Doctor of Nursing Practice (DNP) Final Projects
The Doctor of Nursing Practice Final Projects collection contains the completed works of students from the DNP Program at Arizona State University's College of Nursing and Health Innovation. These projects are the culminating product of the curricula and demonstrate clinical scholarship.
Collaborating Institutions:
College of Nursing and Health Innovation
Displaying 1 - 10 of 10
Filtering by
- All Subjects: Communication
- All Subjects: Patient Portals
Description
Background: Health information technology (HIT) refers to the electronic health care systems organizations used to store, share and analyze healthcare information. A central component of the HIT infrastructure is an electronic health record (EMR) and although HIT has been shown to increase enthusiasm for patient care, decrease healthcare costs and improve patient outcomes overall utilization in the United States (US) remains low.
Methods: At an urban primary care pediatric office located in the southwestern US, an educational quality improvement project for healthcare practice providers and front office staff was conducted to increase the utilization of the existing EMR-linked patient portal. The healthcare providers were asked to complete a pre- and post- survey evaluation of their knowledge and usage of the patient portal. Provider and patient portal data usage was collected over a five-month period, September 2019 to January 2020.
Results: Data was analyzed using the Intellectus Statistics softwareTM. Significant results were found at the conclusion of the project in the number of active patient portal users, web-enabled, portal logins, labs published/viewed, messages sent, appointment reminders and Santovia utilization. At the end of the project no significance was found with messages received by the healthcare providers or staff through the patient portal. Survey results found significant differences between pre- and post- portal usage. No significance was found on providers’ knowledge on how to web-enable patients. Providers’ also demonstrated no significant change in their perceptions of the benefit in utilizing the portal in patient care after the educational intervention. Survey results allowed for additional analysis of commonly utilized portal functionalities, disease or health topics utilized in Santovia, and suggestions on how to make the use of the patient portal easier for providers.
Implications for Health Care Providers: This quality improvement project found that implementation an EMR-linked patient portal requires a comprehensive practice approach with structured education sessions. Including all employees can improve patient portal utilization. This educational project resulted in significant increases in most portal functionalities within 5 months. Further practice change evaluations are needed to evaluate how to improve patient portal utilization with a larger group of participants in a variety of outpatient settings.
Methods: At an urban primary care pediatric office located in the southwestern US, an educational quality improvement project for healthcare practice providers and front office staff was conducted to increase the utilization of the existing EMR-linked patient portal. The healthcare providers were asked to complete a pre- and post- survey evaluation of their knowledge and usage of the patient portal. Provider and patient portal data usage was collected over a five-month period, September 2019 to January 2020.
Results: Data was analyzed using the Intellectus Statistics softwareTM. Significant results were found at the conclusion of the project in the number of active patient portal users, web-enabled, portal logins, labs published/viewed, messages sent, appointment reminders and Santovia utilization. At the end of the project no significance was found with messages received by the healthcare providers or staff through the patient portal. Survey results found significant differences between pre- and post- portal usage. No significance was found on providers’ knowledge on how to web-enable patients. Providers’ also demonstrated no significant change in their perceptions of the benefit in utilizing the portal in patient care after the educational intervention. Survey results allowed for additional analysis of commonly utilized portal functionalities, disease or health topics utilized in Santovia, and suggestions on how to make the use of the patient portal easier for providers.
Implications for Health Care Providers: This quality improvement project found that implementation an EMR-linked patient portal requires a comprehensive practice approach with structured education sessions. Including all employees can improve patient portal utilization. This educational project resulted in significant increases in most portal functionalities within 5 months. Further practice change evaluations are needed to evaluate how to improve patient portal utilization with a larger group of participants in a variety of outpatient settings.
ContributorsProsev, Brittany (Author) / Jacobson, Diana (Thesis advisor)
Created2020-05-01
Description
Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a Federally Qualified Health Center (FQHC). The social cognitive theory underpins the project because patients' portal use behavior can change if changing their environmental factors in the clinic with educational videos.
