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
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Purpose & Background: Serious mental illness among incarcerated people continues to rise within the United States. Correctional officers only receive an average of 13.54 hours of training in special populations, including the mentally ill (Kois et al., 2020). This lack of training leaves new correctional officers inadequately prepared to manage

Purpose & Background: Serious mental illness among incarcerated people continues to rise within the United States. Correctional officers only receive an average of 13.54 hours of training in special populations, including the mentally ill (Kois et al., 2020). This lack of training leaves new correctional officers inadequately prepared to manage this population in prison. Education is a cost-effective modality to provide a long-term change of practice. Mental health education was provided to New Correctional Officers (NCOs) at a 2,000-bed facility in Southwestern United States during their initial correctional officer training. Internal permissions were granted by the prison internal review board (IRB) and the Arizona State University IRB. Methods:NCOs (n = 7) were recruited and consented to participate in psychoeducation specific to mentally ill prisoners. Using an evidence-based curriculum developed by Dr. Dana Dehart at the University of South Carolina, NCOs participated in four (4) 1-hour long mental health trainings that were instructor led. Pre/Post assessment tools were completed using a 10-item trauma quiz and a 12- item Mental Health Knowledge Schedule (MAKS) scale assessing participant attitudes towards mental illness. Results: Participants were primarily male (57 %), White (42%), with an average age range between 31-40 years old, and with a high school degree. Post intervention quiz and MAKS show improved knowledge for all subjects using both tools. Discussion/Conclusion: This project highlights cost-effective training with significant preliminary results in reducing stigma towards the mentally ill in prison. Furthermore, this information justifies the support, development, and funding for increasing mental health training for correctional staff nationwide.
Created2022-05-07
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Police officers have more mental health issues than the general population and face barriers to seeking help, such as stigma, organizational masculinity, and concerns about confidentiality. This project took place in an urban police department in Arizona and aimed to increase the frequency of officers seeking peer support or counseling

Police officers have more mental health issues than the general population and face barriers to seeking help, such as stigma, organizational masculinity, and concerns about confidentiality. This project took place in an urban police department in Arizona and aimed to increase the frequency of officers seeking peer support or counseling and reduce mental health stigma. Peer support volunteers increased officer contact following exposure to traumatic incidents. Officers viewed an educational video on mental health and available resources, and sergeants were provided with a quick reference guide on mental health warning signs. Rates of counselor fund utilization by officers pre-and post-intervention were monitored, and all officers were emailed a Likert-scale peer support satisfaction survey. Survey results (n=39) showed officers were moderately satisfied with peer support and knowledge, but many were not comfortable contacting peer support for personal issues. Of officers surveyed, 74.4% (n=29) did not seek counselor services after contact with peer support. Counselor fund utilization slightly increased post-intervention, but further study is needed to determine the correlation to interventions. This project was unable to definitively demonstrate that peer support and education for officers and leadership increases help-seeking behaviors. Future projects should focus on improving peer support volunteer training and education.
Created2022-05-03
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Background: Current standard of care practices for substance use disorder is inadequate in reducing relapse, with rates persistently 40-60% within one year of treatment. Unconventional approaches must be explored to reduce the risk of relapse, climbing rate of overdoses, and healthcare expenditures exceeding $740 billion annually. The purpose of this

Background: Current standard of care practices for substance use disorder is inadequate in reducing relapse, with rates persistently 40-60% within one year of treatment. Unconventional approaches must be explored to reduce the risk of relapse, climbing rate of overdoses, and healthcare expenditures exceeding $740 billion annually. The purpose of this quality improvement project demonstrates how an evidence-based group exercise intervention, used as adjunctive support to standard addiction treatment, can reduce relapse and promote long-term recovery during a global pandemic. Methods: Aims of this project sought to enhance quality of life scores. Participants were recruited upon admission to a residential treatment center. Pre-posttest design utilized the World Health Organization Quality of Life Abbreviated scale to assess program impact on quality of life. Pre-program descriptive questions and a survey assessing prior addiction treatment were collected. Group exercise and wellness education sessions were delivered twice weekly in a live, interactive, virtual format with on-site participants. Upon completion, a post-program survey was utilized to capture the qualitative experiences of participants and impact of project to instill confidence to execute long-term sobriety. Results: Pre and post scores, as well as domain scores were clinically and statistically significant. Additionally, 80% of participants reported feeling more prepared to achieve long-term sobriety secondary to their participation in this project. Discussion and Conclusion: Results from this project demonstrate the positive impact that group-based exercise and lifestyle interventions can have on quality of life and long-term recovery. Peer support exercise programs may offer means to enhance addiction treatment and reduce overall healthcare expenditures globally by defying the odds of relapse.
Created2021-05-01
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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

