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 - 10 of 10
Filtering by
- All Subjects: Patient Education
- All Subjects: Cognitive Behavioral Therapy
Description
Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a Federally Qualified Health Center (FQHC). The social cognitive theory underpins the project because patients' portal use behavior can change if changing their environmental factors in the clinic with educational videos.
Methods: The Universities Institutional Review Board granted exempt approval to ensure human subject protection. The participants included bilingual adult patients in an FQHC who have access to the internet and email addresses who visited the center during the implementation period. The tablets in the patient rooms displayed the English and Spanish educational video on step-by-step instructions on accessing, using the patient portal, and the benefits of use. The information technology technician pulled aggregate data from the analytics component of the patient portal before and after the four-week implementation period. The data included total number of clinic patients, number of active portal users, number of monthly logins, and gender. The project facilitator used descriptive statistics to compare pre-and post-intervention analytics. Results: Active portal users increased by 0.22% and monthly logins increased by 390 logins.
Only aggregate data was collected so the statistical significance was not calculated. Conclusion: This EBP project enhances knowledge on patient portal utilization's impact on patient engagement and may apply to current practice.
ContributorsHerrera, M. Sara (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Sleep deprivation is linked to poor mental and physical health outcomes for professional firefighters. The importance of sleep hygiene practices and health promotional activities may increase the amount of quality sleep firefighters get on their days off. As the adverse outcomes of circadian misalignment due to sleep deprivation becomes more apparent in firefighter wellbeing, the need for a sleep health program becomes more evident. The purpose of this paper is to examine and assess the effects of a sleep health program for firefighter wellness. Research emphasizing the relevance of poor health outcomes related to sleep disturbances is prevalent in the literature. The findings have prompted the development of an evidence-based sleep coaching program for firefighters in a local fire department guided by The Cognitive Behavioral Therapy Model (Brewin, C.R., 1996). and a knowledge-to-Action process framework for evidence-based-practice (Graham et al., 2006).
ContributorsAnon, Melanie (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in rural populations
Study Design: A top priority of a rural federally qualified healthcare organization (FQHC) was to improve utilization of the AWV due to a patient response well below the national average. A six-week trial was conducted that examined a patient information campaign combined with a strategic workflow that encouraged interoffice collaboration.
Methods: The office staff of a pilot medical clinic was selected by the FQHC quality improvement committee as the project site. A Relational Coordination survey (RC) was administered before and after the intervention to determine if the intervention improved interoffice collaboration regarding the AWV. Descriptive questions were used to determine which aspects of the intervention proved useful. Reliability of the survey results was verified by a Crohnbach’s ? > 0.08. An independent samples t test was used with p value < 0.05 to determine statistical significance and confidence intervals.
Results: The patient information brochure demonstrated improved patient understanding of the AWV from the office staff perspective as demonstrated by an independent samples t test comparing pre and post survey responses (t(32) = -4.14, p < .001, CI 95%). The RC survey results identified an area for collaborative for improvement between the front office and medical staff.
ContributorsSmith, J. Amanda (Author) / Morgan, Michelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Background and Purpose: Across the United States, there are low adherence rates of prenatal
care visits, primarily among the low-income and ethnic populations. Inadequate prenatal care
education contributes to low appointment adherence and missed prenatal care during their first
trimester. The project aim is to assess the current use of paper-based prenatal education in a
Federally Qualified Health Center (FQHC) in southwestern Arizona and inquire if patients
would elect to engage in a phone application for prenatal education with appointment
reminders.
Approach/Methods: The Theory of Planned Behavior was the theoretical framework utilized
to guide this project. The Quality Improvement (QI) project gathered information regarding
patient technology use and accessibility as well as utilization of FQHC prenatal booklet,
collected with a 13-question survey. A non-identifying demographic questionnaire was also
distributed during the prenatal visit.
Results: Survey responses indicated that patients find utility in prenatal education and
appointment reminders provided through a phone application. Out of the total participants
(n=23), only 18 had received the prenatal care booklet and completed the entire survey. 80%
of participants expressed they would use the phone application while 84% find prenatal
education on the phone helpful. In comparison, less than 28% of respondents planned to
continue to use the prenatal booklet they were provided at the clinic during their pregnancy.
Outcomes: There is potential in utilizing digital platform and appointment reminders at FQHC
to improve appointment adherence and early entry to prenatal care. The results will be used to
inform FQHC on decisions regarding continuing prenatal booklet use and integration of techbased
education formatting.
ContributorsAlexander, Yana (Author) / Janicek, Patricia (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management.
Objective: The purpose of this paper is to review the outcomes of a diabetes education program offered to underserved women in the Southwestern United States.