Methods: The Universities Institutional Review Board granted exempt approval to ensure human subject protection. The participants included bilingual adult patients in an FQHC who have access to the internet and email addresses who visited the center during the implementation period. The tablets in the patient rooms displayed the English and Spanish educational video on step-by-step instructions on accessing, using the patient portal, and the benefits of use. The information technology technician pulled aggregate data from the analytics component of the patient portal before and after the four-week implementation period. The data included total number of clinic patients, number of active portal users, number of monthly logins, and gender. The project facilitator used descriptive statistics to compare pre-and post-intervention analytics. Results: Active portal users increased by 0.22% and monthly logins increased by 390 logins.
Only aggregate data was collected so the statistical significance was not calculated. Conclusion: This EBP project enhances knowledge on patient portal utilization's impact on patient engagement and may apply to current practice.
ContributorsHerrera, M. Sara (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Background: With the adoption of the Health Information Technology for Economical and Clinical Health (HITECH) Act of 2009, came the implementation of the electronic health record (EHR) and incentivized provider programs called Meaningful Use (MU). A goal of MU is to utilize patient portals to improve access to care. Current evidence supports patient portal use however providers are concerned about increased work load and lost revenue because of the time spent managing the portals rather than providing direct, billable patient care.
Purpose: The purpose of this project was to assess provider readiness for patient portals and provide an educational intervention to address perceived barriers.
Method: Ten providers at a large family practice clinic in the southwest United States were surveyed using The Provider Readiness Questionnaire prior to and after an educational intervention addressing common concerns.
Results: Improved response to patient portal use after the provider viewed the learning module. A paired-samples t-test was conducted to compare pre-and post-intervention responses. There was a statistically significant difference in the scores for the question “increase my workload” Pretest (M= 3.78, SD=1.201) and; Posttest (M=2.67, SD=1.225) ;(t (8) =5.547, p = .001). There was also a statistically significant difference for the question “increased provider professional satisfaction” Pretest (M=3.89, SD= .333) and Posttest (M= 4.44, SD=.527); t (8) = -2.294, p=.051).
Implications: Providing education addressing perceived barriers to portal use can assist the provider in understanding the value of the portals to improve patient outcomes and address common concerns about the impact of portal use on provider productivity.
Purpose: The purpose of this project was to assess provider readiness for patient portals and provide an educational intervention to address perceived barriers.
Method: Ten providers at a large family practice clinic in the southwest United States were surveyed using The Provider Readiness Questionnaire prior to and after an educational intervention addressing common concerns.
Results: Improved response to patient portal use after the provider viewed the learning module. A paired-samples t-test was conducted to compare pre-and post-intervention responses. There was a statistically significant difference in the scores for the question “increase my workload” Pretest (M= 3.78, SD=1.201) and; Posttest (M=2.67, SD=1.225) ;(t (8) =5.547, p = .001). There was also a statistically significant difference for the question “increased provider professional satisfaction” Pretest (M=3.89, SD= .333) and Posttest (M= 4.44, SD=.527); t (8) = -2.294, p=.051).
Implications: Providing education addressing perceived barriers to portal use can assist the provider in understanding the value of the portals to improve patient outcomes and address common concerns about the impact of portal use on provider productivity.
ContributorsLeal, Lauren (Author) / Velasquez, Donna (Thesis advisor)
Created2017-05-02
Description
Purpose: The purpose of this project is to demonstrate the benefits of therapeutic communication in a mental health clinic with an outcome to increase patient satisfaction of their care and improve patient-caregiver communication and relationship.
Background: The consequences of poor communication or non-therapeutic communication cannot be overemphasized; these can include non-adherence to treatment plan, reduced treatment compliance, higher psychological morbidity, dissatisfaction with care and poor patient-caregiver relationship. Patients’ perception of how they are being treated affects how they respond to treatment plans and medication regimens
Method: The project consisted of providing education on the principles of therapeutic communication to healthcare workers in an outpatient psychiatric clinic. Follow up materials on therapeutic communication principles were provided on a weekly basis for one month. A pre-survey questionnaire was given to patients before intervention and a post-survey questionnaire after intervention to determine patient satisfaction with care and degree of communication with healthcare workers. The Short Assessment of Patient Satisfaction (SAPS) and the Communication Assessment Tool-Team (CAT-T) were the instruments utilized in this project.
