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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Description
Background: Current standard of care practices for substance use disorder is inadequate in reducing relapse, with rates persistently 40-60% within one year of treatment. Unconventional approaches must be explored to reduce the risk of relapse, climbing rate of overdoses, and healthcare expenditures exceeding $740 billion annually. The purpose of this

Background: Current standard of care practices for substance use disorder is inadequate in reducing relapse, with rates persistently 40-60% within one year of treatment. Unconventional approaches must be explored to reduce the risk of relapse, climbing rate of overdoses, and healthcare expenditures exceeding $740 billion annually. The purpose of this quality improvement project demonstrates how an evidence-based group exercise intervention, used as adjunctive support to standard addiction treatment, can reduce relapse and promote long-term recovery during a global pandemic. Methods: Aims of this project sought to enhance quality of life scores. Participants were recruited upon admission to a residential treatment center. Pre-posttest design utilized the World Health Organization Quality of Life Abbreviated scale to assess program impact on quality of life. Pre-program descriptive questions and a survey assessing prior addiction treatment were collected. Group exercise and wellness education sessions were delivered twice weekly in a live, interactive, virtual format with on-site participants. Upon completion, a post-program survey was utilized to capture the qualitative experiences of participants and impact of project to instill confidence to execute long-term sobriety. Results: Pre and post scores, as well as domain scores were clinically and statistically significant. Additionally, 80% of participants reported feeling more prepared to achieve long-term sobriety secondary to their participation in this project. Discussion and Conclusion: Results from this project demonstrate the positive impact that group-based exercise and lifestyle interventions can have on quality of life and long-term recovery. Peer support exercise programs may offer means to enhance addiction treatment and reduce overall healthcare expenditures globally by defying the odds of relapse.
Created2021-05-01
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Description
Background: Existing substance use disorder guidelines are deficient in reducing relapse rates, evidenced by the substantial number of persons experiencing relapse within months of recovery, with most relapsing within one year. Current interventions lack community reinforcement approaches to reduce relapse and risk factors required to combat the extensive damages related

Background: Existing substance use disorder guidelines are deficient in reducing relapse rates, evidenced by the substantial number of persons experiencing relapse within months of recovery, with most relapsing within one year. Current interventions lack community reinforcement approaches to reduce relapse and risk factors required to combat the extensive damages related to substance use as costs exceed $1 trillion annually. Guided by the Social Cognitive Model, this quality improvement project aims to explore how group exercise combined with community reinforcement reduces relapse. It aims to boost recovery capital by improving quality of life scores. Methods: A CrossFit instructor delivered personalized group exercise and wellness education in-person biweekly for six weeks. Adult residential treatment clients were eligible to participate recruited via a flyer upon treatment entry. A pre-intervention demographic questionnaire, a pre-/post World Health Organization Quality of Life Abbreviated scale (reliability ? = > 0.70) assessing intervention influence on the quality of life, and a post-intervention survey was administered. The lead investigator performed all data distribution and collection. Institutional Review Board approval safeguarded participants' rights and risks. Results: Pre/post improvements observed in all domains; psychological and environmental were statistically significant, while 100% of participants reported enhanced QoL, social support, & confidence related to long-term sobriety post-intervention. Discussion/Conclusion: Desired outcomes are increased quality of life scores to boost recovery capital. A sober community reinforcement approach combined with exercise may link to reducing relapse and total costs related to this growing public health crisis.
Created2022-04-30
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Description
Background and Aims: The aim of this research was to assess whether clients receiving treatment for substance abuse in a residential treatment facility will achieve lower rates of relapse with treatment in combination with active sponsorship. Prior studies suggest sponsorship may equally be impactful as attending 12-step meetings.

Design: The

Background and Aims: The aim of this research was to assess whether clients receiving treatment for substance abuse in a residential treatment facility will achieve lower rates of relapse with treatment in combination with active sponsorship. Prior studies suggest sponsorship may equally be impactful as attending 12-step meetings.

Design: The primary hypothesis was that active participation as defined by contact with a sponsor of an hour or more per week, as measured by the impact on affective characteristics correlated with increased levels of sobriety, when measured by the AWARE questionnaire (Advance Warning of Relapse) within 7 days of entry and prior to discharge (within 30 days). Setting: The project took place in a residential treatment facility in Phoenix, Arizona.

