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The Effect Of A Mass Casualty Incident Adult Hyper-Realistic Simulation On Nurse Confidence Levels And Satisfaction Of Nurses: A Quasi-Experimental Study, Melodie Ann Nutter

Doctoral Dissertations and Projects

The purpose of this quantitative quasi-experimental study was to examine registered nurses (RNs) satisfaction and confidence levels after experiencing hyper-realistic simulations using a mass casualty incident (MCI) simulation method. With the world seeing a rise in MCI events, nurses often become one of the first professional medical providers to interact with the affected individuals. To fill this gap in education, the introduction of intensive hyper-realistic simulation training plays a vital role and provides an advanced perspective on the ever-increasing MCIs in today’s healthcare environment. This quasi-experimental study, using the Wilcoxon rank test and paired, assessed the satisfaction and confidence levels …

Home-Based Vs Clinic-Based Stool Testing For Detecting Early Cancer Markers: A Scoping Review, S. Elizabeth Brock, Jacqueline Giles, Sydney James, Cha'landria Mccall, Bobby Bellflower Dnsc, Nnp-Bc-Faanp, Fnap, Faan

Doctor of Nursing Practice Projects

Purpose/Background 

Colorectal cancer (CRC) remains a significant public health concern in the United States, with screening rates below national targets due to persistent socioeconomic and structural barriers, particularly among underserved populations. Stool-based screening modalities offer accessible alternatives to colonoscopy, and emerging evidence suggests that home-based delivery models may improve screening uptake; however, implementation strategies vary and comparisons between home-based and clinic-based approaches remain limited. This scoping review examines current evidence on strategies that support CRC screening uptake, with a focus on stool-based modalities, including fecal immunochemical testing (FIT), fecal occult blood testing (FOBT), and multitarget stool DNA testing (mDNA), and …

How Does Cognitive Behavioral Therapy (Cbt) And Antipsychotics Compare To Antipsychotics Alone Impact Inpatient Length Of Stay: A Scoping Review, Morgan E. Johnson, Hailey M. Wade, Y'Esha V. Williams-Click, Rocquell Duncan, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Background

Psychosis in adults is a serious psychiatric condition that often necessitates inpatient hospitalization for stabilization and the initiation of medication. Untreated psychosis can lead to poor outcomes, including longer hospital stays, loss of occupational functioning, and a decreased quality of life. While antipsychotic medications are typically the first line of treatment, they can have severe side effects, which may lead to patients discontinuing their use. Cognitive Behavioral Therapy (CBT) for psychosis is an evidence-based intervention that targets maladaptive behaviors associated with the condition. CBT may improve treatment responses when used alongside antipsychotic medication. However, there is limited research on …

Impact Of Provider Confidence And Psychiatric Referrals Through Education And Implementation Of The Gad-7 Anxiety Screening Tool In An Outpatient Family Clinic, Maceline E. Check

Doctor of Nursing Practice Projects

Gaps in provider and nurse confidence in identifying and managing anxiety disorders in outpatient family clinic settings contribute to underdiagnosis, delayed intervention, and reduced psychiatric referrals. This quality improvement project evaluated the impact of provider education and implementation of the Generalized Anxiety Disorder-7 (GAD-7) screening tool on provider and nurse confidence and appropriate psychiatric referral rates, with the goal of improving clinical decision-making and standardizing anxiety screening practices. The project was guided by Lewin’s Change Theory and the Iowa Model of Evidence-Based Practice. Using a quasi-experimental pre- and post-intervention design, providers and nurses in an outpatient family clinic received structured, …

Moving Toward Standardization Of Breast Cancer Screening: A Scoping Review Comparing Uspstf And Acs Recommendations For Women Aged 40–74, Gerita F. Perry, Krystal D. Hester-Smith, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose 

To compare U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) breast cancer screening guidelines for women aged 40–74, and to recommend adopting one consistent, standardized guideline in practice. Standardization can improve care continuity, patient adherence, reduce anxiety, support early detection, and lower mortality.

