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: Reifsnider, Elizabeth
- Creators: Bain, Ilyssa D.
Description
Background: Breastmilk is the optimal source of nutrition for infants as recommended by the American Academy of Pediatrics and the World Health Organization (WHO). Despite proven benefits, rates of breastfeeding have shown to decrease drastically at six months of age.
Purpose: The purpose of this project is to assess the effectiveness of virtual peer support and infant education in increasing/improving a mother’s wellbeing and breastfeeding relationship. This project was guided by the theory of self-efficacy.
Methods: Participants were recruited utilizing flyers that were posted to social media and distributed at a breastfeeding center in Southwestern United States. Six breastfeeding mothers were recruited, and each participated in four, one-hour peer support sessions that were held weekly via Zoom. Participants completed the WHO Well Being Index and the Breastfeeding Relationship scale before and after the intervention. Pre- and post-implementation scores were compared.
Ethical Considerations: The research was approved by the IRB board at Arizona State University and was in compliance with ethical considerations and standards of the institution.
Results: Descriptive analysis conducted on the WHO Well-Being Index showed the same results or improvement for 80% of the questionnaire. Descriptive analysis conducted on the Breastfeeding Relationship Scale showed improvement on 81% of questions.
Conclusions/Discussion: Breastfeeding can be taxing and overwhelming for mothers leading them to discontinue earlier than planned. Peer support has been identified to be substantial to women going through this process in helping them initiate and continue to breastfeed their infant.
ContributorsLopez, Danielle (Author) / Reifsnider, Elizabeth (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Background: Advance Care Planning (ACP) conversations are discussions between patients, providers, and loved ones addressing key care decisions in the event of incapacity. Nearly twothirds of US adults have not completed an Advance Directive (AD), yet ACP conversations rarely occur in practice. The objective of this quality improvement project was to implement workflow changes with a reminder system to facilitate ACP conversations during Medicare Wellness Visits (MWV).
Method: Social Cognitive Theory describes the complex relationship between variables that can influence an individual’s decision to address ACP. Providers in a primary care office in the Southwestern United States participated in an ACP education session and confidence survey. Patients presenting for the MWV were screened for ACP, and visual reminders were attached outside the exam room for provider review. Aggregate data were used to evaluate provider surveys. Descriptive statistics were used to evaluate patient characteristics and the Chi-square Test of Independence, and Fisher’s test was used to compare the pre-and post-intervention advance directive documentation.
Results: Qualitative feedback from the survey indicates reminders and easily accessible resources may help facilitate ACP conversations. Of the 251 MWVs, 21 (8%) had an AD documented, significantly less than the nationally reported rate of 37.7% (p < 0.05, z = -2.39).
Conclusions: Healthcare providers face multiple barriers preventing or delaying ACP conversations in practice. System-level changes and provider education can improve the rate of ACP conversations and impact patients’ care at the end of life.
ContributorsSmith, E. Elizabeth (Author) / Reifsnider, Elizabeth (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