Feasibility And Acceptability Of A Home-Health Aide-Delivered Loneliness Reduction Program In A Small Home Care Agency: The Caring Connections Quality Improvement Project, Tontalayia L. Robinson

Doctor of Nursing Practice (DNP) Manuscripts

Loneliness is a significant public health concern that adversely affects mental, cognitive, and physical health, with consequences comparable to smoking 15 cigarettes per day. Home care recipients experience loneliness at rates of 15.9% to 24.2%, yet home-health aides (HHAs), who often have the most consistent contact with homebound clients, lack structured tools for recognizing and responding to loneliness. This gap highlights the need for practical, evidence-based strategies that can be integrated into routine home care practice. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the feasibility, acceptability, and appropriateness of a home-health aide–delivered loneliness …

A Quality Improvement Initiative Utilizing Help To Reduce Delirium, Improve Patient Outcomes, And Provide Age Friendly Care For Patients 65 Years Of Age Or Older With Modifiable Delirium Risk Factors., Maggie Blake

Doctor of Nursing Practice (DNP) Manuscripts

Background: Delirium, an acute change in cognition, occurs in 21% of hospitalized patients and is linked to increased length of stay, readmissions, and increased mortality (Shen et al., 2024). In older adults, delirium prevalence increases and is linked to poor outcomes that inhibit patients' health care goals (Shen et al., 2024). Despite the well-published harms of delirium and standardized prevention measures, delirium prevention is not prioritized. Methods: HELP, originally the Hospital Elder Life Program, now preferred to be known as HELP, is a standardized delirium prevention model specifically designed to address the unique needs of hospitalized older adult patients. HELP …

Improving Chlamydia Testing For Females Through Universal Screening In Outpatient Pediatric Primary Care: An Adolescent Quality Improvement Initiative, Christina Howard

Doctor of Nursing Practice (DNP) Manuscripts

Chlamydia is the most common sexually transmitted infection in the United States in adolescents and young adults (Dutra & Lazenby, 2023). Per Smith, Reirden, and Nyquist (2022), adolescents and young adults between the ages of 15 and 24 account for more than 60% of new chlamydia infections each year. Testing for chlamydia is not standardized, and it is estimated that only 50% of those who qualify receive a yearly screening American Sexual Health Association. (2021). If outpatient testing and treatment is not improved these asymptomatic cases will be missed, infections in general will increase, and reinfections may occur leading to …

Enhancing New Graduate Nurse Confidence And Patient Safety Through Clinical Development Coach Integration, Megan T. Kramer

Doctor of Nursing Practice (DNP) Manuscripts

The transition from student to professional nurse is a critical developmental stage often marked by heightened stress, emotional exhaustion, and uncertainty in clinical judgment. These challenges frequently contribute to lower confidence levels, increased anxiety, and higher risks for patient safety events among new graduate nurses. This program evaluation project aims to assess the effectiveness of integrating a Clinical Development Coach (CDC) role to enhance new graduate nurse’s confidence, comfort, and overall competence while reducing patient safety incidents on a trauma/surgical inpatient unit in a medical center on the East coast. The CDC role is a structured mentorship and resource position, …

Implementation Of A Deteriorating Patient Simulation For New Graduate Nurses To Improve Clinical Judgment: A Quality Improvement Project, Kasey Mundell

Doctor of Nursing Practice (DNP) Manuscripts

New graduate nurses (NGNs) often have trouble recognizing and responding to patient deterioration because of limited clinical judgment and confidence during the transition to practice. This quality improvement project evaluated the implementation of a high-fidelity deteriorating patient simulation within a new graduate nurse orientation program at a Level I trauma center. Guided by the Plan-Do-Study-Act framework and the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice, the simulation focused on the assessment and management of a patient experiencing pulmonary embolism. Eight NGNs participated in the simulation and completed the Attitudes Toward Recognizing Early and Noticeable …

Evaluating The Implementation And Progress Of A Bereavement Care Program In An Acute Care Adult Hospital, Nancy Abraham

Doctor of Nursing Practice (DNP) Manuscripts

Bereavement care is a significant component of patient and family centered care; however, it remains inconsistently addressed in acute adult hospital settings. Families of patients who die in hospitals frequently experience grief, anxiety, and emotional distress, which may be exacerbated by fragmented or inadequate bereavement support (Kustanti et al., 2021). Evidence supports the use of structured, interdisciplinary approaches to bereavement care to ensure timely, consistent, and compassionate support for families. To address this gap, a Bereavement Committee was established at a Level I trauma center in eastern Pennsylvania to implement a standardized Bereavement Care Program aimed at improving bereavement practices …

From Novice To Competent: Enhancing Orientation And Readiness For Post-Anesthesia Care Nurses, Gerri Y. Young

Doctor of Nursing Practice (DNP) Manuscripts

Post-anesthesia care unit (PACU) nurses are responsible for managing complex postoperative patients requiring advanced clinical judgment, airway management, hemodynamic monitoring, and rapid recognition of complications. Many nurses transition into the PACU without formal perianesthesia education, resulting in variability in orientation practices, competency validation, and preparedness for independent practice. At a military treatment facility (MTF) in Mississippi, 78% of newly assigned PACU nurses had only one to two years of medical-surgical experience, and a standardized orientation program was not available.

