First Advisor

Cullen, Patricia L.

Second Advisor

Ernst, Diane


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

87 pages


Executive Summary
Capstone Project Title Reducing Variability Among Multiple Operators Using a Single Technique and Device for Skin Prick Testing in Children
The variability in performance among skin prick test (SPT) operators who performed the twist technique versus the prick technique was raised within the Pediatric Program at the Study Site. Confidence in the SPT results was threatened, treatment plans were delayed and diets remained restricted.
This Doctor of Nursing Practice (DNP) Capstone Project was designed to identify a single device and technique that could be used at the facility to reduce variability, increase reliability, and standardize the skin prick test procedure using a single technique and device within the institution. This inexpensive test has the potential to yield enormous results at a single visit and dictate life saving treatment, which is patient specific.
Research Study Objectives
The PICO (Population, Intervention, Comparison, Outcome) research question asked: (P) Among children ages 1 year through 16 years receiving skin prick testing for diagnosis and treatment of their allergic disease, (I) does the Quintip device puncture technique or Duotip device twist technique (C) when compared to the Duotip prick technique (O) decrease variability and increase reproducibility of results when conducted by multiple operators? The Capstone Project successfully identified a single technique and device to be used by multiple operators to provide high quality, reliable, and valid allergy skin testing results for at-risk patients.
Research Methods and Procedures
This DNP Capstone Project was a prospective, double-blind clinical trial using a convenience sample in which pediatric research participants underwent SPT in a single session, with a single operator using the Duotip twist and Quintip puncture techniques as compared to the Duotip prick/lift technique.
Study Results
Comparing results between the three techniques and two devices, the Quintip twist method was most sensitive (97%) as compared to the punch technique (86%) and prick/lift technique (89%). Only 2.8% of those tested using the twist technique produced false negative responses to histamine as compared to 14% (Quintip punch) and 11.1% (Duotip prick/lift).
Implications for Practice and Future Research
As new SPT technique and devices are introduced, ongoing research will be necessary to evaluate variability and respoducibility among operators, to ensure improvements in diagnosis and treatment food, drug and environmental allergies can be achieved.

Date of Award

Fall 2015

Location (Creation)

Denver, Colorado

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