Date of Doctor of Nursing Practice Project Completion

Summer 8-7-2026

Faculty Advisor

Faith Strunk, PhD, RN, APRN, FNP-BC

Abstract

Purpose

The purpose of this quality improvement (QI) project was to increase provider adherence to Rubeola IgG serology screening during prenatal visits at an outpatient women’s health clinic by 10% from a baseline adherence rate of 63.3%.

Background

Rubeola remains a highly contagious viral infection that poses health risks for nonimmune pregnant patients and their newborns. With increasing Rubeola cases and the importance of identifying immunity status during pregnancy, consistent prenatal screening practices are essential. Baseline data demonstrated inconsistent adherence to Rubeola IgG screening recommendations, highlighting the need for workflow interventions to improve provider compliance.

Methodology

A pre-post QI design guided by the Iowa Model and Donabedian framework evaluated interventions consisting of provider education, visual workflow cues, and audit-and-feedback. Pre-intervention data included 2,568 chart reviews from October 2025 to January 2026. Post-intervention data included 2,173 chart reviews from January to April 2026. Data were analyzed by comparing pre- and post-intervention adherence rates. Project limitations included manual chart extraction due to limited access to Epic reporting.

Results

Provider adherence to Rubeola IgG screening increased from 63.3% pre- intervention to 75.1% post-intervention, an 11.8% increase. 

Implications

The implementation of provider education, visual cues, and audit-and-feedback showed that workflow-based interventions can improve adherence to evidence-based serology screening practices. These strategies identify nonimmune individuals, reduce community transmission during the surge, protect vulnerable populations, and avoid the operational costs of a facility outbreak.

Keywords

Quality improvement, Rubeola screening, prenatal care, provider adherence, audit and feedback

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