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 - 10 of 42
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- All Subjects: Patient education
- All Subjects: Adolescent
- All Subjects: Telemedicine
Description
Background and Objectives: Electronic cigarette use, known as vaping, among adolescents was declared a public health epidemic in 2018 and has acute and chronic health consequences. Healthcare providers (HCP) play a pivotal role as health-related educators, including counseling against vaping. Primary HCPs report a lack of adequate knowledge, confidence, and screening for adolescent vaping. Increasing HCP’s vaping awareness and knowledge may increase rates of adolescent vaping prevention screening and counseling. Rosswurm & Larrabee Model and Health Belief Model were utilized in project design and implementation.
Methods: Primary HCPs (n = 8) that provide care to adolescents at a pediatric clinic in Phoenix, Arizona completed online pre- and post- education surveys measuring vaping knowledge before and after viewing an evidence based online educational video. Participation was voluntary, open to all clinic HCPs, and informed consent was provided before the intervention. Data analysis was completed with Intellectus Statistics using descriptive and inferential statistics.
Results: Results of the paired samples t-test was significant based on "?=.05" , t(7) = -3.56, p = .009. The mean of the post-education survey (12.38) was significantly higher than the mean of the pre-education survey (9.62). Descriptive statistics found 85.71% of HCPs reported increased intent to counsel for vaping and 57.14% of HCPs reported increased implemented vaping counseling with their adolescent patients four-weeks post intervention.
Conclusions: HCP vaping knowledge rates and vaping-related counseling and surveillance significantly increased after viewing the educational video. Implementing mandatory HCP vaping education training could increase adolescent vaping prevention interventions and counseling within primary care settings.
ContributorsMarks, Brianna (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Substance use among adolescents is incessantly problematic, but its recent collision with a rising opioid epidemic has exponentiated deaths in this age group. Despite opioids being a major contributor, indications remain that adolescent prevention efforts should focus on total substance abstinence. Evidence consistently highlights adverse childhood experiences and mental dysfunction as the strongest predictors of youth substance use initiation, and parent-focused interventions as the most significant prevention model. Participants in this project included five parents, with a teen between 11 and 16 years of age, who had recently experienced homelessness or where currently living in a transitional shelter. Guided by the Transtheoretical Model, this project assessed the impact of an evidence-based parenting program among high-risk families. Participants completed the Teen Triple P Online program from home while receiving weekly text message support. Each parent completed a pre-and post- Conflict Behavior Questionnaire (r=.86) and Depression, Anxiety, and Stress Scale (r =.71–.81), and a Client Satisfaction Questionnaire. A two-tailed Wilcoxon signed rank test was performed on the matched pairs of pre- and post- measures with the mean scores compared. Though statistically insignificant results were yielded, this quality improvement project found a clinically significant decrease in conflict behavior and parental anxiety, depression, and stress after completing the Teen Triple P Online program. Participant satisfaction with the program and subsequent family improvements was also found. These results suggest that interventions that decrease family conflict and improve a parent’s mental health, directly impact major family factors that contribute to adolescent substance use and adverse childhood experiences. This project contributes to the evidence that positive parenting programs have an impact at the individual, family, and societal levels.
ContributorsAllen, L. Amber (Author) / Helman, Jonathan (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-01
Description
Introduction: Electronic cigarettes (e-cigarettes) among youth has increased drastically in recent years. E-cigarettes are being used with nicotine which can lead to dependency. Healthcare providers (HPs) are in a unique position to advise against the use of e-cigarettes. Recent studies report a lack of formal education among HPs about e-cigarettes. The purpose of this quality improvement project is to examine how increasing e-cigarette awareness among HPs can change their behavior on patient counseling against e-cigarette use. Methods: A modified E-cigarette Knowledge, Beliefs and Attitude Questionnaire was proctored before and after a virtual educational training about e-cigarettes. All advanced HPs employed, in a Southwestern state, at the organization were invited to participate by email. Results: 29 participants completed the pre-survey, and 4 participants completed the post-survey. While 90% of the participants reported that they first learned about e-cigarettes through informal sources, 72% of the participants reported interest in learning more about e-cigarettes to enhance their practice. Further, a two-tailed Mann-Whitney U test was significant on the “e-cigarettes are helpful aid for smoking cessation” statement based on an alpha value of 0.05, U = 12, z = -2.69, p = .007. Conclusions: Increasing the knowledge about e-cigarettes among HPs is critical in decreasing nicotine use among the public. This project will help in the fight against the use of tobacco products, and adds to the literature on how formal education about e-cigarettes among HPs can increase their intention to screen and counsel patients.
ContributorsWelch, Analuisa (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese adolescents. Healthcare providers must continuously explore novel ways to empower teens to make healthy lifestyle changes. The Creating Opportunities for Personal Empowerment (COPE) Thinking, Emotions, Exercise, and Nutrition (TEEN) program was delivered to three adolescent participants in a primary care pediatric clinic in Southwest Arizona. The 15 sessions were provided weekly in the pediatrician’s office using the COPE TEEN manual. The participants completed the HABITS questionnaire and the Patient Health Questionnaire-9 (PHQ-9) before starting the program and after program cessation and kept confidential. The survey results were compared using descriptive analysis and paired t-tests to analyze the data collected. Due to a small sample size (n=3), statistical significance could not be calculated. However, clinical significance was found as evidenced by lower depression scores and improvement in healthy habits. A cognitive behavior skills-building program such as the COPE TEEN program has the potential to empower adolescents to make healthy decisions in life. These healthy choices lead to a long, happy life free from diseases caused by unhealthy choices. This program positively impacts the clinical care of adolescents who are overweight or obese by offering providers an alternative manner of educating adolescents.
