Nursing Commons^™

Improving Medication Adherence In Patients With Uncontrolled Hypertension, Suzanne Cockrell

Doctor of Nursing Practice Final Project Abstract

The project’s purpose was to improve medication adherence and blood pressure with an educational packet. The project was necessary due to patient’s elevated blood pressure readings during visit encounters. Implementation occurred at a clinic in Central Texas and included established patients ages 18 or older with uncontrolled hypertension and employed staff members. The Health Belief Model provided a framework to form a hypertension educational packet. The packet was provided at varying locations within the clinic and via staff handouts. Visual aids were intentionally selected to depict the damaging effects of hypertension, hypertension monitoring, and guidance on medication reminder apps. The …

Effectiveness Of An Educational Program To Enhance Medication Adherence Knowledge For Licensed Vocational Nurses In An Outpatient Psychiatric Clinic, Imelda Okoli

Walden Dissertations and Doctoral Studies

This staff education project focused on the practice problem of a knowledge deficit of licensed vocational nurses (LVNs) related to evidence-based medication adherence strategies for psychiatric patients. The practice-focused question addressed how effective an education would be for improving medication adherence knowledge, confidence, and practice readiness among LVNs in an outpatient psychiatric clinic. It is important to address this practice gap because insufficient knowledge of medication adherence could limit LVNs’ ability to engage patients and foster higher medication adherence. Participants were nine LVNs working in an outpatient psychiatric facility who attended face-to-face education sessions. LVNs completed a pretest, followed by …

Staff Education To Improve Knowledge Of Phq-9 Use, Grace Eluma

Walden Dissertations and Doctoral Studies

The DNP project revolved around educating healthcare staff on using a depression screening tool known as the Patient Health Questionnaire (PHQ-9). Undiagnosed depression can affect people’s quality of life, their functional condition, and general health outcomes, making it a significant problem that needs to be addressed. The U.S Preventive Services Task Force (USPSTF) recommends using evidence-based screening tools such as the PHQ-9 to assess, diagnose, and monitor the condition’s severity. However, a few nurses use this tool despite being aware of it or misusing it, resulting in under-utilization, inappropriate assessment, and increased events. The project aimed to implement a staff …

Implementation Of A Pre-Discharge Screening Program For Fracture Prevention, Sarah J. Russell

Master's Projects and Capstones

Problem Osteoporotic fractures are a major public health concern in the United States; 1 in 2 women and 1 in 4 -5 men will experience a fracture due to low bone density. Despite established clinical guidelines, many patients in this managed care health system do not receive timely osteoporosis screening or treatment, placing them at increased risk for costly readmissions averaging $50,000 per hospitalization especially among those discharged to skilled nursing facilities.

Context The improvement project targeted patients admitted with fractures and integrated DEXA scanning during the acute care stay to avoid delays in diagnosis and bisphosphonate therapy. Barriers included …

Policy Change: Analysis Of Public Health Policies To Address Issues With Inclusivity Within The Hiring Process, Donna Barnes

Doctor of Nursing Practice Projects

This project evaluated employee satisfaction with inclusivity efforts in a community health department setting prior to and after revisions to hiring and promotion policies. Interventions promoting and fostering inclusion efforts amongst employees in the healthcare setting have been linked to the best practice standards of increased patient satisfaction and improvements in outcomes. The purpose was to determine if policy revisions resulted in feelings of belonging to improve organizational culture towards inclusion, which has been demonstrated as a widespread problem in many workplace settings. Using Leininger’s Cultural Care Diversity and Universality Theory as a guiding framework and the FOCUS-PDSA model to …

A Toolkit For Treating Obesity In Children With Metabolic Syndrome, Karen Mayers-Scott

Walden Dissertations and Doctoral Studies

This doctoral project seeks to bridge the existing knowledge gap in using Metformin to manage childhood obesity in patients with metabolic syndrome. The primary goal was to develop a complete toolkit to educate healthcare providers on utilizing Metformin in obese children with metabolic syndrome. Metabolic syndrome, characterized by higher triglycerides, decreased high-density lipoprotein cholesterol, increased blood pressure, elevated fasting plasma glucose, and increased waist circumference, offers considerable health hazards for children. The practice-focused question is, Is the toolkit deemed useful to providers for treating obesity in children with metabolic syndrome using metformin?” The project employed the theory of planned behavior, …

Preventing Hospital-Acquired Pneumonia In Non-Ventilated Oncology Patients, Carmi Villanueva

Master's Projects and Capstones

Problem - Hospital Acquired Pneumonia (HAP) remains the leading cause of death among hospital-acquired infections, underscoring the need for effective prevention strategies. Between October 2023-2024, six HAP infections occurred in non-ventilated oncology patients. A routine audit revealed zero adherence to the existing evidenced based ROUTE “bundle” to prevent HAP. ROUTE indicates Respiratory care (R), Oral Care (O), Up in bed (U), Tube care (T), Education (E).

