship Program To Increase Pediatric Advanced Practice Provider Engagement At An Academic Institution, Erica Annotti, Dnp, Aprn, Pnp

Doctor of Nursing Practice Final Project Abstract

Introduction/Purpose: Advanced Practice Providers (APPs) transitioning into academic healthcare often face challenges related to role clarity, professional identity, and emotional support, which can hinder their engagement and retention. This quality improvement project aimed to design, implement, and evaluate a structured mentorship pilot program for pediatric APPs to increase work engagement by 10%.

Methods: Grounded in the Strong Model for Advanced Practice and Wagner’s Caring Mentorship Framework, the project employed a mixed-methods QI design. Four pediatric APPs (n=4) participated in an 8-week structured mentorship program. Interventions included the intentional pairing of mentors and mentees, biweekly one-on-one sessions, and targeted professional development …

Implementation Of A Discharge Process For Pediatric Patients Hospitalized With Asthma Exacerbations To Improve Post-Discharge Follow-Up, Emiko N. Dudley

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to improve pediatric pulmonary outpatient follow-up after hospital discharge for pediatric patients hospitalized with asthma exacerbations through the implementation of a standardized discharge process designed to improve communication, education, and care coordination.

Background

The project was completed in acute care and intermediate care units within a women's and children’s hospital in San Antonio, Texas.

Methodology

Following the IHI Improvement Model, serial PDSA cycles were completed over a 10-week period. An interprofessional team developed a standardized process map and interventions, including a discharge checklist, communication board, patient/family education, medications in hand at discharge, community asthma …

Controlling Hypertension In The African American Population Through Dash Diet Education, Tanya K. Mccaskill

Doctor of Nursing Practice Projects

Hypertension disproportionately affects African Americans, contributing to elevated risks of stroke, cardiovascular disease, and kidney failure. Despite the well-established benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, its adoption remains limited due to cultural, socioeconomic, and health literacy barriers. This Quality Improvement (QI) project aimed to evaluate the effectiveness of a culturally tailored DASH diet education intervention in improving nutritional knowledge among African American adults with hypertension (HTN). Using a quasi-experimental pre-post intervention design, 50 participants received a structured educational session during a single clinic visit, which included counseling, printed materials, and sample menus. The intervention was guided …

Implementation Of A Nurse-Driven Process To Decrease Npo Times In A Geriatric Emergency Department, Luke D. Little

Dissertations

Prolonged nil per os (NPO) status for geriatric patients in the emergency department is a critical safety issue, leading to increased rates of delirium, hypoglycemia, and perioperative complications. A quality improvement project was designed to address this problem through a targeted, nurse-driven intervention. In geriatric patients (age ≥70) in a geriatric emergency department, this project aimed to determine if implementing an electronic health record (EHR)-prompted nursing workflow to obtain a diet order would reduce the length of time patients were kept NPO compared with standard practice. An EHR documentation tool was designed and implemented along with targeted nursing education sessions …

Improving Compliance With Safe Sleep Bundles In The Neonatal Intensive Care Unit., Lindsey Davenport Shepherd

Doctor of Nursing Practice Papers

Abstract

Sudden Unexpected Infant Death Syndrome (SUIDS) is the leading cause of infant death. There is literature stating nursing compliance with safe sleep modeling in the hospital is a concern. In 2022, the American Academy of Pediatrics (AAP) updated their safe sleep guidelines which include the Neonatal Intensive Care Unit (NICU). The national average rate of SUIDS is 94.8 deaths per 100,000 live births (CDC, 2024). In Kentucky the rate is higher than that at a rate of 128.4 deaths due to SUID per 100,000 live births (CDC, 2024). The purpose of this project was to educate nursing staff, with …

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …

Preventing Hospital-Acquired Pressure Injuries Using Turn Teams And Verbal Reminders, Joyce O. Blaboe

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) are a preventable, yet persistent issue in healthcare, particularly in the pulmonary and infectious disease unit of a Northeastern U.S. hospital. HAPIs prolong hospital stays, increase healthcare costs, and pose potential legal risks. Despite implementing evidence-based protocols, including the leaf patient monitoring system, the hospital reported six avoidable HAPIs cases in the early fiscal year 2025.

