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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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The Innovative Environment of the Engaged Nurse Scholar: Setting the Stage for a Nurse Scholar Program

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…

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
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Stroke Screening Education for Emergency Department Nurses

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)…

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
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A Clinical Decision Support Tool for the Management of Sexually Transmitted Infections Among Women

Description
Sexually transmitted infections (STIs) are a variety of infections caused by pathogens acquired and transmitted through sexual activity (World Health Organization [WHO], 2021). STIs are associated with an increase in chronic pelvic pain, pelvic inflammatory disease (PID), infertility, and pregnancy complications (Centers for Disease Control and Prevention [CDC], 2021e). A…

Sexually transmitted infections (STIs) are a variety of infections caused by pathogens acquired and transmitted through sexual activity (World Health Organization [WHO], 2021). STIs are associated with an increase in chronic pelvic pain, pelvic inflammatory disease (PID), infertility, and pregnancy complications (Centers for Disease Control and Prevention [CDC], 2021e). A clinical decision support (CDS) tool provides assistance to healthcare providers to use a logical, step-by-step method in patient management by incorporating different reminders or guidelines into practice. The purpose of this project is to assist healthcare providers to manage positive STI results per the CDC guidelines via a CDS tool. A CDS tool for positive STI management was implemented as a system wide practice change. A retrospective chart audit revealed the CDS tool was used 49% of the time. When the CDS tool was utilized, documented partner treatment, screening for additional STIs, documented follow-up, condoms offered, provider discussion of screening of other STIs, and treatment of the STI all increased. This project displays that utilization of a CDS tool can improve the management of positive STIs in a women’s healthcare setting.
ContributorsLawson, D. Leighanna (Author) / Santerre, Jennifer (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-05
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Strategies for Help in Crowded Emergency Rooms

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.
ContributorsBain, Ilyssa D. (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-23
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Supporting Mothers to Breastfeed with Peer Support Via Facebook©

Description
Breastfeeding provides significant health benefits for mothers and infants, but many women fall short of the breastfeeding goals set by the Healthy People initiative. National guidelines such as the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Academy of Breastfeeding Medicine, and the American Academy of…

Breastfeeding provides significant health benefits for mothers and infants, but many women fall short of the breastfeeding goals set by the Healthy People initiative. National guidelines such as the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Academy of Breastfeeding Medicine, and the American Academy of Family Physicians recommend exclusive breastfeeding through six months of age. Peer support and education are key components in helping women achieve their breastfeeding goals and improve breastfeeding self-efficacy. A private obstetrics and gynecology office in the Southwestern United States did not routinely provide breastfeeding support. As the number of people using online peer support groups has grown in popularity and with the project site having an existing active Facebook© page, a project was created utilizing a private Facebook© group for breastfeeding mothers to receive peer support and evidence-based education. Over 12 weeks, evidence-based education postings and discussion prompts were created to encourage conversation upon participants. Sixteen participants made 30 discussion posts. After 11 weeks, three completed the confidential survey and the Breastfeeding Self-Efficacy Scale Short Form, which showed significant levels of breastfeeding self-efficacy. One hundred percent (n=3) of participants accessed the education handouts and found them helpful. Education and peer support results in high breastfeeding self-efficacy which in turn increases breastfeeding duration and exclusivity.
ContributorsSchwartz, Jennifer (Author) / Santerre, Jennifer (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
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A Walking Plan for Pregnant Women with Gestational Diabetes: A Feasibility Study

Description

Gestational diabetes mellitus (GDM) is a well-established predictor for the development of type II diabetes mellitus (T2DM) later in life. The incidence of GDM has been on the rise over the past 30 years and is the leading co-morbidity during pregnancy (Ferrara, 2007). Physical activity (PA) in combination with nutritional…

Gestational diabetes mellitus (GDM) is a well-established predictor for the development of type II diabetes mellitus (T2DM) later in life. The incidence of GDM has been on the rise over the past 30 years and is the leading co-morbidity during pregnancy (Ferrara, 2007). Physical activity (PA) in combination with nutritional therapy has been shown to achieve glycemic control in women with GDM and is therefore first line therapy for management (American College of Obstetrics and Gynecology [ACOG], 2017; Center for Disease Control and Prevent [CDC], 2018).

