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.
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- All Subjects: Parents
Purpose: Implementation of a postpartum depression (PPD) screening while using evidence-based interventions to improve depressive symptoms, enhance breastfeeding (BF) self-efficacy, and strengthen the mother-infant dyad (MID).
Background and Significance: PPD is highly prevalent among women living in the United States and threatens the physical and psychological health of MIDs. Many of these women go undiagnosed and without treatment, further worsening symptoms and outcomes. This has inspired world healthcare leaders and organizations to address maternal mental health among postpartum women.
Methods: A 12-week evidenced-based project consisted of two-sets of participants including mothers and staff. A comprehensive maternal support program guided by an informational pamphlet (IP) and implementation of PPD screening using the Edinburgh Postnatal Depression Scale served as the two-part intervention for this project. Goals were to decrease PPD, enhance BF satisfaction, and strengthen the MID. Comprehensive maternal support encompasses interventions proven to meet the project goals and includes tailored BF education and care to maternal needs, social support by peer/family involvement, skin-to-skin contact during BF, emotion-regulation strategies, and availability of community resources.
Outcomes: The BSES-SF scores did result in statistical significance based on an alpha value of 0.10, t(3) = -2.98, p = .059, proving a positive effect was seen in breastfeeding self-efficacy post intervention. The results did not show statistical significance (t(3) = 0.60, p = .591) in regard to pre and post-depression scores. However, the mean pre-score (M =3.50, SD 3.11) did decrease post-intervention (M =2.75, SD 1.26) and exemplifies clinical significance.
Conclusion: The outcomes of this Quality-Improvement project showed improved scores for depression and BF self-efficacy post-intervention. This demonstrates the value in screening for PPD using a validated screening tool and instituting comprehensive maternal support guided by evidence-based practice in a community setting.
The birth of a new baby is known to be a joyful time for families. However, such a treasured experience can quickly reroute in a matter of moments which leaves the family feeling helpless, frightened, and guilty. The innate process of bonding and attachment is interrupted by the resuscitative course following a traumatic birth. Separation, grief, anger, and fear promote what’s being deemed more and more frequently as parental posttraumatic stress disorder (PTSD). Rates of parental PTSD associated with separation at birth are equivalating those of post-partum depression and post-partum psychosis. Emotionally unstable parents are unable to adequately care for their newborn for both short and long term needs.
Facilitation and support of the parental role in an altered environment, such as a neonatal intensive care unit (NICU), is thought to create opportunities for relationship security. Establishment of an emotionally invested caregiver has been proven to minimize sequelae of the NICU patient, reduce length of stay, cut readmission rates, and lower the incidence of failure to thrive post-discharge. A parental psychosocial program was instituted in a 32-bed NICU within a southwest children’s hospital. The program efficacy was analyzed several months after implementation. Results are concurrent with the thought that individual counseling for NICU families reduces stress scores and improves patient satisfaction at discharge.
Adverse childhood experiences (ACEs) are traumatic events experienced during childhood that have negative effects starting as a child and extending into adulthood. The presence of multiple ACEs increases negative mental, physical, and behavioral health outcomes. Children of parents who have experienced ACEs are at a higher risk of experiencing ACEs themselves, creating an intergenerational cycle of trauma between parents and their children. Evidence suggests that parenting education can reduce the impact of ACEs and potentially eliminate poor health outcomes. The literature revealed that parenting education was found to increase parenting competency, which will in turn reduce the impact of ACEs on children.
The purpose of this evidence-based project is to evaluate parenting competency and parenting self-efficacy after implementing six parenting workshops. The workshop topics consist of: (a) stress management, (b) understanding trauma, (c) positive parenting, (d) positive discipline, (e) play, and (f) learning development and support. The workshops were delivered at a community residential facility for women seeking recovery from abuse, incarceration, chemical dependency and other life-controlling problems. Participants included 10 female residents.
Demographics, ACE scores, pre and post Parenting Sense of Competency Scale, and a post intervention satisfaction questionnaire and discussion were used to collect data from the participants. Mothers’ ACE scores ranged from 2-9. The parenting self-efficacy score increased in the subgroup that attended all six workshops. All of the mothers agreed that the workshops would help with parenting their children. The findings suggest that parenting education increases parenting knowledge and self-efficacy, and may reduce the impact of ACEs on children.
Design: Using an established program for health literacy education, a Doctor of Nursing Practice project was implemented. The effect the program had on increasing the health literacy of participants over a period of 4 weeks was examined. The predominately, Latina participants received three hours of instruction based upon the health literacy book “What to do When Your Child Gets Sick”.
Setting and Subjects: The educational program took place in a large, urban county in the Southwestern United States with 24 parents of preschool age children in Head Start.
Intervention: The educational program contained three hours of classroom instruction utilizing PowerPoint® presentation, demonstration, and teach-back techniques on how to care for a child’s healthcare needs.
Measures and Analysis: Pre-, post- and telephone surveys were used to assess the impact of the health literacy educational program. Wilcoxon and Freidman tests were used to interpret the results.
Results: Despite no significant increases in health literacy post implementation, participants’ remarked that they felt the class was helpful and wanted to share the information with friends and family. They appreciated the program and wanted more educational opportunities.
Conclusion: Advanced practice nurses must acquire understanding, cultural sensitivity, and assess the needs of the community when implementing health literacy educational projects.
Background: Cyberbullying and cyber-victimization are rising problems and are associated with increased risk for mental health problems in children. Methods for addressing cyberbullying are limited, however, interventions focused on promoting appropriate parental mediation strategies are a promising solution supported by evidence and by guided by the Theory of Parenting Styles.
Objective: To provide an educational session to parents of middle school students that promotes effective methods of preventing and addressing cyberbullying incidents. Design: The educational sessions were provided to eight parents middle school student. Surveys to assess parent perception of and planned response to cyberbullying incidents and Parent Adolescent Communication Scale (PACS) scores were collected pre-presentation, post-presentation, and at one-month follow up.
Results: Data analysis of pre- and post-presentation PACS using a Wilcoxon test found no significant difference (Z = -.405, p >.05). There was not enough response to the 1-month follow-up to perform a data analysis on follow-up data.
Conclusions: Due to low attendance and participation in the follow-up survey the results of this project are limited. However, parents did appear to benefit from communicating concerns about cyberbullying with school officials. Future studies should examine if a school-wide anti-cyberbullying program that actively involves parents effects parental response to cyberbullying.