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.

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Description
Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding

Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding effective education. Nonsuicidal self-injury is highly correlated with suicidal behavior, and suicide is the second leading cause of death among ten to nineteen year olds in the US. Research points to the use of a specific type of Coping Skills Training known as Mental Health Literacy that reduces the chances that maladaptive coping will become the norm in adulthood.
ContributorsLandon, Rebecca J. (Author) / McIntosh, Wayne (Thesis advisor)
Created2019-04-15
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Description
Background: There is a great need to provide people with Parkinson disease (PD) not only quality medical care, but social support and disease-related resources. Nurses have the training and interpersonal relationship skills to make a tremendous difference in the lives of people living with PD. Objective: This quality improvement project

Background: There is a great need to provide people with Parkinson disease (PD) not only quality medical care, but social support and disease-related resources. Nurses have the training and interpersonal relationship skills to make a tremendous difference in the lives of people living with PD. Objective: This quality improvement project evaluated the effect of a nurse navigation program on self-efficacy among people living with PD.

Methods: Twenty-four members of a PD specific wellness center in the United States were recruited to participate in a nurse navigation program for a 12-week period. The intervention period included an initial needs assessment, ten individual 45-minute sessions focused on specific aspects of PD wellness, and a concluding visit. Results: There was a significant decline in quality of life based on average PDQ-39 scores for the participants in January 2019 (M =24.44, SD=16.66) compared to January 2018 (M=20.11, SD =12.78) where higher scores signify worse quality of life; t(23)-4.329 p=0.025. Average self-efficacy for managing chronic disease pre-intervention scores (M=6.58, SD=1.70) verses post-intervention scores (M=7.44, SD=1.48) showed a significant increase in self-efficacy with a medium effect size; t(23)-0.854 p=0.016, d=0.54. Additionally, unique satisfaction surveys showed high satisfaction with nurse navigation throughout the participant sample and wellness center staff members.

Conclusions: A nurse navigation program focusing on specific aspects of PD management can help improve participant’s confidence in self-management of PD despite disease progression. Additionally, nurse navigation for people with PD was associated with high satisfaction among participants and staff members of a PD wellness center.
ContributorsDe Santiago, Stephanie (Author) / Nunez, Diane (Author, Thesis advisor)
Created2019-04-15
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Description
Background: Obesity is a known comorbidity for chronic disease and is responsible for 47% of related medical costs. Recognizing the complex etiology of obesity, the need for an effective and comprehensive screening tool will assist primary care providers in assessing their patient's needs and facilitating success in managing their weight

Background: Obesity is a known comorbidity for chronic disease and is responsible for 47% of related medical costs. Recognizing the complex etiology of obesity, the need for an effective and comprehensive screening tool will assist primary care providers in assessing their patient's needs and facilitating success in managing their weight and health. Primary care providers (PCP) have limited knowledge of current evidence in obesity treatment. The project guides the form of tools to help identify the patients' self-efficacy, change readiness, and insurance reimbursement. Methods: Expedited IRB approval was obtained, allowing for data analysis from completed de-identified screenings, surveys, and medical records gathered between September 2022 and April 2023. Screenings including Weight Efficacy, Lifestyle long-form (WEL-LF), and Stages Of Change Readiness And Treatment Eagerness Scale In Overweight And Obesity (SOCRATES-OO) were used to assess the effectiveness of the treatment plan. Russwurm and Larrabee's model for evidence-based practice change was chosen for the project's framework. The provider was given a guide for obesity management with tips for billing insurance. A convenience sample of eight patients met with the providers over three months as part of their obesity management treatment plan. Results: The pre and post-screenings collected from the remaining participants (n=8) showed no statistical differences. However, the satisfaction and feedback survey from patients (n=8), provider (n=1), and office staff (n=4) showed improved quality of care and greater confidence in the provider's part in initiating and managing their patient's chronic obesity. Conclusion: Improving PCPs' knowledge of Obesity treatment improves patient care. Expanding this project to a larger scale and disseminating the information can impact patients' lives positively. Keywords: Obesity; self-efficacy; readiness for change; stages of change; primary care, Weight Efficacy Lifestyle questionnaires
ContributorsBrock-Andersen, Marian (Author) / Moffett, Carol (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-28
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Description
Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental

Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental health literacy (MHL) in adolescents would improve while decreasing stigma and improving help-seeking behaviors after a program of enhanced mental health education. Partnering with a large Arizona suburban school district social work department, a teen Mental Health First Aid (tMHFA) pilot program was implemented for a class of nine (n = 9) adolescent students (aged 17-18 years) old during the school day. tMHFA was delivered in three 90-minute class days. Using the Mental Health Literacy questionnaire (MHLq), a pre and post-test design revealed a significant (p value=less than 0.05) increase in the students' MHL, help-seeking behaviors, and decreased stigma after delivery. This quality improvement project was IRB approved, and all human subjects' rights were protected. In conclusion, there is strong evidence that enhanced mental health programming, such as tMHFA, effectively educates adolescents about mental health challenges and, perhaps, could promote behavioral changes in future generations.
ContributorsJones, M. Christina (Author) / Schiller, Zita (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-15
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Description
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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Description
Breastfeeding provides significant health benefits for mothers and infants, but many women fall short of the breastfeeding goals set by the Healthy People initiative. National guidelines such as the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Academy of Breastfeeding Medicine, and the American Academy of

Breastfeeding provides significant health benefits for mothers and infants, but many women fall short of the breastfeeding goals set by the Healthy People initiative. National guidelines such as the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Academy of Breastfeeding Medicine, and the American Academy of Family Physicians recommend exclusive breastfeeding through six months of age. Peer support and education are key components in helping women achieve their breastfeeding goals and improve breastfeeding self-efficacy. A private obstetrics and gynecology office in the Southwestern United States did not routinely provide breastfeeding support. As the number of people using online peer support groups has grown in popularity and with the project site having an existing active Facebook© page, a project was created utilizing a private Facebook© group for breastfeeding mothers to receive peer support and evidence-based education. Over 12 weeks, evidence-based education postings and discussion prompts were created to encourage conversation upon participants. Sixteen participants made 30 discussion posts. After 11 weeks, three completed the confidential survey and the Breastfeeding Self-Efficacy Scale Short Form, which showed significant levels of breastfeeding self-efficacy. One hundred percent (n=3) of participants accessed the education handouts and found them helpful. Education and peer support results in high breastfeeding self-efficacy which in turn increases breastfeeding duration and exclusivity.
Created2021-04-28
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Description
Sickle cell disease is a genetic hemoglobinopathy resulting in chronic and daily pain, risk of serious sequelae, and altered activities of daily living. Resources dedicated to helping individuals with sickle cell disease are lacking, especially compared to other chronic diseases. Children with sickle cell disease experience school absence, fractured peer

Sickle cell disease is a genetic hemoglobinopathy resulting in chronic and daily pain, risk of serious sequelae, and altered activities of daily living. Resources dedicated to helping individuals with sickle cell disease are lacking, especially compared to other chronic diseases. Children with sickle cell disease experience school absence, fractured peer relationships, frequent healthcare visits, stigma, and feelings of isolation. Additionally, chronic pain decreases developmentally important play and physical activity in these children. The purpose of this Doctor of Nursing Practice (DNP) project is to conduct a needs assessment to inform sickle cell disease family camp programming in southern Arizona. Once a camp experience can be safely implemented, the effects of a camp experience on knowledge, empowerment, and disease management in children with sickle cell disease will be investigated. Research specific to camps for children suffering from sickle cell disease is lacking, however ample evidence suggests the benefit of disease specific camps. Medical specialty camps provide an opportunity for children and families to normalize their condition, participate in activities, and form peer relationships in an environment that safely accommodates their unique needs. This has led to the initiation of an evidence-based project to develop a needs assessment for families affected by sickle cell disease and community partners to inform camp activity development guided by Bandura’s theory of self-efficacy and the Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation.
Created2021-04-23
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Description

The mentor role can help support the experienced nurse practitioner (NP) enhance a sense of belonging and commitment to the organization; however, NPs identify barriers of time, dedication, and lack of knowledge about mentoring. Current mentoring programs in Arizona are sporadic and formal training for the mentor is even more

The mentor role can help support the experienced nurse practitioner (NP) enhance a sense of belonging and commitment to the organization; however, NPs identify barriers of time, dedication, and lack of knowledge about mentoring. Current mentoring programs in Arizona are sporadic and formal training for the mentor is even more limited. In this project, an online training intervention to develop mentorship skills was provided for experienced NPs who viewed three video sessions of 20-25 minutes each. The topics (Open Communication & Accessibility; Mutual Respect & Trust; Independence & Collaboration) focused on developing key mentoring competencies identified from the literature. Participants did not report a significant increase in their mentoring skills after the video sessions, but they identified useful individual outcomes. Participants identified the need to formalize the experience with objectives for both the mentee and mentor and recommended seeking out the novice NP to build a mentoring relationship.

