Campus Location

Dallas Campus (Online)

Date of Award


Document Type

DNP Project



Degree Name

Doctor of Nursing Practice

Committee Chair or Primary Advisor

Sandra Cleveland

Second Committee Member or Secondary Advisor

Roneisa Matero

Third Committee Member or Committee Reader

Donna Atobajeun


The American College of Cardiology and American Heart Association clinical practice guidelines recommend a cardiovascular risk assessment every 4–6 years in ages 40–75 to prevent cardiovascular disease. This DNP project aimed to improve awareness, compliance with cardiac risk assessments, and stratification of high and low-risk patients. This quality improvement project utilized the Johns Hopkins nursing evidence-based model to create the inquiry question and foundational plan for implementing the clinical practice guideline, calculating the cardiac risk score, and creating a clinical workflow process. A retrospective chart audit was guided by the Plan-Do-Study-Act (PDSA) method to collect pre- and postintervention data on compliance with the clinical practice guideline, and a pre-/posttest survey to measure the effect of an educational intervention on healthcare provider behavior. In evaluating the data, the PDSA allowed for revisions in the implementation plan. The goals of the DNP project were to reveal a 10% increase in compliance with the completion of cardiac risk assessments with the use of the workflow process and an increase in the data analyzed from the pretest and posttest to show an increase in knowledge of cardiovascular disease guidelines. The project study question was answered with 2 (4.4%) in compliance with completing the cardiac risk assessment postintervention. Low risk, less than 5% chance of having a cardiovascular event in the next 10 years, was predominantly N = 45 found among the participants with no cardiac risk assessment completed 43 (95.6%), the next highest level, intermediate, 12 (100%), and 2 (100%) were borderline. The difference between pre- and posttest survey results revealed with respect to the healthcare provider belief in question 7 (z = -2.000, p = .046) was statistically significant (p < .05). An inverse relationship with the ASCVD level, the risk is lower as HDL increases. The results of this DNP project suggest an evidence-based educational intervention can improve knowledge of screening cardiac risk assessment guidelines, compliance with the clinical practice guideline, and workflow process for a sustainable practice change leading to positive patient outcomes.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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