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.
Collaborating Institutions:
College of Nursing and Health Innovation
Displaying 1 - 5 of 5
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- Creators: Morgan, Michelle
- Creators: Bain, Ilyssa D.
- Creators: Bay, Sarah L.
Description
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.
ContributorsSmith, J. Amanda (Author) / Morgan, Michelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
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.
ContributorsBlythe, M. Lindsay (Author) / Morgan, Michelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
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.
ContributorsKrug, Kayla Day (Author) / Morgan, Michelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-09
Description
Objective: Pediatric patients with asthma are frequently cared for in the emergency department (ED). Many studies show early administration of corticosteroids (CS) can improve outcomes for children experiencing an asthma exacerbation. Despite the evidence, delays in care remain. The purpose of this study is to streamline the process for nurse-initiated, triage-based CS administration and determine the effect on overall length of stay (LOS). Methods: For this quality improvement initiative, ED nurses at a large, freestanding, children’s emergency department in the southwestern United States were given education on inclusion and exclusion criteria for nurse-initiated CS in ED triage. Time to CS administration, LOS, and whether the ED nurse or provider ordered the CS were evaluated through chart reviews of patients presenting with a chief complaint of difficulty breathing. These metrics were compared to charts from the previous year during the same timeframe to evaluate for improved timeliness of CS delivery. Results: Time to CS administration decreased from a mean of 98.6 minutes to 57.6 minutes. LOS decreased from an average of 259.3 minutes to 169.6 minutes. The effect of timely CS on LOS was significant for December p =.003, January p =.002, and February p = <.001. Conclusion: A streamlined process for CS delivery to pediatric patients experiencing an asthma exacerbation can enable providers to achieve efficient and effective care in the ED and decrease a patient’s overall LOS.
ContributorsBain, Ilyssa D. (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-23
Description
Purpose: To integrate text messaging into a multi-component reminder system to improve influenza vaccination rates among children with chronic respiratory conditions.
Background: Influenza presents burdens for children with chronic respiratory conditions including increased mortality, morbidity, hospitalizations, and decreased quality of life for children and caregivers. Influenza vaccinations may reduce these complications yet approximately half of children remain unprotected annually. Synthesized evidence supports integration of text messaging into a multi-component strategy to increase the influenza vaccination rate in many populations of interest.
Methods: The intervention was a single text message and electronic mail message sent to all families in a private pediatric pulmonology practice who enabled text and/or electronic mail messages in the patient portal. A follow-up survey assessed various aspects of message receipt. Surveys were completed without collection of demographic information.
Results: Electronic mail messages were sent to 3140 addresses available in the patient portal. The number of text messages sent out via the patient portal was 75 with 66 (88%) delivered successfully. Follow-up surveys were initiated by 107 recipients. Frequency analysis showed that participants preferred text and electronic mail messages over other forms of communication. A statistically significant positive relationship was found utilizing Chi Square between those who received a message and those whose child received an influenza vaccination (p= .027).
Conclusions: Text and electronic mail messaging are cost-effective and well-received forms of communication that can be easily integrated into existing systems. These delivery routes are translatable to many populations and can convey various types of messages.
Background: Influenza presents burdens for children with chronic respiratory conditions including increased mortality, morbidity, hospitalizations, and decreased quality of life for children and caregivers. Influenza vaccinations may reduce these complications yet approximately half of children remain unprotected annually. Synthesized evidence supports integration of text messaging into a multi-component strategy to increase the influenza vaccination rate in many populations of interest.
Methods: The intervention was a single text message and electronic mail message sent to all families in a private pediatric pulmonology practice who enabled text and/or electronic mail messages in the patient portal. A follow-up survey assessed various aspects of message receipt. Surveys were completed without collection of demographic information.
Results: Electronic mail messages were sent to 3140 addresses available in the patient portal. The number of text messages sent out via the patient portal was 75 with 66 (88%) delivered successfully. Follow-up surveys were initiated by 107 recipients. Frequency analysis showed that participants preferred text and electronic mail messages over other forms of communication. A statistically significant positive relationship was found utilizing Chi Square between those who received a message and those whose child received an influenza vaccination (p= .027).
Conclusions: Text and electronic mail messaging are cost-effective and well-received forms of communication that can be easily integrated into existing systems. These delivery routes are translatable to many populations and can convey various types of messages.
ContributorsBay, Sarah L. (Author)
Created2016-05-03