Nursing Commons^™

Improving Cervical Cancer Screening In Rural Primary Care: A Quality Improvement Dnp Project, Shelbie Kr Graham

The Eleanor Mann School of Nursing DNP Capstone Projects

Abstract

Purpose This quality improvement project addresses the inconsistencies in patient identification of those indicated for cervical cancer screening and targets provider practice change to improve screening rates. The purpose of this project is to standardize the cervical cancer screening practice in a rural health clinic system to increase the rate of screening.

Methods A paired samples comparison was used to measure the difference in participating providers’ number of cervical cancer screenings pre and post implementation.

Results Despite seeing nearly 5% fewer patients within the intended population, the screening practice remained consistent at nearly 3% of all encounters before and …

Improving The Patient Care Experience In Residential Eating Disorder Treatment: A Quality Improvement Project, Paige H. Nguyen

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project was to implement structured biweekly patient check-ins at a residential treatment facility for eating disorders. This project was intended to increase the patient care satisfaction scores on patient discharge surveys from under 80% to over 90%.

Background

The project was implemented at a 12-bed residential treatment facility for adolescents and adults diagnosed with eating disorders located in Cypress, Texas.

Methodology

The Baird 2007 concept of scripting during rounds was utilized as well as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) patient care experience survey questions when creating the script used during …

Quality Improvement Project Provider Burnout Related To Patient Satisfaction, Sherita Lee

Doctor of Nursing Practice Projects

Provider burnout is a critical issue in healthcare, often intensified by increasing demands to meet patient satisfaction benchmarks. This quality improvement project aimed to examine whether a structured stress reduction program could reduce provider burnout and positively influence patient satisfaction scores in a small outpatient clinic. Guided by the PICOT question—In the clinic setting (P), does the implementation of a stress reduction program for providers (I), compared to no intervention (C), lead to improved patient satisfaction scores (O) over a six-week period (T)? —the project used a pre- and post-intervention design. The intervention included mandatory provider breaks, communication training, and …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Quality Improvement Project Empowering Outpatient Providers: A Training Initiative On Social Determinants Of Health, Shannon Wrenn

Doctor of Nursing Practice Projects

Healthcare providers play a critical role in assessing social determinants of health (SDOH), yet many lack the knowledge and confidence to effectively address these factors during patient encounters. Research indicates that SDOH contribute to approximately 80% of health outcomes, yet only 41% of providers feel confident in discussing them with patients. This quality improvement project aimed to improve provider knowledge and confidence about SDOH as measured by pre- and post-education assessments. The SDOH targeted training took place at an outpatient interventional nephrology practice in Memphis, Tennessee. A quasi-experimental, one-group pretest-posttest design was used. Ten clinical staff members participated in an …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim Jorgensen

Doctor of Nursing Practice Projects

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session with …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

Preventing Errors With Two-Component Pediatric Vaccines, Angela C. Clarke

MSN Student Capstones

No abstract provided.

Massive Transfusion Done Right In The Emergency Room, Angela Sams

MSN Student Capstones

No abstract provided.

Provider-Nurse Rounding Checklist: A Qi Project, Danielle Ursone Rn, Bsn, Jennifer O'Neil Bsn, Rn, Ccrn, Susan Penque Ph.D, Anp-Bc, Ne-Bc, Nc-C

Posters

• Communication between healthcare providers and nurses is an essential component for a good working relationship.
• Increased collaboration has been shown to improve staff attitudes and job satisfaction.
• Interprofessional rounds with a rounding checklist provide an organized way to perform rounds to increase satisfaction with teamwork and decrease miscommunication.
• At the DNP project site, a rounding checklist is not being used, resulting in a disconnect between the nurses and healthcare providers.

Patient Care Technician Led Reduction In Blood Culture Contamination Rates, Elena Estrella Pct, Elissa Reyes Msn, Rn, Ccrn, Bethany Zoufaly Msn, Rn, Jennifer O'Neil Bsn, Rn, Anne M. Aquila Dnp, Rn, Cenp

Posters

Purpose:

To decrease blood culture contamination by improving staff competency

Dnp Final Report: An Evidence-Based Initiative To Improve Bowel Preparation Quality For Colonoscopy, Jennifer L. Gassett

DNP Final Reports

Good colonic bowel preparation (CBP) is an important component of colonoscopy but is often inadequate. Improving CBP can help increase detection of precancerous polyps, prevent procedures from being canceled or repeated, and decrease medical expenses. A quality improvement project was implemented to increase adequate CBP rates at an ambulatory surgery center specializing in endoscopy. Several factors correlate with suboptimal CBP, but the practice question focused on patient education. The PICOT question guiding evidence synthesis was posed: In adult patients preparing for outpatient colonoscopy, how do revised instructions with visual aids compared to written instructions affect CBP adequacy and patient satisfaction? …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim S. Jorgensen