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.
Created2022-04-30
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Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The

Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The project was guided by the Health Belief Model. Methods: Consent was obtained from 15 participants working as nurse advocates for a large insurance company. Nurse advocates are tasked with improving the health of patients and connecting them to additional resources. A twenty-minute educational intervention focused on the impact cancer has on mental health and the benefit of multiple psychosocial supportive resources was delivered to the participants. Education included a comprehensive review of the resources available for cancer patients at the project site. Participants were then given 10 minutes to complete a retrospective post-then-pre survey, based on a Likert Scale. Results: Statistically significant improvements in survey scores were observed in each of the three KAB domains. Statistical analysis confirmed improvements in survey scores were significant and not likely due to random variation. Participants also referred more patients into a cancer support program following the intervention. Conclusion: A brief educational intervention was able to improve KAB scores among nurses. There was also an increase in the number of patients these nurses referred into a psychosocial supportive program. Nurses that better understand the mental health needs of cancer patients are more likely to connect them with psychosocial resources. This intervention will become part of standard training for new nurse advocates at the project site.
Created2022-05-02
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Background: Existing substance use disorder guidelines are deficient in reducing relapse rates, evidenced by the substantial number of persons experiencing relapse within months of recovery, with most relapsing within one year. Current interventions lack community reinforcement approaches to reduce relapse and risk factors required to combat the extensive damages related

Background: Existing substance use disorder guidelines are deficient in reducing relapse rates, evidenced by the substantial number of persons experiencing relapse within months of recovery, with most relapsing within one year. Current interventions lack community reinforcement approaches to reduce relapse and risk factors required to combat the extensive damages related to substance use as costs exceed $1 trillion annually. Guided by the Social Cognitive Model, this quality improvement project aims to explore how group exercise combined with community reinforcement reduces relapse. It aims to boost recovery capital by improving quality of life scores. Methods: A CrossFit instructor delivered personalized group exercise and wellness education in-person biweekly for six weeks. Adult residential treatment clients were eligible to participate recruited via a flyer upon treatment entry. A pre-intervention demographic questionnaire, a pre-/post World Health Organization Quality of Life Abbreviated scale (reliability ? = > 0.70) assessing intervention influence on the quality of life, and a post-intervention survey was administered. The lead investigator performed all data distribution and collection. Institutional Review Board approval safeguarded participants' rights and risks. Results: Pre/post improvements observed in all domains; psychological and environmental were statistically significant, while 100% of participants reported enhanced QoL, social support, & confidence related to long-term sobriety post-intervention. Discussion/Conclusion: Desired outcomes are increased quality of life scores to boost recovery capital. A sober community reinforcement approach combined with exercise may link to reducing relapse and total costs related to this growing public health crisis.
Created2022-04-30
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Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and

Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and Larabee’s change model. The Questionnaire on Stigmatizing Attitudes Towards Children with Emotional and Behavioral Disorders (EBD) was completed by voluntary participants at pretest, posttest and at a one month follow up. Between pretest and posttest, participants engaged in three educational modules regarding mental health. Participants were voluntary, anonymous staff members at a pediatric hospital currently employed in the PICU. Results of the questionnaires pre M= 23 post M=11 and follow up M=9.5 indicates education improves attitudes, and decreases bias in PICU staff. Recommendation to obtain larger population of study with trial implementation. Recommend adding educational modules to annual education or to new hire orientation.
Created2022-04-28
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Introduction: Poor knowledge and negative perceptions regarding mental health disorders are barriers to parents seeking mental health care for their child. Mental health literacy comprises both the knowledge and ability to recognize mental health disorders, combat stigma, and obtain treatment. Research demonstrates increased mental health literacy increases parental help-seeking behaviors.