Finding: Patient satisfaction and communication with staff were statistically and significantly improved after education on therapeutic communication was given to staff.
Conclusion: Education on therapeutic communication is an effective intervention tool in improving patient’s satisfaction and communication with staff and health care team members in a psychiatric outpatient clinic.
Background: The consequences of poor communication or non-therapeutic communication cannot be overemphasized; these can include non-adherence to treatment plan, reduced treatment compliance, higher psychological morbidity, dissatisfaction with care and poor patient-caregiver relationship. Patients’ perception of how they are being treated affects how they respond to treatment plans and medication regimens
Method: The project consisted of providing education on the principles of therapeutic communication to healthcare workers in an outpatient psychiatric clinic. Follow up materials on therapeutic communication principles were provided on a weekly basis for one month. A pre-survey questionnaire was given to patients before intervention and a post-survey questionnaire after intervention to determine patient satisfaction with care and degree of communication with healthcare workers. The Short Assessment of Patient Satisfaction (SAPS) and the Communication Assessment Tool-Team (CAT-T) were the instruments utilized in this project.
Finding: Patient satisfaction and communication with staff were statistically and significantly improved after education on therapeutic communication was given to staff.
Conclusion: Education on therapeutic communication is an effective intervention tool in improving patient’s satisfaction and communication with staff and health care team members in a psychiatric outpatient clinic.
ContributorsUmoren, Marshall (Author)
Created2017-05-01
Description
Purpose: The purpose of this evidence-based practice project was to improve participation by increasing registration on to a medical patient portal to an uninsured population. Medical patient portals have the potential to provide patients with timely, transparent access to health care information and engage them in their health care process and management. This may result in improved disease management outcomes.
Methods: This project was guided by a The Rosswurm and Larrabee Model for Change to Evidence- Based Practice and Pender’s health promotion framework. IRB Approved by ASU. The instruction was implemented at an urban clinic in downtown phoenix that serves uninsured and underserved individuals. Uninsured participants were recruited (n=50). A survey pre and post registration was conducted to assess knowledge and medical portal participation in addition a random pre and post chart review was performed.
Results: Descriptive statistics was used to describe sample and outcome variables. A chi-square test of independence was calculated comparing pre and post intervention significant change was found (χ2 (1) = .002, P<0.05.), a paired sample t test was calculated to compare knowledge pre and post registration instruction the mean pre-10.187(SD = 4.422), post mean was 16.958(SD=.856). A significant increase of knowledge was found (t (47) =-9.573, p (<.001).
Outcomes: In this population both patients and providers have seen significant benefits such as increased communication and patient participation, from the implementation of evidence based educational tools such as instruction with teach back, and the usage of brochures. Potential Implication for sustainability includes the lack of a designated individual that is bilingual to register patients, making patients aware of the existence of a medical patient portal, patient’s fear of sharing immigration status.
Methods: This project was guided by a The Rosswurm and Larrabee Model for Change to Evidence- Based Practice and Pender’s health promotion framework. IRB Approved by ASU. The instruction was implemented at an urban clinic in downtown phoenix that serves uninsured and underserved individuals. Uninsured participants were recruited (n=50). A survey pre and post registration was conducted to assess knowledge and medical portal participation in addition a random pre and post chart review was performed.
Results: Descriptive statistics was used to describe sample and outcome variables. A chi-square test of independence was calculated comparing pre and post intervention significant change was found (χ2 (1) = .002, P<0.05.), a paired sample t test was calculated to compare knowledge pre and post registration instruction the mean pre-10.187(SD = 4.422), post mean was 16.958(SD=.856). A significant increase of knowledge was found (t (47) =-9.573, p (<.001).
Outcomes: In this population both patients and providers have seen significant benefits such as increased communication and patient participation, from the implementation of evidence based educational tools such as instruction with teach back, and the usage of brochures. Potential Implication for sustainability includes the lack of a designated individual that is bilingual to register patients, making patients aware of the existence of a medical patient portal, patient’s fear of sharing immigration status.
