First Advisor

Dr. Kathleen Whalen


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

65 pages


Improving Self-Efficacy and Nursing Knowledge in Cardiac Step-Down Unit Nurses


The Cardiac Step-Down Unit (CSDU) is a fast-paced, high-acuity patient unit that consists of patients with a variety of complex medical issues. Many nurses working on this CSDU have worked as a nurse for three years or less, many being new graduates. Each CSDU patient has multiple nursing needs, some of which the nurses have not received additional education or training. This can lead to stress and frustration on the part of the nurse, and less than optimal care for the patient. The purpose of this quality improvement (QI) initiative was to explore the effect of an evidence-based cardiac education program on the nurses’ level of self-efficacy and cardiac nursing knowledge. A one-group, pre- and post-test design with a convenience sample was performed using the General Self-Efficacy Scale (GSE) and test questions based on the American Association of Critical Care Nurses (AACN) progressive care certification exam. The independent variable was the evidence-based cardiac education program presented, and the dependent variable was the CSDU nurses’ level of self-efficacy and nursing knowledge. The data was analyzed to determine if a correlation existed between the intervention and the dependent variables. In the paired samples t-test for self-efficacy, the pre- and post-test results were statistically significant (t= -11.640, p=.000), and for nursing knowledge (t= -15.285, p=.000), also significant, showing an increase in both self-efficacy and nursing knowledge after the education program. As patient care continues to increase in complexity, nurses need to meet the ongoing challenges that go along with it. While this project demonstrated an increase in self-efficacy and nursing knowledge in these nurses, additional research is needed to determine the most effective educational interventions for nurses in various clinical settings.

Key words: Nurse retention, DNP project, high-acuity nursing units, nursing education

Date of Award

Spring 2021

Location (Creation)

Denver, Colorado

Included in

Nursing Commons