Date of Award

Spring 5-7-2021

Document Type

DNP Project

Project Team Faculty Member

Dr. Debra Jenkins

Project Team Faculty Member

Dr. Mary Zerlan


implementation strategies, project implementation, conceptual framework for implementation, cataract surgery, intranasal midazolam



Quality improvement projects improve processes for delivering safe and effective care to patients. Most protocols can be implemented successfully, but what factors lead to an unexpected outcome? This project sought feedback from anesthesia providers after a protocol for administering intranasal midazolam instead of intravenous midazolam in older adults during cataract removal had unfavorable results. Using the concepts developed by Proctor et al. (2010) to analyze the feedback from the anesthesia providers, this project sought to understand why this change in practice elicited these unfavorable results.

The goal of the change in practice was to improve turnover times and reduce resources by eliminating the need of placing an intravenous catheter for a procedure lasting less than 10 minutes. This project examined why this change in practice received unfavorable results by seeking input from anesthesia providers and perioperative nurses using open-ended questions. Upon examination of their feedback, the project investigator found patient dissatisfaction with the route of medication administration and provider’s inability to monitor dosage. Additionally, COVID restrictions imposed at the time provided opportunities for the project investigator to provide a self-evaluation of implementing a project during a very restrictive time that might not otherwise occur. Lessons learned from implementing a project during unconventional times can be invaluable to future DNP students and healthcare providers.

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