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Quality Improvement Project Enhancing Maternal Health Outcomes: Evaluating The Impact Of Universal Social Determinants Of Health (Sdoh) Screening In An Interdisciplinary Pregnancy Care Model, Shannon Morgen

Doctor of Nursing Practice Projects

Social determinants of health (SDOH), including housing instability, food insecurity, transportation barriers, and interpersonal violence, significantly influence maternal outcomes and contribute to disparities such as preterm birth and maternal morbidity. Despite national recommendations for universal SDOH screening, implementation in prenatal care remains inconsistent, limiting opportunities to identify and address social needs. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a standardized SDOH screening and documentation process to improve referral completion and examine its impact on hospital readmissions among obstetric patients. Guided by Bronfenbrenner’s Socio-Ecological Model and the Plan-Do-Study-Act framework, the project …

Optimizing Central Line Discontinuation In The Surgical Intensive Care Unit: A Quality Improvement Initiative Using A Visual Aid To Reduce The Risk Of Central Line-Associated Bloodstream Infections, John Quyen D. Van

Doctor of Nursing Practice Final Project Abstract

PURPOSE 

The aim of this quality improvement (QI) project was to reduce unnecessary central line dwell time by 20% in a surgical intensive care unit (SICU) in Central Texas.

BACKGROUND 

Central line–associated bloodstream infections (CLABSIs) contribute to patient harm and increased healthcare costs. The literature strongly supports the timely removal of central venous catheters (CVCs) to reduce this risk; however, delays often occur due to workflow demands, communication gaps, and inconsistent daily necessity assessments.

METHODOLOGY 

Guided by the Health Belief Model (HBM) and the Institute for Healthcare Improvement (IHI) Model for Improvement, the QI project consisted of an 8-week baseline …

Impact Of Provider Self-Efficacy On Caring For Patients With Prediabetes, David R. Knight

Doctor of Nursing Practice Projects

Prediabetes affects millions of adults in the United States, yet inconsistent provider knowledge and confidence limit evidence-based screening and management in primary care, a gap well-documented in the literature. The purpose of this quality improvement project was to evaluate whether a structured educational intervention improved provider self-efficacy related to prediabetes identification and management. Guided by Social Cognitive Theory and the Transtheoretical Model, with implementation guided by the Plan-Do-Study-Act cycle, this project asked: among family practice providers, how does prediabetes education affect provider self-efficacy over four weeks? A quasi-experimental pre/post design was used. Four asynchronous educational modules focused on evidence-based screening, …

Quality Improvement Project: The Critical Role Of Provider Knowledge In The Golden Hour, Kimberly Mcglothan

Doctor of Nursing Practice Projects

Maternal and infant mortality rates in the Southern United States remain disproportionately high, and inconsistent implementation of the Golden Hour, defined as uninterrupted skin to skin contact for at least the first hour after birth, continues to limit its evidence based maternal and neonatal benefits. The aim of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate the impact of a structured provider education intervention on Golden Hour compliance and provider confidence. Guided by Benner’s Novice to Expert Theory and implemented using Kotter’s 8-Step Change Model, a quantitative, quasi experimental pre-post design was used. The project was …

Improving Patient Health Portal Enrollment In The Primary Care Setting, Erika L. Bell

Doctoral Dissertations & Projects

In today’s increasingly digital healthcare environment, patient health portals have become critical tools for enhancing communication, improving care coordination, and empowering patients to actively participate in their health management. These secure, web-based platforms allow patients to access medical records, request prescription refills, view lab results, and message providers. Although patient health portals are offered by a vast majority of U.S. health systems, they remain underutilized, with only 15-30% of patients engaging with these platforms despite their potential to improve patient engagement, health status awareness, and care quality. Enhancing patient health portal use not only empowers patients but also supports broader …

Vap Prevention By Improving Icu Oral Care, Chi Hao Su

Doctor of Nursing Practice Final Project Abstract

Purpose 
To increase night-shift adult ICU nurse compliance with standardized oral care documentation by at least 20% as a core ventilator-associated pneumonia (VAP) prevention process.
Background
VAP is a preventable healthcare-associated infection associated with increased morbidity, mortality, ICU length of stay, and costs. Oral-care documentation is often inconsistent because of competing priorities and workflow barriers.
Methodology
Guided by the Knowledge-to-Action framework, this QI project used three PDSA cycles after a September 2025 baseline in a 16-bed ICU. Interventions included 1:1 simulation, EPIC prompts, and bedside coaching; manual audits addressed EPIC misclassification. Trends and run charts analyzed 183 records; surveys assessed …

