Gail Davis

Degree Name

Doctor of Nursing Practice (DNP)

Document Type

Project Paper


Zvart Onanian School of Nursing



Date of Original Version



Background: Exposure to environmental tobacco smoke is a leading cause of respiratory illness in children. Although evidence-based best practices to improve outcomes are well-documented, they are inconsistently implemented.

Purpose/Specific Aims: The purpose of this project was to improve provider implementation of evidence-based best practices in environmental tobacco smoke exposure reduction in children. The overarching aim was to reduce related morbidity and mortality. Specific aims included increased knowledge and skill related to best evidence-based practices, and fostering implementation in practice.

Methods: This project involved a quasi-experimental quality improvement design involving an educational intervention on the scope and nature of the problem, the potential for impact, and evidence-based strategies to enhance the feasibility of intervention in the office setting. Differences between pre and post-test outcomes were analzed. A second follow up post-test was implemented at 1-2 weeks post-intervention to assess improvement in practice.

Results: Of 56 eligible employees, 31(55.4%) attended the presentation. The average pre-test score of 4.31 out of a total of 5 demonstrates a strong baseline knowledge. The average post-test score was 4.67 demonstrating a significant improvement (p <0.01).

Conclusion: The project’s resulted in significant improvement in provder knowledge, and uptake of best practices in environmental tobacco smoke exposure reduction. This improvement was consistent regardless of role or area of practice. The average pre-test score of 4.31 out of a total of 5 demonstrated a strong baseline knowledge and was consistent with state-wide performance in smoking reduction. There was strong participation engagement with 55.4% of eligible employees attending.