Participants: There were 12 clients from a men’s house and 12 clients from a woman’s house, all of which were going through recovery. Intervention: The educational session explained what a sponsor is and the importance of finding one early as a key role in relapse prevention.

Measurements: Pre and post-test results were compared to see if there was an impact on the predictability of relapse and sponsorship. The paired t-test was performed to compare the two means of AWARE scores. A lower score on the AWARE questionnaire indicates a person is more likely to succeed in sobriety.

Findings: Based on 24 samples collected, the mean scores within the first seven days were 91.17 with a standard deviation of 18.59 and the mean score prior to discharge were 72.78 with a standard deviation (SD) of 20.02. The mean difference between the two scores was 18.39 (SD=2.84). There was a significant effect of the relapse prevention program which included sponsorship, t (22) = 4.79, p < 0.001.

Conclusion: Implications for practice include increased time with sponsors to reduce rates of relapse. Future concerns include good fit matching which may reduce rates of relapse even further.
ContributorsMoore, Christa (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-21
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Description
Substance use disorder has been increasing in the United States year after year. Modern treatments fail as often as they succeed. The current standards of practice fail to provide patients with the ability to harness thoughts and control anxiety. Mindfulness practices are currently being adapted as a therapeutic technique to

Substance use disorder has been increasing in the United States year after year. Modern treatments fail as often as they succeed. The current standards of practice fail to provide patients with the ability to harness thoughts and control anxiety. Mindfulness practices are currently being adapted as a therapeutic technique to address some of these concerns. An exhaustive literature review was conducted to investigate how various mindfulness techniques impact substance use disorder. Ten high-quality studies were retained and synthesized to show current understandings of the effectiveness of a mindfulness therapeutic technique. An evidence-based intervention is suggested for implementing mindfulness-based relapse prevention into a residential treatment facility. The intervention created incorporates the self-efficacy theory and an adapted health-belief model. Adults in a residential treatment facility for substance use disorder were given eight mindfulness sessions over the course of four weeks. Participants were given pre- and post-intervention screenings for mindful attention and anxiety. The data analysis after two-tailed paired T-tests showed that anxiety significantly decreased (α=.05, p<.001) and mindful attention increased significantly (α=.05, p=.015). Overall, mindfulness shows promise in its potential to reduce substance abuse.
ContributorsWandler, Ryan (Author) / Nunez, Diane (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
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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.
Created2021-04-28
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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%.
Created2021-05-03
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Description

According to the National Institute on Drug Abuse (NIDA), tobacco, alcohol, and illicit drugs accounted for 820 billion dollars in costs related to crime, lost work productivity, and health care services. Nearly 20 million Americans suffer from substance misuse, but only 3.7 million received treatment. Of those who receive treatment,

According to the National Institute on Drug Abuse (NIDA), tobacco, alcohol, and illicit drugs accounted for 820 billion dollars in costs related to crime, lost work productivity, and health care services. Nearly 20 million Americans suffer from substance misuse, but only 3.7 million received treatment. Of those who receive treatment, the risk of relapse is high, ranging from 40-60% within a year of treatment. Improvement in the treatment of substance use disorders (SUD) is necessary to improve the health of our society.

Current literature demonstrates that individualized recovery plans and follow-up care are effective in reducing relapse and readmission. Costs to the individual, institution, and healthcare system can be reduced. This project aimed to decrease the risk for relapse and readmission with recovery plan reviews at 72hrs, and two-weeks, post-discharge. The risk of relapse was measured by the Time-To-Relapse questionnaire and the UCLA loneliness scale. The project took place in a residential treatment facility in Phoenix, Arizona. There were five participants initially; two were lost at the two-week follow-up. Pre and post-test results were compared to measure potential predictability of relapse. The two-tailed paired samples t-test was performed to compare the means of the scores but yielded insignificant results.

All participants maintained sobriety. Qualitative data via interview showed positive results demonstrated by statements from the participants. Recovery plan review with follow-up care is a promising evidence-based practice that can be implemented to help individuals maintain sobriety. Additional research is recommended to examine further the impact on the maintenance of sobriety over time.

ContributorsEkstrom, Vince (Author) / Guthery, Ann (Thesis advisor)
Created2020-05-03
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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