Degree Name
Nursing Practice, DNP
Publication Date
9-1-2025
First Advisor
Lisa Drake
Second Advisor
Beverly Clark
Abstract
Primary care teams develop lasting relationships with patients that can reveal subtle cognitive changes during routine visits (e.g., identity verification and brief mobility checks). Yet, cognitive decline often goes unnoticed and poorly documented, which can lead to delayed care. This quality improvement (QI) project addressed a gap in the detection of mild cognitive impairment (MCI), such as Alzheimer’s disease (AD), among frontline staff. It assessed whether an educational intervention could improve self-efficacy in recognizing early cognitive impairment, measured by the General Self-Efficacy Scale (GSES). Guided by Bandura’s Self-Efficacy Theory and Lewin’s change model, a quasi-experimental pretest–posttest study was conducted at a Houston-area primary care clinic with five medical assistants. Using the Plan–Do–Study–Act (PDSA) framework, a 30–to 40-minute session (lecture, role-play, discussion, and resources) was delivered. Self-efficacy was measured with the GSES immediately before and after; changes were analyzed using the Wilcoxon signed-rank test (α = .05). The GSES increased from M = 31.0 to M = 36.0; although the change was not statistically significant, W = 0.00, p = .109, post-test scores showed three participants' improvement, and two remained unchanged; none declined. Limitations include the small sample size, single site, and scheduling constraints. A brief, theory-based intervention was feasible and associated with meaningful gains in self-efficacy at the project site, supporting earlier recognition in primary care and informing nursing practice. Recommendations include incorporating AD/MCI detection into onboarding and refresher training, appointing a clinic “cognitive champion,” and scaling up these initiatives across various settings.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Guzman, Jicky, "Quality Improvement Project The Role of Targeted Education and Its Impact on Self-Efficacy and Cognitive Impairment Recognition Among Medical Assistants" (2025). Doctor of Nursing Practice Projects. 217.
https://arch.astate.edu/dnp-projects/217