Peri-Op Protect: A Unified Pre-Op To Pacu Medication Reconciliation System, Tyler G. Van Note, Ariana Amalia Anast, Samantha Ashley Steiner, Tara Gilbert

SPARK Symposium Presentations

Peri-Op Protect: A Unified Pre-Op to PACU Medication Reconciliation System

Peri-Op Protect is a nurse-led change initiative designed to improve medication safety and communication during surgical patient transitions from pre-operative care through the operating room and into the post-anesthesia care unit at a local hospital. Transitions of care are among the most vulnerable moments in the surgical process, as critical medication information – including home medications, last doses, allergies, intraoperative medications, and pain management plans – must be accurately communicated across multiple teams. Communication breakdowns are a leading contributor to adverse events in healthcare, and inconsistent medication handoff processes can …

Improving Throughput: A Quality Improvement Initiative To Expedite Inpatient Psychiatric Placement From The Emergency Room, Candice J. Battle

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of a standardized psychiatric transfer workflow designed to reduce emergency room (ER) boarding time for psychiatric patients in a 30-bed acute care hospital from an average of 3-5 days to an average of 2-3 days.

Background

Psychiatric patients often experience prolonged ER boarding while awaiting inpatient psychiatric placement. These delays contribute to delayed treatment, worsening psychiatric symptoms, ER overcrowding, and increased healthcare costs.

Methodology

This four-week quality improvement project utilized the Plan-Do-Study-Act (PDSA) framework. Interventions included a standardized psychiatric transfer protocol, simplified transfer checklist and staff education. …

Reduction Of Waste And Cost In A Cardiac Intensive Care Unit, Jincy C. Skaria

Doctor of Nursing Practice Final Project Abstract

Purpose:
To reduce medical supply waste and associated costs in a Cardiac ICU using a standardized supply cart system.
Background:
Pre-packed post-operative recovery kits were routinely opened for all admissions in the Cardiac ICU, resulting in disposal of unused supplies due to infection control and single-use policies. This practice contributed to avoidable waste, increased costs, and poor resource stewardship.
Methodology:
This quality improvement project was conducted in a 20-bed Cardiac ICU from September 28 to December 6, 2025. The intervention replaced routine opening of full recovery kits with selective retrieval of supplies by nurses from a standardized cart located outside …

Quality Improvement Project: Implementation Of A Screening Tool For Postpartum Depression, Yaminah Johnson

Doctor of Nursing Practice Projects

Postpartum depression (PPD) remains underrecognized in clinical practice, with many cases going undiagnosed due to inconsistent or absent screening processes. At the project site, only 60% of postpartum patients reported that their mental health needs were adequately addressed, highlight-ing a critical gap in care. The purpose of this quality improvement project was to implement an evidence-based PPD screening tool and evaluate its impact on provider confidence and patient outcomes. Guided by Lewin’s Theory of Planned Change and Orem’s Self-Care Deficit Theory, the project aimed to improve physician and nursing staff confidence in screening and increase appropriate interventions for patients who …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

Implementation Of A Standardized Suicide Risk Screening Protocol Using The Columbia-Suicide Severity Rating Scale (C-Ssrs) In An Outpatient Mental Health Clinic, Kemisola Ebietomiye

Doctor of Nursing Practice Projects

The outpatient mental health clinics across the United States lack consistent suicide risk assessment methods. This project developed standardized procedures which used Columbia-Suicide Severity Rating Scale (C-SSRS) assessment together with provider education and electronic health record systems to evaluate how these elements impacted provider self-efficacy and their ability to record screening results. The project used a pre-post design to examine (n=24) psychiatric providers at an urban outpatient clinic through the combined methods of Lewin's Change Theory and the Plan-Do-Study-Act framework. The General Self-Efficacy Scale measured provider self-efficacy, and structured EHR audits tracked documentation rates pre- and post-implementation over six weeks. …

Quality Improvement Project: Empowering Nurses And Medical Assistants To Improve Medication Adherence: A Screening-Based Quality Improvement Initiative, Maria Garcia