Context – In a 325-bed hospital in Northern California, a 26-bed telemetry/oncology microsystem serves a mixed population including immunocompromised, non-ventilated oncology patients at higher risk for developing HAP. A quality improvement project was initiated …

Kid Power: Mastering Asthma Management To Keep Hospitals Away!, Kriste L. Moret

Master's Projects and Capstones

Problem: Pediatric asthma remains a leading cause of preventable hospitalizations, particularly in California’s Central Valley, where environmental and health disparities worsen symptoms. Many children are discharged without understanding their Asthma Action Plan (AAP) or feeling confident in symptom management.

Context: On a unit in a community hospital in this high-risk region, asthma-related admissions persisted. Gaps in discharge education highlighted the need for a structured intervention. The Institute for Healthcare Improvement (IHI) Model for Improvement (MFI) guided this effort.

Intervention: A nurse-led, developmentally appropriate asthma education bundle was implemented. Teaching began on admission and was reinforced using teach-back, color-coded AAPs, culturally …

Red Room Redesign: Improving Operating Room Workflow For Urgent And Emergency Procedures, Hipolito Jamilan

Master's Projects and Capstones

Problem: Limited operating room (OR) availability is a significant challenge in many healthcare facilities. Overbooked or understaffed ORs can lead to delays in surgical procedures, which are particularly detrimental in urgent and emergency situations (Cholewa et al., 2024). The OR is among the costliest areas in a hospital; it is essential to improve efficiency in surgical throughput to deliver timely care for urgent and emergent cases, enhance patient outcomes, and manage healthcare costs effectively.

Context: The microsystem for this project is a Northern California OR that handles a high volume of surgical procedures. There is a dedicated red room for …

Best Practices To Prevent Nurse Burnout And Reduce Turnover In The Hospital, Bernice Marie Yale

Master's Projects and Capstones

Abstract

Problem Nursing is facing a crisis in workforce well-being, and trends indicate signs and symptoms of burnout. Increasing turnover rates, emotional exhaustion, staff depersonalization, and team disengagement have resulted in a perceived toxic environment in a hospital-based microsystem.

Context A 4-month project was initiated to improve morale and communication. Several assessment tools were utilized to foster a high-performing team and reinforce principles of Watson’s theory of caring.

Interventions Optimization of required daily leader rounds to encourage patient participation, and monthly 1:1 “direct report” rounds (n=65) were conducted to assess well-being, workplace stressors, and promote job satisfaction.

Measures To improve …

Mental Health Provider Education On The Benefits Of Telepsychiatry To Increase Knowledge And Promote Adoption To Improve Organizational Efficiency, Standards Of Care, And Revenue Generation., Jada Eugene

Doctoral Dissertations and Projects

The study implemented an educational intervention on the benefits of telehealth among mental health providers to improve their level of knowledge and promote technology adoption to improve organizational efficiency, revenue generation, and standards of care. The clinical question was: Among mental health providers, does an educational intervention on the benefits of telehealth, compared to no education, enhance knowledge of telepsychiatry consultations and promote adoption to improve organizational efficiency, standards of care, and revenue generation? Utilizing the Iowa Model of EBP, the researcher implemented a pilot study using the quasi-experimental design. Knowledge, telehealth usability, revenue generation, and standards of care were …

Evaluating The Effectiveness Of The Comprehensive Unit-Based Safety Program In Reducing Hospital-Acquired Infections, Peta Ann Anderson

Walden Dissertations and Doctoral Studies

This doctoral project is an evaluation of a quality improvement initiative that applied a mixed method approach to evaluate the impact of the Comprehensive Unit-based Safety Program (CUSP) on hand hygiene (HH) compliance and healthcare-associated infection rates. The project was conducted in the United States of America (USA), Florida in an acute care hospital. The practice problem addressed was the persistent low adherence to HH protocols among healthcare staff, a critical issue in nursing practice due to its direct link to preventable patient harm. Quantitative data demonstrated a substantial reduction in infection rates following the implementation of the CUSP program. …