Aim: The quality improvement (QI) project aimed to reduce HAPIs incidents by 10% within 12 weeks by introducing turn teams and verbal reminders to enhance existing protocols.

Evidence Review: Regular turning and repositioning are essential to HAPIs prevention. Additionally, …

Evidence-Based Pain Management Bundle For Pediatric Postoperative Orthopedic Patients, Samantha Firmstone

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Postoperative pain management in pediatric orthopedic patients is often inconsistent due to variability in provider practices and a lack of standardized protocols. At a Central Texas pediatric orthopedic clinic, all patients received opioid prescriptions post-knee surgery regardless of procedure severity, leading to frequent caregiver calls for clarification. This practice revealed a critical gap in preoperative education and multimodal pain management strategies, contributing to patient safety concerns and increased clinic workload.

Aim of the Project: The primary aim of the project was to improve pain control, reduce opioid reliance, and decrease postoperative pain-related follow-up calls by implementing a standardized, evidence-based …

Optimizing Pressure Injury Prevention: Implementation Of The Sskin Bundle In Acute Care, Joycelyn Mccall

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Hospital-acquired pressure injuries (HAPIs) contribute to increased morbidity, extended hospitals stay, and significant healthcare costs. At the project site in northwest, Indiana, HAPI rates averaged 6.29%, which significantly higher than the national benchmark of 2.24%. Inconsistencies in documentation, a lack of standardized preventive practices, and variable staff engagement contributed to these increased rates. Despite the use of the Braden Scale, staff inconsistently implemented preventive interventions.

Aim of the Project: The aim of the project is to reduce HAPI incidence by 30% over 10 weeks by implementing the surface, skin inspection, keep moving, incontinence/moisture management, and nutrition (SSKIN) bundle and …

Reducing Catheter-Associated Urinary Tract Infections In The Intensive Care Unit, Rosa Shiffman

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections in intensive care units (ICUs), contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Despite established prevention guidelines, inconsistent practices in catheter removal and gaps in daily necessity reviews persist. At the project site’s 24-bed ICU, the CAUTI rate was 1.9 per 1000 catheter days, which exceeds the national benchmark of 1.0. Gaps in consistent assessment of necessity and delays in removal contributed to an elevated infection risk.

Aim of the Project: This project aimed to reduce CAUTI rates in the ICU through evidence-based interventions …

Reporting And Tracking Of Occupational Bloodborne Pathogen Exposures, Olivia Smith

Doctor of Nursing Practice Final Project Abstract

Purpose/Background: Underreporting of occupational bloodborne pathogen (BBP) exposures remains a significant patient and employee safety issue. At UT Health, outdated paper-based systems hindered accurate tracking, timely follow-up, and reporting compliance. The aim of this quality improvement (QI) project was to achieve a 30% increase in quarterly BBP exposure reports, from 30 to 39, by implementing an electronic reporting system between January 1 and March 31, 2025.

Methodology: Guided by the Health Belief Model and using the Implementation and Improvement Science (IIS) Framework, the project replaced the existing paper form with an external, user-friendly digital system. Staff received structured training, and …

Quality Improvement Project Enhancing Self-Efficacy In Managing Patient No-Shows: A Staff-Focused Intervention, Aaron Wabang

Doctor of Nursing Practice Projects

No-shows are widely reported in behavioral health venues. They hinder continuity of care, decrease clinic efficiency, and compromise patient care. The solution requires addressing patients’ behavior and internal facility processes. This quality improvement (QI) project aimed to reduce no-show rates by providing staff with tools and enhancing their self-efficacy in managing appointments. The project was conducted in a rural East Texas behavioral clinic. Clinic staff reported challenges with patient reminders, scheduling, and follow-up issues that cause increased no-shows. The QI project aimed to empower staff by providing evidence-based scheduling strategies and decision support resources to enhance their confidence and attendance …