Introduction: Poor knowledge and negative perceptions regarding mental health disorders are barriers to parents seeking mental health care for their child. Mental health literacy comprises both the knowledge and ability to recognize mental health disorders, combat stigma, and obtain treatment. Research demonstrates increased mental health literacy increases parental help-seeking behaviors. Aim: To increase mental health literacy of parents in Maricopa County through increased access to evidence-based education and support. Methods: A local mental health organization utilized the Model for Improvement (MFI) Plan Do Study Act (PDSA) quality improvement framework to increase the number of parents attending an evidence-based, six-session educational class and bi-monthly support group. Interventions included 1) outreach and recruitment via social media and community partners, and 2) convening one six-week educational class and four support group sessions. Results: Parental awareness and attitudes toward mental health disorders were measured at Class One (N=11, M = 30.9, SD 5.15) and Class Six (N=5, M = 40.2, SD 1.64) and analyzed utilizing the Mann-Whitney U Test; results demonstrate improved awareness and attitudes (U =50, p = .001). Eleven parents attended a support group session; 91% (10) reported they learned new information about how to support their child; 82% (9) reported they improved their ability to access and advocate for mental health services. Conclusions: Findings suggest that participating in this organization’s educational classes and support groups increases mental health literacy. Barriers that prevent more parents from participating should be explored.
Created2021-04-27
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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

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.
Created2021-04-27
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Purpose: The purpose of this project was to examine if a relationship existed between the changes in attitude and knowledge of a mental health care provider, before and after an educational intervention was given on how to identify sex trafficking victims.

Background: According to the National Trafficking Hotline (2017), last year

Purpose: The purpose of this project was to examine if a relationship existed between the changes in attitude and knowledge of a mental health care provider, before and after an educational intervention was given on how to identify sex trafficking victims.

Background: According to the National Trafficking Hotline (2017), last year there were over 5,000 cases of sex trafficking reported. Lederer & Wetzel (2014) discuss that more than 88% of victims interact with a health care provider while being trafficked at least once. A majority of cases, mental health care providers were informed that their patient was a sex trafficking victim through collaboration of other services. Without this collaboration, many providers would have never
known that they had interacted with a victim (Domoney, Howard, Abas, Broadben, & Oram, 2015).

Methods: The participant population consisted of psychiatrists, psychiatric nurse practitioners and psychologists working in acute and out patient settings.
A pre survey was given to identify the participant’s knowledge of sex trafficking and their awareness of available resources and tools to help screen as well as treat victims of sex trafficking. After completion, the participants viewed an educational voice over presentation that educated them on how to identify current sex trafficking victims, what screening tools are available, the mental health risk factors and how to protect both the victim and provider from potential danger from the alleged trafficker. A post survey was then given to assess their knowledge after the presentation intervention, how much they retained and their confidence in being able to assess and treat sex trafficking victims. All surveys and the presentation were available online for participant convenience via a private link.

Results: The knowledge posttest score was higher than the pretest (Z=-2.694, p<0.007).
The confidence score on treating sex trafficking victims was higher posttest (Z=-2.251, p<0.024) No significant change in attitudes for advocating for sex trafficking victim care. All providers agreed that this high-risk vulnerable population needs advocates (Z=4.67, p<0.707).

Conclusion: All providers agreed for the need to advocate for victim care prior to the educational intervention. The results suggest that mental health providers are more knowledgeable posttest about risk factors, have a higher level of confidence in treating sex trafficking victims and have a higher confidence in their ability to protect victims and provide adequate care.

ContributorsChang, Lillian (Author) / Chen, Angela Chia-Chen (Thesis advisor)
Created2018-04-29