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 - 7 of 7
Filtering by
- All Subjects: Cognitive Behavioral Therapy
- All Subjects: Drowning
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
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
Purpose/Aims: We aim to increase understanding of water safety measures among primary care providers and improve the quality and efficiency of parent water-safety education.
Background and Significance: Drownings are the leading cause of death in one to four year old children in the United States. Arizona’s drowning rate is nearly double the national average for this age group. Water safety is an important anticipatory guidance topic a primary care provider should be discussing at all well visits. The Health Belief Model is an effective framework to guide family education interventions. It is strongly encouraged that providers incorporate water safety education into the developmental milestone discussions.
Methods: Ten providers recruited from six Arizona pediatric primary care clinics participated in an educational one-hour session. Providers were encouraged to prioritize water safety discussions within the one to four year old age group and deliver education in the context of individual child development. Additionally, providers were updated on water safety recommendations from the Center for Family Health and Safety at Phoenix Children’s Hospital. Supplemental handouts with developmental water safety information were given to each office to aid providers in parent education. A pre-survey was administered to the providers prior to the education session and a post-survey was given at an eight-week follow up. The surveys measured provider perception and current practices of water safety education and utilized a Likert scale to compare data sets. Current and retrospective chart reviews were conducted to evaluate sustainability of the educational intervention.
Outcomes/Results: Sixty percent of provider participants were Medical Doctors (MD) and 40% were Nurse Practitioners (NP) with experience ranging from one year to over 20 years. Following the education session, providers were more likely to discuss keeping a child at arms-reach at all times (p=0.046) during their well visits. There was also an increase in providers incorporating water safety discussions into milestone education (p=0.054).
Conclusion: This educational intervention empowered providers to deliver water safety education in the context of normal developmental milestones at each one to four year old well visit. The anticipatory guidance emphasizes to parents that the behaviors their children exhibit are healthy and normal, but also explains how achieving these milestones put their children at greater risk for drownings. This quality improvement project is part of a larger initiative to decrease the number of drownings in Arizona through education and policy
Background and Significance: Drownings are the leading cause of death in one to four year old children in the United States. Arizona’s drowning rate is nearly double the national average for this age group. Water safety is an important anticipatory guidance topic a primary care provider should be discussing at all well visits. The Health Belief Model is an effective framework to guide family education interventions. It is strongly encouraged that providers incorporate water safety education into the developmental milestone discussions.
Methods: Ten providers recruited from six Arizona pediatric primary care clinics participated in an educational one-hour session. Providers were encouraged to prioritize water safety discussions within the one to four year old age group and deliver education in the context of individual child development. Additionally, providers were updated on water safety recommendations from the Center for Family Health and Safety at Phoenix Children’s Hospital. Supplemental handouts with developmental water safety information were given to each office to aid providers in parent education. A pre-survey was administered to the providers prior to the education session and a post-survey was given at an eight-week follow up. The surveys measured provider perception and current practices of water safety education and utilized a Likert scale to compare data sets. Current and retrospective chart reviews were conducted to evaluate sustainability of the educational intervention.
Outcomes/Results: Sixty percent of provider participants were Medical Doctors (MD) and 40% were Nurse Practitioners (NP) with experience ranging from one year to over 20 years. Following the education session, providers were more likely to discuss keeping a child at arms-reach at all times (p=0.046) during their well visits. There was also an increase in providers incorporating water safety discussions into milestone education (p=0.054).
Conclusion: This educational intervention empowered providers to deliver water safety education in the context of normal developmental milestones at each one to four year old well visit. The anticipatory guidance emphasizes to parents that the behaviors their children exhibit are healthy and normal, but also explains how achieving these milestones put their children at greater risk for drownings. This quality improvement project is part of a larger initiative to decrease the number of drownings in Arizona through education and policy
ContributorsTretiakova, Catherine (Author) / Isaacson, Tiffaney (Author) / Jacobson, Diana (Author, Thesis advisor) / Bowman, Diana (Author)
Created2019-04-29
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
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
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
Introduction and Background: Drowning is the leading cause of preventable injury death in Arizona for children under five years old. Tailored education has demonstrated efficacy in behavior change and knowledge retention. The purpose of this evidence-based project was to evaluate if tailored education improved knowledge and self-reported behaviors related to pediatric drowning. The Elaboration Likelihood Model provided the framework for this project.
Methods/Experimental Approach: The prospective pilot project was conducted using the Iowa Model of Evidence Based Practice. Parents with children under five years, presenting with low acuity complaints in a pediatric emergency department were approached. A baseline assessment identified high-risk behaviors and a custom education plan was delivered to parents. Outcome variables were measured at baseline and three weeks after initial assessment.
Results: The average parent age was 29 (M = 28.5; SD = 6.35) years. Participant (n=29) responses were analyzed using descriptive statistics. Participants (n = 27, 93%) reported likelihood to change behaviors and 29 (100%) perceived the tailored intervention as relevant. Secondary outcome variables were not measured at three weeks due to a lack of survey response.
Conclusions: Parents reported a high likelihood of behavior change when water safety education was tailored and relevant to their child. The tailored intervention evoked positive interaction and receptivity from parents and suggested a high motivation to make a behavior change. The effect of the intervention could not be tested due to the lack of follow-up and post data collection. The design of this evidence-based project is quantifiable and replicable in a low-acuity setting, which allows for future evaluations of self-reported behavior change and knowledge improvement.
Funding: No sponsorship or financial conflict of interest.
ContributorsRiggs, Jodi (Author) / Jacobson, Diana (Thesis advisor)
Created2019-05-01