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
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Objective: To understand and prevent adverse discharge events, the project assesses the needs and gaps of discharge care coordination for child(ren) with medical complexities (CMC). The National Survey of Children’s Health show 87.4% of CMC does not receive care in a well-functioning system, and 47.4% did not receive adequate care

Objective: To understand and prevent adverse discharge events, the project assesses the needs and gaps of discharge care coordination for child(ren) with medical complexities (CMC). The National Survey of Children’s Health show 87.4% of CMC does not receive care in a well-functioning system, and 47.4% did not receive adequate care coordination 1. Therefore, does initiating measurement tools and communication before and after discharge identify and prevent discharge related adverse events? Methods: After IRB approval, a mixed-methods approach project occurred at southwestern pediatric free-standing hospital. Through eight weeks of convenience sampling, CMC caregivers were recruited in the inpatient setting (n=5). Qualitative and quantitative data were obtained through: [Pediatric] Care Transitions Measurement Tool – 15 (CTM- 15), with a Cronbach’s alpha of .932; a demographics survey; a post-discharge survey; and electronic health records. Results: The CTM-15 post-discharge score was 83.3 (N = 4, SD = 9.83, SE¬M = 4.92). CTM-15 qualitative data included: communication issues; rushed discharge; poor discharge anticipatory guidance; hospital policy concerns; follow-up appointment issues; and prescription errors. LOS average for all participants was 137.8 days (SD = 102.75, SEM = 45.95) with 40 unintended hospital days (SD = 41.55, SEM = 18.51). Issues encountered 30 days post-discharge included: prescription errors, follow-up issues, and home health issues. Conclusion: Hospitalized CMC have an increased risk to encounter a discharge adverse event because of a complex intertwining of disciplines, services, medications, and needs. Communication, tools, and surveys did not capture all the problems encountered by families with CMC; however, it did identify areas of notable concern.
Created2022-05-02
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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,

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.
Created2021-04-23