Doctor of Nursing Practice Projects

Medication nonadherence is a persistent challenge in clinical settings that negatively influences patient outcomes and is often driven by cost, access, and patient-related barriers, as widely documented in the literature. Nurses and medical assistants play a critical role in identifying these barriers; however, inconsistent screening and limited staff confidence may hinder intervention. The purpose of this quality improvement project was to evaluate the impact of implementing the Brief Medication Questionnaire (BMQ) on staff confidence in addressing medication adherence and to assess clinic-wide utilization of the tool. The project was guided by the Iowa Model of Evidence-Based Practice and Lewin’s Change …

Quality Improvement Project Standardizing Simulation In Nursing Education: A Faculty Training Initiative, Andrea Reyes

Doctor of Nursing Practice Projects

Simulation-based education is essential in nursing programs as clinical placement opportunities decline. However, inconsistent faculty preparation can compromise the quality of simulation delivery. The purpose of this quality improvement project was to implement and evaluate a standardized simulation faculty training initiative to determine its impact on nursing faculty's confidence in simulation facilitation. Guided by the Jeffries Simulation Framework and Lewin’s Change Theory, a quasi-experimental pre-post design was used to examine changes in faculty confidence following participation in a training program aligned with national standards and guidelines. Faculty confidence was measured using the Simulation Educator Needs Assessment Tool (SENAT) administered pre- …

Improving Diabetes Care: Staff Training On Updated Ada Guidelines, Jeffrey Wilson

Doctor of Nursing Practice Projects

The incidence of diabetes is rising, requiring clinical staff to stay current with the American Diabetes Association (ADA) Standards of Care. A lack of knowledge and outdated practices were revealed during the needs assessment at the project site. This quality improvement (QI) project sought to determine whether ADA‑centered educational training could impact staff members' knowledge of diabetes. Orem’s Self‑Care Deficit Nursing Theory and Lewin’s Change Theory served as the theoretical frameworks to promote provider competence and adherence to evidence‑based diabetes treatment. Quasi‑experimental pre–post design was used with a convenience sample of four clinical staff at a rural outpatient clinic. Study …

Quality Improvement Project: Protecting Young Kidneys: Optimizing Albuminuria Management In Youth With Diabetes, Mili Vakharia

Doctor of Nursing Practice Projects

Diabetic nephropathy is a major microvascular complication and the leading cause of chronic kidney disease (CKD) among individuals with diabetes. Children and adolescents with type 1 and type 2 diabetes face a higher risk of developing CKD earlier in life due to longer disease duration, poor glycemic control, and delayed CKD diagnosis. Guidelines emphasize timely detection and intervention to slow disease progression. Albuminuria is an early marker of glomerular injury and signals the need to initiate CKD treatment. Despite evidence supporting early detection and treatment, standardized management of albuminuria in pediatric diabetes care remains inconsistent. This Doctor of Nursing Practice …

Quality Improvement Project: Impact Of Mindfulness-Based Stress Reduction On Nurse Burnout In Skilled Nursing Facilities, Chinenye Okafor

Doctor of Nursing Practice Projects

Burnout is a persistent and critical problem in skilled nursing facilities, contributing to reduced job satisfaction, increased turnover, and compromised quality of care. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of a Mindfulness-Based Stress Reduction program on burnout among registered nurses in a skilled nursing facility. Guided by the Job Demands–Resources framework and Lewin’s Change Theory, a quantitative pretest–posttest design was implemented using the Plan–Do–Study–Act. Ten nurses consented to participate in an eight-week intervention, and four completed both pre- and post-intervention measures. Burnout was measured using the Maslach Burnout Inventory–Human Services …

Quality Improvement Project: Improving Pneumococcal Vaccination Rates Through Provider Education In Primary Care, Leikasha Allen

Doctor of Nursing Practice Projects

Pneumococcal disease remains a major cause of illness and mortality among adults aged 65 years and older, leading to severe pneumonia, bacteremia, and meningitis, particularly in vulnerable populations. Although effective vaccines and clear Centers for Disease Control (CDC) and Advisory Committee Immunization Practice (ACIP) guidelines, vaccination in this age group remains inadequate. This Doctor of Nursing Practice (DNP) quality improvement project aimed to determine the impact of pneumococcal vaccination compliance through evaluating provider knowledge, confidence, and adherence to evidence-based guidelines through targeted education. Guided by Rogers’ Diffusion of Innovation Theory and the Health Belief Model, a 20-minute evidence‑based educational session …

