Nursing Commons^™

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

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The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

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The Impact Of A Structured Education Program On Artificial Intelligence Use For Nursing Faculty On Teaching Practices, Katy White

Doctor of Nursing Practice Projects

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Artificial intelligence (AI) is increasingly integrated into nursing education; however, nursing faculty report inconsistent preparedness, including gaps in AI knowledge and self-efficacy for responsible AI integration. This quality improvement project addressed inconsistent faculty preparedness through an asynchronous AI educational program. The purpose was to address gaps in AI knowledge and self-efficacy, and the aim was to evaluate changes in AI self-efficacy and AI knowledge while supporting AI integration into nursing education. Rogers' Diffusion of Innovations Theory served as the change theory, the Technology Acceptance Model served as the theoretical framework, and the Plan-Do-Study-Act framework guided implementation. A quantitative one-group pretest-posttest …

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Quality Improvement Project: Experienced Nurse To Novice Adjunct Educator: Bridging The Gap, Karen Liddy

Doctor of Nursing Practice Projects

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A formal mentoring program is an effective approach for enhancing mentee satisfaction and self-efficacy and decreasing turnover rates. Although evidence supports the benefits of mentoring, many universities lack formal mentoring programs for adjunct faculty. Utilizing the PDSA framework, this quality improvement Doctor of Nursing Practice (DNP) project executed and evaluated a structured adjunct faculty mentoring program to improve faculty self-efficacy and mentee satisfaction. The project was led by Bandura's Social Cognitive Theory and the Theory of Change and used a pre- and post-test design involving adjunct nursing faculty members with fewer than three years of academic teaching experience. Mentors and …

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Hypothermia Management In Adult Trauma Patients: Enhancing Nursing Knowledge And Self-Efficacy In The Emergency Department, Shannon M. Rapert

Doctor of Nursing Practice Projects

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Trauma-induced hypothermia is a significant, preventable condition that contributes to increased mortality. Evidence suggests that inconsistent recognition and management of hypothermia persist in the emergency department (ED), highlighting the need to strengthen ED nurses’ knowledge and self-efficacy in evidence-based warming strategies. The purpose of this quality improvement project was to evaluate the impact of an educational intervention on ED nurses’ knowledge and self-efficacy in managing trauma-induced hypothermia. Guided by the Iowa Model of Evidence-Based Practice, the ADKAR Change Model, and the Plan-Do-Study-Act framework, this quantitative, quasi-experimental, pretest–posttest project evaluated the effect of an instructor-led educational intervention in ED nurses at …

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Standardizing Hypertension Care In An Occupational Medicine Clinic: A Quality Improvement Project, Carolyn Duncan

Doctor of Nursing Practice Projects

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Hypertension remains a leading modifiable risk factor for cardiovascular disease, and inconsistent implementation of evidence-based hypertension management may contribute to variability in patient education, documentation, and follow-up care. This quality improvement project evaluated an evidence-based educational program and a standardized hypertension management workflow, based on the 2025 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines, in an occupational medicine clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's 8-Step Change Model, and the Plan-Do-Study-Act framework, the intervention aimed to impact staff self-efficacy, documentation of lifestyle education, and follow-up appointment scheduling. A quantitative quasi-experimental pre-post design was used with …

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Dnp Final Report: Improving Diabetes Self-Efficacy Through Nutrition Education: A Quality Improvement Project, Lakimberely S. Wooten

DNP Final Reports

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Diabetes affects 12.7% of residents in Northeast Texas and is the 7th leading cause of death. Internal evidence indicates low health literacy and a heavy disease burden in the service area, underscoring the need for a standardized, low-cost, and feasible approach to nutrition education. This quality improvement project evaluated the feasibility of implementing an instructor-led nutrition education session. Guided by the Johns Hopkins Evidence-Based Practice Framework and the ADKAR behavioral change model, adult participants with Type 2 diabetes received instruction on the Plate Method. Participants enrolled in a 4-week, instructor-led diabetes education class completed a 1-hour, nutrition education session using …

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Quality Improvement Project: Addressing Appointment Non-Adherence Through Social Needs Screening, Dorathy Anderson