ContributorsCortes, Holly (Author) / Esperas, Amanda (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Objectives: Asthma education is essential for every pediatric asthma management plan. This Doctor of Nursing Practice (DNP) Quality Improvement (QI) project, guided by the Social Cognitive Theory, aims to explore effective and innovative interventions for asthma management and determine if telehealth is an effective way to deliver asthma education to parents.
Methods: Parents (n = 5) of children with asthma at an urban pediatric primary care clinic were recruited to attend four weekly, 60-minute asthma education sessions over Zoom®. Participants were recruited with flyers and clinic referrals. Participants answered pre- and post-intervention online questionnaires following informed consent, including the Parental Asthma Management Self-Efficacy Scale (PAMSES), the Asthma Control Test (ACT), and a parent program evaluation. Paired sample t-tests were conducted to analyze data and measure mean differences in pre-and post-parent self-efficacy and asthma control in their child.
Results: The results include a statistically significant change in pre-intervention and post-intervention mean PAMSES scores. There was no significant difference between pre-intervention and post-intervention ACT scores; however, there was an increase in mean ACT scores from baseline.
Conclusions: Telehealth is a practical and cost-effective way to address gaps in asthma education and improve patient outcomes. The use of telehealth may be an effective way to address gaps in parent/patient education regarding the prevention of and management of asthma symptoms. Ongoing assessment is needed to evaluate if asthma telehealth education can be effective in other settings, languages, and age groups.
ContributorsFlores, M. Cynthia (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
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.
ContributorsBarrante, Adrianne (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-20
Description
Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in ADHD and if a brief education on sex differences in ADHD affects the primary care setting's screening rate.
Design/Methods: With the Arizona institutional review Boards' approval, primary care providers (PCP) in a Southwest family practice in Arizona (n=35) are provided with virtual education on sex differences in ADHD. Pre- post-intervention surveys were electronically administered to five PCPS. Data were deidentified. A two-tailed paired t-test was conducted to examine the mean difference of responses.
Results: Analysis of responses demonstrate that primary care providers are well aware of sex differences in ADHD but screened less for ADHD before the education intervention. Major themes emerged from provider comments on ADHD symptom recognition, time constraints, and increased screening to identify girls in the primary setting. A significant increase in ADHD screening is seen four weeks post-intervention t(4) = -6.32, p = .003.
Conclusion: Future research is needed to identify other factors that could strengthen ADHD screening during well-child visits overall. Also, the use of a pediatric screener which can highlight inattentive symptoms would assist in the process of identifying girls with ADHD.
ContributorsO'Connell, Roseann (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
False accusations concerning the development of autism and other hazardous side effects have triggered parental vaccine hesitancy, leading to outbreaks of vaccine-preventable diseases. This opposition to vaccination risks the health of both individuals and entire communities. The purpose of this project was to determine the effectiveness of prenatal education on maternal vaccine hesitancy and infant immunization rates. In a pretest posttest design, pregnant mothers greater than or equal to 30 weeks gestation were recruited by The Arizona Partnership for Immunization (TAPI) and virtually educated about infant immunization. A voice-over PowerPoint presentation was delivered to the participants virtually and focused on vaccine knowledge, intention to vaccinate, and vaccine hesitancy. These outcomes were evaluated virtually pre- and post-intervention with the Parent Attitudes about Childhood Vaccines (PACV) survey (⍺ = 0.84), and the infants’ vaccination records were compared against the recommended immunization schedule at two months of age. Using the Wilcoxon Signed-Ranks test, data analysis revealed vaccine hesitancy was significantly reduced between pre- and post-intervention (Z = 27.70, p = .000), and 100% of the 2-month-old infants were fully immunized with the recommended vaccines. The effect size (d = 12.807) also indicated a strong relationship between pre- and post-intervention vaccine hesitancy. Vaccine hesitancy remains a threat to public health. With prenatal education, pregnant mothers will likely become more knowledgeable of vaccine benefits and better prepared to make informed decisions. Confident vaccination will decrease vaccine hesitancy and improve immunization rates, while promoting individual and societal health.
ContributorsWolsey, Carly M. (Author) / Chen, Angela (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
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 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.
ContributorsSchwartz, Jennifer (Author) / Santerre, Jennifer (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Background: Type II diabetes mellitus (T2DM) is a growing issue globally. Social determinants of health (SDH) play a crucial role on patients’ outcomes and complications from the disease. Hispanics are twice as likely to suffer from T2DM when compared to non-Hispanic whites, and they often rely on federally qualified community health centers (FQCHC) for their medical needs. These centers are then faced with high volume of patients with high acuity, which leads to limited time and resources to provide diabetic education.
Methods: The Purnell model of cultural competence will be used as a framework to provide unbiased, culturally tailored (CT) education to improve patients’ outcomes. The advancing research and clinical practice through close collaboration (ARCC) model will be used as it focuses on evidence-based practice (EPB) implementation that is sustainable across the system.
Purpose: The purpose of this EBP project is to promote culturally tailored (CT) DSME at a low-income FQCHC in greater Phoenix to improve diabetes outcomes and decrease complications from the disease. Consequently, decreasing the costly effects of diabetes complications to patients, FQCHC, and the state of Arizona.
Conclusion: Evidence suggest that diabetes self-care management education (DSME) is successful, independent of the format of delivery, in improving diabetes outcomes and patients’ self-care. However, it is underutilized in the United States even though it is a covered Medicare service.
ContributorsDavis, Maria Regiane (Author) / Rauton, Monica (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28