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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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Sleep Coaching for Uniformed Firefighters

Description
Sleep deprivation is linked to poor mental and physical health outcomes for professional firefighters. The importance of sleep hygiene practices and health promotional activities may increase the amount of quality sleep firefighters get on their days off. As the adverse outcomes of circadian misalignment due to sleep deprivation becomes more…

Sleep deprivation is linked to poor mental and physical health outcomes for professional firefighters. The importance of sleep hygiene practices and health promotional activities may increase the amount of quality sleep firefighters get on their days off. As the adverse outcomes of circadian misalignment due to sleep deprivation becomes more apparent in firefighter wellbeing, the need for a sleep health program becomes more evident. The purpose of this paper is to examine and assess the effects of a sleep health program for firefighter wellness. Research emphasizing the relevance of poor health outcomes related to sleep disturbances is prevalent in the literature. The findings have prompted the development of an evidence-based sleep coaching program for firefighters in a local fire department guided by The Cognitive Behavioral Therapy Model (Brewin, C.R., 1996). and a knowledge-to-Action process framework for evidence-based-practice (Graham et al., 2006).
ContributorsAnon, Melanie (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
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The Effects of mindfulness on Depression and Anxiety

Description
Depression and anxiety are common and debilitating illnesses that negatively impact personal well-being and functioning. The effects of depression and anxiety not only affect the individual, but also peers, family, the community, economy, and even the health care system. Pharmacological therapy is a first line treatment for depression and anxiety,…

Depression and anxiety are common and debilitating illnesses that negatively impact personal well-being and functioning. The effects of depression and anxiety not only affect the individual, but also peers, family, the community, economy, and even the health care system. Pharmacological therapy is a first line treatment for depression and anxiety, but the risk for relapse remains. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are treatments that have demonstrated effectiveness in treating depression. The evidence suggests that both therapies are successful in terms of reducing depressive symptoms, but most effective when combined. Further, evidence shows that the combination of MBCT and traditional pharmacological therapy provides relief from depressive symptoms and lengthens the amount of time between recurrent episodes and improves the quality of life. A project was implemented at an integrated health clinic to evaluate the effectiveness of a mindfulness-based intervention to reduce the symptoms of depression and anxiety. The results revealed that practicing mindfulness was statistically and clinically significant in reducing depression and anxiety. In addition, mindfulness scores increased over 30 day application of the intervention. The results demonstrated the value of utilizing mindfulness as a cost-effective therapy in addition to pharmacological treatment to decrease symptoms of depression and anxiety, as well as improve mindfulness. The ease of use demonstrated the value of mindfulness and self-directed skills aimed at improving wellness, reducing depression and anxiety which will result in the improvement of individual, economic, healthcare system, and community health.
ContributorsFong, Luis (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-28
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DNP Project Report: Alternative Treatment for Mood in PD

Description
Background: Around 40-50% of people with Parkinson’s disease will develop anxiety or depression, the number one factors affecting their quality of life. Cognitive behavioral therapy is the most well-established intervention for anxiety and depression in people with Parkinson’s disease. Purpose: The project addresses a southwestern Parkinson-specific community center’s need for…

Background: Around 40-50% of people with Parkinson’s disease will develop anxiety or depression, the number one factors affecting their quality of life. Cognitive behavioral therapy is the most well-established intervention for anxiety and depression in people with Parkinson’s disease. Purpose: The project addresses a southwestern Parkinson-specific community center’s need for mental health by incorporating a cognitive behavioral therapy-based mental health program, guided by the Cognitive Behavioral Model. Methods: Recruitment at the center took place during a virtual weekly meeting with inclusion criteria of a Parkinson’s disease diagnosis, 50 years or older, and English speaking. A four-week, virtual, nurse-led cognitive behavioral therapy-based mental health program was created to examine the effects on anxiety, depression, and quality of life in ten people with Parkinson’s disease. Pre-and post-intervention Geriatric Anxiety Inventory (Cronbach’s alpha, 0.91), Hamilton Depression Rating Scale (Cronbach’s alpha, 0.87), and Parkinson’s Disease Questionnaires (Cronbach’s alpha, 0.84) were used to assess anxiety, depression, and quality of life. Results: Using a Two-tailed paired samples t-Test, mean values and p-value were calculated with alpha value of 0.05, t(39) = -0.10, p = .922 for anxiety, Alpha value of 0.05, t(16)=3.69, p=0.002 for depression, Alpha value of 0.05, t(38)=5.07, p<0.001 for quality of life, and Alpha value of 0.05, t(5)=4.54, p=0.006 for emotional wellbeing. Conclusion: A cognitive behavioral therapy-based mental health program at a Parkinson-specific center has the potential to improve quality of life and decrease depression in people with Parkinson’s disease. Implications: Research with larger sample sizes, longer duration of therapy, and in-person format would be beneficial.
ContributorsKielbania, Meghan (Author) / De' Santiago, Stephanie (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
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Educating Emergency Department Staff on Sex Trafficking Victim Identification: A Quality Improvement Project