Methods: Four weekly nutrition classes were individualized and taught at a nonprofit organization in the southwest United States. Behavior change was measured using the Summary of Diabetes Self-Care Activities (SDSCA) tool. Classes were advertised via the center’s monthly class calendar and fliers. A total of nine participants (N=9) came to every class and took the SDSCA survey before and after class instruction.
Results: Descriptive statistics and two 2-tailed t-tests with the critical value set at p<0.05 were used for data analysis. The participants were Hispanic women, most between the ages of 40-49, and had an income between $0-14,000. The mean difference between the variables of both general diet and specific diet pre and post-tests were significantly different from zero. The assumptions of normality and homogeneity were met. The results of both two-tailed paired sample t-tests were significant suggesting the means of general and specific diet pre-tests were significantly lower than the means of the general and specific diet post-tests.
Discussion: The assumptions of normality and homogeneity were met and the results were significant. The pre-intervention scores for both categories were statistically significantly lower than the post-intervention scores for both categories. Thus, the desired outcome of helping clients within the organization modify, adapt, or change self-care behaviors related to diet was met.
ContributorsGandee, Marisol (Author) / Chiffelle, Rochelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Depression and anxiety are common and debilitating illnesses that negatively impact personal well-being and functioning. The effects of depression and anxiety not only affect the individual, but also peers, family, the community, economy, and even the health care system. Pharmacological therapy is a first line treatment for depression and anxiety, but the risk for relapse remains. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are treatments that have demonstrated effectiveness in treating depression. The evidence suggests that both therapies are successful in terms of reducing depressive symptoms, but most effective when combined. Further, evidence shows that the combination of MBCT and traditional pharmacological therapy provides relief from depressive symptoms and lengthens the amount of time between recurrent episodes and improves the quality of life. A project was implemented at an integrated health clinic to evaluate the effectiveness of a mindfulness-based intervention to reduce the symptoms of depression and anxiety. The results revealed that practicing mindfulness was statistically and clinically significant in reducing depression and anxiety. In addition, mindfulness scores increased over 30 day application of the intervention. The results demonstrated the value of utilizing mindfulness as a cost-effective therapy in addition to pharmacological treatment to decrease symptoms of depression and anxiety, as well as improve mindfulness. The ease of use demonstrated the value of mindfulness and self-directed skills aimed at improving wellness, reducing depression and anxiety which will result in the improvement of individual, economic, healthcare system, and community health.
ContributorsFong, Luis (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-28
Description
Background: The cost of health care for end-stage kidney disease patients has exponentially increased over the years, costing 91,000 annually per patient. Peritoneal dialysis has proven to be a cost-effective renal replacement therapy compared to in-center hemodialysis. Quality evidence from a systematic literature review indicates that peritonitis is one of the leading causes of patients' ability to maintain peritoneal dialysis. Evidence suggests that enhanced patient education on infection control practices beyond standard education effectively reduces peritonitis incidents.
Methods: Enhanced education on infection control practices was delivered to 18 peritoneal dialysis patients in Southern Arizona through the application of determinants of the Health Belief Model utilizing the principles of the ADKAR framework. Data analysis will be available through facility-specific quality metrics of decreased peritonitis and modality loss episodes. Each of these measures is to have data compared to pre/post-intervention.
Results: All participants in the study were able to sustain peritoneal dialysis as their renal replacement therapy. Of the 18 participants, one patient episode of peritonitis occurred three months before the intervention, and zero episodes were reported during the first three months of monthly infection control education. Facility-specific peritonitis and modality loss measures are not available until after project publication.
Conclusion: To decrease peritonitis rates and modality loss, the intervention will continue for eight to 12 months to determine success. More time is needed to determine if patients adhere to monthly infection control practices taught during enhanced education.
ContributorsSchneeweis, A. Danielle (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29
Description
Background: Around 40-50% of people with Parkinson’s disease will develop anxiety or depression, the number one factors affecting their quality of life. Cognitive behavioral therapy is the most well-established intervention for anxiety and depression in people with Parkinson’s disease. Purpose: The project addresses a southwestern Parkinson-specific community center’s need for mental health by incorporating a cognitive behavioral therapy-based mental health program, guided by the Cognitive Behavioral Model. Methods: Recruitment at the center took place during a virtual weekly meeting with inclusion criteria of a Parkinson’s disease diagnosis, 50 years or older, and English speaking. A four-week, virtual, nurse-led cognitive behavioral therapy-based mental health program was created to examine the effects on anxiety, depression, and quality of life in ten people with Parkinson’s disease. Pre-and post-intervention Geriatric Anxiety Inventory (Cronbach’s alpha, 0.91), Hamilton Depression Rating Scale (Cronbach’s alpha, 0.87), and Parkinson’s Disease Questionnaires (Cronbach’s alpha, 0.84) were used to assess anxiety, depression, and quality of life. Results: Using a Two-tailed paired samples t-Test, mean values and p-value were calculated with alpha value of 0.05, t(39) = -0.10, p = .922 for anxiety, Alpha value of 0.05, t(16)=3.69, p=0.002 for depression, Alpha value of 0.05, t(38)=5.07, p<0.001 for quality of life, and Alpha value of 0.05, t(5)=4.54, p=0.006 for emotional wellbeing. Conclusion: A cognitive behavioral therapy-based mental health program at a Parkinson-specific center has the potential to improve quality of life and decrease depression in people with Parkinson’s disease. Implications: Research with larger sample sizes, longer duration of therapy, and in-person format would be beneficial.
