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 - 7 of 7
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- All Subjects: Nurses
Description
Background: Pressure injuries inflict a major, preventable burden onto hospital systems, healthcare providers, and patients. The purpose of this evidence based project was to evaluate the impact of a pressure injury prevention education program on nursing staff knowledge and pressure injury rates in an Arizona post-cardiac care unit.
Method: A single group pre-test post-test design was utilized to evaluate nursing staff knowledge before and after an education program on pressure injury prevention. Staff knowledge was evaluated using a modified version of the Pressure Ulcer Knowledge Assessment Tool 2.0. Participants completed pre- and post-education surveys. Rates of hospital acquired pressure injuries were obtained via chart review.
Results: Pre- and post-education scores were analyzed in participants who completed both surveys using a paired t-test. Post-education scores (M = 0.73, SD = 0.07) were significantly higher than pre-education scores (M = 0.59, SD = 0.09); t(7) = -5.39, p = .001. Pre- and post-education median scores of all participants were analyzed using two-tailed Mann-Whitney U test. Post-education scores (Mdn = 0.71) were significantly higher compared to pre-education scores (Mdn = 0.56); U = 102.5, z = -4.05, p = .001. Monthly incidence of pressure injuries on the unit increased following education.
Discussion: Increase in scores from pre- to post-education surveys indicate staff knowledge improved. The increased incidence of pressure injuries is thought to be secondary to staff’s increased ability to detect pressure injuries. Staff education is recommended, but more research is needed regarding the impact on pressure injury rates.
Method: A single group pre-test post-test design was utilized to evaluate nursing staff knowledge before and after an education program on pressure injury prevention. Staff knowledge was evaluated using a modified version of the Pressure Ulcer Knowledge Assessment Tool 2.0. Participants completed pre- and post-education surveys. Rates of hospital acquired pressure injuries were obtained via chart review.
Results: Pre- and post-education scores were analyzed in participants who completed both surveys using a paired t-test. Post-education scores (M = 0.73, SD = 0.07) were significantly higher than pre-education scores (M = 0.59, SD = 0.09); t(7) = -5.39, p = .001. Pre- and post-education median scores of all participants were analyzed using two-tailed Mann-Whitney U test. Post-education scores (Mdn = 0.71) were significantly higher compared to pre-education scores (Mdn = 0.56); U = 102.5, z = -4.05, p = .001. Monthly incidence of pressure injuries on the unit increased following education.
Discussion: Increase in scores from pre- to post-education surveys indicate staff knowledge improved. The increased incidence of pressure injuries is thought to be secondary to staff’s increased ability to detect pressure injuries. Staff education is recommended, but more research is needed regarding the impact on pressure injury rates.
ContributorsHolloway, Jonathan (Author) / Ochieng, Judith (Thesis advisor)
Created2020-04-16
Description
Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as well as exposure to patient’s trauma. The aim of this project was to decrease burnout among psychiatric nurses in a private practice out-patient family psychiatric facility using Rossworm and Larabee’s change model (Appendix D). The MBI-HSS was completed by 1 participant (n=1) at pre-intervention and post-intervention. Between the pre/post MBI-HSS questionnaire the participant was asked to partake in a mindfulness-based intervention utilizing the smartphone application Headspace to complete a 10-session meditation course over one week. The results conclude the participant’s burnout decreased overall from pre-intervention to post-intervention. Internal Review Board (IRB) was granted in September 2021, and the project was completed in November 2021. The impact of the project was projected to have a more thorough statistical influence, but due to the participant size, there is minimal impact of system or polices in the psychiatric facility.
ContributorsSteward, M. Shannon (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-30
Description
Purpose & Background: Nurses regularly have encounters with traumatic and stressful events
which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention would reduce burnout levels among registered nurses (RNs) working in in-patient settings.
Methods: Participants enrolled in nursing programs from a local university were recruited for the project with the following inclusion requirements: (1) RNs working in an in-patient setting, (2) aged 18 years old or older; (3) fluent in the English language. Participants completed a pre-survey and then enrolled in a free mindfulness application via their phone or computer. Participants listened to one ten-minute mindfulness session for a consecutive ten days and then completed a post-survey.
Results: Data collected from the pre and post surveys included the use of the following valid and reliable instrument tools: Copenhagen Burnout Inventory, Brief Resiliency Coping Scale, and Short Form Health Survey. Data was analyzed using descriptive statistics and the Wilcoxon Signed Ranks Test. The analyzed data showed that there was statistical significance in decreased burnout levels, increased resiliency, and increased health perceptions of the participants.
Conclusion: By finding ways to cope with the experience of burnout in nurses, nurses’ mental health wellness can improve in order for nurses to continue to be an integral part of the healthcare system.
ContributorsPanopio, Christine (Author) / Chen, Angela (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-06
Description
Background: Workplace violence (WV) is a significant problem in healthcare that affects the nurses' physical and mental health and impacts patient care. This is costing healthcare organizations millions of dollars for damage control as there is a lack of prevention. Hence, this evidence-based practice project uses the theory of planned behavior and nursing process discipline theory to explore the effectiveness of screening patients for violence.
