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: Palliative Care
- All Subjects: Human trafficking
Methods: Educational sessions developed using information processing theory and outlining referral recommendations were offered to providers in the NICU, PICU, and Center for Cancer and Blood Disorders at a tertiary care facility. Presurveys and postsurveys were administered at the time of the intervention and referral numbers for the organization were collected for two months prior and two months following.
Results: Descriptive statistics and paired t-tests were used to compare survey data and referral rates.
Discussion: Palliative care is imperative for meeting patient goals and optimizing quality of life. Provider knowledge of referral criteria ensures that patients receive this service early in their disease trajectory and can benefit from its inclusion within their care team.
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.
Hospital readmissions for palliative care patients are costly for patients, families, insurance providers, and palliative care organizations. The evidence shows that integrating virtual visits into palliative care is an innovative way to reduce hospital readmissions, preserve costs, and reduce geographical barriers. The purpose of this article is to evaluate how well transitional care virtual visits reduce future hospital readmissions for palliative care patients when compared to usual care of in-home nurse visits. Palliative care patients from a large palliative company in Arizona, who received a transitional care, post hospital discharge, virtual visit with traditional model care (intervention) were compared to randomly selected traditional model care patients (control).
Data was collected through a retrospective chart review at 30 and 60 days post hospital discharge to evaluate for hospital readmissions and avoided readmissions. The Fishers Exact test was used to compare the results of the two groups to each other. There was no significant difference between the two groups. Virtual visits have an added cost to the agency without decreasing the risk of readmission. Implications for practice are to continue offering transitional care in-home nurse visits. Future research should evaluate if using virtual visits justify the increased costs of use.
Early and effective end-of-life care are associated with increased quality of life for those patients who may be nearing the end-of-life (EOL). However, evidence suggests that most non-palliative healthcare providers lack the skills and confidence to initiate EOL conversations. Consequently, about 70% of Americans would prefer to die at home with their families, yet only 25% die according to their wishes (State of California Department of Justice, n.d). In alignment with the Peaceful End of Life Theory, the purpose of this evidence-based project is to increase primary healthcare providers’ level of skills and confidence in end-of-life discussions.
This project utilized a pre and post study design. A total of 11 participants were recruited using convenience sampling from three primary care clinics in Phoenix, Arizona. Due to the small sample size and assumption of a non-normal distribution of the data, Wilcoxon Signed Ranks test and Pearson correlation coefficient were used for statistical analysis. There were clinical and statistical significant improvements in the EOL knowledge of the participants after the implementation of the two-and-a-half-hour Serious Illness Care Program (Z = -2.950, p = .003) with a large effect size (r = -0.62).
The project evaluation also demonstrated that most participants deemed that the intervention was effective. A brief and systematic education session, such as the SICP can be utilized to improve non-palliative healthcare providers’ skills in having more and effective end-of-life conversations.