Kira Bloxom

Date of Award


Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chair

Sallyann Storer


COVID-19 (Disease)--Diagnosis, COVID-19 (Disease)--Treatment


Coronavirus-19 has been recognized worldwide as a respiratory illness that extended into a global pandemic in 2020. Despite the consistency of new reported diagnoses, many are eager to resume pre-pandemic life with less caution to the virus and its effect on healthcare. This project evaluated the use of a management protocol to improve Coronavirus-19 screening, testing, diagnosing, and treatment among adult patients in a primary care setting in Alabama. The project was implemented by two nurse practitioners, two medical assistants, and two clinic receptionists. Designed as a clinical practice change project, this intervention evaluated the following outcomes: staff knowledge level and rate of screening, testing, diagnosis, treatment, and isolation in managing patients at risk for coronavirus. Pre-intervention data showed a lack of screening and inconsistent testing, treatment, and isolation. There was no screening tool available for use and no COVID-19 management protocol for clinicians. Implementing a consistent triage process for use of a screening tool improved screening and testing rates. During the pre-implementation data analysis, no patients consistently screened for COVID-19 prior to assessment by the providers. Patients spent on average 10 to 15 minutes within the clinic’s waiting room in contact with other patients before COVID screening occurred in exam rooms. Two hundred ninety-six (296) eligible patient encounters were used in the project during the post-implementation phase. Two hundred seventy-five of the eligible patient encounters included (92.9%) COVID-19 screenings, and two hundred sixty-five (89.5%) patient encounters included testing via nasal swabs, polymerase chain reaction (PCR) tests. One hundred four patient (35%) encounters included a documented positive coronavirus test. Providers provided treatment and isolation orders to all one hundred-four patient (100%) patient encounters with diagnoses of coronavirus. Lastly, each staff member scored 100% on the post-training session clinician knowledge check survey indicating increased provider knowledge levels with managing COVID-19 in the primary care setting. This project addresses the clinical practice gap causing missed diagnoses of COVID-19 and increased risks for infection. More importantly, early recognition and management of COVID-19 through screening and appropriate treatment created an opportunity to improve access to care and advance health equity in rural Alabama.

Available for download on Wednesday, June 11, 2025