Our DNP program empowers students to lead real-world healthcare improvements through a project. By applying evidence-based solutions, DNP students directly impact patient care, optimize systems, or implement new policies. Our students are passionate about making a difference in healthcare, exploring DNP projects is a key step toward becoming a nursing leader.
Learn more about the exciting projects our DNP students are leading! Please check back as we continue to add our students' projects.
Title: Providers' perspectives on produce prescription programs in rural communities.
Brief description: Food insecurity and obesity were the 2nd highest community health needs identified by Parkview’s Community Health Needs Assessment (CHNA) for Whitley County, Indiana (Parkview Health, 2023). The top community health concern of Whitley County citizens were obesity and chronic disease. Suboptimal nutrition and food insecurity are essential mediators of health disparity and have been closely tied to chronic illness (Mozaffarian, 2024). Obesity in Whitley County is on the rise with a rate of 36.6% compared to Indiana’s 33.4%, and food insecurity is at 10.1%. Limited access to healthy foods is a key contributor to these rates (Parkview Health, 2023).
Produce Prescription Programs are supported by the American College of Cardiology as a prevention strategy for diet-related chronic diseases and a way to improve health equity (Mozaffarian, 2024). A produce prescription program has been successfully implemented by Parkview in Allen County since 2019 and is supported through a USDA grant (https://www.parkview.com/mirro-center/hsir/veggie-rx-to-heal).
This project aims to examine primary care providers’ perspectives regarding barriers and facilitators to implementing a produce prescription program to address food insecurity and diet-related chronic illness in rural Whitley County. The health-related goal is to gather information and concerns to address barriers before implementing a program in Whitley County. There will be a short PowerPoint presentation and discussion with healthcare providers followed by a survey asking about concerns, barriers, and support providers need to refer and educate patients on the program.
Mozaffarian, D., Aspry, K., Garfield, K.. et al. (2024) “Food Is Medicine” Strategies for nutrition security and cardiometabolic health equity: JACC state-of-the-art review. Journal of the American College of Cardiology, 83(8,) 843–864. https://doi.org/10.1016/j.jacc.2023.12.023
Research Methods: “For the study, I identified all the providers who would have an ongoing relationship with patients,” Ward explained. “So, I excluded walk-in clinics and ERs but concentrated on 24 providers in our county who did pediatrics, OB-GYN, family practice, and then the federally qualified [Bowen] health center.”
Ward gave the 24 providers a brief presentation about the Produce Prescription Program and then asked them to complete a 10-item survey. She was then able to get a cross-section of different health systems and independent practices to pull from.
Ward followed that theory and its seven constructs, and the model is based on the point that an intervention is successful when the health care providers have buy in. So, the seven constructs follow the attitude and experience of the healthcare providers, how much the healthcare provider perceives that the intervention is going to require them to participate, and how ethical the intervention appears to them.
Providers were asked 10 questions, including, "Before this presentation, how aware were you that Produce Prescription Program existed?”
Findings: Ward found that nearly 80% of the providers were either not aware or only a little aware of the program.
“So, where the health system may have had trouble in the past launching it in rural communities, I think it shows that talking to the providers and making sure they understand how it works and who qualifies is really important,” she said.
The evaluation is best done through the two-question Hunger Vital Sign screening tool for food insecurity. Only one of the 24 providers had ever used the tool. The biggest barrier they saw was time, because in primary care, providers only get 15-20 minutes per patient, so fitting in another screening and another referral is difficult.
Ward found that providers felt like they did have time to discuss nutrition with the patient, but it was a more abridged version than what they received through the Produce Prescription Program.
“It’s valuable to them, 100% of the 24 providers I surveyed said this program would be valuable to their patients and is needed in their community.”
Hopes for Future Impact: “A few years ago in Allen County, Indiana, they were able to get a grant of more than $1 million from the Gus Schumacher Nutrition Incentive Program (GusNIP),” said Ward. “We’re hoping other rural areas will be able to apply for grants so that this can be a part of the programming that’s offered... I think that the outcomes speak for themselves.”
“The outcomes from the urban program in Allen County were pretty amazing,” she continued. “There was an almost a full percent, a 0.9%, drop in A1C, people lost weight, and their hospitalization rates and ER visits dropped by 50%. So just in those 6 months of the program, the outcomes were really great. I would like to see that happen in my own community, too.”
Project mentor: Dr. Sarah Giaquinta, Senior VP of Community Health & Equity for Parkview Health
Title: Providers' perspectives on produce prescription programs in rural communities.
Project site: Eskenazi Health
Brief description: High nursing turnover remains a challenge in healthcare, often driven by normalized uncivil behaviors in the workplace (Muharraq, E.H., et al.). Toxic environments contribute to staffing shortages, increased stress, decreased job satisfaction, and heightened risk to patient safety. To address this issue, healthcare organizations must adopt a proactive framework that discourages incivility (King, C., et al.). This project aims to raise awareness about the comprehensive impact of incivility within healthcare settings.
Methods: A secure online survey, administered using Qualtrics, was conducted before and after a 20-minute virtual civility training module. The Workplace Civility Index (WCI), a validated 20-item Likert-scale tool, measured participants' baseline understanding of civility and assessed changes in their perception following the intervention. No identifying information beyond basic demographics was collected, ensuring confidentiality and minimizing ethical concerns.
