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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Substance use among adolescents is incessantly problematic, but its recent collision with a rising opioid epidemic has exponentiated deaths in this age group. Despite opioids being a major contributor, indications remain that adolescent prevention efforts should focus on total substance abstinence. Evidence consistently highlights adverse childhood experiences and mental dysfunction

Substance use among adolescents is incessantly problematic, but its recent collision with a rising opioid epidemic has exponentiated deaths in this age group. Despite opioids being a major contributor, indications remain that adolescent prevention efforts should focus on total substance abstinence. Evidence consistently highlights adverse childhood experiences and mental dysfunction as the strongest predictors of youth substance use initiation, and parent-focused interventions as the most significant prevention model. Participants in this project included five parents, with a teen between 11 and 16 years of age, who had recently experienced homelessness or where currently living in a transitional shelter. Guided by the Transtheoretical Model, this project assessed the impact of an evidence-based parenting program among high-risk families. Participants completed the Teen Triple P Online program from home while receiving weekly text message support. Each parent completed a pre-and post- Conflict Behavior Questionnaire (r=.86) and Depression, Anxiety, and Stress Scale (r =.71–.81), and a Client Satisfaction Questionnaire. A two-tailed Wilcoxon signed rank test was performed on the matched pairs of pre- and post- measures with the mean scores compared. Though statistically insignificant results were yielded, this quality improvement project found a clinically significant decrease in conflict behavior and parental anxiety, depression, and stress after completing the Teen Triple P Online program. Participant satisfaction with the program and subsequent family improvements was also found. These results suggest that interventions that decrease family conflict and improve a parent’s mental health, directly impact major family factors that contribute to adolescent substance use and adverse childhood experiences. This project contributes to the evidence that positive parenting programs have an impact at the individual, family, and societal levels.
Created2022-05-01
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Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in

Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in rural populations Study Design: A top priority of a rural federally qualified healthcare organization (FQHC) was to improve utilization of the AWV due to a patient response well below the national average. A six-week trial was conducted that examined a patient information campaign combined with a strategic workflow that encouraged interoffice collaboration. Methods: The office staff of a pilot medical clinic was selected by the FQHC quality improvement committee as the project site. A Relational Coordination survey (RC) was administered before and after the intervention to determine if the intervention improved interoffice collaboration regarding the AWV. Descriptive questions were used to determine which aspects of the intervention proved useful. Reliability of the survey results was verified by a Crohnbach’s ? > 0.08. An independent samples t test was used with p value < 0.05 to determine statistical significance and confidence intervals. Results: The patient information brochure demonstrated improved patient understanding of the AWV from the office staff perspective as demonstrated by an independent samples t test comparing pre and post survey responses (t(32) = -4.14, p < .001, CI 95%). The RC survey results identified an area for collaborative for improvement between the front office and medical staff.
Created2022-04-29
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Falls in hospitalized patients are a widespread occurrence in the United States, resulting in unfavorable outcomes amongst patients, healthcare providers, and hospital organizations. Current fall prevention efforts have failed to adequately reduce patient fall rates. Nursing peer review (NPR) seeks to refine the quality and safety of patient care, making

Falls in hospitalized patients are a widespread occurrence in the United States, resulting in unfavorable outcomes amongst patients, healthcare providers, and hospital organizations. Current fall prevention efforts have failed to adequately reduce patient fall rates. Nursing peer review (NPR) seeks to refine the quality and safety of patient care, making its use applicable in post-fall reviews. This evidenced-based quality improvement project implements a post-fall NPR program to examine patient falls in an inpatient setting, in addition to the facilitation of patient safety culture education. The Hospital Survey on Patient Safety Culture was used to assess nurses’ perceptions of their units’ patient safety culture. The pre- and post-survey results were analyzed using a two-tailed Mann-Whitney U test, determining significant differences in event (U=2033, z=-2.81, p=.005) and learning (U=1196, z=-2.52, p=.012). No significant differences were noted in support (U=1587, z=-0.05, p=.959), prevent (U=1369, z=-0.70, p=.485), and rate (U=1355.5, z=-0.34, p=.737). Post-fall NPR participation survey results were analyzed using descriptive statistics, showing that it improved patient safety culture (n=10, 91%), reduced “blame & shame” culture (n=9, 82%), and was a non-punitive learning method (n=10, 91%). Reviewing falls through NPR and educating nurses on patient safety culture can create a positive environment to learn from falls. Additional research is needed to determine the impact on patient fall rates.
Created2022-04-28
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Purpose: The purpose of this quality improvement project was to train healthcare professionals (HCP) on evidence-based interventions for domestic violence (DV). Background: DV occurs at high rates and negatively impacts physical and mental health. Intermittently screening patients for DV is healthcare’s current response and this is inadequate. Evidence shows the most

Purpose: The purpose of this quality improvement project was to train healthcare professionals (HCP) on evidence-based interventions for domestic violence (DV). Background: DV occurs at high rates and negatively impacts physical and mental health. Intermittently screening patients for DV is healthcare’s current response and this is inadequate. Evidence shows the most effective way to assist DV victims is through active psychoeducation. Active psychoeducation involves a conversation between the HCP and patient about relationship safety, the sharing of local resources, and a referral to a local DV agency if warranted. Methods: A virtual educational intervention was recorded and made available to members of a professional nursing organization in the Western United States. The educational intervention provided instruction on the Confidentiality, Universal education, Empowerment, Support (CUES) method, an active psychoeducation technique. The post-education survey was a modified version of Project Catalyst’s Post-Training Survey for Community Health Centers with twenty-one questions pertaining to understanding of the training and intention to incorporate CUES into clinical practice. Results: Eleven participants completed the educational intervention and post-education survey. Descriptive statistics demonstrated that participants strongly agreed (73%) and agreed (27%) that the training improved their ability to provide active psychoeducation on DV. All participants reported an intention to incorporate CUES into their clinical practice. Conclusion: Training HCP to provide active psychoeducation on DV to their patients increases professionals’ ability to incorporate this evidence-based method into clinical practice.
Created2021-04-09
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Description

Oral health in the pediatric population is an overlooked topic in primary care, yet it is vital to their overall health. Dental caries, otherwise known as cavities, are a significant problem among the pediatric population. Dental caries is the most common non-transmittable disease across the globe. Dental caries can have

Oral health in the pediatric population is an overlooked topic in primary care, yet it is vital to their overall health. Dental caries, otherwise known as cavities, are a significant problem among the pediatric population. Dental caries is the most common non-transmittable disease across the globe. Dental caries can have painful effects that can lead to serious health implications and reduce the quality of life. Prevention is key when addressing dental caries and oral health care. Oral health prevention and education should begin early on in life and continue throughout the lifetime.

Pediatricians and primary care practitioners play a vital role in the prevention identification, and treatment of dental caries. Individuals in these care roles must become familiar with dental caries and the best evidence-based practices. Furthermore, these health care providers can have an active role in policy creation and change within the community to address the issue. A project was conducted to help improve oral health in the pediatric population. The project consisted of a well-child template modification at the 9-month well-child visit that would prompt providers to encourage a dental visit by the 12-month appointment. The results were limited, and the outcomes were not statistically significant. A recommendation for future studies will be to verbalize the recommendation and provide a handout or recommend a specific pediatric dentist.

ContributorsCox, Karen N. (Author) / Sebbens, Danielle (Thesis advisor)
Created2020-05-01