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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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College of Nursing and Health Innovation
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Heparin Anticoagulation in Pediatric ECMO Patients

Description
Extracorporeal membrane oxygenation (ECMO) is a high-risk, but highly successful intervention for the survival of critically ill neonatal and pediatric patients. Patients supported by ECMO require continuous infusions of anticoagulant medications to prevent clotting of the ECMO circuit, thrombotic events in the patient, and other bleeding complications. Close monitoring, care,…

Extracorporeal membrane oxygenation (ECMO) is a high-risk, but highly successful intervention for the survival of critically ill neonatal and pediatric patients. Patients supported by ECMO require continuous infusions of anticoagulant medications to prevent clotting of the ECMO circuit, thrombotic events in the patient, and other bleeding complications. Close monitoring, care, and management of the ECMO circuit and its components, with specific focus on systemic anticoagulation, is vital as many factors may influence the efficacy of the anticoagulant and ultimately the patient condition. Globally accepted guidelines exist for the correct management of anticoagulation while supported on ECMO; however, health care centers frequently deviate from these recommendations. This project report synthesizes the most current literature on anticoagulation management in the pediatric ECMO supported population, discusses the limitations in current research, and demonstrates the necessity to use standardized anticoagulation protocols for the safest and most successful outcomes. To implement these findings, this project report suggests the need for an evidence-based project that focuses on the quality improvement of current ECMO anticoagulation guidelines.
ContributorsHolmes, Lauren Michelle (Author) / Sebbens, Danielle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-26
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Improving the Identification of Depression in Pediatric Primary Care

Description
Introduction: Depression screening in the pediatric setting is a crucial part of the adolescent's examination. A standardized screening tool and protocol streamlines the process of assessing adolescents and minimizes the chances of serious mental health disorders going undetected and untreated. Evaluation of current evidence demonstrates the use of a standardized…

Introduction: Depression screening in the pediatric setting is a crucial part of the adolescent's examination. A standardized screening tool and protocol streamlines the process of assessing adolescents and minimizes the chances of serious mental health disorders going undetected and untreated. Evaluation of current evidence demonstrates the use of a standardized tool improves detection, diagnosis, and management of depression and other mental health illnesses. Method: The Patient Health Questionnaire—modified for adolescents (PHQ9-A) was administered to all eligible adolescents, ages 12-18, during an annual well visit for a period of 6 weeks. Lewin's Change Theory guided a system change in the electronic health record, and the questionnaire results were documented and provided to the pediatric provider at the time of the appointment. A chart review was conducted to determine whether all eligible patients were administered the questionnaire and if a depression diagnosis or mental health referral had been made. Results: Out of 76 eligible well visits, 65 (86%) patients completed the PHQ9-A. The average score was 5.29 (SD = 6.49) with a maximum score of 25. Out of those that completed screening, 11 (17%) had a positive PHQ9-A score resulting in 8 referrals to mental health services and 2 mental health diagnoses in the clinic.
ContributorsCoomer, Meagan (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27