Results: Descriptive statistics revealed no change in mean self-rated civility scores from pre- to post-intervention (M = 84.38), although the median score declined slightly, and variability increased. Ratings of others' civility were notably lower, with an unchanged mean of 65.25 and a drop in median from 68.0 to 64.0. These findings suggest high self-perceived civility, continued lower perceptions of peer civility, and minimal overall impact from the intervention.
Conclusion: Although the intervention did not yield statistically significant results, it provided insights into perceptions of civility and highlighted the need for more comprehensive, sustained, inclusive strategies. The gap between self and others' ratings underscores the importance of fostering shared accountability and cultural transformation. Continued efforts should prioritize reflection, dialogue, and education to support respectful environments and improve patient outcomes.
How did you become interested in this area of research? I became interested in the topic of incivility after witnessing and experiencing unprofessional behavior over the years and observing its negative effects on morale and patient care. I observed how such behavior was often excused or normalized, even when individuals had the courage to speak up and express their concerns. However, it was seeing my nursing students directly subjected to incivility at clinical sites that truly motivated me to act and advocate for healthier, more respectful work environments.
How has your project been introduced at Eskenazi Health? My project was introduced through the Patient Care Leadership Council (PCLC), where staff were invited to voluntarily participate in a brief, structured Cognitive Rehearsal Training (CRT) session delivered via PowerPoint, along with pre- and post-intervention surveys to assess perceptions of civility. The project was framed as a proactive, awareness-focused initiative that offered practical strategies for addressing unprofessional behavior while minimizing disruption to daily workflows.
Post-graduation plans? After graduation, I plan to continue my work in public health, focusing on reducing Indiana's maternal morbidity and mortality rates, which I’m extremely passionate about. I also plan to expand my role in academia, influencing the next generation of nursing professionals. Additionally, I’m interested in potentially publishing my research findings to contribute to meaningful organizational change in healthcare.
Title: Building Firm Foundations: Expanded Medical Assistant Orientation Focused on Safe Medication Administration and Lab Collection
Project site: Parkview Health
Brief description: Medication and lab errors significantly contribute to adverse patient outcomes, eroding trust in healthcare systems. The average cost of a medication error per patient occurrence is $472 USD (Najafzadeh, M.,Schnipper, J.L., et al. 2016). Osterwell (2016) reports that lab errors per patient occurrence average between $400-$580 USD. This quality improvement project aims to expand the current orientation process for medical assistants (MAs) onboarding to ambulatory clinics, focusing on safe medication administration, patient safety, and accurate lab collection to decrease outpatient medication and lab errors in a Midwest health system.
Methods: Eight-hour educational sessions were added to the existing MA orientation. These sessions included didactic sessions, role-play scenarios, interrupted simulation sessions, and skill demonstrations for correct medication administration and lab collection workflow.
Measures: A 15-question survey was administered pre-training and post-training to determine knowledge, skills, and attitudes concerning medication dosage calculation, correct workflow policy, and procedures. MIDAS reports for outpatient medication and lab collection errors were tracked from December 2023 to March 2024 and from December 2024 to March 2025.
Procedures: A link to the questionnaire was sent to each participant’s employee email before the training. An embedded QR code was used to complete the post-training survey at the end of the sessions.
Results: Post-intervention medication administration errors decreased by 28%, p-value = 0.013. (Vieyra, 2025). No statistically significant changes occurred in clinic-collected and labeled lab errors. Significant improvements MA confidence levels and attitudes were noted as secondary outcomes.
Conclusion: Focused medication administration and lab safety simulated training decreased clinic-administered medication error and improved MA confidence levels. Continued evaluation and training for lab collection workflows will remain a process improvement focus.
How did you become interested in this area of research? I work as an APRN in outpatient clinics, where mostof the clinical staff are medical assistants who administer medications and collect labs. I routinely witness medical assistants lack confidence when intramuscular medications are ordered or if a dosage calculation is needed. Providers were often asked to help with calculations, particularly when Rocephin IM was ordered. Many medical assistants had difficulty with math calculations. I discussed this with the leadership in the walk-in clinic department to include math skill checkoffs annually.
My mentor is the vice president of Patient Care. Nursing leaders from outpatient clinics identified increasing numbers of medication and clinic-collected lab errors. My mentor identified this project and desired to implement expanded medical assistant training.
How has your project been introduced at Parkview? The data was presented to my mentor, the Nursing Research Evidence-Based Committee, and the Nursing Professional Development (NPD)team that showed significant improvement in medical assistantconfidence and medication administration knowledge. There was a 28% reduction in medication administration errors post training. The NDP have incorporated the medication dosage training and medication administration workflow simulation into routine orientations and offer refresher sessions for clinical staff needing skill renewal.
Post-graduation plans? I am currently PRN status at Parkview in the walk-in clinics.I am applying to nursing faculty positions to help advance APRN practice, and I’ve applied to be APRN candidate for the Indiana State Board of Nursing. I’llalso work in my garden and increase social activities with my church and neighbors.