The project outcomes led to several recommendations. To support ongoing mentor relationships, organizations may need to push training out to their experienced NPs on the role of the mentor. Mentors who do not self-identify for remediation or training may need organizations to provide the training and not make it optional. Community and professional organizations like the Arizona Board of Nursing, Arizona Nurses Association and others could create training modules utilizing multiple platforms to reach NPs in rural and urban parts of the state. Finally, further projects are necessary to identify the most effective modalities when delivering training.

ContributorsHealy, Heather (Author) / Hagler, Dr. Debra (Thesis advisor)
Created2020-04-30
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Description
Purpose: The purpose of health literacy education is to increase an individual’s understanding of health and use of the healthcare system. Low health literacy is associated with misuse of healthcare resources and misunderstanding of healthcare teaching. Education has demonstrated efficacy in improving health literacy. A personalized educational program was provided

Purpose: The purpose of health literacy education is to increase an individual’s understanding of health and use of the healthcare system. Low health literacy is associated with misuse of healthcare resources and misunderstanding of healthcare teaching. Education has demonstrated efficacy in improving health literacy. A personalized educational program was provided to parents of Head Start children, offered in Spanish and English, and at a 3rd to 5th education level.

Design: Using an established program for health literacy education, a Doctor of Nursing Practice project was implemented. The effect the program had on increasing the health literacy of participants over a period of 4 weeks was examined. The predominately, Latina participants received three hours of instruction based upon the health literacy book “What to do When Your Child Gets Sick”.

Setting and Subjects: The educational program took place in a large, urban county in the Southwestern United States with 24 parents of preschool age children in Head Start.

Intervention: The educational program contained three hours of classroom instruction utilizing PowerPoint® presentation, demonstration, and teach-back techniques on how to care for a child’s healthcare needs.

Measures and Analysis: Pre-, post- and telephone surveys were used to assess the impact of the health literacy educational program. Wilcoxon and Freidman tests were used to interpret the results.

Results: Despite no significant increases in health literacy post implementation, participants’ remarked that they felt the class was helpful and wanted to share the information with friends and family. They appreciated the program and wanted more educational opportunities.

Conclusion: Advanced practice nurses must acquire understanding, cultural sensitivity, and assess the needs of the community when implementing health literacy educational projects.
ContributorsVasquez, Damara (Author) / Jacobson, Diana (Thesis advisor)
Created2017-05-02
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Description

As the incidence of acute and chronic wound conditions rises and wound dressing protocols become more complex, uninsured patients lacking access to specialty wound care are challenged to manage their own wounds. Understanding multistep dressing change protocols may be inhibited by low health literacy. Low health literacy is associated with

As the incidence of acute and chronic wound conditions rises and wound dressing protocols become more complex, uninsured patients lacking access to specialty wound care are challenged to manage their own wounds. Understanding multistep dressing change protocols may be inhibited by low health literacy. Low health literacy is associated with reduced disease knowledge and self-care. Little evidence of health literacy effects on wound patients is available nor are literacy-sensitive educational interventions that address wound knowledge and self-care. Improved outcomes occur in all health literacy levels in other diseases with the use of literacy-sensitive educational interventions that incorporate more than one literacy strategy over multiple sessions. To examine the effectiveness of a literacy-sensitive wound education intervention on wound knowledge and self-care, an evidence-based pilot project was conducted in an urban wound clinic.

A convenience sample of 21 patients received a literacy-sensitive wound education intervention consisting of spoken and written communication over several sessions. Instruments measured health literacy level, wound knowledge, dressing performance, and wound healing status. There was a significant increase in wound knowledge scores in all literacy groups from baseline to visit two (p < .01) and four (p < .01). Dressing performance scores remained consistently high through visit four in all literacy levels. All participant’s wounds progressed toward wound healing significantly from baseline to visit two (p < .01) and four (p < .01). Incorporation of a literacy-sensitive education intervention with supportive literacy aids over several sessions supports improved wound knowledge and dressing self-care and can affect healing in patients of all health literacy levels.

ContributorsTharalson, Erin (Author) / Root, Lynda (Thesis advisor)
Created2018-04-20