ContributorsAlvarado, Cecilia I. (Author) / Thrall, Charlotte (Thesis advisor)
Created2019-05-03
Description
According to The Joint Commission, most sentinel events in healthcare can be attributed to errors in communication. Thousands of medical students in the United States lack adequate communication training. Current literature illustrated that communication skills training programs increase confidence and communication skills of medical students and residents. These programs vary in techniques, with many including lectures and role play exercises. This project aimed to improve outcomes at a forensic facility in Arizona by utilizing a student role play intervention and lecture. Outcomes were measured utilizing developed pre- and post-intervention surveys. The surveys included a validated tool which measured four communication skill categories. A convenience sample consisted of pre-medical interns who participated in the project. The small sample size (four) led to descriptive statistics utilization to provide preliminary data. Prior to the intervention, communication skill average scores were as follows: listening (15), giving and getting feedback (12), sending clear messages (13.75), and handling emotional interactions (11.5). Post-intervention, the average scores for the communication skills were as follows: listening (18.25), giving and getting feedback (13), sending clear messages (16), and handling emotional interactions (12.75). Average scores for each category showed an increase after the implementation of the intervention. The survey was completed for four (100%) of participants, and 75 percent of participants stated they felt more confident with utilizing communication skills in their internship. A communication skills training program can enhance communication skills of medical trainees by providing structured support. Further research is needed on effective techniques to train medical trainees.
ContributorsIliescu, Michelle (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
Description
Purpose: The COVID-19 pandemic government regulations and mandates have caused feelings of overload, isolation, anxiety, depression, and loneliness. This project aimed to evaluate the level of impact of social distancing and homestay mandates on seniors during the COVID-19 pandemic. The knowledge from the data guided the implementation of Information Communication Technology (ICT) as a focused intervention to address loneliness, social
isolation, and depression among seniors.
Methods: Quantitative reviews were employed to assess the impact of ICT on lonely seniors. A convenience sample of 5 seniors aged 65 and up from a local church congregating in worship center located in southwestern United States enrolled in this voluntary pre-and post-educational intervention project. Participants were informed of the confidentiality of the study and that the study had no known risks on participants. The participants willingly signed a consent for the
study. The attendees received two one-hour education sessions on how to use WhatsApp and Zoom as communication strategies. The pre-and post-loneliness scale scores were collected using the Revised UCLA Loneliness Scale as a tool. Results were compared before and after the educational intervention using a paired Wilcoxon signed-rank test.
Results: The results indicate significant reductions in reported loneliness from pre to post intervention (z = -2.02, p = 0.043). These results indicate that using ICT can help address loneliness in the seniors.
Conclusion: Implementing communication strategies such as WhatsApp and Zoom effectively addresses social isolation and loneliness in seniors. The data reveals that integrating electronic communication in the life of the seniors can manage the social isolation problem. Future nursing practices may benefit from the project's data to address loneliness in the seniors.
ContributorsTambala, Sandikonda (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Purpose: Understanding the factors impacting communication between residents and peer staff in peer-run residential substance abuse treatment programs. The purpose of this paper is to explore male survival behaviors and cultural norms such as no snitching that impede communication to prevent relapse. Methods: The sample was male residents accepted into a residential treatment facility in the southwestern United States. Stories of peer-staff’s personal struggles with the no snitching code videotaped and shown in group followed with a guided discussion of relapse triggers, communication, and behavior norms that impede treatment. An online confidential pre-post retrospective survey designed using the Drug Abstinence Self-Efficacy Scale. Results: Descriptive statistics run show Cronbach's alpha of 0.96. A two-tailed paired samples t-test was conducted to examine the Overall Confidence Pre-test and Post-test mean difference. The overall confidence post-test was not statistically significant, but it was clinically significant. Clinical significance evidenced by residents 3-point lower confidence post-intervention. Conclusions: How-to elicit behavior change is unique to every individual. The goal is behavior change to sustain recovery and better communication between clients and peer staff to prevent relapse.
ContributorsKoreny, Danielle M. (Author) / Harrell, Liz (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-26
Description
Purpose: To integrate text messaging into a multi-component reminder system to improve influenza vaccination rates among children with chronic respiratory conditions.
