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.
Filtering by
- All Subjects: Communication
- All Subjects: Survivorship
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.
There is an increasing number of cancer patients outliving their diagnosis and treatment and requiring more support as they transition to cancer survivors. To bridge this gap, survivorship care plans should be provided to all cancer survivors to provide post treatment plans of care, recommendations, and resources (Commission on Cancer, 2016). A quality improvement project was implemented in the urology practice of a National Cancer Institute-designated, academic hospital in Phoenix, Arizona to provide survivorship care plans to prostate cancer patients with surgical intervention as their cancer treatment.
Through interprofessional collaboration, the process change was designed and implemented with the residents and Physician Assistants of the urology practice. There was a 93% adherence rate in delivering the survivorship care plans during the project. The “Confidence in Survivorship Information” questionnaire was used to measure the patients’ confidence in survivorship information prior to and after receiving a survivorship care plan. A paired t-test showed statistical significance in improvement in confidence in the knowledge of long-term physical effects of cancer treatment, strategies for preventing and treating long-term physical effects, and resources available for family members who may be at risk. The project will continue in order to meet requirements for cancer programs established by the Commission on Cancer (Commission on Cancer, 2016).
Cancer survivors meet survivorship with uncertainty due to a lack of uniform information provided post cancer treatment. The implementation of survivorship care plans (SCP) has been recognized by key stakeholders as the solution to transitional uncertainties. In fact, to achieve accreditation by the Commission on Cancer (CoC) cancer centers are required to deliver SCPs to cancer survivors within a year of their treatment completion. Research demonstrates SCP delivery results in significant improvement in patient satisfaction, coordination of care, and survivorship care knowledge.
In order to meet CoC standard 3.3 and bring understanding to SCPs function in cancer survivorship care a quality improvement project was initiated within an Arizona cancer center. SCPs were delivered at a survivorship visit to adult breast cancer patients. SCPs affect on survivors’ confidence in cancer self-care knowledge and care satisfaction was evaluated as well as the organization’s adherence to CoC standard 3.3 requirements. Identified survivors were scheduled for a survivorship visit where a SCP was delivered by a oncology provider.
Survivors perceived confidence in knowledge and satisfaction was measured using the modified 16-item Confidence in Survivorship Information Questionnaire (CSI). Questionnaires were completed pre and post survivorship visit. A paired t-test analysis was used to evaluate SCP effectiveness. There was an increase in the delivery of SCPs from zero to 57 with an 84 percent SCP delivery from August 2017 to January 2018. Survivors and providers verbalize value in SCPs.
No statistical significance was found in the comparison of SCPs affect on survivors’ confidence in cancer self-care knowledge and care satisfaction to that of standard follow-up care; however, when comparing the pre/post questionnaire averages an improvement was noted across the board.The prospect of this project is to unveil the impact SCP delivery at a survivorship visit has on the selected metrics. This project aids as a director for organization wide implementation for CoC standard 3.3 requirement compliance.
Cancer survivorship has been identified as separate stage in cancer treatment posing unique issues that arise from the diagnosis of cancer, as well as late effects associated with treatments. Evidence shows that cancer survivors demonstrate suboptimal follow-up care, and report high levels of unmet needs related to their cancer experience. To improve care for the increasing number of cancer survivors in the United States, survivorship care plans (SCPs) have been proposed as way to strengthen care coordination and improve patient outcomes.
Research suggests that SCPs have favorable impact on patient satisfaction and quality of life, however little research to date investigates the utility of SCPs in improving patient outcomes, adherence to follow-up recommendations, or patients’ confidence in self-care management. To further understand the role of SCPs in survivorship care, a pilot implementation of SCPs in colon cancer patients was implemented to gather data on the identified gaps.
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.