Recommendations for PA in pregnancy include 150 minutes of moderate intensity exercise most days of the week (ACOG 2015; U.S. Department of Health & Human Services, 2018). Because of this, an innovative project was created to determine the feasibility of adding a walking plan into GDM care. Participants in the project received verbal and written instruction on an unsupervised structured walking plan set up for a beginner to gradually increase PA to the recommended time of 150 minutes per week for a total of four weeks. Eight women were interested, recruited, and enrolled in the project.

Results show that overall, participant PA increased. One hundred percent agreed that the walking plan was useful and increased their awareness about PA. The addition of a walking plan in GDM teaching is an effective strategy to lower serum blood glucose (SBG) levels and for meeting PA recommendations during pregnancy.
ContributorsWhitney, Brittney (Author) / Santerre, Jennifer (Author, Thesis advisor)
Created2019-04-29
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Breast Cancer Screening in Uninsured Women

Description
Breast cancer is one of the leading causes of cancer-related deaths among women in the United States. Uninsured women are less likely to receive breast cancer screenings, more likely to be diagnosed at an advanced stage, and more likely to have poorer outcomes following a breast cancer diagnosis (Abdelsattar et…

Breast cancer is one of the leading causes of cancer-related deaths among women in the United States. Uninsured women are less likely to receive breast cancer screenings, more likely to be diagnosed at an advanced stage, and more likely to have poorer outcomes following a breast cancer diagnosis (Abdelsattar et al., 2016; Akinlotan et al., 2021; Ko et al., 2020; & Ntiri et al., 2018). Women in underserved communities often experience socioeconomic barriers which impact obtaining preventative screenings, such as mammograms. Lack of patient navigation, transportation, and financial concerns interfere with obtaining breast cancer screening (Akinlotan et al., 2021 & Miller et al., 2019). Through the intervention of mobile mammography, uninsured women in underserved communities can be reached and access to screening mammograms can be achieved (Stanley et al., 2017 & Vang et al., 2018). Two mobile mammography events were hosted at the project site which provided 35 women with screening mammograms. All scheduled mammogram time slots at the events were filled and completed. Offering mobile mammography to this population has the potential to increase breast cancer surveillance.
ContributorsGlessner-Vallee, Paula (Author) / Santerre, Jennifer (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
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Impact of a Comprehensive Sexual Health History Taking Tool

Description

Obtaining a comprehensive sexual health history is an important part of the patient history taking process and is essential to providing high-quality, patient-centered, and accessible healthcare. Information gathered from the sexual health history guides delivery of appropriate education about prevention, counseling, treatment, and care. A federally qualified health center (FQHC)…

Obtaining a comprehensive sexual health history is an important part of the patient history taking process and is essential to providing high-quality, patient-centered, and accessible healthcare. Information gathered from the sexual health history guides delivery of appropriate education about prevention, counseling, treatment, and care. A federally qualified health center (FQHC) reported that they did not have a standardized comprehensive sexual health history taking process. To address this concern, a literature review was conducted to survey current evidence regarding both patient and healthcare provider perspective on sexual health history taking. While it is recommended for a sexual health history to be performed routinely, both healthcare providers and patients have reported sexual health is not discussed at most visits.

The findings led to the initiation of an evidence-based project implementing a comprehensive sexual health history taking tool at the FQHC. The tool assists in obtaining a comprehensive sexual history and provides an understanding of the sexual practices of the patients. If healthcare providers become aware of the sexual practices of their patients, they are better able to provide evidence-based education that could lead to better health outcomes. The participants reported they liked being asked about their sexual health, did not find the questions too personal, and reported the questionnaire addressed their sexual health concerns, and was worth their time. Taking a comprehensive sexual health history is a fundamental skill that all healthcare providers must strive to improve for the general health of their patients and the community.
ContributorsLarter, Kara (Author) / Santerre, Jennifer (Thesis advisor)
Created2020-05-04