Date of Conferral

4-6-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Gross

Abstract

This quality improvement project aimed to enhance the assessment of dyspnea in patients presenting with shortness of breath, particularly those with asthma, through a staff education program. At the practice site, staff primarily relied on SpO₂ readings to evaluate dyspnea, which often led to misassessment and delays in care. The project addressed this gap by providing urgent care staff with training on comprehensive assessment techniques, including evaluation of respiratory rate, work of breathing, ability to speak, patient history, and use of validated tools such as Borg’s scale and peak flow meters. Twenty triage staff members participated, including licensed practical nurses, paramedics, certified nurse assistants, and registration staff. A pretest–posttest design was employed to evaluate the intervention’s impact. Data were analyzed using descriptive and inferential statistics with IBM SPSS (Version 25). Results showed significant improvements: assessment accuracy increased from 75% to 90%, staff skills from 65% to 85%, and compliance with triage protocols from 60% to 90% (p < .01). Mis-triage rates decreased (over-triage from 15% to 5%, under-triage from 25% to 10%), and patient wait times for urgent cases dropped from 120 to 15 minutes. These findings demonstrate that staff education can improve diagnostic precision, decision-making efficiency, and patient flow, ultimately enhancing outcomes for patients with dyspnea. Although limited by sample size and project duration, this initiative highlights the value of comprehensive assessment training in urgent care settings. Broader adoption could strengthen nursing practice and contribute to equitable, timely care for patients with respiratory conditions.

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