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
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- Creators: Denke, Nancy
- Creators: Bain, Ilyssa D.
Description
BACKGROUND: Strokes remain the number one cause of long-term disability in the United States. Delays in reperfusion after a stroke increase a patient’s risk for unfavorable outcomes. PURPOSE: The purpose of this project is to decrease the time from patient’s arrival to the emergency department (ED) to interventional radiology (IR) for mechanical thrombectomy intervention by educating nurses on how to identify IR-qualifying strokes using specific screening tools. Bandura’s self-efficacy theory will serve as an essential model to guide this project. METHODS: A PowerPoint presentation and brochure were distributed to all ED nursing staff via email at a large urban teaching hospital in the Southwestern United States. These documents discussed the vision, aphasia, neglect (VAN) and balance, eyes, face, arm, speech, time (BE-FAST) screening tools which have high rates of reliability and validity in detecting large vessel occlusions (LVOs) and posterior circulation strokes. Included was a 5-question survey to assess for completion of provided material. Data on the facilities door-to-interventional radiology (IR) times were collected for two months and compared to data from the previous two months prior to the intervention. IRB approval was obtained from the project site. RESULTS: Average door-to-IR times at project site decreased by twenty-eight minutes after ED nurses received stroke screening tool education. DISCUSSION/CONCLUSION: The ability to recognize stroke symptoms consistent with LVOs and posterior circulation strokes upon arrival to the ED allows for timely IR intervention which supports better patient outcomes.
ContributorsEaton, Summer (Author) / Denke, Nancy (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
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
Background: The purpose of this project was a culture assessment on nurses’ perception about evidence-based practice (EBP) prior to creating an EBP training program. EBP improves patient outcomes, job satisfaction and retention, and decrease healthcare costs.
Methods: A descriptive study design was used. Nurses at a hospital and outpatient cancer center were sent a voluntary anonymous survey through work email. 630 nurses were invited to participate, and 245 completed the survey with a response rate of 38.9%. The survey consisted of 3 instruments developed by Melnyk, along with demographic information.
Results: Most nurses surveyed answered “strongly agree” or “agree” to questions pertaining to EBP knowledge and implementation. “I believe that EBP results in the best clinical care for patients,” resulted in 93.9% answering “strongly agree” or “agree.” For questions referring to the organizational culture towards EBP, the results were less positive. Only 59.6% answered, “strongly agree” or “agree” to “My organization provides EBP mentors to assist clinicians in implementing EBP.”
Discussion: Strengths and current EBP beliefs and practices can be identified through organizational assessment. This project will spur further discussion and knowledge growth of EBP practice, inspiring the nursing organization to examine current culture to create an innovative community.
Conclusions: Along with areas of strength including a positive knowledge and use of EBP in the organization, barriers to implementation such as leadership support were identified. These factors will influence further development of mentors and education and the formulation and implementation of the fellowship program.
ContributorsWarren, Jason (Author) / Denke, Nancy (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02