Abstract
Stress among undergraduate nursing students is a well-documented concern that negatively affects academic performance, clinical readiness, well-being, and program retention. Stress levels are often heightened before clinical skills check-offs, highlighting the need for practical, evidence-based interventions. This Doctor of Nursing Practice quality improvement project examined whether mindfulness-based mandala coloring could reduce perceived stress in undergraduate nursing students. Using the PICOT framework, the project evaluated whether undergraduate nursing students (P) who participated in mindfulness-based mandala coloring (I), compared with no intervention (C), experienced reduced perceived stress levels (O) over a 12-week implementation period (T).
A comprehensive search of the literature supported the use of mindfulness-based and art-based interventions to reduce stress and improve emotional regulation in college students. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and the Plan–Do–Study–Act framework, a mindfulness-based mandala coloring intervention was implemented prior to clinical skills check-offs. Stress was measured using the Perceived Stress Scale (PSS-10) to establish baseline levels, with pre- and post-intervention surveys used to assess effectiveness.
Results demonstrated a slight overall reduction in mean perceived stress scores and positive student-reported outcomes, including improved calmness, focus, and emotional control. Although unmatched surveys limited individual-level statistical analysis, findings indicate the intervention was feasible, acceptable, and beneficial. This low-cost, scalable strategy has meaningful implications for nursing education, with sustainability supported through integration into routine clinical preparation and dissemination through academic and professional channels.
Date of publication
4-2026
Document Type
DNP Scholarly Project
Language
english
Persistent identifier
http://hdl.handle.net/10950/5035
Committee members
Deanna Adams DNP, APRN, AGACNP-BC, FNP-C, GS-C, CEN, Committee Chair
Degree
Doctor of Nursing Practice
Recommended Citation
Wallace, Elaine, "DNP Final Report: An Evidence-Based Project To Decrease Stress In Undergraduate Nursing Students" (2026). DNP Final Reports. Paper 78.
http://hdl.handle.net/10950/5035