Background 

Breast cancer is the second leading cause of cancer-related death amongst women. The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. The ACS recommends an annual mammogram. Differences between the two organizations for screening emphasize the need for a common alignment to reduce breast cancer mortality. As breast …

Staff Educational Impact On School-Based Mental Health Services: A Scoping Review, Daniel J. Kim, Di'yana Fisher, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

            Trends are consistently increasing among adolescents in regard to mental health diagnoses and suicide risks, which emphasizes the necessity for early identification via school-based psychiatric screenings. The Patient Health Questionnaire-9 (PHQ-9) has proven effective in uncovering symptoms of depression; variable application and limited staff knowledge continue to be substantial hurdles. This scoping review examined the influence of staff education and training on the efficacy of school-based psychiatric screening.

Methods

            PubMed, CINAHL, Medline, Elsevier, Google Scholar, and JAMA were utilized to conduct this scoping review. Peer-reviewed studies published between 2020 and 2025 were included if they involved adolescents aged 13-18, …

Transesophageal Echocardiogram Training For Student Registered Nurse Anesthetists, Sophie Hesse, Annie Krippene, Christian Shelton

Doctor of Nursing Practice (DNP) Student Projects

Background and Significance: Transesophageal echocardiography (TEE) is a vital diagnostic tool in perioperative care. At Barnes-Jewish College Goldfarb School of Nursing (GSON), Student Registered Nurse Anesthetists (SRNAs) formerly received limited TEE instruction, consisting primarily of didactic content. This quality improvement project aimed to enhance SRNA proficiency in TEE by integrating online and simulation-based training.

Review of Literature Findings: Simulation-based education has been shown to improve knowledge, skill, and confidence compared to lecture-only methods (Bloch et al., 2017; Chenkin et al., 2023; Pezel et al., 2023; Weber et al., 2019; Zhao et al., 2021).

Methods: Guided by the Iowa Model and …

Preventing Information Loss During Icu To Or Handoff, Jenna Alfeldt, Kristen Hoffer, Ashley Miles, Amanda Schwarztrauber

Doctor of Nursing Practice (DNP) Student Projects

Background and Significance: Inconsistent ICU to OR handoff practices create conditions for information loss, threatening patient safety and continuity of care. Communication errors contribute to an estimated 250,000 fatalities and $20 billion in annual U.S. healthcare costs.

Review of Literature Findings: A thorough literature review revealed that standardized handoff procedures are shown to improve communication and team dynamics.

Methods: This quality improvement (QI) project implemented a standardized handoff process using the Handoff Reference Tool when transferring patients from the Intensive Care Unit (ICU) to the Operating Room (OR) in a large academic medical center. Pre- and post-implementation …

Do-Not-Resuscitate Orders In The Perioperative Period: A Quality Improvement Project, Brooke Popejoy, Connor Lebsack, Rena Bish

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Management of do-not-resuscitate (DNR) orders during the perioperative period presents ongoing ethical and clinical challenges. Variability in provider knowledge and documentation can compromise patient autonomy and safety. Despite institutional policies, such as Barnes-Jewish Hospital’s “Goals of Care Directive,” inconsistent adherence remains common.

Review of Literature Findings: Evidence reveals that limited provider education contributes to uncertainty in managing perioperative DNRs. Studies by Baumann et al. (2017), Chappell et al. (2023), and Crowe and Marsh (2023) support targeted educational interventions to improve provider competence and consistency with national guidelines regarding required reconsideration.