Staff Education To Increase Staff Knowledge On Pressure Injury Prevention, Sunita Khati

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) are unfortunate events that can impact all healthcare system stakeholders. In-patient nursing units such as medical surgical (med surg) units are facing challenges in nursing practice in initiating prevention measures and reducing the incidents of hospital-acquired pressure injuries (HAPIs). The nursing staff’s lack of knowledge can lead to nursing practice issues, poor patient outcomes, and be costly. The purpose of this Doctor of Nursing Practice (DNP) staff education project was to educate nursing staff in initiating pressure injury (PI) prevention measures to avoid HAPI events in the hospital. The practice-focused question examined if providing education to med …

Staff Education To Improve Stroke Management Knowledge Among Medical-Surgical Emergency Department Overflow Staff Nurses, Andrea Terri Branch

Walden Dissertations and Doctoral Studies

Summary This quality improvement initiative aimed to enhance stroke knowledge through an evidence-based staff education program for medical-surgical emergency department (ED) overflow nurses. The impetus for the project stemmed from recognition of the need for enhancing prompt response and communication during acute stroke events. Variations in stroke knowledge among nursing staff contributed to delays in recognizing and responding to stroke symptoms. The practice-focused question guiding this Doctor of Nursing Practice (DNP) project addressed whether the implementation of an evidence-based stroke education program could improve nursing knowledge. The purpose of the project was to evaluate whether an evidence-based stroke education program …

Falls Risk And Prevention: Improving Staff Knowledge, Ashley Vargas Delarosa

Walden Dissertations and Doctoral Studies

Objective This project aimed to enhance nursing staff knowledge and engagement in evidence-based fall prevention strategies, addressing the practice problem of inconsistent staff education and the absence of a standardized fall prevention protocol, contributing to high patient fall rates in acute care settings. Design The project employed an educational session both in-person and online. A pre- and post-test education design, utilizing knowledge assessments (pre-test and post-test) and qualitative feedback to evaluate the impact of a structured education program on nursing staff knowledge related to fall prevention. The education module focused on risk assessment tools, including the Morse Fall Scale, and …

Staff Education To Address Medication Noncompliance In Outpatient Behavioral Health Settings, Elmase Nicolas Toussaint

Walden Dissertations and Doctoral Studies

This quality improvement project is a staff education initiative designed to address psychotropic medication noncompliance in an outpatient behavioral health clinic setting. The project arose from the identification of a significant gap in staff knowledge and confidence related to medication adherence strategies. Medication noncompliance in psychiatric care is associated with symptom exacerbation, increased hospitalization, and poorer patient outcomes, making it a critical issue in nursing practice. The practice-focused question guiding the project was: In an outpatient behavioral health clinic setting, does implementing a structured staff education program improve staff knowledge and confidence in addressing medication noncompliance? Analytical strategies included a …

Implementation Of A Triage System For The Residents At A Residential Facility To Improve Triage Assessment Skills Of The Staff As Well As Improve The Level And Timeliness Of Care, Andrew J. Choi Rn, Neha Gopal Rn, Andres N. Padilla Rn, Dana Son

Master's Projects and Capstones

Triage is an integral part of the clinical process which involves assessing patients and determining their level of care in order to get them appropriate, timely treatment. Several countries utilize a standardized triage system with established criteria to aid staff in their decision-making during assessments (Peta et al., 2023). The Nursing and Residential Triage (NaRT) tool, from the Manchester Triage System (MTS), was shown to enhance staff clinical assessment skills and help avoid inappropriate ED transfers during a study among older adults in a residential facility (Markey et al., 2024). For this project, the main issue identified at the residential …

Enhancing Patient Safety: Fall Prevention Through Video Education, Fithawit T. Zere

Master's Projects and Capstones

Abstract

Problem: Globally, hospital falls remain a leading cause of injuries, increased costs, short and long-term disability and emotional impact on patients/families. Despite required prevention measures, a local hospital experienced rising fall rates during 2024 (n=71);13 of these occurred in the Med-telemetry microsystem. Although multiple strategies and financial investments occurred, nursing compliance with the fall prevention “bundle” remained suboptimal.

Context: Thirteen falls resulted in $182,000 in 2024. A quality improvement (QI) project was initiated over 12 weeks after routine audits revealed inconsistency in application of several components of the required bundle: particularly, the fall prevention video upon admission.

