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 - 5 of 5
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- All Subjects: Healthcare Disparities
Description
Purpose: The purpose of this project was to implement a change in workflow to increase colorectal cancer (CRC) screening rates and improve Meaningful Use scores in a primary care setting.
Background and Significance: CRC is the second leading cause of cancer-related deaths in the United States among men and women. Current CRC screening rates remain low, even with advanced screening options available. Meaningful Use sets specific objectives for health care providers to achieve. Documenting CRC screening status and recommending CRC screenings to patients is one of the objectives of Meaningful Use and is considered a Clinical Quality Measure (HealthIT.gov). Factors that lead to CRC screening include primary care providers (PCPs) raising the topic, involving support staff, involving patients in the decision-making process, and setting alerts in electronic health records (EHRs).
Methods: The Health Belief Model and Ottawa Model of Research Use helped guide this project. The project took place at a private primary care practice. The focus was on patients between the ages of 50 and 75 years old meeting criteria for CRC. Five PCPS and five medical assistants (MAs) chose to participate in the study. Participants were given pre and post Practice Culture Assessment (PCA) surveys to measure perceptions of the practice culture. The project included a three-part practice change: PCP and MA education about CRC screening guidelines, EHR documentation and reminders, and a change of patient visit workflow which included having MAs review patient's CRC screening status before they were seen by the PCP and handing out CRC screening brochures when appropriate. PCPs then ordered the appropriate CRC screening, and the MA documented the screening in the EHR under a designated location. CRC Screening Project Evaluation Forms were completed by MAs after each patient visit.
Outcomes: No significant difference from pre to post survey satisfaction scores were found (t (8) = - 1.542, p= = .162). Means of quantitative data were reported from the CRC screening evaluation forms; N=91. The most common method of screening chosen was colonoscopy, 87%. A strong correlation was found (r (-.293) = .01, p<.05) between receiving a CRC brochure and choosing a form of screening. Meaningful Use scores pre and post project are pending.
Conclusion: Patients are more likely to choose a screening method when the topic is raised in a primary care setting. Continued staff education on workflow is important to sustain this change. Further research is needed to evaluate cost effectiveness and sustainability of this practice change.
Background and Significance: CRC is the second leading cause of cancer-related deaths in the United States among men and women. Current CRC screening rates remain low, even with advanced screening options available. Meaningful Use sets specific objectives for health care providers to achieve. Documenting CRC screening status and recommending CRC screenings to patients is one of the objectives of Meaningful Use and is considered a Clinical Quality Measure (HealthIT.gov). Factors that lead to CRC screening include primary care providers (PCPs) raising the topic, involving support staff, involving patients in the decision-making process, and setting alerts in electronic health records (EHRs).
Methods: The Health Belief Model and Ottawa Model of Research Use helped guide this project. The project took place at a private primary care practice. The focus was on patients between the ages of 50 and 75 years old meeting criteria for CRC. Five PCPS and five medical assistants (MAs) chose to participate in the study. Participants were given pre and post Practice Culture Assessment (PCA) surveys to measure perceptions of the practice culture. The project included a three-part practice change: PCP and MA education about CRC screening guidelines, EHR documentation and reminders, and a change of patient visit workflow which included having MAs review patient's CRC screening status before they were seen by the PCP and handing out CRC screening brochures when appropriate. PCPs then ordered the appropriate CRC screening, and the MA documented the screening in the EHR under a designated location. CRC Screening Project Evaluation Forms were completed by MAs after each patient visit.
Outcomes: No significant difference from pre to post survey satisfaction scores were found (t (8) = - 1.542, p= = .162). Means of quantitative data were reported from the CRC screening evaluation forms; N=91. The most common method of screening chosen was colonoscopy, 87%. A strong correlation was found (r (-.293) = .01, p<.05) between receiving a CRC brochure and choosing a form of screening. Meaningful Use scores pre and post project are pending.
Conclusion: Patients are more likely to choose a screening method when the topic is raised in a primary care setting. Continued staff education on workflow is important to sustain this change. Further research is needed to evaluate cost effectiveness and sustainability of this practice change.
ContributorsMcKillop, Ashley (Author) / Chiffelle, Rochelle (Thesis advisor)
Created2018-05-05
Description
Background: With the adoption of the Health Information Technology for Economical and Clinical Health (HITECH) Act of 2009, came the implementation of the electronic health record (EHR) and incentivized provider programs called Meaningful Use (MU). A goal of MU is to utilize patient portals to improve access to care. Current evidence supports patient portal use however providers are concerned about increased work load and lost revenue because of the time spent managing the portals rather than providing direct, billable patient care.
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.
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.
ContributorsLeal, Lauren (Author) / Velasquez, Donna (Thesis advisor)
Created2017-05-02
Description
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.
ContributorsSaqib, Syed (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available community resources. Children residing in remote areas may experience more burdensome needs as they progress in the cancer treatment trajectory, which healthcare providers may not be aware of unless the information is specifically solicited or incidentally discovered. Use of an evidence-based needs assessment for families who reside in remote zip codes will aid in identification of unique needs and assist the multi-disciplinary care team to specifically tailor interventions to the family. Forty semi-structured interviews were conducted with parents of childhood cancer survivors using an expert-validated needs assessment tool. The purpose of this Doctor of Nursing Practice (DNP) project is to develop a needs assessment for children with cancer in order to identify which needs are amplified in a remote community in order to match and create resources to meet those needs.
ContributorsHarrell, Lauren (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-30
Description
Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events to obtain these unmet primary care services. Community services events effectively disseminate health-related material and provide access to vital medical services. Currently, community services strive to bridge the gap between underserved individuals and primary care clinics by providing participants referrals for low-fee or free clinics to establish ongoing care. A lack of data exists on whether these events sufficiently impact the participants to motivate them to follow-up with a health care clinic. A critical appraisal of evidence showed that follow-up adherence rates are remarkably improved by directly referring participants to a primary clinic during a community services event. This paper explores the effect on health outcomes and health disparities when establishing connections between community services participants and ongoing healthcare services.
ContributorsNavarrete, Elizabeth (Author) / Thrall, Charlotte (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-22