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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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College of Nursing and Health Innovation
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Transformational Leadership’s Impact on Finding Meaning and Joy in Work

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Aim: To evaluate the impact transformational leadership (TFL) behaviors and What Matters to You conversations have on RNs finding meaning and joy in work (MJW) and turnover. Background: The nursing profession is plagued by burnout - a precursor to loss of MJW. Loss of MJW was exhibited as low…

Aim: To evaluate the impact transformational leadership (TFL) behaviors and What Matters to You conversations have on RNs finding meaning and joy in work (MJW) and turnover. Background: The nursing profession is plagued by burnout - a precursor to loss of MJW. Loss of MJW was exhibited as low morale and increased turnover among acute care RNs at a small hospital in Southwest Arizona. Addressing loss of MJW aligns with caring for the caregiver, the fourth aim of the quadruple aim initiative. Methods: This was a quasi?experimental mixed methodology evidence-based project. The target populations were core RNs and leaders working in the intensive care unit, care unit, and emergency department. Intervention was multimodal – survey using Meaning and Joy in Work Questionnaire, TFL education, and steps one and two of the IHI four steps for leaders model. Results: Final sample was 18 RNs. Statistical analyses did not reveal significant impact; pre- and post-survey MJWQ scores remained above four. Themes from the What Matters to You conversations included making a difference, coworkers/connections, staffing, and negativity. Turnover trended positively in two of the three units. Conclusion: This project heightened awareness about MJW and illuminated the impact TFL behaviors can have on RNs finding MJW and turnover. The coronavirus pandemic and acute nursing shortage were significant limitations of the project. Implications: Healthcare organizations are encouraged to view MJW as a system asset, embed it in their cultures, invest in innovative solutions, and continually evaluate outcome measures of MJW.
ContributorsSalmon, P. Melisa (Author) / Mangold, Kara (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
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Primary Provider Education Regarding Adults with Autism Spectrum Disorder

Description

The purpose of this project is to look at the relationship between education about Autism Spectrum Disorder (ASD) and knowledge, attitudes and beliefs in adult primary care providers. The project addresses the transition challenges adults with ASD have in finding a primary care provider who is comfortable and competent with…

The purpose of this project is to look at the relationship between education about Autism Spectrum Disorder (ASD) and knowledge, attitudes and beliefs in adult primary care providers. The project addresses the transition challenges adults with ASD have in finding a primary care provider who is comfortable and competent with ASD. Education was provided to adult primary care providers in a multi-site primary care clinic in a large metropolitan city in the Southwestern United States. The Modified Knowledge/Attitudes/Belief instrument was used. A pre-test was administered prior to the education session, then a post-test and a one-month post-test were given afterward.

The results of the education program showed that attitudes and beliefs increased after the education and continued to increase more in the month following. Knowledge improved after the education session but declined after a month although scores were not back to the pre-education level. Primary care providers who receive education about ASD may be more comfortable in caring for this population and more likely to welcome adults with ASD into their practice. Education for primary care providers is key to improving health outcomes for adults with ASD.
ContributorsChesebrough, Geri Anne (Author) / Mangold, Kara (Thesis advisor)
Created2018-04-30
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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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Advance Care Planning: How Do We Get to Completion?

Description
Advance care planning (ACP) is the act of deciding ones wishes at the end-of-life and making those wishes known. Healthcare providers rely on these wishes to provide end-of-life care. Despite the impact ACP has on quality of life at the end-of-life, most conversations remain undocumented. Even when ACP conversations take…

Advance care planning (ACP) is the act of deciding ones wishes at the end-of-life and making those wishes known. Healthcare providers rely on these wishes to provide end-of-life care. Despite the impact ACP has on quality of life at the end-of-life, most conversations remain undocumented. Even when ACP conversations take place, completion rates remain at an all-time low. This report explored the impact of appointment call reminders and patient portal messages on advance directive (AD) completion and documentation in the EHR. Following completion, a primary care practice experienced an increase in ACP conversation and ACP completion in the EHR. This report will discuss the methods utilized to improve ACP completion.
ContributorsDaily, Stephanie M. (Author) / Mangold, Kara (Thesis advisor)
Created2019-04-28
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The Effect of Post Partum Breastfeeding Peer Support on Breastfeeding Success Outcomes

Description

The health benefits of breastfeeding are well documented and exclusive breastfeeding for at least the first six months of life is the target of national and global health care organizations. Although initial breastfeeding is on the rise, the percentage of infants still breastfeeding at six months drops significantly. In the…

The health benefits of breastfeeding are well documented and exclusive breastfeeding for at least the first six months of life is the target of national and global health care organizations. Although initial breastfeeding is on the rise, the percentage of infants still breastfeeding at six months drops significantly. In the population of newly delivered mothers of an obstetric practice, there is no readily accessible breastfeeding support offered following hospital discharge. A review of relevant literature revealed that lack of support is often cited as a key factor in the discontinuation of breastfeeding, whereas the evidence shows that participation in peer support has a positive effect on breastfeeding self-efficacy, which can have a positive effect on breastfeeding duration.

To address this problem, the initiation of a breastfeeding closed social network Facebook group for this practice setting population was developed and implemented to provide readily accessible peer support and have a positive effect on the outcome of breastfeeding self-efficacy. Three months after initiation of the Facebook group, an anonymous voluntary survey was offered to group members, and 25 members participated in the survey. Responses demonstrated that peer support is helpful with breastfeeding confidence and that, following participation in the group, the respondents wanted to continue breastfeeding.
ContributorsStorto, Pamela (Author) / Mangold, Kara (Thesis advisor)
Created2018-05-03