Date of Award

Spring 4-4-2024

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sheri Jacobson

Second Advisor

Anjal Pong


Practice Problem: Staff adherence to new procedures is crucial for ensuring patient safety, maintaining quality care, reducing risks and liabilities, and fostering a positive organizational culture that supports continuous improvement. Having a procedure done safely for patients infected with C.diff provides an overall benefit to the healthcare system.

PICOT: In an endoscopy lab staffed with nurses and surgical technicians (P), does the implementation of a new standardized process of administering FDA approved Fecal Microbiota Transplant Therapy (I) compared to the current process (C), increase staff adherence to the process (O) over 12 weeks(T)?

Evidence: Leadership, supervision, and organizational culture are crucial for promoting adherence to guidelines, while factors such as lack of knowledge, lack of confidence, organizational climate, and forgetfulness contribute to non-adherence. Direct observation proved invaluable in bridging the gap between perceived and actual actions, while workplace culture holds sway over compliance with procedures.

Intervention: Fecal microbiota therapy is recommended for preventing Clostridioides difficile infection recurrence, administered as an enema without sedation or bowel prep, unlike traditional options. A stepwise process was established to ensure proper execution, including creating a checklist to aid endoscopy unit staff who will assist in the procedures.

Outcome: Nurses generally adhered closely to the checklist, with one nurse at 75% adherence. Feedback was provided to improve infusion pace for optimal results, and overall staff adherence exceeded the 70% threshold, with 74% adherence. Even though no statistical significance was calculated, clinically, the checklist was an important tool to utilize when training nurses for the first time or when refreshing someone who hasn’t done a procedure in some time.

Conclusion: This DNP project aimed to establish a standardized process with a checklist for treating CDI, emphasizing the crucial role of nursing staff adherence in delivering safe, effective, and high-quality patient care.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

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