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.
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- Creators: Bay, Sarah
- Creators: Colao, Deirdre
Background: Asthma is a chronic illness that impacts 10.9% of the pediatric population in Arizona. Poor asthma understanding and management leads to high-utilization of emergency rooms and urgent care clinics, negatively impacting the healthcare economy. Poor asthma management also leads to decreased health outcomes and impacts on the child’s academic functioning, mental health, and overall quality of life. Current evidence supports use of written asthma action plans (WAAP) and inhaler/spacer instruction to improve asthma management.
Methods: The intervention was an evidence-based educational session provided to the staff of a military, pediatric primary care clinic in southwest Arizona regarding the use of WAAP, the Asthma Control Test (ACT) and integrated inhaler/spacer instruction. Chart reviews were conducted to evaluate the documentation of use of WAAP, ACT, and inhaler/spacer education.
Results: Charts were collected from pre-intervention (n = 33) and post-intervention (n = 18). Data analysis demonstrated a statistically significant higher use of WAAP (U = 0.008, p < 0.05, d = 0.83). Although there was not a statistically significant change in use of ACT tool, Cohen’s value (d = 0.48) suggested a moderate positive effect. A Pearson correlation coefficient was also calculated for the relationship between use of ACT tool and use of WAAP, demonstrating a moderate positive correlation (r (49) = .372, p < .01).
Conclusions: An evidence-based education session for pediatric staff members is a cost-effective and simple method of improving pediatric asthma management practices.
Harm reduction in cardiovascular disease is a significant problem worldwide. Providers, families, and healthcare agencies are feeling the burdens imparted by these diseases. Not to mention missed days of work and caregiver strain, the losses are insurmountable. Motivational interviewing (MI) is gaining momentum as a method of stimulating change through intrinsic motivation by resolving ambivalence toward change (Ma, Zhou, Zhou, & Huang, 2014).
If practitioners can find methods of educating the public in a culturally-appropriate and sensitive manner, and if they can work with community stakeholders to organize our resources to make them more accessible to the people, we may find that simple lifestyle changes can lead to risk reduction of cardiovascular diseases. By working with our community leaders and identifying barriers unique to each population, we can make positive impacts on a wide range of issues that markedly impact our healthcare systems.
Current obesity statistics exceed national goals with Hispanics disproportionately affected. Evidence suggests a family centered methodology focusing on culture can positively improve weight loss, client satisfaction and participation. This project will evaluate use of culturally tailored resources for primary care providers to educate Hispanics on weight loss. Eight providers in a small practice in the Southwestern US were recruited to complete a pre- and postEBPAS tool after an educational session. A BMI form tracked provider use of the fotonovela intervention against preferred methods.
Feedback on time spent educating and overall perception were collected. Four providers completed the pre-EBPAS, three completed the post-, one participated in the intervention, and six contributed project feedback. Descriptive statistics revealed an aggregate provider decrease of five-points post-educational session for attitude toward adopting EBP. The BMI documentation form demonstrated a 53% (n = 8) use of the fotonovela. However, there were five undocumented fotonovelas taken/given out postintervention. Key themes noted by providers included poor timing of the project, satisfaction with workflow and resources, and overall discontent for the fotonovela. Future implications include re-evaluating the project in a practice not undergoing significant changes with specific focus on timing of the intervention.
Background and Significance: Anxiety is a prevalent health problem affecting up to 30% of the general population. Over 95% of radiation oncology patients report anxiety often related to not knowing what to expect during treatments. The current guideline for management of anxiety is the use of benzodiazepines; which can impose a risk to patients. Evidence demonstrates virtual reality videos can be an effective non-pharmacologic approach to reduce anxiety..
Design: Observational cohort evidence based project.
Setting: Outpatient radiation oncology facility in the Southwest United States.
Sample: 40 patients who have not previously undergone radiation therapy, but have been prescribed radiation treatments for malignant or non malignant conditions.
Methods: Patients who had not previously undergone radiation treatments were identified based on chart review and consented for participation in the project. The patient's were assessed for both their general (trait) anxiety and situational (state) anxiety using The State Trait Anxiety inventory (STAI). They were then shown a virtual reality video that walked them through what they would experience during their radiation treatment. The patient's were re-administered the STAI questionnaire following the video to assess any change in anxiety levels.
Variables: Trait and State anxiety scores before and after the virtual reality video intervention.
Findings/Outcomes: A paired t-test was conducted to assess the data. There was a significant difference in the state anxiety scores pre intervention (m = 32.65, SD = 11.47) and post intervention (M = 25.50, SD 8.95), p =< 0.001.
Conclusions: The use of virtual reality videos was an effective non-pharmacological approach to reduce anxiety in patients receiving radiation treatment.
Implications for nursing: The results provide support for the use of a virtual reality intervention as a non-pharmacologic option to reduce anxiety for patients.