Method: After an aggregate IRB approval, a violence screening tool with high sensitivity and specificity, Broset Violence Checklist (BVC), was implemented twice daily and as needed for 15 days with 275 adult patients in a neurology/telemetry unit to help identify patients at high-risk for violence. All interventions and procedures were based on established policies, not the BVC score.
Results: A generalized estimating approach with a logit link and linear regression was used for data analysis. Of the 1504 BVC screenings completed, 43 violent incidents were reported, with interventions recorded in 106 (7.1%) screenings. Patients with a BVC score of <2 required an intervention 16 times (1.2%), and BVC score of >2 required an intervention 90 times (54.2%), OR= 17.95 (95% CI: 3.55 to 90.84), p< 0.001.
Discussions: Total BVC score, male gender, and older age were highly predictive of violence. Also, as the BVC score increased above 1, additional interventions were utilized.
Conclusion: The BVC has value, indicating that patients who score above 1 can pose enough threat to require an intervention. Thus, uncovering risks and identifying the potential for violence is essential to diminishing harm and WV.
ContributorsSilwal, Sadikshya (Author) / Moffett, Carol (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-01
Description
Objective: Mental health illnesses are complex conditions that afflict many university students. International students are uniquely vulnerable to these conditions due to challenges such as adjusting to the new environment and culture of American universities. They are also less likely than domestic students to receive mental health services. Research indicates that there are obstacles for international students when it comes to seeking mental health services, but these obstacles are typically over-generalized and less applicable to each specific university setting. The purpose of this paper was to assess the barriers in seeking mental health services by international students. Participants: International students at a large university located in Southwestern United States. Students 18 years of age or older, enrolled as an international student, proficient in English, exhibiting mental health symptoms, and refusal of primary care physician’s referral to mental health services. Method: Physicians at Health Services verbally recruited the participants during routine visits. Participants did not provide any personal information, and completion of the questionnaire indicated their consent. This project was guided by the model of mental health help-seeking, where a questionnaire was administered to students, allowing them to identify what specifically prevents them from receiving mental health services.
Result: Due to the COVID-19 pandemic, only 1 questionnaire was completed, but it was rejected as it was filled by domestic student. Conclusion: The data gathered through this questionnaire was intended to be provided to university healthcare providers to better understand how they can connect with international students with mental health concerns.
ContributorsSaqib, Syed (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Healthcare organization leaders greatly rely on evidence-based practice (EBP) to guide the delivery of care and support clinical decisions on patient care. EBP is a process of assessing and implementing best evidence, patient values, and clinical expertise to make clinical decisions on patient care. Engagement in EBP is an opportunity to overcome the barriers that lead to poor patient and system outcomes. However, EBP implementation can be difficult due to barriers such as lack of time, lack of EBP knowledge, lack of leadership support, and difficulty accessing resources. Several studies support educational programs for nurses to strengthen EBP beliefs and implementation. The purpose of this project was to increase participation in EBP for nurses practicing at Mayo Clinic Arizona. The project involved planning for redesign of existing EBP courses along with new types of support and educational sessions. DNP students participated in the initiative through searching for and synthesizing evidence, collecting and analyzing survey data, and presenting recommendations for program development and outcome measurement to nursing leaders in the organization.
Keywords: evidence-based practice, hospital, nurses, engagement, continuing education
ContributorsVea, Davina; Espinosa, Gloria (Author) / Hagler, Debra (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
Background: Vaccine-preventable diseases significantly influence the health and academic success of college students. Despite the known negative impact of these diseases, vaccination rates routinely fall short of national goals and recommendations. Although vaccination decisions are complex, a recommendation from a health care provider is one of the key motivators for individuals receiving a vaccine. Motivational interviewing (MI), a counseling approach primarily used to address substance abuse, can be applied to other health-related behaviors.
Local Problem: Despite previous quality improvement efforts aimed at increasing vaccine rates for influenza, human papillomavirus (HPV), and meningitis B (MenB), vaccinations at large university health centers have been well below benchmarks set by Healthy People 2020.
Methods: This study was guided by the Theory of Planned Behavior and included MI training and regular reinforcement for health care providers to address vaccine hesitancy with college students.
Results: Influenza vaccination rates improved, but HPV vaccine rates remained stable and MenB vaccine rates decreased compared with the previous year. Clinicians demonstrated a significant increase in knowledge of MI techniques after a targeted educational intervention. Repeat measures indicate the potential for sustained improvement when ongoing reinforcement is provided.
Conclusion: MI can be an effective part of a strategy to increase vaccination rates.
ContributorsWermers, Rita (Author) / Ostroski, Tammy (Author, Thesis advisor) / Hagler, Debra (Author, Thesis advisor)
Created2019-04-26