Methods: Preintervention and postintervention surveys will be …

Riding The End-Tidal Wave: Enhancing Nurse Confidence And Clinical Competence On Capnography Waveform Interpretation, Megan Monda, Kirk Wallis, Rachel Zehner

Doctor of Nursing Practice (DNP) Student Projects

This quality improvement project addressed inconsistent use of end-tidal carbon dioxide (ETCO2) monitoring among nurses in the Cardiac Procedure Center (CPC) at Barnes-Jewish Hospital. Although capnography detects respiratory compromise earlier than pulse oximetry, limited staff education contributed to variability in waveform interpretation and clinical response. Guided by Kurt Lewin’s Change Model and the Plan-Do-Study-Act cycle, four structured one-hour educational sessions were delivered to CPC nurses and supplemented with hands-on practice and visual cognitive aids. Pre-, immediate post-, and two-week post-education surveys evaluated changes in knowledge, confidence, and clinical skill. Mean knowledge scores improved from 65% at baseline to 75% immediately …

Quality Improvement Project: Evaluating The Effectiveness Of Chlorhexidine Gluconate Bathing Education On Staff Perceived Knowledge, Kaonta Spencer

Doctor of Nursing Practice Projects

A community hospital set strategic goals to achieve Vizient top-decile performance and drive continuous improvement by reducing surgical site infection (SSI) rates. The purpose of this quality improvement project was to support this goal by implementing an evidence-based educational intervention to improve nurses' perceived knowledge and self-reported ability with the chlorhexidine gluconate (CHG) bathing protocol for hysterectomy patients. Guided by Lewin's Change Theory, the Iowa Model Revised, and the Iowa Implementation Framework, the educational intervention applied a structured approach to address behavioral and organizational barriers contributing to protocol noncompliance. A quantitative, quasi-experimental pre- and post-intervention design was used to evaluate …

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

Doctor of Nursing Practice Projects

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 …

Implementation Of A Nurse-Led Discharge Protocol To Impact Nurse Confidence And Optimize Transitional Care Management, Jessi-Ann Elrod

Doctor of Nursing Practice Projects

Heart failure (HF) remains a leading cause of hospitalization and readmission, with the transition from hospital to home representing a vulnerable period for patients. Variability in discharge education and follow-up scheduling contributes to poor self-management and adverse outcomes. This quality improvement (QI) project evaluated whether implementing a standardized nurse-led HF discharge protocol impacted nurses' confidence and the rate of 7–14-day transitional care management (TCM) follow-up appointments. Guided by Meleis’ Transitions Theory and Lewin’s Change Theory, a one–group pretest–posttest QI design was implemented on a cardiac step-down unit. Twelve discharge nurses participated. The intervention included a structured education session and the …

Quality Improvement Project Reducing Attrition Rates In Nursing Students: Evaluating The Enhanced Student Success Program, Jason Grigg

Doctor of Nursing Practice Projects

The high attrition rate in the Associate of Applied Science in Nursing (AASN) program created an opportunity to develop the enhanced Student Success Program (eSSP). This is a faculty-based quality improvement project designed to increase support for students at risk of withdrawal from the AASN program. The aim of eSSP is to reduce attrition rates, however, this project evaluated only short-term changes in faculty confidence. Using Lewin's Change Model and the Theory of Planned Behavior as a guide, this QI implemented a one-group pre-post experimental design to determine whether a short eSSP training program, combined with a 5-week implementation period, …

Quality Improvement Project : Educating Critical Care Nurses On Braden Scale And Sskin Care Bundle To Impact Pressure Injuries, Andrea Garrett

Doctor of Nursing Practice Projects

Hospital-acquired pressure injuries (HAPIs) increase patients' risk of infection, prolonged hospitalization, death, and healthcare costs. The Agency for Health Research and Quality (AHRQ) has shown that implementing a standardized skin assessment process and a care bundle helps prevent skin injuries. A critical care unit (CCU) at an acute care 339-bed hospital in Southaven, MS, has seen an increase in HAPIs. This quality improvement project aimed to educate CCU nurses about the Braden Scale and the SSKIN care bundle to impact pressure injuries in the CCU within 8 weeks. Education on the Braden Scale and the Skin, Sensory, Keep Moving, Incontinence, …

