Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Graduate Programs Faculty


Doctor of Nursing Practice


A challenging issue in nursing education is the high rate of student failures, often referred to as attrition. Student failures have undesirable consequences for students and faculty, but more importantly, there are negative impacts at a broader system level, within institutions of higher education and the healthcare workforce. At the project site, thirty percent of practical nursing students failed their initial theory course even though these students met program admission criteria. This quality improvement project focused on nursing faculty and the lack of a streamlined process for early identification and referral of students at risk for academic performance issues. The purpose of this project was to design and implement a workflow process, a student success plan, and ongoing communication processes between faculty and learning resource center (LRC) staff. The project was guided by PDSA quality improvement methodology in three cycles: an educational session with survey analysis of attitudes and barriers, a staff interview to identify potential gaps in student services, and a group review of all referrals to evaluate overall adequacy of services. The project intervention included the design and implementation of a standardized, evidence-based workflow algorithm. Despite system barriers, the total number of student referrals entered into early alert system software improved significantly and faculty expressed an increased awareness in referral timing and identified additional categories of at-risk students. Nursing faculty were satisfied with the workflow algorithm but challenged with adherence based on a stated desire to self-remediate students within the department. Nursing faculty have opportunities for improved workflow processes and interprofessional collaboration to impact student success, also known as retention, and prepare qualified practical nurses for immediate entry into the workforce.