Doctor of Nursing Practice Projects

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Mental health care access in the US faces systemic barriers that delay treatment and disrupt care, often worsening patient outcomes. Unmet social needs of health, such as transportation, financial, and housing issues, lead to missed appointments and fragmented care, thereby increasing health disparities. This quality improvement project evaluated whether targeted staff education improved the identification and response to social needs that affect appointment adherence. Adult Learning Theory guided the training, while Lewin’s Theory of Change and the Plan-Do-Study-Act framework informed implementation and evaluation. The intervention population consisted of five clinic staff members. A quasi-experimental pretest-posttest design was used to evaluate …

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Advancing School-Based Sexual Reproductive Health Education Through A Fifth-Grade Educator Toolkit, Emira Romero

Doctor of Nursing Practice (DNP) Projects

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Background: Although sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion, educators remain underprepared to deliver this education. Local Problem: A gap analysis conducted at School A, a public elementary school in the San Francisco Bay Area, revealed the absence of a SRH curriculum for their fifth graders. Methods: A Doctor of Nursing Practice (DNP) student-led quality improvement project to introduce a SRH educator toolkit to increase educator confidence and self-efficacy was conducted at School A among fifth grade teachers. Pre- and post-intervention data were collected on implementation day to evaluate the …

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Quality Improvement Project: Improving Interdisciplinary Care In Nursing Education Through Simulation, Anna Williams

Doctor of Nursing Practice Projects

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Interprofessional education (IPE) is essential in preparing nursing students for effective teamwork and communication in clinical practice and is supported by the literature as improving these outcomes. However, limited faculty training in interprofessional simulation design contributes to reduced IPE opportunities within nursing curricula. A needs assessment at the project site identified a lack of structured, hands-on training for simulation faculty, resulting in decreased faculty confidence and limited implementation of IPE simulations. The purpose of this quality improvement project was to evaluate whether a structured training intervention improved simulation faculty self-efficacy in developing and implementing IPE simulations. Bandura’s Self-Efficacy Theory guided …

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Enhancing Provider Self-Efficacy And Documentation In Hypertension Management, Stephanie Nsiah

Doctor of Nursing Practice Projects

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Primary care providers often experience inconsistent confidence and incomplete documentation when managing hypertension, contributing to suboptimal blood pressure control. This quality improvement project addressed the need for structured provider education at an outpatient family clinic. The purpose was to evaluate the impact of a structured educational intervention on provider self-efficacy and documentation completeness. Using a quasi-experimental pre-post design guided by the Plan-Do-Study-Act model and Lewin's Change Theory, a 60-minute educational session was delivered to 12 licensed providers. Participants completed pre- and post-intervention self-efficacy surveys using the Acceptability of Intervention Measure (AIM) and Intervention Appropriateness Measure (IAM) and Feasibility of Intervention …

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Quality Improvement Project: Enhancing Efficacy And Reducing Urine Contamination Through Simulation In The Ed, Kimberley Strong

Doctor of Nursing Practice Projects

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Urine specimen contamination in emergency department settings contributes to diagnostic inaccuracies, unnecessary antibiotic use, increased healthcare costs, and decreased patient satisfaction. This quality improvement project evaluated the impact of a simulation-based educational intervention on staff knowledge, self-efficacy, and urine specimen contamination rates among emergency department nurses and patient care technicians with less than six years of clinical experience in a rural Texas hospital. The aim of this project was to enhance knowledge and self-efficacy while reducing contamination rates over a six-week period. The project was guided by Knowles’ Adult Learning Theory as the theoretical framework, supported by Lewin’s Change Theory, …

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Effect Of The Senior Clinical Practicum On Baccalaureate Nursing Student Self-Efficacy, Allyson N. Mattingly

Graduate Theses, Dissertations, and Capstones

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While nursing shortages are increasing and nurses are reporting higher rates of burnout and job-related stress, it is critical that educators in pre-licensure nursing programs identify strategies to better prepare novice nurses for entering the workforce. Using Bandura’s Social Cognitive Theory as a framework, this study sought to investigate whether a senior clinical practicum experience increases general and nursing competence self-efficacy, which may indicate better ability to cope in the face of adversity. This study was a quantitative one-group pretest-posttest design, investigating undergraduate Bachelor of Science in Nursing (BSN) students from accredited institutions in Kentucky. Results suggest that the clinical …

