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: Patient Portals
- All Subjects: Relapse
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.
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.
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.
Design: The primary hypothesis was that active participation as defined by contact with a sponsor of an hour or more per week, as measured by the impact on affective characteristics correlated with increased levels of sobriety, when measured by the AWARE questionnaire (Advance Warning of Relapse) within 7 days of entry and prior to discharge (within 30 days). Setting: The project took place in a residential treatment facility in Phoenix, Arizona.
Participants: There were 12 clients from a men’s house and 12 clients from a woman’s house, all of which were going through recovery. Intervention: The educational session explained what a sponsor is and the importance of finding one early as a key role in relapse prevention.
Measurements: Pre and post-test results were compared to see if there was an impact on the predictability of relapse and sponsorship. The paired t-test was performed to compare the two means of AWARE scores. A lower score on the AWARE questionnaire indicates a person is more likely to succeed in sobriety.
Findings: Based on 24 samples collected, the mean scores within the first seven days were 91.17 with a standard deviation of 18.59 and the mean score prior to discharge were 72.78 with a standard deviation (SD) of 20.02. The mean difference between the two scores was 18.39 (SD=2.84). There was a significant effect of the relapse prevention program which included sponsorship, t (22) = 4.79, p < 0.001.
Conclusion: Implications for practice include increased time with sponsors to reduce rates of relapse. Future concerns include good fit matching which may reduce rates of relapse even further.
According to the National Institute on Drug Abuse (NIDA), tobacco, alcohol, and illicit drugs accounted for 820 billion dollars in costs related to crime, lost work productivity, and health care services. Nearly 20 million Americans suffer from substance misuse, but only 3.7 million received treatment. Of those who receive treatment, the risk of relapse is high, ranging from 40-60% within a year of treatment. Improvement in the treatment of substance use disorders (SUD) is necessary to improve the health of our society.
Current literature demonstrates that individualized recovery plans and follow-up care are effective in reducing relapse and readmission. Costs to the individual, institution, and healthcare system can be reduced. This project aimed to decrease the risk for relapse and readmission with recovery plan reviews at 72hrs, and two-weeks, post-discharge. The risk of relapse was measured by the Time-To-Relapse questionnaire and the UCLA loneliness scale. The project took place in a residential treatment facility in Phoenix, Arizona. There were five participants initially; two were lost at the two-week follow-up. Pre and post-test results were compared to measure potential predictability of relapse. The two-tailed paired samples t-test was performed to compare the means of the scores but yielded insignificant results.
All participants maintained sobriety. Qualitative data via interview showed positive results demonstrated by statements from the participants. Recovery plan review with follow-up care is a promising evidence-based practice that can be implemented to help individuals maintain sobriety. Additional research is recommended to examine further the impact on the maintenance of sobriety over time.
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.