Date of Conferral

10-21-2026

Date of Award

October 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

Summary This quality improvement (QI) project evaluated a practice change at a rural ambulatory care clinic where patients’ menopause symptom experiences were often underrecognized and screening relied on a nonvalidated assessment supplied by a hormone-product vendor. The purpose was to determine whether replacing that tool with the validated Menopause-Specific Quality of Life (MENQOL) questionnaire, with staff education and a consultation-first, symptom-focused workflow improved documentation and patient-reported outcomes. Guided by the Plan-Do-Study-Act framework, preimplementation and postimplementation patient surveys were compared using descriptive statistics and independent-samples t tests, and patient comments and staff interviews were reviewed for themes. Documentation compliance was complete, and patient ratings remained high without statistically significant differences, showing that the vendor-neutral process maintained patient experience. Qualitative findings were stronger: The provider reported that asking the MENQOL questions changed the encounter and invited patients to discuss sensitive symptoms, and patients described feeling heard and better understanding their symptoms. Recommendations are to sustain MENQOL and the new workflow, add electronic health record prompts, continue staff education, and address the telephone access and follow-up barriers identified. For nursing practice, standardized assessment helps nurses identify undisclosed symptoms. The project supports positive social change by strengthening patient voice, health literacy, and shared decision making, and it advances diversity, equity, and inclusion by offering every eligible woman the same validated assessment regardless of intent to purchase products.

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