ContributorsKielbania, Meghan (Author) / De' Santiago, Stephanie (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Background: Suicidal ideation and attempts are increasing in the adolescent population and suicide is now the second leading cause of death for youth 10-24 years of age (Center for Disease Control and Prevention [CDC], 2016). Children that continue to struggle with suicidality and depression after treatment as usual have an increased length of stay, from an average of five days to nine days per admission. Recidivism rates are also increasing, with some patients
requiring readmission the same day as discharge.
Method: The purpose of project was to check the feasibility of the use of cognitive behavioral therapy-based group called Creating Opportunities for Personal Empowerment (COPE) in the treatment of children with depression and suicidality. The study patients participated in up to 7 groups of a 60-minute lesson of COPE each day, combined with interactive activities that helped
them practice problem solving and coping skills. The feasibility of the COPE groups were measured by the consistent decrease of Columbia Suicide Severity Rating Scale at the beginning and conclusion of lessons as well as consistency of engaged participation in the COPE groups on the unit based of staff observation obtained from Staff Survey.
Results: The results analyzed using the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -3.64, p < .001. This indicated that the differences between Pre-CSSR and Post-CSSR were not likely due to random post variation. The median of Pre-CSSR (Mdn = 1.00) was significantly lower than the median of Post-CSSR (Mdn = 2.00).
Discussion: The results proved feasibility of a cognitive behavioral therapy-based group in the treatment of depression and suicidality of children in an inpatient unit.
requiring readmission the same day as discharge.
Method: The purpose of project was to check the feasibility of the use of cognitive behavioral therapy-based group called Creating Opportunities for Personal Empowerment (COPE) in the treatment of children with depression and suicidality. The study patients participated in up to 7 groups of a 60-minute lesson of COPE each day, combined with interactive activities that helped
them practice problem solving and coping skills. The feasibility of the COPE groups were measured by the consistent decrease of Columbia Suicide Severity Rating Scale at the beginning and conclusion of lessons as well as consistency of engaged participation in the COPE groups on the unit based of staff observation obtained from Staff Survey.
Results: The results analyzed using the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -3.64, p < .001. This indicated that the differences between Pre-CSSR and Post-CSSR were not likely due to random post variation. The median of Pre-CSSR (Mdn = 1.00) was significantly lower than the median of Post-CSSR (Mdn = 2.00).
Discussion: The results proved feasibility of a cognitive behavioral therapy-based group in the treatment of depression and suicidality of children in an inpatient unit.
ContributorsFreeman, Latasha (Author) / Guthery, Ann (Thesis advisor)
Created2020-05-02
Description
Background and Objectives: Electronic cigarette use, known as vaping, among adolescents was declared a public health epidemic in 2018 and has acute and chronic health consequences. Healthcare providers (HCP) play a pivotal role as health-related educators, including counseling against vaping. Primary HCPs report a lack of adequate knowledge, confidence, and screening for adolescent vaping. Increasing HCP’s vaping awareness and knowledge may increase rates of adolescent vaping prevention screening and counseling. Rosswurm & Larrabee Model and Health Belief Model were utilized in project design and implementation.
Methods: Primary HCPs (n = 8) that provide care to adolescents at a pediatric clinic in Phoenix, Arizona completed online pre- and post- education surveys measuring vaping knowledge before and after viewing an evidence based online educational video. Participation was voluntary, open to all clinic HCPs, and informed consent was provided before the intervention. Data analysis was completed with Intellectus Statistics using descriptive and inferential statistics.
Results: Results of the paired samples t-test was significant based on "?=.05" , t(7) = -3.56, p = .009. The mean of the post-education survey (12.38) was significantly higher than the mean of the pre-education survey (9.62). Descriptive statistics found 85.71% of HCPs reported increased intent to counsel for vaping and 57.14% of HCPs reported increased implemented vaping counseling with their adolescent patients four-weeks post intervention.
Conclusions: HCP vaping knowledge rates and vaping-related counseling and surveillance significantly increased after viewing the educational video. Implementing mandatory HCP vaping education training could increase adolescent vaping prevention interventions and counseling within primary care settings.
ContributorsMarks, Brianna (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26