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Quality Improvement Project: Impact Of National Culturally And Linguistically Appropriate Services (Clas) Standards Education On Behavioral Health Providers’ Self-Efficacy, Zita Anigbou

Doctor of Nursing Practice Projects

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Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners …

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Quality Improvement Project: Integrating Modified Early Warning Score (Mews) Criteria Into A Local Community College's Nursing Curriculum, Breanna C. Bell

Doctor of Nursing Practice Projects

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There is an international priority for early recognition of patient deterioration with adequate responses to facilitate patient safety. The modified early warning score (MEWS) tool is commonly used to identify and respond to acute patient deterioration, so it is effective to educate nursing students on its use to influence their future practice. However, there is a lack of a curriculum to integrate MEWS criteria for associate degree in nursing (ADN) students at a local community college. This quality improvement project aimed to enhance ADN faculty’s self-efficacy and ability to integrate MEWS criteria into the didactic curriculum at a community college …

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

Doctor of Nursing Practice Projects

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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 …

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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

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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 …

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Enhancing Stroke Recovery: A Proposal To Implement Self-Efficacy Strategies In Rehabilitation, Ariana M. Allen, Elliott P. Mcneely

Williams Honors College, Honors Research Projects

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Self-efficacy is a critical predictor of rehabilitation success in stroke survivors, influencing motivation, therapy adherence, and functional recovery. This study will investigate the current use of structured self-efficacy enhancement programs (SEEPs) by healthcare professionals in post-stroke rehabilitation settings. Guided by Bandura's Self-Efficacy Theory, this proposal outlines a study that will include a comprehensive literature review and suggestions for further research. It will explore the frequency and methods of SEEP use, including goal setting, motivational feedback, and graded task planning. Data would be analyzed through descriptive statistics and thematic analysis. Findings are expected to identify usage patterns, barriers, and opportunities to …

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Factors Influencing Senior Practicum Readiness For Nursing Practice: A Descriptive Correlational Study, Beth Nease Phd, Dnp, Rn, Ne-Bc, Cynthia F. Corbett Phd, Rn, Faan, Stephanie Armstrong Phd, Msn, Rn, Kesheng Wang Phd, Ma, Bs, Kathy Casey, Kong Chen

Faculty Publications

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Background:

This study investigated the influence of belongingness, self-efficacy, and clinical learning support on readiness for nursing practice and explored the role of demographic factors and nursing program differences.

Method:

A quantitative, descriptive approach was used to explore undergraduate prelicensure senior nursing students' perceptions across the United States.

Results:

Descriptive statistics, Pearson correlation, and multiple linear regression demonstrated students in traditional Bachelor of Science in Nursing programs reported significantly higher scores across all domains compared with those in associate degree programs (p < .01). Similarly, students in programs with ≤400 clinical hours and those assigned only one preceptor scored significantly higher on all measures (p < .01 and p < .05, respectively). Regression analysis indicated self-efficacy and learning support explained 47.9% of the variance in practice readiness (p < .05).

Conclusion:

These findings share how clinical experiences shape students' readiness for nursing practice. Recommendations …

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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

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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 …

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

Doctor of Nursing Practice Projects

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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 …

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Quality Improvement Project: Effect Of Multi-Level Student Collaboration On Clinical Judgment In High-Fidelity Simulation, Jillian Carroll

Doctor of Nursing Practice Projects

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There is a gap in undergraduate nursing curriculum on incorporating collaboration and communication into patient care, leading to a lack of competence and confidence in novice practice. Using collaboration in high-fidelity simulation, students gain real-world exposure and opportunities to communicate and make independent decisions. Using Kotter’s eight-step change theory, this project addresses the limited exposure to collaboration by implementing purposeful interdisciplinary collaboration within high-fidelity simulation to improve undergraduate nursing students’ confidence and competence in nursing practice. This will build on Patricia Benner’s novice-to-expert theory and help advance Associate Degree Nursing (ADN) students into a safe and effective novice year of …

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Gender Differences In Psychological Strengths Among Rural Adolescents, Angela Preston, Jodi Bullard, Rachel Smith, Ashlyn Peppler

Nursing Faculty Publications and Presentations

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Purpose: Rural adolescents often lack access to mental health care along with increased rates of depression and suicide completion. While psychological strengths have been associated with positive outcomes globally, little is known regarding the prevalence of these indicators (hope, self‐efficacy, resilience, optimism, and gratitude) among adolescents living in rural Texas. The purpose of this study was to describe how rural adolescents report their psychological strengths and examine the data for potential gender differences.

