Date of Graduation

Fall 12-12-2014

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions



First Advisor

Timothy S. Godfrey SJ, DNP, RN, PHCNS-BC

Second Advisor

Barbara Sattler, RN, DrPH, FAAN

Third Advisor

William J. Bosl, PhD


There are 30 million people in Nepal, 85% live in rural areas and have access to 15% of health care resources. This deficit in health care resources is supplemented by services provided by non-governmental organizations who organize short-term medical missions. At a rural Nepalese health post 45% of the patients complained of abdominal discomfort. As the prevalence of helicobacter pylori is 50-90% in Southeast Asia, the patients believed that they had helicobacter pylori.

In resource-poor communities, there is a gap between best practices and the care delivered. To decrease the gap in one rural Nepalese health post, a Nurse Practitioner implemented a Helicobacter pylori test and treat program at a health clinic. This project was designed to identify the causes of abdominal discomfort and provide disease-specific treatment. Among those tested 25% were Helicobacter pylori positive and received antibiotics. The other 75% were treated using evidence-based protocols according to the characteristics of their symptoms, lifestyle, and diet.

The aim of this project was to improve health care quality by decreasing the prevalence of abdominal complaints at a Nepalese health post. This paper delineates a process to implement a quality improvement program in short-term medical missions. The role of the Nurse Practitioner employing the Doctor Nursing Practice core measures facilitates improvement in health care processes to close the quality chasm in resource-poor communities.