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.
Filtering by
- All Subjects: Vaccination
- All Subjects: Health literacy
The human papillomavirus (HPV) is a sexually transmitted infection (STI) that is associated with several types of cancer and genital warts. No cure exists for those currently infected with HPV, but a vaccine is available that can prevent the virus and development of cancers associated with HPV. Military servicemembers are at a high risk for contracting HPV; it is one of the most common STIs among active duty service members. The health consequences of HPV can impact a servicemember’s military readiness. The HPV vaccine is not required for military servicemembers, but it is offered free of charge. HPV vaccination rates among military service members remain relatively low.
The purpose of this evidence-based project was to increase the level of knowledge about HPV, improve health beliefs regarding HPV, increase HPV vaccine intention, recommendation, and uptake. Using the Health Belief Model as an organizing framework, a population targeted eight-minute education video on HPV and HPV vaccination was developed. It was implemented at an outpatient military treatment facility located in the southwest United States over a 6-week period, to newly reported service members. Participants included 116 military service members aged 18 to 45. A pretest and posttest questionnaire were used to assess the impact of the intervention. HPV level of knowledge increased significantly from pretest to posttest mean scores were 3.00 to 4.39 respectively (p < .001). HPV vaccine intention increased from 62% to 66% (p = .739). HPV vaccine recommendation increased from 62% to 85% (p < .001).
experiencing homelessness are a vulnerable population in which access to preventative health care services is lacking. Prevention of acute illness, whenever possible, is crucial to maintaining the health of this population. The purpose of this project is to increase influenza vaccinations through staff education at a homeless clinic.
Methods: Eighty-eight volunteer staff, at a student led homeless clinic, received education on the influenza vaccinations. The education occurred at the first orientation meeting of the fall semester in 2016 and consisted of; the importance of immunizations, goals of Healthy People 2020, and an emphasis on addressing patient objections. The effectiveness of the program
compared the percentage of patients immunized from August - December 2016 to 2015.
Results: Post intervention, 44% of the clinic patients were immunized against influenza,
compared to 18% (pre-intervention). This finding resulted in a statistically significant increase in
vaccinations (Z= -5.513, p= < .001, Wilcoxon signed rank test). Eighty-eight volunteers were
present at the influenza vaccination educational intervention and 82 returned their surveys
(response rate 93%). The average score of the posttest was 96% (range 70-100%).
Conclusions: These findings support staff education on influenza vaccinations as a strategy for
increasing vaccination in the homeless population. Such interventions provide promise to
increase influenza vaccinations, however, they fall short of meeting the goals of Healthy People
2020. Identifying innovative interventions is critical to meet the goals of Healthy People 2020.
The human papillomavirus (HPV) is the most commonly spread sexually transmitted infection in the United States. Although the HPV vaccine protects against transmission of the most common strains of HPV that cause genital warts and numerous urogenital cancers, uptake in the United States remains suboptimal. Failure to vaccinate leaves individuals vulnerable to the virus and subsequent complications of transmission. The evidence demonstrates that provider recommendation alone increases rates of vaccine uptake. The literature does not suggest a specific method for provider recommendation delivery; however, best practice alerts (BPAs) were correlated with increased vaccination rates.
These findings have directed a proposed project that includes an electronic health record (EHR) change prompting internal medicine, family practice and women’s health providers to educate and recommend the HPV vaccine at a Federally Qualified Health Center (FQHC) in the Southwest United States. The project demonstrates that after the implementation of a practice change of a HPV BPA in the EHR, HPV vaccination rates increased. Practice settings pre and post were similar, making the increase clinically significant.
The strengths of this project include an increase in HPV vaccination rates, a sustainable intervention, and an intervention that can easily be replicated into other health maintenance tasks. There were some limitations including the BPA alert only catching the HPV 9 vaccine series and the BPA did not always capturing historical data. Despite these technical barriers the HPV BPA delivered an increase in the HPV vaccine to protect more individuals from the HPV virus, increased provider adherence to national guidelines, and provides a platform for BPAs to be utilized for other vaccines.
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.
Background: Vaccine-preventable diseases significantly influence the health and academic success of college students. Despite the known negative impact of these diseases, vaccination rates routinely fall short of national goals and recommendations. Although vaccination decisions are complex, a recommendation from a health care provider is one of the key motivators for individuals receiving a vaccine. Motivational interviewing (MI), a counseling approach primarily used to address substance abuse, can be applied to other health-related behaviors.
Local Problem: Despite previous quality improvement efforts aimed at increasing vaccine rates for influenza, human papillomavirus (HPV), and meningitis B (MenB), vaccinations at large university health centers have been well below benchmarks set by Healthy People 2020.
Methods: This study was guided by the Theory of Planned Behavior and included MI training and regular reinforcement for health care providers to address vaccine hesitancy with college students.
Results: Influenza vaccination rates improved, but HPV vaccine rates remained stable and MenB vaccine rates decreased compared with the previous year. Clinicians demonstrated a significant increase in knowledge of MI techniques after a targeted educational intervention. Repeat measures indicate the potential for sustained improvement when ongoing reinforcement is provided.
Conclusion: MI can be an effective part of a strategy to increase vaccination rates.