Design and Methods: A secondary analysis of cross‐sectional data was performed on the RStudio platform using tests of central tendency and inferential statistics. Results: There were 425 …

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Assessing The Impact Of Cultural Competence Training For Providers Serving Native Americans, Chinazo Obi

Doctor of Nursing Practice Projects

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The United States is a culturally diverse nation, yet many healthcare providers report challenges in delivering care that respects cultural values and traditions. Within mental health settings, this gap is especially concerning for Native American populations, who experience disproportionately high rates of mental health conditions and face barriers to culturally responsive care. The purpose of this quality improvement project was to assess the impact of a cultural competence education and training intervention on mental health providers’ knowledge and self-efficacy in delivering culturally competent care to Native American patients. Guided by Leininger’s Culture Care Theory of Diversity and Universality and the …

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Quality Improvement Project: Impact Of Simulation Training On The Self-Efficacy Of Registered Nurses During A Code Stroke, Kakeya James

Doctor of Nursing Practice Projects

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Self-efficacy levels affect decision-making skills and overall confidence in handling critical situations. However, knowledge gaps often hinder the maintenance of high self-efficacy. (Farčić, et al., 2020). The project site provides limited training opportunities that may not adequately prepare registered nurses with the confidence and skills needed to respond to stroke emergencies, potentially causing delays in patient care and adverse health outcomes. As a result, the quality improvement project aims to examine how simulation-based training impacts registered nurses’ self-efficacy in managing stroke emergencies. The project employed a quasi-experimental pretest/posttest design and was guided by the Plan-Do-Study-Act (PDSA) cycle, the Jeffries Simulation …

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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

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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 …

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Quality Improvement Project: The Impact Of A Dedicated Education Unit On The Self-Efficacy Of First-Year Associate Degree Nursing Students, Danita Broussard

Doctor of Nursing Practice Projects

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Nursing education continues to face challenges in preparing students to meet the complex demands of modern healthcare, particularly due to limited clinical placements and faculty shortages. This quality improvement project addressed the gap between classroom instruction and clinical practice by implementing a Dedicated Education Unit (DEU) model designed to impact students' self-efficacy. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether participation in a DEU impacted the self-efficacy of the first-year associate degree nursing students compared to the traditional clinical model. Guided by Bandura’s Self-Efficacy Theory and grounded in Evidence-Based Practice (EBP) principles, the project …

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

Doctor of Nursing Practice Projects

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

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

Doctor of Nursing Practice Projects

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

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Quality Improvement Project The Role Of Targeted Education And Its Impact On Self-Efficacy And Cognitive Impairment Recognition Among Medical Assistants, Jicky Guzman

Doctor of Nursing Practice Projects

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Primary care teams develop lasting relationships with patients that can reveal subtle cognitive changes during routine visits (e.g., identity verification and brief mobility checks). Yet, cognitive decline often goes unnoticed and poorly documented, which can lead to delayed care. This quality improvement (QI) project addressed a gap in the detection of mild cognitive impairment (MCI), such as Alzheimer’s disease (AD), among frontline staff. It assessed whether an educational intervention could improve self-efficacy in recognizing early cognitive impairment, measured by the General Self-Efficacy Scale (GSES). Guided by Bandura’s Self-Efficacy Theory and Lewin’s change model, a quasi-experimental pretest–posttest study was conducted at …

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Self-Efficacy And Burnout Of Nursing Faculty: The Mediating Role Of Fear Of Negative Evaluation, Sarah Murray Kelly

Doctoral Dissertations and Projects

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The contents of this manuscript include a dissertation of a survey research study using the theoretical models of self-efficacy and burnout. The quantitative study used mediation analysis to explore the relationship between self-efficacy and burnout, with fear of negative evaluation as a mediator. Fear of negative evaluation was measured using the Brief Fear of Negative Evaluation Scale-Revised; self-efficacy was calculated using the General Self-Efficacy Scale; and burnout was measured using the Oldenburg Burnout Inventory. The study drew a sample of 98 academic nurse educators (N = 98) who were evaluated by student evaluations of teaching. The sample included educators who …

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