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 - 3 of 3
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- All Subjects: Quality Improvement
- Creators: Jacobson, Diana
- Creators: Bain, Ilyssa D.
Description
Introduction: Drowning is the leading cause of death in children between 1 and 4 years of age; in Arizona drownings are double the national average for this age group. The goal of this Doctor of Nursing project was to educate and empower pediatric providers to give quality drowning prevention (DP) anticipatory guidance (AG) to caregivers of children between 1 and 4 years of age at every well exam.
Method: This quality improvement (QI) project included 32 providers from six pediatric clinics in Arizona. A one-hour education session focused on drowning prevention followed one month later by a a thirty-minute follow-up feedback session were conducted. Pre- and post- education surveys were administered at the first session to measure perceived previous and future intended DP AG practice. An additional follow-up survey was administered at the second session to evaluate perceived change. In addition, caregivers were contacted and surveyed one to three months post initial education to assess provider delivery of AG. Likert-scales and descriptive statistics were used to evaluate data sets.
Results: Post-educational intervention, providers reported increased intention (p = 0.027) to provide water safety AG, and increased intention (p < 0.001) to connect water AG to developmental milestones. Post-intervention follow-up indicated an increased provision of developmentally specific water safety AG to caregivers (p < 0.001) and increased connection of developmental milestones in AG (p = 0.016). Barriers that prevent water safety AG were reported as time constraints and other perceived AG of higher priority.
Implications: This QI project adds to the literature and demonstrates the benefit of education to invigorate and empower increased provision of quality DP AG from providers.
ContributorsDiMiceli, Carolyn (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-22
Description
Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated, triage-based CS administration and determine the effect on overall length of stay (LOS). Methods: For this quality improvement initiative, ED nurses at a large, freestanding, children’s emergency department in the southwestern United States were given education on inclusion and exclusion criteria for nurse-initiated CS in ED triage. Time to CS administration, LOS, and whether the ED nurse or provider ordered the CS were evaluated through chart reviews of patients presenting with a chief complaint of difficulty breathing. These metrics were compared to charts from the previous year during the same timeframe to evaluate for improved timeliness of CS delivery. Results: Time to CS administration decreased from a mean of 98.6 minutes to 57.6 minutes. LOS decreased from an average of 259.3 minutes to 169.6 minutes. The effect of timely CS on LOS was significant for December p =.003, January p =.002, and February p = <.001. Conclusion: A streamlined process for CS delivery to pediatric patients experiencing an asthma exacerbation can enable providers to achieve efficient and effective care in the ED and decrease a patient’s overall LOS.
ContributorsBain, Ilyssa D. (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-23
Description
Background: Health information technology (HIT) refers to the electronic health care systems organizations used to store, share and analyze healthcare information. A central component of the HIT infrastructure is an electronic health record (EMR) and although HIT has been shown to increase enthusiasm for patient care, decrease healthcare costs and improve patient outcomes overall utilization in the United States (US) remains low.
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.
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.
ContributorsProsev, Brittany (Author) / Jacobson, Diana (Thesis advisor)
Created2020-05-01