Quality Improvement Project: Gpt Prompts As Tools For Cultural Competence In Undergraduate Nursing Education, Elizabeth K. Hobbs

Doctor of Nursing Practice Projects

In rural nursing programs, student exposure to diverse cultures is limited, which can hinder development of cultural competence. Artificial intelligence (AI) simulation is an evidence-based strategy to improve cultural competence and clinical decision-making, a practice gap exists due to lack of structured, accessible tools. This quality improvement project evaluated whether Generative Pre-trained Transformer (GPT)–based structured prompts would increase culturally inclusive simulation activities and improve faculty perceptions of usefulness and ease of use at a rural community college. The guiding PICOT asked: Among nursing faculty, how does the use of GPT-based structured prompts, compared to an unstructured approach, impact perceived usefulness, …

Quality Improvement Project: Faculty Development For Understanding And Utilization Of Exam Data, Deanne Hutchens

Doctor of Nursing Practice Projects

This quality improvement project focused on inconsistent use and understanding of exam data among Associate Degree in Nursing (ADN) faculty, which can influence teaching decisions and student success. Many nursing faculty enter education with strong clinical backgrounds but limited experience working with exam statistics such as item difficulty, discrimination values, and Kuder-Richardson 20 (KR-20) reliability. Without a consistent approach, exam results may not be fully used to guide remediation or adjust instruction. This Doctor of Nursing Practice (DNP) project examined whether a structured faculty development session could improve faculty confidence and ability to interpret and apply exam data. A pre- …

Quality Improvement Project: Evaluating The Impact Of Provider Education On Sbirt On Screening For Suds, Faith Ogala

Doctor of Nursing Practice Projects

Substance use disorder (SUD) is a serious public health issue in people with psychiatric disorders. However, diagnosis and treatment are often delayed, leading to poor treatment outcomes and increased social and economic costs. The purpose and aim of this Doctor of Nursing Practice (DNP) project was to educate providers on the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model to facilitate the timely diagnosis of SUDs in patients with dual diagnoses. The key outcomes were provider knowledge and SBIRT implementation rates. The Donabedian Model of Healthcare Quality assessed the outcomes, whereas Lewin’s Change Model guided implementation. The project employed …

Establishing A Standardized Suicide Risk Screening Policy For Psychiatric Providers: Closing Gaps In Provider Accountability And Clinical Documentation, Fadekemi Olude

Doctor of Nursing Practice Projects

Psychiatric providers in outpatient settings often experience inconsistent confidence and incomplete documentation when conducting suicide risk screening, contributing to missed opportunities for early identification of at-risk patients. This quality improvement project addressed the need for standardized suicide risk screening at an urban outpatient psychiatric clinic. The purpose was to evaluate documentation using the Columbia-Suicide Severity Rating Scale (C-SSRS). Using a pre-post intervention design guided by Lewin's Change Theory and the Donabedian Model of Quality Improvement, a 60-minute training session was delivered to 31 psychiatric providers. Participants completed pre- and post-intervention General Self-Efficacy Scale (GSES) surveys. Chart audits (N = 1,970) …

Quality Improvement Project Ai-Powered Conversations: Enhancing Nursing Students’ Interview Skills, Judy K. Staley

Doctor of Nursing Practice Projects

Professional communication is an essential skill for nursing students, particularly in job interviews. Deficits in professional communication can negatively impact future employment and accreditation outcomes. Current practices in faculty-led mock interviews can be limited by time constraints and the need for consistent feedback, underscoring the need for a more consistent and effective method supported by current evidence-based literature. The purpose of this quality improvement project is to evaluate whether integrating AI-assisted mock interviews into faculty-led practices influences faculty perceptions of student preparedness. Guided by Kotter’s Change Model and supported by the constructivist framework, the project aimed to enhance the effectiveness …