This quality improvement project aimed to implement and evaluate a standardized, evidence-based PACU orientation program designed to improve nurse knowledge, confidence, …

Quality Improvement Project From Novice-To-Expert: Training Nurse Faculty On Virtual Simulation, Dae'visha Kinniebrew

Doctor of Nursing Practice Projects

Virtual simulation is an evidence-based teaching strategy that enhances student learning; however, inconsistent faculty preparation limits its implementation in nursing education. A needs assessment identified a practice gap, with 70% of nursing faculty reporting no virtual simulation training within the previous 12 months. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to evaluate the effectiveness of a structured non-immersive virtual simulation training program on nursing faculty confidence, perceived competence, and technology readiness in an Associate Degree Nursing (ADN) program. The aim was to improve faculty preparedness to implement non-immersive virtual simulation. A quantitative, quasi-experimental, …

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

Doctor of Nursing Practice Projects

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 …

The Measles Serology Initiative: A Quality Improvement Intervention To Increase Provider Compliance With Rubeola Serology Screening, Erika S. Martinez

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to increase provider adherence to Rubeola IgG serology screening during prenatal visits at an outpatient women’s health clinic by 10% from a baseline adherence rate of 63.3%.

Background

Rubeola remains a highly contagious viral infection that poses health risks for nonimmune pregnant patients and their newborns. With increasing Rubeola cases and the importance of identifying immunity status during pregnancy, consistent prenatal screening practices are essential. Baseline data demonstrated inconsistent adherence to Rubeola IgG screening recommendations, highlighting the need for workflow interventions to improve provider compliance.

Methodology

A pre-post QI design …

Reducing Potentially Preventable Emergency Department Visits (Ppvs) Through A Telehealth Intervention In Children With Asthma Within A Managed Care Organization (Mco), Renee A. Roker

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose:  The purpose of this quality improvement project was to reduce unnecessary ED utilizations among children with asthma enrolled in a Medicaid managed care health plan. The project aimed to improve access to care and enhance asthma self-management.

Background:  Asthma is one of the leading causes of Emergency Department (ED) utilization, among vulnerable populations. Members experience barriers to timely primary and specialist care, contributing to Potentially Preventable ED Visits (PPV) rates. This places managed care organizations (MCOs) at risk for financial penalties if not meeting the Texas PPV benchmark.

Methodology:  Guided by the Chronic Care Model, Lean Six Sigma …

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

Doctor of Nursing Practice Projects

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 …

Improving Implementation Of The Cmqcc Obstetric Hemorrhage Risk Assessment Tool To Improve Maternal Hemorrhage Response And Outcomes, Emily Hobbs, Karla Beiswenger

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to …

Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …

Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso

Walden Dissertations and Doctoral Studies

The transition from student nurse to professional practice remains a vulnerable period marked by role ambiguity, stress, and early turnover. At a large medical center, the lack of a structured bridge between the final capstone experience and the residency program contributed to inconsistent onboarding, reduced confidence, and diminished resilience among new graduates. Addressing this gap is essential for strengthening retention, supporting workforce stability, and improving patient outcomes within nursing practice. An evidence‑based clinical practice guideline (CPG) outlining best‑practice recommendations for a new graduate transition program from capstone to residency was developed for the facility. The practice‑focused question asked whether the …

Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape

Walden Dissertations and Doctoral Studies

Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% …

Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa

Walden Dissertations and Doctoral Studies

Pressure injuries that patients develop while hospitalized continue to be a major safety concern in hospitals treating very sick patients. These wounds hurt, make infections more likely, keep people in the hospital longer, and increase expenses. On many units, the steps meant to stop these injuries, like checking each patient's risk level and turning patients regularly are not carried out the same way for everyone. Because of this inconsistency, some patients develop preventable pressure injuries. The purpose of this Doctor of Nursing Practice (DNP) project was to create a clinical practice guideline (CPG) for organized pressure injury prevention and to …

Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala

Walden Dissertations and Doctoral Studies

Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …

Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …

Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise

Walden Dissertations and Doctoral Studies

Delirium is a preventable and manageable neuropsychiatric condition characterized by acute fluctuations in attention, awareness, and cognition. The burden of this acute confusion syndrome among older adults aged > 65 years is disproportionate higher, due to age-related neurocognitive vulnerabilities. Nurse-led delirium prevention interventions can reduce incidence from 70% to 20% following structured education, gaps persist in nursing knowledge around evidence-based prevention strategies. The purpose of this project was to evaluate whether a structured nursing education intervention on enhanced mobility and sensory aid optimization strategies, as components of the ABCDEF bundle, improved nursing knowledge compared to standard care practices. Nineteen registered nurses …