Doctor of Nursing Practice Projects

Abstract

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session …

Provider Burnout Related To Patient Satisfaction, Sherita A. Lee

Doctor of Nursing Practice Projects

Provider burnout is a critical issue in healthcare, often intensified by increasing demands to meet patient satisfaction benchmarks. This quality improvement project aimed to examine whether a structured stress reduction program could reduce provider burnout and positively influence patient satisfaction scores in a small outpatient clinic. Guided by the PICOT question—In the clinic setting (P), does the implementation of a stress reduction program for providers (I), compared to no intervention (C), lead to improved patient satisfaction scores (O) over a six-week period (T)? —the project used a pre- and post-intervention design. The intervention included mandatory provider breaks, communication training, and …

Strategies To Improve Nurse Documentation Compliance And Confidence In The Delivery Of Preprocedural Education, Danielle A. Burris

Doctor of Nursing Practice Final Project Abstract

Strategies to Improve Nurse Documentation Compliance and Confidence in the Delivery of Preprocedural Education:

Abstract

Introduction:This project aimed to implement tools to improve preprocedural education compliance between nurses and patients in an interventional radiology department. The secondary aim was increasing staff confidence in providing education, reducing the potential for avoidable harm and adverse procedural-related outcomes. The project was implemented within an interventional radiology department of a healthcare system in the Texas Medical Center, Houston, Texas.

Methodology: The project utilized the Model for Improvement and followed the steps of the Plan-Do-Study-Act cycle to implement change. Strategies included checklists, reminder tools, …

The Prevalence Of Suicide And Suicidal Ideation In Adult Oncology Patients, Mutiat Bamiloshin

Doctor of Nursing Practice Final Project Abstract

Objective

The aim of this quality improvement initiative is to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) to enhance the early detection of suicide risk among adult oncology patients and to facilitate timely referrals for mental health support.

Background

Adult cancer patients experience substantial psychological distress due to the challenges related to their diagnoses and treatments, significantly increasing their suicide risk. The lack of routine suicide screenings in oncology settings impedes the early identification of at-risk patients, necessitating evidence-based approaches.

Methodology

The project involved 50 adult oncology patients and was conducted at a hospital in Texas over eight weeks. Weekly …

Utilizing Chatgpt To Address Billing & Coding Gaps Among Rural Nurse Practitioners, Sarah A. Rosander, Laura Gray, David R. Phillippi

DNP Projects

Over 75% of new healthcare providers report feeling unprepared to manage billing and coding requirements. The challenge is in part a result of limited coverage of these topics in advanced practice curricula and the lack of free, accessible, and up-to-date coding resources. This quality improvement project explored the potential of ChatGPT as an innovative tool to support rural nurse practitioners in Tennessee with billing and coding challenges. Using the IHI Model for Improvement, two Plan-Do-Study-Act cycles were conducted to assess ChatGPT’s effectiveness as a billing and coding resource. The first cycle evaluated ChatGPT's accuracy in generating Current Procedural Terminology (CPT) …

A Nursing Education Intervention In An Adult Inpatient Setting To Improve Compliance Rate With Pressure Injury Prevention Intervention, Brooklynn Jane Janke

Doctoral Dissertations and Projects

Pressure injuries can lead to life-threatening health complications for patients and cause physical, psychological, and financial stress to patients suffering from them. The literature review demonstrated that bedside nursing staff often have not received the appropriate education about pressure injury prevention and care. The literature review also revealed that nurses prefer to be educated one-on-one and peer-to-peer. Therefore, providing focused and frequent education on pressure injury prevention and improving nurses’ understanding of the importance of pressure injury prevention can improve the quality of care a nurse provides, and patients receive, thus reducing the number of health care-acquired pressure injuries. The …

Reducing Acute Care Visits In Oncology: A Pilot Quality Improvement Project, Judy Metropulos

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Patients receiving high-toxicity chemotherapy are at risk for post-infusion complications, which can result in unplanned hospital visits or admissions. Structured post-infusion follow-up may improve symptom management and reduce these events.

Local Problem: At North Region hospital, the 30-day post-infusion revisit rate was 31%, substantially exceeding the national average of 14.7%. A pilot program launched in 2021 reduced hospital visits by 7%; however, following its discontinuation due to staffing shortages and inadequate data collection, the rate subsequently increased, underscoring the need for sustainable interventions.

Methods: A quality improvement project was conducted in two, ten weeks phases. Phase 1 included …

Reducing Spinal Induced Hypotension In Cesarean Sections: A Multimodal Approach, Tyran D. Heilig

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Spinal anesthesia is the preferred method for elective cesarean sections due to its rapid onset, ability to keep the mother awake, and lower risk of complications compared to general anesthesia (Shitemaw et al., 2020). However, spinal-induced hypotension (SIH), caused by a sympathetic block, occurs in up to 75% of cases (Sklebar et al., 2019). A 2019 global study conducted in Ethiopia of 410 women found the incidence of SIH in cesarean sections to be 64% (Shitemaw et al., 2020). A Texas study found that 99.4% of cesarean deliveries experienced SIH, and 12% of those cases resulted in severe hypotension, …

A Quality Improvement Approach To Reducing Post-Surgical Acute Care Falls, Tiffany C. Mitchell

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient falls remain one of the most preventable adverse events in hospitals. Falls result in serious injuries and increasing healthcare costs. This quality improvement project evaluates the implementation of Fall TIPS to reduce fall incidence and promote sustainable safety practices.