Interventions: A …

Does The Addition Of Digital Care Along With Standard Chemotherapy Teaching That Is Provided At City Of Hope Increase Patient Satisfaction And Confidence?, Sheridan Wendy Lomeli, Brooklin Mize, Tatyana Franco, Daniela Naemi

Master's Projects and Capstones

Chemotherapy education is critical when it comes to improving patient confidence, reducing anxiety, and enhancing symptom management. However, there is still a variety of patients who begin their infusion therapy with a limited understanding of what to expect. This quality improvement project was conducted at an outpatient infusion center, exploring whether combining traditional nurse-led chemotherapy education calls with a digital care platform would enhance patient satisfaction and confidence compared to standard care alone. A total of forty-one adult oncology patients participated in an educational survey at the end of each follow-up phone call, which was completed three days after their …

Improving The Medication Communication Domain Of The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey In A Pediatric Hospital, Bailey N. Godwin

Doctoral Dissertations and Projects

Patient education is a key responsibility of nurses. Providing education is the most effective when the teach-back method is used in combination with tangible education materials. Patient satisfaction in the pediatric setting is measured using the Child Hospital Consumer Assessment of Healthcare Providers and Systems survey (Child-HCAHPS). This evidence-based practice project aimed to improve patient/caregiver satisfaction scores for medication education on the Child-HCAHPS survey through comprehensive medication education and improved usage of patient education materials at discharge. Three pediatric units within an academic health institution in central North Carolina were identified for participation in the intervention by their managers and …

Establishing Operational Foundations In A Faculty-Led Clinic: Workflow Design, Role Development, And Service Planning, Rebecca Wensmann

DNP Projects

A Central Minnesota College, in collaboration with local community partners, sought to provide access to medical care for an underserved population while offering opportunities for graduate and undergraduate nursing education. They achieved this by establishing a faculty-led clinic in a high-poverty level area in Central Minnesota, where nearly 7% of the population under the age of 65 lacked health insurance (U.S. Census Bureau, 2024). Research was completed on clinic workflows and processes, as well as many interviews with clinics and community members throughout Minnesota. With this data, a clinic workflow, job description list, and services offered were created. This information …

Staff Education To Improve Staff Knowledge On Preeclampsia, Doris Wanmban Fombo

Walden Dissertations and Doctoral Studies

Preeclampsia is a disorder that usually develops after 20 weeks of pregnancy and can lead to serious adverse outcomes or death for the mother and fetus if not promptly diagnosed and managed. Hence, a staff education project was designed and implemented to enhance staff knowledge of preeclampsia. The practice problem was limited staff knowledge of preeclampsia a pregnancy complication that can affect both the mother and fetus. The practice-focused question explored whether a staff education project on preeclampsia affected office staff knowledge. The purpose of the project was to develop and implement a staff education program to improve staff knowledge …

Implementation Of A Standardized Onboarding Program, Sarah J. Wall

Doctor of Nursing Practice Final Project Abstract

Purpose: To evaluate the impact of a standardized onboarding program on Advanced Practice Provider (APP) retention and productivity within an academic department.

Background: High APP turnover in specialized settings disrupts care and leads to financial losses. Previously, onboarding lacked structure, leading to early attrition and delayed productivity. A 24-week phased, competency-based orientation program was developed to improve retention, job satisfaction, and clinical performance.

Methods: The program, implemented in April 2024, included clinical precepting, didactic modules, and mentorship. Retention and Relative Value Units (RVUs) were measured before and after implementation. Qualitative data was collected through mentorship surveys and APP focus groups. …

Decreasing Emergency Department (Ed) Revisits: Providing Resources That Address Overutilization For Patients With Substance Use Disorder, Amber May

Doctor of Nursing Practice Final Project Abstract

Date of Doctor of Nursing Practice Project Completion

Summer 8-5-2025

Faculty Advisor

Rebecca Tsusaki PhD, APRN-CNP, WHNP-BC, IBCLC

ABSTRACT

PURPOSE This quality improvement project was intended to decrease emergency department (ED) revisits by 10%, from high-utilizer patients (those with more than 10 ED visits in the past year), by implementing community health worker–led follow-up phone calls within one week of discharge, over a 30-day period. The project was conducted at a large metropolitan hospital in Houston, Texas.

