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: Psychiatry
- All Subjects: Human trafficking
Background: The consequences of poor communication or non-therapeutic communication cannot be overemphasized; these can include non-adherence to treatment plan, reduced treatment compliance, higher psychological morbidity, dissatisfaction with care and poor patient-caregiver relationship. Patients’ perception of how they are being treated affects how they respond to treatment plans and medication regimens
Method: The project consisted of providing education on the principles of therapeutic communication to healthcare workers in an outpatient psychiatric clinic. Follow up materials on therapeutic communication principles were provided on a weekly basis for one month. A pre-survey questionnaire was given to patients before intervention and a post-survey questionnaire after intervention to determine patient satisfaction with care and degree of communication with healthcare workers. The Short Assessment of Patient Satisfaction (SAPS) and the Communication Assessment Tool-Team (CAT-T) were the instruments utilized in this project.
Finding: Patient satisfaction and communication with staff were statistically and significantly improved after education on therapeutic communication was given to staff.
Conclusion: Education on therapeutic communication is an effective intervention tool in improving patient’s satisfaction and communication with staff and health care team members in a psychiatric outpatient clinic.
Mental health issues are a growing concern for individuals and the public. When patients do not attend their mental health appointments they place themselves at risk for poor health outcomes including worsening of symptoms, relapse, hospitalization, or danger to self and other behaviors. The breadth, background, and significance of this issue were investigated to determine a clinically relevant PICOT question. These elements of the PICOT question were investigated and high-quality evidence was gathered, analyzed, and synthesized in order to develop recommendations for an evidence-based project to help with no-shows at a non-profit integrated healthcare organization that is experiencing a high incidence of no-shows. The Quality Health Outcomes Model and Ottawa Model of Research Use guide the implementation and monitoring of the project.
A chart review was completed in order to understand the impact of a novel automated reminder system on the no-show rate for all psychiatric appointments for 18 months. Additionally, demographic and appointment information was gathered to identify trends in the data and factors related to appointment status. The no-show rate significantly increased in 2019 with the new reminder system. No-shows occurred significantly more in males, tele-medicine appointments, and hospital discharge appointments. There were significant differences in no-show rates observed between reported races, with different providers, and at different practice locations. This gap analysis has provided insight into further projects and work to be completed in order to decrease no-shows, improve treatment compliance, produce better health outcomes, and increase revenue for this organization.
Purpose: The purpose of this project was to examine if a relationship existed between the changes in attitude and knowledge of a mental health care provider, before and after an educational intervention was given on how to identify sex trafficking victims.
Background: According to the National Trafficking Hotline (2017), last year there were over 5,000 cases of sex trafficking reported. Lederer & Wetzel (2014) discuss that more than 88% of victims interact with a health care provider while being trafficked at least once. A majority of cases, mental health care providers were informed that their patient was a sex trafficking victim through collaboration of other services. Without this collaboration, many providers would have never
known that they had interacted with a victim (Domoney, Howard, Abas, Broadben, & Oram, 2015).
Methods: The participant population consisted of psychiatrists, psychiatric nurse practitioners and psychologists working in acute and out patient settings.
A pre survey was given to identify the participant’s knowledge of sex trafficking and their awareness of available resources and tools to help screen as well as treat victims of sex trafficking. After completion, the participants viewed an educational voice over presentation that educated them on how to identify current sex trafficking victims, what screening tools are available, the mental health risk factors and how to protect both the victim and provider from potential danger from the alleged trafficker. A post survey was then given to assess their knowledge after the presentation intervention, how much they retained and their confidence in being able to assess and treat sex trafficking victims. All surveys and the presentation were available online for participant convenience via a private link.
Results: The knowledge posttest score was higher than the pretest (Z=-2.694, p<0.007).
The confidence score on treating sex trafficking victims was higher posttest (Z=-2.251, p<0.024) No significant change in attitudes for advocating for sex trafficking victim care. All providers agreed that this high-risk vulnerable population needs advocates (Z=4.67, p<0.707).
Conclusion: All providers agreed for the need to advocate for victim care prior to the educational intervention. The results suggest that mental health providers are more knowledgeable posttest about risk factors, have a higher level of confidence in treating sex trafficking victims and have a higher confidence in their ability to protect victims and provide adequate care.
Findings suggest that stigma associated with mental health may be as strong in healthcare providers as it is in the general public. Research involving non-behavioral health nurses, and medical and nursing students, sought to identify bias and negative attitudes directed towards psychiatric patients in a non-psychiatric setting. Studies were reviewed to determine the effects of educational interventions to teach empathy and increase knowledge related to the pathology of, and treatment modalities for, psychiatric patients. Several scales were used to measure bias and rate interventions to minimize it.
Studies found that healthcare personnel, including nurses, are considered by mental health consumers to be primary contributors to stigma and discrimination against those with mental illness. The studies also discovered that participation in an educational intervention to learn empathy and acquire knowledge about psychiatric patients directly decreased bias. The project utilized the evidence-based practice PRECEDE-PROCEED model (PPM) supported by Bandura’s Social Cognitive Theory (SCT). Combining the PPM with the SCT is supported in the literature as they both rely on learned behavior.
Moving forward, the presentation was completed and participation sought. It was at this point the project shifted its perspective. Out of 80 nurses asked to attend 1 of the 2 presentations, a total of 3 nurses participated. The search for statistical significance was not possible. We were left to formulate descriptive statistics to interpret the outcomes and reflect on their meaning.
Aim: To determine the change in provider’s compassion fatigue after implementing an education-based intervention in behavioral health.
Materials and Methods: A four-part education-based intervention for compassion fatigue was implemented over the course of 16 weeks. The Professional Quality of Life instrument was used to measure compassion fatigue and compassion satisfaction.
Results: Although not statistically significant, mean compassion fatigue scores decreased in the sample.
Conclusion: Based on these results, further exploration into the causative factors of compassion fatigue in behavioral health are recommended.