Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Carole A. Pepa


Stress is a complex phenomenon that has significant effects on students which may disturb their physiological, psychological, and spiritual health and well-being. Nursing students have been identified to be at high risk for stress during their education. Stress can arise from new clinical experiences, academic load, and personal stressors (Jones & Johnston, 2006). This increase in stress can lead to the student’s inability to assimilate and learn within the classroom and clinical settings. A review of the literature provided evidence that reported a positive relationship between guided imagery and a decrease in stress and anxiety. This evidence-based practice (EBP) project assessed whether a stress relief guided imagery intervention improved perceived stress in nursing students. The Stetler Model and The Neuman Systems Model guided this project. Fourth semester sophomore nursing students from the Fundamentals of Nursing class were invited to participate in the project. Participant demographics, and Cohen’s Perceived Stress Scale (PSS) were administered to students prior to the intervention. The intervention included 20 minutes of a stress relief guided imagery audio CD by Belleruth Naparstek. At the completion of the eight week period, the PSS was re-administered, and students completed a post intervention self-report survey of usefulness to evaluate project success. Paired samples t tests were performed on pre and post intervention PSS scores, which did not reveal a statistically significant difference (p = .239). Thirteen of 21 students had lower perceived levels of stress post intervention. The results of the post intervention survey indicated that 18 of 21 students would utilize guided imagery in the future, 19 of 21 students would recommend guided imagery to family, friends, and patients, and 20 of 21 students found guided imagery helpful in reducing school related stressors. Implications for future practice have been validated by the results of this EBP project. Based on the positive results of this project, the integration of guided imagery in undergraduate nursing curricula should be considered to reduce perceived stress among nursing students.