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: Burnout
- All Subjects: Human Papilloma Virus
The purpose of this project is to implement an on-site mindfulness-based intervention to reduce stress and burnout among mental health care workers. Healthcare professionals are among the most stressed of any profession, and mental health workers are at an extremely high risk for burnout and compassion fatigue (Christopher & Meris, 2010) with an estimated 21% to 67% of mental health workers reporting that they experience high levels of burnout (Salyers et al., 2011).
After researching the literature, it was evident that practicing mindfulness can lead to less stress and higher job satisfaction. In an effort to combat this problem, an on-site mindfulness intervention was implemented at an outpatient psychiatric setting for eight weeks. Twenty-seven mental health workers gave their consent to be part of the study, and eleven were able to complete the study and self-assessment surveys for three time periods. The Maslach Burnout Inventory (MBI) (the Human Service Version) and a 1-item job satisfaction were used to measure the effect of intervention on employees’ levels of stress and job satisfaction.
A non-parametric Friedman test of differences among repeated measures was conducted and findings were not significant when comparing the average total scores of means between pre-, post-, or 1-month follow-up for Emotional Exhaustion (p = .148), Depersonalization (p = .223), Personal Achievement (p = .784) and job satisfaction (p = .422). The positive outcomes cited by participant support the thesis that the on-site mindfulness-based intervention is better than no intervention though the effect was not statistically significant.
Study Design: Ten health care providers from Vaccines for Children (VFC) clinics in New Mexico were included in this pretest/posttest study. Providers were given a questionnaire adapted from the Determinants of Intent to Vaccinate (DIVA) questionnaire. Only two subscales were utilized for this project (total of 10 items): Adaptation to the Patient’s Profile and General Practitioner’s Commitment to the Vaccine Approach. Martinez et al. (2016) suggest that PCP’s commitment to the vaccination approach” can be used as a stand-alone tool with a Cronbach’s alpha > .70. Following the pretest, which served as consent, providers viewed a short, four video series addressing common barriers to the HPV vaccine, followed by the same questionnaire. First and second dose rates of the HPV vaccine were measured prior to the intervention and three months post intervention using the New Mexico Immunization Information System (NMSIIS).
Results: A Wilcoxon Ranks test was used for statistical analysis of the survey responses. Alpha was set at ≤ .10. Four of the 10 questions were statistically significant for increasing provider intent to vaccinate. HPV first dose rates increased in all three clinics and second dose rates increased in two out of the three clinics.
Conclusions: Web-based education is a successful intervention for increasing
provider intent to vaccinate and first and second dose HPV administration rates. Not only can the intervention be used for the HPV vaccine, but to help increase administration rates of all other vaccines.
In today’s healthcare environment, there is ample evidence to support early identification of disease and implementation of effective treatment to improve patient outcomes. The objectives of this clinical intervention were twofold; the implementation of an innovative change within an organization, allowing for systematic screening through incorporation of the Mood Disorder Questionnaire (MDQ), and evaluation of mental health provider’s willingness to incorporate practice change.
A pre- and post-quasi-experimental design evaluated the attitude of providers regarding practice change using the Evidence-Based Practice Attitude Scale and the utilization of the MDQ following educational intervention. Parametric testing was used to explore the relationship between education specific to practice change and the provider's attitude through the use of the paired t test. The Chi-square test evaluated the use of the MDQ by clinic healthcare providers in relation to an innovative practice change.
Results of this study illustrate enhanced provider willingness to adopt innovation and increased MDQ use following the intervention. Ensuring provider access to screening tools and education during the process of practice change provides a strategy for early intervention enhanced willingness to support practice evolution.
The human papillomavirus (HPV) is the most commonly spread sexually transmitted infection in the United States. Although the HPV vaccine protects against transmission of the most common strains of HPV that cause genital warts and numerous urogenital cancers, uptake in the United States remains suboptimal. Failure to vaccinate leaves individuals vulnerable to the virus and subsequent complications of transmission. The evidence demonstrates that provider recommendation alone increases rates of vaccine uptake. The literature does not suggest a specific method for provider recommendation delivery; however, best practice alerts (BPAs) were correlated with increased vaccination rates.
These findings have directed a proposed project that includes an electronic health record (EHR) change prompting internal medicine, family practice and women’s health providers to educate and recommend the HPV vaccine at a Federally Qualified Health Center (FQHC) in the Southwest United States. The project demonstrates that after the implementation of a practice change of a HPV BPA in the EHR, HPV vaccination rates increased. Practice settings pre and post were similar, making the increase clinically significant.
The strengths of this project include an increase in HPV vaccination rates, a sustainable intervention, and an intervention that can easily be replicated into other health maintenance tasks. There were some limitations including the BPA alert only catching the HPV 9 vaccine series and the BPA did not always capturing historical data. Despite these technical barriers the HPV BPA delivered an increase in the HPV vaccine to protect more individuals from the HPV virus, increased provider adherence to national guidelines, and provides a platform for BPAs to be utilized for other vaccines.
Identifying Opportunities for Process Improvement in Innovative Healthcare Technology Implementation
SolarSPELL is a digital learning library created at Arizona State University for
educational environments in the Pacific and East Africa. The library is curated to deliver information to resource-challenged communities around the world, providing culturally relevant materials in a solar-powered data repository. A new SolarSPELL health library was deployed in a border-adjacent community in Sonora, Mexico to enhance health education resources. The Sonoran SolarSPELL (SSS) library is a community-driven model established through Doctor of Nursing Practice (DNP) leadership and reflects the innovative focus of SolarSPELL.
The purpose of this report is to contextualize the Sonoran SolarSPELL experience, identify opportunities for process improvement and innovative leadership, and identify an evidence-based framework to guide implementation in new communities. Implementation framework utilization is especially important in the integration of technology into healthcare settings, where barriers can be novel and complex. Key focal points included the development of strong partnerships with the community members, collaborative design, and leadership roles of DNPs in project development and implementation. This study provides a paradigm for both DNP leadership and the application of innovative healthcare technologies in under-served communities throughout the world.