Description
Objective: Nearly 90% of sex trafficking victims will come into contact with an emergency department healthcare provider during his or her period of exploitation. Yet, victim identification by healthcare providers remains inadequate. The purpose of this quality improvement project is to improve emergency department healthcare providers’ confidence and ability to…

Objective: Nearly 90% of sex trafficking victims will come into contact with an emergency department healthcare provider during his or her period of exploitation. Yet, victim identification by healthcare providers remains inadequate. The purpose of this quality improvement project is to improve emergency department healthcare providers’ confidence and ability to identify sex trafficking victims through staff education centered around sex trafficking. Method: A quality improvement project, guided by the Social Cognitive Theory, was implemented in an Arizona emergency department. ED staff were provided with a 40-minute education video about sex trafficking, including victim identification and appropriate responses. Participation in this project was open to all current healthcare workers employed at this emergency department. Stakeholders within the facility assisted with recruitment via weekly staff emails over a three-week period. A pre- and post-survey, consisting of a self-evaluation Likert scale, was used to assess confidence in identifying victims. Case studies were included to measure the participants’ ability to identify victims of trafficking. All aspects of this project were approved by Arizona State University’s and the organization’s Institutional Review Board. Results: One hundred percent of staff agreed to feeling confident in their ability to identify sex trafficking victims post intervention. However, there was no improvement in staff’s actual ability to identify victims through case studies post intervention. Conclusions: Education can be a valuable tool to improve confidence in identifying victims of sex trafficking in an emergency setting.
ContributorsKieser, Reynaldo (Author) / Helman, Jonathan (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
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Educating Healthcare Providers on Human Trafficking: A Small Intervention, Large Benefits

Description
Human trafficking affects men, women, and children, of all races, and incomes. Healthcare providers can work directly with those who are trafficked when they come into the emergency room or clinic to seek care. The identification of those who are trafficked is key to assisting those who need hel…

Human trafficking affects men, women, and children, of all races, and incomes. Healthcare providers can work directly with those who are trafficked when they come into the emergency room or clinic to seek care. The identification of those who are trafficked is key to assisting those who need help obtain resources and get the help they need to move forward in their lives. Unfortunately, many healthcare providers do not have the knowledge to identify or the time it takes to pick up on cues that a patient is being trafficked. Currently, there is no set education or curriculum to teach healthcare providers. This has resulted in increased lack of identification of those who are trafficked. An evidence-based quality improvement practice change was implemented. The purpose of this project was to educate healthcare professionals about the red flags that trafficked individuals might exhibit and to implement a screening tool in the emergency department. A brief educational Power Point on human trafficking was provided. A pre-test, post-test and a post-survey was utilized to evaluate awareness and knowledge. After the implementation of the human trafficking screening tool, 1,749 patients were screened, for a screening rate of 71%.
ContributorsRosch, Lisa (Author) / Chifelle, Rochelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-03
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Feasibility of Cognitive Behavioral Therapy in the Treatment of Suicidality of Children

Description
Background: Suicidal ideation and attempts are increasing in the adolescent population and suicide is now the second leading cause of death for youth 10-24 years of age (Center for Disease Control and Prevention [CDC], 2016). Children that continue to struggle with suicidality and depression after treatment as usual have an…

Background: Suicidal ideation and attempts are increasing in the adolescent population and suicide is now the second leading cause of death for youth 10-24 years of age (Center for Disease Control and Prevention [CDC], 2016). Children that continue to struggle with suicidality and depression after treatment as usual have an increased length of stay, from an average of five days to nine days per admission. Recidivism rates are also increasing, with some patients
requiring readmission the same day as discharge.

Method: The purpose of project was to check the feasibility of the use of cognitive behavioral therapy-based group called Creating Opportunities for Personal Empowerment (COPE) in the treatment of children with depression and suicidality. The study patients participated in up to 7 groups of a 60-minute lesson of COPE each day, combined with interactive activities that helped
them practice problem solving and coping skills. The feasibility of the COPE groups were measured by the consistent decrease of Columbia Suicide Severity Rating Scale at the beginning and conclusion of lessons as well as consistency of engaged participation in the COPE groups on the unit based of staff observation obtained from Staff Survey.

Results: The results analyzed using the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -3.64, p < .001. This indicated that the differences between Pre-CSSR and Post-CSSR were not likely due to random post variation. The median of Pre-CSSR (Mdn = 1.00) was significantly lower than the median of Post-CSSR (Mdn = 2.00).

Discussion: The results proved feasibility of a cognitive behavioral therapy-based group in the treatment of depression and suicidality of children in an inpatient unit.
ContributorsFreeman, Latasha (Author) / Guthery, Ann (Thesis advisor)
Created2020-05-02
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An Education for Mental Health Care Providers: Sex Trafficking Victim Identification

Description

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…

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.
ContributorsChang, Lillian (Author) / Chen, Angela Chia-Chen (Thesis advisor)
Created2018-04-29