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

Doctor of Nursing Practice Projects

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

Quality Improvement Initiative To Decrease Excessive Testing For Streptococcal Pharyngitis In Adults In An Outpatient Clinic Setting, Hana Roussey, Jennifer Sternberg, David Phillippi

SPARK Symposium Presentations

Project Title: Quality Improvement Initiative to Decrease Excessive Testing for Streptococcal Pharyngitis in Adults in an Outpatient Clinic Setting

Background and Rationale: Current guidelines recommend utilization of a clinical decision-making tool, like the Centor score, in conjunction with confirmatory diagnostic methods, such as a throat culture or rapid test, rather than either method alone. The existing practice at the clinic site was to test most adults with upper respiratory infection symptoms (e.g., sore throat, cough, fever, sinus congestion) with little discretion. With the reported prevalence of streptococcal pharyngitis or “strep throat” in adults being 5-15%, universally testing adult patients could …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino

SPARK Symposium Presentations

Project Title: The Impact of High Deductible Health Plans on Mental Health Treatment

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact …

Improving Perinatal Outcomes With The Mood Disorder Questionnaire: A Quality Improvement Project To Increase Identification And Referral, Elizabeth R. Bargardo

Master's Theses and Capstones

Abstract

Background: Perinatal mental health is a growing concern, with under identification and lack of access to mental health as contributing factors. Screening tools such as the Mood Disorder Questionnaire are one way to increase identification of patients at risk for bipolar-spectrum disorders and subsequent postpartum psychosis and initiate referrals to appropriate mental health services.

Local Problem: One outpatient women’s health center has a 94% screening rate for the Edinburgh Postnatal Depression Score (EPDS) for anxiety and depression but has not implemented a screening for bipolar disorder. In addition, while approximately one in five perinatal patients struggles with a mental …

Effective Measurement-Based Care For Depression Within Va Health Systems: A Quality Improvement Initiative, Amie L. Doyle

DNP Scholarly Projects

Background: Depression is highly common among U.S. veterans, surpassing civilian rates. Measurement-Based Care (MBC), including the Patient Health Questionnaire-9 (PHQ-9), facilitates systematic symptom monitoring and treatment enhancement. At Manchester VA Medical Center (VAMC), PHQ-9 completion in primary care was low (18.93% in May 2025) due to workflow inefficiencies, provider workload, and dependence on Mental Health Service Line (MHSL) referrals.

Local Problem: Underutilization of the PHQ-9 in primary care hampers early detection and effective treatment of depression among veterans.

Methods: Four primary care teams received training on using the Behavioral Health Laboratory (BHL) software, which facilitates pre-visit electronic completion of the …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca L. Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Improvement Of Hpv Vaccination Rate In Pediatric Patients In A Clinic Through Implementation Of A Bundle, Macalah Jenschke

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Human papillomavirus (HPV) is a major cause of several cancers, and vaccination is a highly effective preventive measure. However, HPV vaccination rates remain suboptimal, particularly in rural pediatric populations. This quality improvement (QI) project aims to enhance HPV vaccination rates through the implementation of a comprehensive vaccination bundle targeting provider education, patient and parent education, appointment reminders, and the use of a vaccine waiver when needed.

Method: This QI project was conducted over twelve weeks in a rural pediatric clinic with approximately 130 patients seen daily. The intervention bundle included provider education on effective communication regarding HPV vaccination, educational …

Improving The Effectiveness Of Post-Anesthesia Care Unit Transitions: A Quality Improvement Initiative Using A Standardized Nurse Handoff Report Sheet, Myra Mcauley

Master's Theses and Capstones

Background: Effective communication during patient handoff in the post-anesthesia care unit (PACU) is essential to ensuring patient safety and continuity of care. Unstructured or inconsistent handoff processes can lead to information omissions and care delays.

Methods: This quality improvement project implemented a structured nurse-to-nurse handoff report tool in the PACU. A pre- and post-intervention survey design was used to assess nurses’ perceptions of handoff clarity, completeness, and satisfaction. Educational sessions supported implementation.

Results: Pre-intervention survey data revealed dissatisfaction with the current handoff process, citing frequent information gaps. Following implementation of the structured tool, post-survey results showed improved communication clarity, increased …

A Quality Improvement Project Reinforcing Nursing Education On Support Resources For Families In The Icu, Emily Siel

Master's Theses and Capstones

BACKGROUND: The Intensive Care Unit (ICU) is often a source of psychological, physical, social, financial, and spiritual distress for families of patients. Multidisciplinary support resources are available but are often underutilized. Nurses are uniquely positioned to assess needs and integrate resources into care. Therefore, enhancing nurses' ability to guide families to appropriate support resources may alleviate distress and promote holistic well-being for patients and their families.

METHODS: The Plan-Do-Study-Act (PDSA) model was used to guide this project. A pre-intervention survey assessed awareness, utilization, and perception of ownership. Following dissemination of the intervention, a post-survey evaluated improvements in knowledge and integration. …