BACKGROUND Non-urgent revisits and overutilization affect ED wait times, are associated with overcrowding, contribute to unnecessary care delays, impact patient satisfaction scores, and …

Staff Education Program To Improve Nursing Knowledge On Fall Prevention Strategies, Chioma C. Achonye

Walden Dissertations and Doctoral Studies

In nursing practice, falls among adults aged 65 and above are a critical concern due to their potential to cause serious injuries and complications. As a result, fall prevention has become a top priority for healthcare providers striving to ensure patient safety and quality. The Doctor of Nursing Practice (DNP) project was designed to address the issue of falls in long-term care facilities by implementing a staff education program focused on patient fall risk assessment, identifying intrinsic and extrinsic factors influencing falls, and implementing evidence-based interventions. The DNP project practice-focused question was Does an education program on fall prevention strategies …

Next-Gen Leaders: Cultivating Board Room Readiness For Emerging Nurse Professionals, Cheryl Nikol Hamilton

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice (DNP) project addressed the critical underrepresentation of nurses on healthcare boards by implementing an evidence-based intervention to improve board readiness among emerging nurse leaders in Arkansas. The purpose of the project was to assess and enhance nurses’ self-perceived competencies in governance through a structured educational program and the SHIP-BC© readiness assessment tool. A quasi-experimental pre-post design was utilized with honorees from two leadership programs within a statewide nursing organization. Participants first completed the SHIP-BC© survey to establish baseline perceptions of board readiness across domains of analytical, interpersonal, and organizational skills. Following a four-week microlearning board …

Enhancing Nurse Well-Being Through Mandatory Rest Breaks At A Hospital, Elise Njang

Doctor of Nursing Practice Projects

Nurses are essential to the healthcare system, yet their demanding 12-hour shifts in hospital settings often leave little opportunity for adequate rest. The absence of structured rest breaks not only endangers nurses' well-being but may also compromise the quality of patient care. This quality improvement (QI) project aimed to evaluate the effects of implementing structured, mandatory 15-minute rest breaks on nurse burnout and job satisfaction. The initiative addressed a critical gap at the project site, where nurses typically received only one 30-minute lunch break per shift, despite evidence supporting the benefits of more frequent rest breaks. A quasi-experimental pre- and …

Quality Improvement Project Impacting Healthcare Providers’ Knowledge And Self-Efficacy On Peripheral Artery Disease In An Outpatient Cardiovascular Clinic, Nikki Naphaphone Phanyoraj

Doctor of Nursing Practice Projects

Peripheral artery disease (PAD) affects over 200 million people worldwide and contributes to functional limitations, decline in quality of life, and increased risk of cardiovascular morbidity and mortality. Failure to effectively screen patients for PAD can lead to delayed treatment and poorer health outcomes. Early detection and intervention are key to altering the disease progression, reducing complications, and improving health outcomes. The purpose of the quality improvement project is to impact the knowledge and self-efficacy of the healthcare providers working in the outpatient cardiovascular clinic on PAD. A quasi-experimental design with pre- and post-test PAD knowledge exam and a pre- …

Yo Soy Minnesota: Bridging Health Equity Gaps With Culturally And Linguistically Inclusive Resources For Hispanics In Central Minnesota, Liz Damaris Vincente Berrios

DNP Projects

Health disparities are preventable yet persist due to systemic inequities in social, economic, and healthcare structures. Rooted in historical injustices and social determinants of health, these disparities disproportionately impact minority communities, including Hispanics in Central Minnesota. Barriers such as limited English proficiency (LEP), provider biases, and inadequate health literacy further exacerbate inequitable health outcomes. Culturally and Linguistically Appropriate Services (CLAS) offer a modifiable solution to mitigate these disparities by ensuring healthcare resources align with diverse beliefs, practices, and linguistic needs. This project focuses on CLAS as a modifiable factor affecting Hispanics in Central Minnesota and explores the impact of "Yo …

Quality Improvement Project Fall Prevention Among Skilled Nursing Facility Residents Through Staff Education, Reena Mathew

Doctor of Nursing Practice Projects

Falls among older adults in Skilled Nursing Facilities (SNFs) remain a leading cause of injury, hospitalization, and decreased quality of life. Preventing these falls requires awareness and effective staff engagement. This Quality Improvement (QI) initiative is targeted to decrease fall rates in a 90-bed SNF by educating caregivers on the significance and practice of purposeful hourly rounding. The project helped to improve staff knowledge, consistency, and accountability in implementing hourly rounding as a preventive measure. A pre- and post-intervention design was utilized. Staff members received structured educational sessions based on evidence-based guidelines, including interactive modules and printed resources. Twenty staff …