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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College of Nursing and Health Innovation
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Purpose & Background: Serious mental illness among incarcerated people continues to rise within the United States. Correctional officers only receive an average of 13.54 hours of training in special populations, including the mentally ill (Kois et al., 2020). This lack of training leaves new correctional officers inadequately prepared to manage

Purpose & Background: Serious mental illness among incarcerated people continues to rise within the United States. Correctional officers only receive an average of 13.54 hours of training in special populations, including the mentally ill (Kois et al., 2020). This lack of training leaves new correctional officers inadequately prepared to manage this population in prison. Education is a cost-effective modality to provide a long-term change of practice. Mental health education was provided to New Correctional Officers (NCOs) at a 2,000-bed facility in Southwestern United States during their initial correctional officer training. Internal permissions were granted by the prison internal review board (IRB) and the Arizona State University IRB. Methods:NCOs (n = 7) were recruited and consented to participate in psychoeducation specific to mentally ill prisoners. Using an evidence-based curriculum developed by Dr. Dana Dehart at the University of South Carolina, NCOs participated in four (4) 1-hour long mental health trainings that were instructor led. Pre/Post assessment tools were completed using a 10-item trauma quiz and a 12- item Mental Health Knowledge Schedule (MAKS) scale assessing participant attitudes towards mental illness. Results: Participants were primarily male (57 %), White (42%), with an average age range between 31-40 years old, and with a high school degree. Post intervention quiz and MAKS show improved knowledge for all subjects using both tools. Discussion/Conclusion: This project highlights cost-effective training with significant preliminary results in reducing stigma towards the mentally ill in prison. Furthermore, this information justifies the support, development, and funding for increasing mental health training for correctional staff nationwide.
Created2022-05-07
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Police officers have more mental health issues than the general population and face barriers to seeking help, such as stigma, organizational masculinity, and concerns about confidentiality. This project took place in an urban police department in Arizona and aimed to increase the frequency of officers seeking peer support or counseling

Police officers have more mental health issues than the general population and face barriers to seeking help, such as stigma, organizational masculinity, and concerns about confidentiality. This project took place in an urban police department in Arizona and aimed to increase the frequency of officers seeking peer support or counseling and reduce mental health stigma. Peer support volunteers increased officer contact following exposure to traumatic incidents. Officers viewed an educational video on mental health and available resources, and sergeants were provided with a quick reference guide on mental health warning signs. Rates of counselor fund utilization by officers pre-and post-intervention were monitored, and all officers were emailed a Likert-scale peer support satisfaction survey. Survey results (n=39) showed officers were moderately satisfied with peer support and knowledge, but many were not comfortable contacting peer support for personal issues. Of officers surveyed, 74.4% (n=29) did not seek counselor services after contact with peer support. Counselor fund utilization slightly increased post-intervention, but further study is needed to determine the correlation to interventions. This project was unable to definitively demonstrate that peer support and education for officers and leadership increases help-seeking behaviors. Future projects should focus on improving peer support volunteer training and education.
Created2022-05-03
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Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as

Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as well as exposure to patient’s trauma. The aim of this project was to decrease burnout among psychiatric nurses in a private practice out-patient family psychiatric facility using Rossworm and Larabee’s change model (Appendix D). The MBI-HSS was completed by 1 participant (n=1) at pre-intervention and post-intervention. Between the pre/post MBI-HSS questionnaire the participant was asked to partake in a mindfulness-based intervention utilizing the smartphone application Headspace to complete a 10-session meditation course over one week. The results conclude the participant’s burnout decreased overall from pre-intervention to post-intervention. Internal Review Board (IRB) was granted in September 2021, and the project was completed in November 2021. The impact of the project was projected to have a more thorough statistical influence, but due to the participant size, there is minimal impact of system or polices in the psychiatric facility.
Created2022-04-30
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Purpose: The COVID-19 pandemic has increased depression among the population. Exercise is a useful coping mechanism for depression and high intensity interval training (HIIT) can be utilized. Background: A community exercise facility provides HIIT exercises for gym members. The gym owner believed their HIIT program is a great tool for coping

Purpose: The COVID-19 pandemic has increased depression among the population. Exercise is a useful coping mechanism for depression and high intensity interval training (HIIT) can be utilized. Background: A community exercise facility provides HIIT exercises for gym members. The gym owner believed their HIIT program is a great tool for coping with depression. Methods: The gym offered a 21-day free HIIT program. Those who signed up for the program, 18 years of age or older, and were able to exercise under the Physical Activity Readiness Questionnaire were offered to participate in the study. Participants were given a pre-survey before they started exercises. This survey utilized the Patient Health Questionnaire-9 (PHQ-9), a standard depression rating tool that determines depression symptom prevalence. After the 21-day program, participants were given a post-survey involving the same PHQ-9. The survey scores were compared pre- to post-program. The surveys were coded to exclude any identifying information. Results: Mean PHQ-9 pre-test was 7.67, mean score post-test was 3. A paired t-Test resulted in a p=0.60, showed that it was not statistically significant. Discussion: The goal of this study was to determine if HIIT training was an effective coping mechanism for depression. The data shows that participants had decreased PHQ-9 scores from the pre- and post-program surveys showing a clinical significance. This data can be used to provide those suffering from depression a coping mechanism.
Created2022-05-02
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Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The

Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The project was guided by the Health Belief Model. Methods: Consent was obtained from 15 participants working as nurse advocates for a large insurance company. Nurse advocates are tasked with improving the health of patients and connecting them to additional resources. A twenty-minute educational intervention focused on the impact cancer has on mental health and the benefit of multiple psychosocial supportive resources was delivered to the participants. Education included a comprehensive review of the resources available for cancer patients at the project site. Participants were then given 10 minutes to complete a retrospective post-then-pre survey, based on a Likert Scale. Results: Statistically significant improvements in survey scores were observed in each of the three KAB domains. Statistical analysis confirmed improvements in survey scores were significant and not likely due to random variation. Participants also referred more patients into a cancer support program following the intervention. Conclusion: A brief educational intervention was able to improve KAB scores among nurses. There was also an increase in the number of patients these nurses referred into a psychosocial supportive program. Nurses that better understand the mental health needs of cancer patients are more likely to connect them with psychosocial resources. This intervention will become part of standard training for new nurse advocates at the project site.
Created2022-05-02
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Purpose & Background: This project evaluates the impact of education on a provider’s intent to screen for vitamin D deficiency in adults with depression. An internal Quality Improvement (QI) study at a local mental health primary care clinic revealed that only 1 in 3 patients with depression were routinely screened

Purpose & Background: This project evaluates the impact of education on a provider’s intent to screen for vitamin D deficiency in adults with depression. An internal Quality Improvement (QI) study at a local mental health primary care clinic revealed that only 1 in 3 patients with depression were routinely screened for vitamin D deficiency. Vitamin D is a crucial component of numerous systemic functions, including mental health, specifically depression. Methods: This QI project used the Rosswurm and Larrabee Model implementation framework. Institution Review Board (IRB) expedited review approval was received. This project was conducted at 10 Veteran’s Affairs (VA) primary care clinics in Arizona. An initial email with a recruitment flyer was sent to providers to launch the project. A second email was sent to participants who volunteered to participate in the project, with instructions and links to the asynchronous pre-survey, recorded education PowerPoint, and post-survey. Responses were analyzed using Intellectus Statistics software. Results: Provider knowledge of impact and intent to screen for vitamin D deficiency increased after viewing a brief education video (n=30). Frequency distribution analyses revealed a 23% average increase in agreement to screen for vitamin D deficiency at annual visits, “at-risk” individuals, knowledge of the association, and intent to screen regularly in depression. Conclusion: The education intervention was found to positively impact the provider’s intent and demonstrate the importance of screening for vitamin D deficiency in adults with depression.
Created2022-05-02
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Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and

Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and Larabee’s change model. The Questionnaire on Stigmatizing Attitudes Towards Children with Emotional and Behavioral Disorders (EBD) was completed by voluntary participants at pretest, posttest and at a one month follow up. Between pretest and posttest, participants engaged in three educational modules regarding mental health. Participants were voluntary, anonymous staff members at a pediatric hospital currently employed in the PICU. Results of the questionnaires pre M= 23 post M=11 and follow up M=9.5 indicates education improves attitudes, and decreases bias in PICU staff. Recommendation to obtain larger population of study with trial implementation. Recommend adding educational modules to annual education or to new hire orientation.
Created2022-04-28
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Major depressive disorder contributes to a growing disease burden globally, with limiting or inadequate treatment options available to patients and healthcare providers. Traditional medications to treat the disorder demonstrate modest efficacy while best outcomes are seen when psychotherapy is implemented adjunctively. Barriers to delivering optimal treatment can lead to relapse, diminished psychosocial functioning, and

Major depressive disorder contributes to a growing disease burden globally, with limiting or inadequate treatment options available to patients and healthcare providers. Traditional medications to treat the disorder demonstrate modest efficacy while best outcomes are seen when psychotherapy is implemented adjunctively. Barriers to delivering optimal treatment can lead to relapse, diminished psychosocial functioning, and suicide, a leading cause of death in the United States. The purpose of this paper is to examine the rapid antidepressant effects of ketamine combined with nurse-delivered mindfulness-based cognitive therapy to help reduce depression severity and support remission. Research differentiating ketamine’s mechanism of action from traditional anti-depressants and the efficacy of mindfulness-based interventions to reduce depression, have led this evidence-based project integrating these modalities.
Created2021-04-20
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Successful management of pediatric procedures is challenging. Many procedures have a detailed list of pre-procedural requirements and post-procedural pain control regimens. Patients and families often get lost in the many requirements needed before scheduling the procedure and often delay intervention. This delay can cost both the families and facility time

Successful management of pediatric procedures is challenging. Many procedures have a detailed list of pre-procedural requirements and post-procedural pain control regimens. Patients and families often get lost in the many requirements needed before scheduling the procedure and often delay intervention. This delay can cost both the families and facility time and money but often leave the patient needlessly suffering. Inadequate pain control results in emergency room (ER) visits or hospital admissions for acute postoperative pain management. The opioid epidemic has significantly impacted postoperative opioid prescriptions at discharge. The limited prescriptions available after discharge, paired with inadequate understanding and support of discharge postoperative instructions by the family, result in increased acute postoperative pain management admissions. Postoperative pain is the leading cause of hospital readmissions within 48 hours of discharge. These ER visits are typically for issues that are easily addressed at home. Teach-back methods have shown to be the cornerstone of education, resulting in knowledge gained and increased pain regimen adherence. A literature review exploring current evidence regarding postoperative pain control and interventions coupled with teach-back was conducted to address this concern, and an evidenced-based intervention is proposed.
Created2021-04-20
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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