Addressing Faculty Gaps In The Psychiatric Mental Health Nurse Practitioner Program, Shea Brock

Doctor of Nursing Practice Projects

Graduate nursing programs increasingly rely on adjunct faculty to sustain enrollment growth; however, inconsistent onboarding processes may contribute to variability in faculty preparedness and job satisfaction. The purpose of this quality improvement project was to implement a standardized adjunct faculty education program and evaluate its impact on adjunct faculty knowledge and job satisfaction within an online Psychiatric–Mental Health Nurse Practitioner (PMHNP) program. A quantitative, quasi-experimental one-group pre–post design was utilized. Six adjunct faculty members (n = 6) completed a 10-item EXXAT Knowledge Survey and a 10-item Faculty Satisfaction Survey before and after participation in a structured one-hour education session focused …

Quality Improvement Project: Leveling Pharmacology: A Faculty Development Initiative, Allison Berg

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to address limited faculty self-efficacy in developing higher-level, competency-based pharmacology questions for clinical quizzes within an Associate Degree in Nursing (ADN) program. A faculty needs assessment identified an overreliance on recall-based pharmacology assessments, contributing to gaps in students’ clinical reasoning and medication competency. Guided by Bandura’s Theory of Self-Efficacy and Lewin’s Change Theory, a structured faculty development session was implemented to improve faculty confidence and skills in writing application-based pharmacology questions. A pre- post intervention design was used with ADN faculty participants (N = 5) at a …

Quality Improvement Project: Reducing Medication Errors To Improve Patient Safety, Paulina Irish

Doctor of Nursing Practice Projects

Medication administration errors remain a persistent threat to patient safety in emergency department settings, where high acuity, rapid throughput, and workflow interruptions increase vulnerability to preventable adverse events. The purpose of this Doctor of Nursing Practice quality improvement project was to increase medication-safety knowledge scores by at least 10% and reduce medication administration error rates by 20% within eight weeks among registered nurses in a freestanding emergency department in South Texas. The project was grounded in Lewin’s Change Theory as the theoretical framework and implemented using the Plan–Do–Study–Act quality improvement model. A quasi-experimental, single-group pretest–posttest design was used with a …

Quality Improvement Project: The Impact Of Hypertension Management Education In Primary Care, Toyin K. Aliu

Doctor of Nursing Practice Projects

Hypertension (HTN) is one of the leading causes of clinic visits and prescription medication use in primary care settings. Despite the availability of evidence-based guidelines to improve HTN management, adherence in clinical practice is often lacking. At the project site, 30% of patients have uncontrolled HTN. This is attributed to providers’ inadequate knowledge of the JNC-8 HTN management guidelines and inconsistent adherence to them. This project aimed to improve hypertension management in a primary care setting by educating providers on the JNC-8 guidelines to enhance adherence to evidence-based practices over six weeks. The purpose was to align medical providers with …

Quality Improvement Project: The Influence Of Education On Provider Self-Efficacy And Utilization Of The Columbia Suicide Severity Rating Scale (C-Ssrs), Doreen Nwaogwugwu

Doctor of Nursing Practice Projects

Suicide remains one of the leading causes of death worldwide, underscoring the critical need for consistent, evidence-based suicide risk screening in mental health facilities. Despite being a validated, evidence-based tool, the use of the Columbia Suicide Severity Rating Scale (C-SSRS) is often hindered by inadequate provider training. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the impact of provider education on self-efficacy and utilization of the C-SSRS in an outpatient mental health clinic. This quality improvement project used a quasi-experimental, one-group pretest-posttest design guided by the Health Belief Model, Lewin’s Change Theory, and the …

Quality Improvement Project: Improving Transitional Care Management (Tcm) Follow-Up Through Medical Assistant Education, Oben Assick