Quality Improvement Project Enhance Self-Efficacy And Knowledge In Pediatric Emergency Care For Nurses In An Adult Acute Care Facility, Tiffany Daniel

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project addresses the significant gap in emergency nursing preparedness for managing pediatric emergencies in adult-focused emergency departments. A quasi-experimental pre/ post intervention design was used to implement a pediatric-specific training intervention consisting of didactic education and simulation-based learning. A total of 87 night shift ED nurses participated. Knowledge and self-efficacy were measured using pre- and post-intervention surveys and assessments. The training equipped nurses with critical skills to manage pediatric emergencies more confidently and competently, addressing both clinical and emotional barriers. Knowledge scores significantly improved, t = -20.45, p < 0.001, with post-test means rising from 5.56 (SD = 1.58) to 9.03 (SD = 0.32). Post-intervention self-efficacy scores also increased significantly, t(86) = -21.57, p < .001, indicating greater confidence in pediatric emergency care. These findings validate the effectiveness of structured pediatric emergency training in enhancing nurse competency and self-efficacy. Lewin's change theory and Newman’s systems model guided this quality improvement project. The results support the continuation of the program in population-specific education and simulation as part of annual competency development. This project demonstrated that targeted pediatric training improves nurse preparedness and has the potential to enhance patient outcomes in a setting traditionally focused on adult care.

Enhancing Education In Nursing Skills: The Impact Of Simulation Use On Faculty Self -Efficacy, Annie Kyle

Doctor of Nursing Practice Projects

This quality improvement (QI) project aimed to improve nursing faculty self-efficacy in teaching nursing skills using medium- and high-fidelity simulation. The problem addressed was the increasing number of students requiring multiple attempts to pass skills checkoffs, with some ultimately being withdrawn from the program. Faculty at the project site reported a lack of training and confidence in utilizing simulation technology effectively. A quasi-experimental design was used with a single group of full-time faculty (n=6), who received simulation training and completed the Self-Efficacy Towards Teaching Inventory for Nurse Educators (SETTI-NE) before and after the intervention. The data analysis was conducted using …

Improving Patient Outcomes Post-Discharge: Implementing Evidence-Based Discharge Planning For High-Risk Mental Health And Substance Use Disorder Populations, Margaret Phillips

Doctor of Nursing Practice Projects

A significant gap in standardized discharge procedures was identified at a nonprofit, community-based clinic serving male residential patients with substance use disorder (SUD) and co-occurring mental health conditions. The lack of a standardized discharge process led to poor follow-up appointment adherence, poor medication adherence and increased risk of relapse. This quality improvement (QI) project aimed to address these issues through the implementation of a cross-departmental discharge process that produced tailored Individualized Discharge Plans (IDP) or each patient, using the Donabedian and Kotter’s 8-Step Change models as guiding frameworks. Data were collected using custom-built tracking tools over two four-week periods, pre- …

Quality Improvement Project The Introduction Of Gratitude Journaling To Decrease Test Anxiety In Prelicensure Bachelor Of Science In Nursing Students, Jourdan Scoggins

Doctor of Nursing Practice Projects

Test anxiety is a substantial barrier to success among prelicensure nursing students, given the heavy course load and high academic pressure of the educational environment. The purpose of this quality improvement project was to measure the impact of gratitude journaling on levels of test anxiety in first-semester Bachelor of Science in Nursing (BSN) enrolled in a nursing math course at a regional university in Arkansas. Following a quasi-experimental design, students participating in the project completed the Westside Test Anxiety Scale (WTAS) before and after five weeks of gratitude journaling. Thirty-two students participated in the intervention and 24 of those completed …

Stakeholders' Expectations And Experiences Of Being Involved With A Global Accreditation Process For Midwifery Centres In Lmics: A Rapid Ethnography, Summer M. Aronson, Laura Batinelli, Lucia Rocca-Ihenacho, Jennifer R. Stevens

College of Health Professions Faculty Papers

BACKGROUND: This study explored the expectations and experiences of stakeholders involved in the accreditation of midwifery centres (MCs) in low- and middle-income countries (LMICs). With increasing evidence that MCs provide safe, respectful, and evidence-based care that improves maternal and neonatal outcomes, accreditation may serve as a mechanism to bridge quality gaps in maternal health systems, particularly in regions with high maternal and neonatal mortality.

