Publication Date

Spring 2023

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Denise Dawkins

Second Advisor

Robin L. Whitney

Third Advisor

Denise Stough


Utilization Review, Evidence Based Guidelines, Nursing Education


The quality improvement project focused on determining why utilization review nurses submitted epidural steroid injection treatment requests within evidence-based guidelines to peer review. The study reviewed six months of data from June 2022 through December 2022 to develop a pre-training baseline for the number of epidural steroid injection treatment requests approved by the nurse and approved by peer review. Deming's method for quality improvement was identified as the framework for implementing changes. The UR nurses were provided four weeks of refresher training on applying evidence-based guidelines to epidural steroid injection treatment requests. Post-group training sessions reflected a 91% increase in the UR nurse's approval of epidural steroid injection treatment requests. The rationale for submitting the epidural steroid injections treatment request was unexpected; however, the explanation was consistent with the nursing advocacy and purpose of utilization review.

Included in

Other Nursing Commons


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