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.
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- Creators: Alvarado, Cecilia I.
Methods: This project was guided by a The Rosswurm and Larrabee Model for Change to Evidence- Based Practice and Pender’s health promotion framework. IRB Approved by ASU. The instruction was implemented at an urban clinic in downtown phoenix that serves uninsured and underserved individuals. Uninsured participants were recruited (n=50). A survey pre and post registration was conducted to assess knowledge and medical portal participation in addition a random pre and post chart review was performed.
Results: Descriptive statistics was used to describe sample and outcome variables. A chi-square test of independence was calculated comparing pre and post intervention significant change was found (χ2 (1) = .002, P<0.05.), a paired sample t test was calculated to compare knowledge pre and post registration instruction the mean pre-10.187(SD = 4.422), post mean was 16.958(SD=.856). A significant increase of knowledge was found (t (47) =-9.573, p (<.001).
Outcomes: In this population both patients and providers have seen significant benefits such as increased communication and patient participation, from the implementation of evidence based educational tools such as instruction with teach back, and the usage of brochures. Potential Implication for sustainability includes the lack of a designated individual that is bilingual to register patients, making patients aware of the existence of a medical patient portal, patient’s fear of sharing immigration status.
Purpose: The purpose of this project was to implement health promotion education for overweight and obese adults with endocrine disorders. The overarching goal was to change dietary intake and improve exercise to reduce the incidence, prevalence, and impact of comorbidities associated with obesity.
Background/Synthesis: Obesity is a significant epidemic facing the nation today with multiple impacts on the national healthcare system. There is often an association between obesity and endocrine disorders such as type 2 diabetes and prediabetes. Both obesity and diabetes cost the nation billions of dollars annually in healthcare costs. Evidence shows that lifestyle modifications related to nutrition and physical activity are effective in weight reduction and prevention of chronic disease, especially when given by a healthcare provider.
Methods: Fifteen adult patients at an endocrinology office in Arizona received individual counseling using the teach-back method focusing on health promotion behaviors through nutrition and exercise with a two-week follow-up phone call. Short-term outcomes measured in this project included changes in dietary intake and exercise behaviors through a pre- and post-test adapted from an obesity-screening tool developed by Greenwood et al. (2008).
Outcomes/Results: Participants were primarily Caucasian and Hispanic, married, female, average age of 50 years, average BMI of 34.5, and some college education. There was a statistically significant increase in health promoting behavior on posttest scores (M=66, SD=6.23, range=58-76) compared to pretest scores (M=61, SD=4.72, range=50-66), t(14)=-2.55, p=0.023.
Conclusions and Implications: Overall, patient health promotion behaviors increased with this educational intervention. Clinical implications include a potential decrease in patient comorbidities related to overweight and obesity. Implications for the greater healthcare system include decreased comorbidities, utilization of healthcare resources, and costs associated with overweight and obesity. Future recommendations would include determining weight and BMI changes over a longer period of time for even better outcome measures.
Keywords: obesity, obese, overweight, health promotion, health education, diet, exercise, nutrition