METHODS: A rapid ethnographic approach, combining participant observation and semi-structured interviews, was conducted in partnership with the GoodBirth Network (GBN), which identified six pilot midwifery centres in Haiti, Uganda, and South Africa. Convenience sampling was applied, …

Optimizing Pediatric Peri-Anesthesia Care: A Donna Wright Nursing Competency Framework, Marisa Elise Gauna

Master's Projects and Capstones

Problem: Preventable hospital errors are often associated with inconsistent nursing competency, especially in high-acuity areas such as pediatric peri-anesthesia units. Traditional evaluation tools like checklists have limited effectiveness, as they frequently fail to engage staff or adapt to changing clinical demands (Wright, 2005). Context: At a Bay Area children’s hospital, baseline data from August 2024 revealed that only 65% of peri-anesthesia nurses reported feeling “very” or “somewhat” comfortable with key clinical skills. To address this, a quality improvement project was launched with the goal of increasing comfort levels by 15% using the Donna Wright Competency Model, which emphasizes staff engagement, …

From Silence To Clarity: Enhancing Surgical Icu Communication Through Personalized Whiteboards, Braeden R. Woods

Master's Projects and Capstones

Objective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform …

Implementing Sacred Pause After Patient Death To Reduce Burnout In Icu Nurses, Kimberly Lee

Doctor of Nursing Practice Final Project Abstract

This quality improvement project aimed to implement the Sacred Pause in a hospital Intensive Care Unit (ICU) and evaluate its impact on nurse burnout using the Maslach Burnout Inventory (MBI). Background ICU nurses are at high risk for burnout due to frequent exposure to trauma, highacuity care, and patient death. Burnout can negatively affect nurse well-being, staff retention, and quality of care delivery. The Sacred Pause is a brief, intentional moment of silence observed by staff following a patient’s death. This practice honors the life lost and acknowledges the contributions of the healthcare Methodology team, offering a potential source of …

Enhancing Nurse Competency: Proper Application Of Chlorhexidine Gluconate Dressings To Prevent Central Line Associated Bloodstream Infections, Joseph Earich

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) pose a significant risk to patient safety and healthcare outcomes. The proposed Doctor of Nursing Practice (DNP) project addresses the knowledge gap among nurses regarding the correct procedures for changing chlorhexidine gluconate (CHG) dressings on central lines. The goal is to enhance nurse education and adherence to best practices, thereby reducing the incidence of CLABSIs. The project employs a quasi-experimental design with a pre-test and post-test methodology. Nurses will complete a pre-test to assess their baseline knowledge of CHG dressing changes. The nurse will participate in a hands-on educational session to improve their understanding and …

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Tracking Colorectal Cancer Screening In A Rural Primary Care Clinic: A Quality Improvement Project, Elaine Olbertz

Doctor of Nursing Practice

Background

Colorectal cancer screening is understood to be the most effective way to prevent colorectal cancer and associated mortality. The U.S. remains below-goal for colorectal cancer screening rates, especially in rural areas.

Purpose

The purpose of this project was to implement and evaluate the use of a colorectal cancer Screening and Tracking Worksheet at a rural primary care clinic in Washington to measure the impact on screening rates.

Methods

The number of patients current with colorectal cancer screening was compared pre- and post-Screening and Tracking Worksheet implementation.

Results

There was statistically significant improvement in colorectal cancer screening rates reported by …