Doctor of Nursing Practice Projects

The underutilization of Transitional Care Management (TCM) services in primary care significantly contributes to preventable hospital readmissions and revenue loss. Despite established Centers for Medicare & Medicaid Services (CMS) guidelines, execution often fails due to knowledge gaps among frontline staff. This quality improvement project addressed low TCM task completion rates by implementing a structured educational intervention for medical assistants (MAs). The purpose was to evaluate whether targeted training improves timely patient follow-up, visit scheduling, and billing accuracy. The project utilized Kotter’s 8-Step Change Model to guide organizational change and the Health Belief Model to address behavioral barriers. A quantitative, quasi-experimental …

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

Optimizing Efficiency In Joint Injections In An Outpatient Orthopedic Oncology Clinic Using Lean Six Sigma, William Alexander Byrd

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Prolonged in-room wait time in an outpatient orthopedic oncology clinic was identified as an important driver of dissatisfaction and operational inefficiency. Baseline in-room times in this setting were reported as M=96.2 minutes for patients receiving injections and M=92.9 minutes for those not receiving injections. This quality improvement project used Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, Control) framework to streamline clinic workflow for the joint injection process. Over an eight-week period, four key interventions were introduced: a standardized order set for medications, pre-bundled supplies and portable supply toolbox, telephone pre-consenting of patients, and optimized scheduling of …

Implementation Of A Turn Team To Reduce Hospital-Acquired Pressure Injuries In A Medical Intensive Care Unit, Heather A, Adair

Doctor of Nursing Practice Final Project Abstract

Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

PURPOSE

The project aimed to reduce hospital-acquired pressure injury (HAPI) rates in a Medical Intensive Care Unit (MICU) by improving nurses' knowledge of the Braden Scale and implementing a structured two-nurse turn team workflow to reposition high-risk patients every two hours.

RESULTS

Repositioning compliance improved substantially and consistently exceeded the project goal of 90% after implementing a pod-based workflow. The HAPI prevalence rate decreased from a baseline of 8% to below the project goal of ≤5% during implementation but was not sustained in the …

Bridging The Gap: Human Trafficking Education Improves Nursing Students’ Knowledge And Confidence, Stephanie P. Arceneaux, Sharon Boudreaux

LHC Group • Myers School of Nursing

Background: Human trafficking (HT) is a global, national, and local public health concern, yet victims often go unidentified due to limited provider education and a lack of screening protocols. This quality improvement project implemented an asynchronous online HT education module for senior nursing students to enhance knowledge and confidence in identifying victims through recognition of red flags and use of screening questions. Method: The module addressed HT indicators, screening tools, screening questions, and available resources. Pre- and posttests using the PROTECT instrument assessed perceived knowledge, actual knowledge, and confidence. Results: Postintervention scores showed statistically significant improvement (p < .001) in knowledge and confidence. Only 10.67% of participants had prior HT training, and 52% preferred online, asynchronous learning. Conclusion: HT education …

Improving Hypertension Management With An Educational Patient Intervention Bundle, Gertie Silva

Doctor of Nursing Practice (DNP) Scholarly Projects

Aim

Uncontrolled hypertension remains a significant risk factor for cardiovascular disease. This quality improvement project aimed to improve hypertension knowledge and blood pressure control among adults with uncontrolled hypertension by implementing lifestyle counseling, home blood pressure monitoring, and regular follow-up.

Design

This quality improvement project used a pre- and post-intervention design.

Methods

Forty-one adults with uncontrolled hypertension took part in an eight-week educational program. Outcomes measured included weight, systolic and diastolic blood pressure, and HK-LS scores. Descriptive statistics and paired-samples t-tests analyzed the results.

Results

Participants showed significant improvements in weight, blood pressure, and hypertension knowledge. Mean weight decreased from …

Reducing Live Discharges In Hospice Care Through A Bundled Intervention, Fiona P. White

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction

 Among Medicare fee-for-service hospice beneficiaries, the national live discharge rate increased from 16.9% in FY2021 to 19.1% in FY2025. At a Medicare-certified hospice agency in a southern state, the pre-intervention live discharge rate of 35.3% substantially exceeded national norms, with 68.7% of events representing patient-initiated revocations.

Methods

 A pre-post quality improvement design guided by the Plan-Do-Study-Act framework was implemented over 8 weeks at a single site with 106 newly admitted hospice patients and 15 clinical staff. The four-component bundled intervention comprised Revocation Risk Assessment administration within 24 hours of admission, structured patient and caregiver education within 72 hours of …