Background: Influenza presents burdens for children with chronic respiratory conditions including increased mortality, morbidity, hospitalizations, and decreased quality of life for children and caregivers. Influenza vaccinations may reduce these complications yet approximately half of children remain unprotected annually. Synthesized evidence supports integration of text messaging into a multi-component strategy to increase the influenza vaccination rate in many populations of interest.
Methods: The intervention was a single text message and electronic mail message sent to all families in a private pediatric pulmonology practice who enabled text and/or electronic mail messages in the patient portal. A follow-up survey assessed various aspects of message receipt. Surveys were completed without collection of demographic information.
Results: Electronic mail messages were sent to 3140 addresses available in the patient portal. The number of text messages sent out via the patient portal was 75 with 66 (88%) delivered successfully. Follow-up surveys were initiated by 107 recipients. Frequency analysis showed that participants preferred text and electronic mail messages over other forms of communication. A statistically significant positive relationship was found utilizing Chi Square between those who received a message and those whose child received an influenza vaccination (p= .027).
Conclusions: Text and electronic mail messaging are cost-effective and well-received forms of communication that can be easily integrated into existing systems. These delivery routes are translatable to many populations and can convey various types of messages.
Background: Influenza presents burdens for children with chronic respiratory conditions including increased mortality, morbidity, hospitalizations, and decreased quality of life for children and caregivers. Influenza vaccinations may reduce these complications yet approximately half of children remain unprotected annually. Synthesized evidence supports integration of text messaging into a multi-component strategy to increase the influenza vaccination rate in many populations of interest.
Methods: The intervention was a single text message and electronic mail message sent to all families in a private pediatric pulmonology practice who enabled text and/or electronic mail messages in the patient portal. A follow-up survey assessed various aspects of message receipt. Surveys were completed without collection of demographic information.
Results: Electronic mail messages were sent to 3140 addresses available in the patient portal. The number of text messages sent out via the patient portal was 75 with 66 (88%) delivered successfully. Follow-up surveys were initiated by 107 recipients. Frequency analysis showed that participants preferred text and electronic mail messages over other forms of communication. A statistically significant positive relationship was found utilizing Chi Square between those who received a message and those whose child received an influenza vaccination (p= .027).
Conclusions: Text and electronic mail messaging are cost-effective and well-received forms of communication that can be easily integrated into existing systems. These delivery routes are translatable to many populations and can convey various types of messages.
ContributorsBay, Sarah L. (Author)
Created2016-05-03
Description
Background: Communication is a critical healthcare skill; communication errors in healthcare settings have produced sentinel events and caused patient deaths. Situation, Background, Assessment, Recommendation (SBAR), a standardized clinical communication format, is being introduced in nursing education to support early development of successful inter-professional communication. Role modeling has been shown to be an effective way to teach students complex communication skills.
Method: Pre-licensure nursing students participated in a high fidelity simulation experience. One group of students viewed a video role modeling SBAR before beginning the simulation (N=20). Student communication using SBAR was evaluated after the simulation experience for both groups. The second group of students did not view the video role modeling SBAR until after completing the simulation (N=20).
Results: Viewing a role modeling video on SBAR before participating in a simulation had no effect on the students SBAR performance after the simulation. The students’ evaluation of the video reported the video provided a clear, helpful demonstration of the SBAR communication method.
Conclusion: Role modeling can be used to improve students’ ability to apply SBAR, however more research needs to be done to determine the most effective way to role model the behavior.
Method: Pre-licensure nursing students participated in a high fidelity simulation experience. One group of students viewed a video role modeling SBAR before beginning the simulation (N=20). Student communication using SBAR was evaluated after the simulation experience for both groups. The second group of students did not view the video role modeling SBAR until after completing the simulation (N=20).
Results: Viewing a role modeling video on SBAR before participating in a simulation had no effect on the students SBAR performance after the simulation. The students’ evaluation of the video reported the video provided a clear, helpful demonstration of the SBAR communication method.
Conclusion: Role modeling can be used to improve students’ ability to apply SBAR, however more research needs to be done to determine the most effective way to role model the behavior.
ContributorsDay, Kimberly (Author)
Created2016-03-31