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: Guthery, Ann
- Creators: Bay, Sarah
- Creators: Root, Lynda
Description
Background and Objectives: Electronic cigarette use, known as vaping, among adolescents was declared a public health epidemic in 2018 and has acute and chronic health consequences. Healthcare providers (HCP) play a pivotal role as health-related educators, including counseling against vaping. Primary HCPs report a lack of adequate knowledge, confidence, and screening for adolescent vaping. Increasing HCP’s vaping awareness and knowledge may increase rates of adolescent vaping prevention screening and counseling. Rosswurm & Larrabee Model and Health Belief Model were utilized in project design and implementation.
Methods: Primary HCPs (n = 8) that provide care to adolescents at a pediatric clinic in Phoenix, Arizona completed online pre- and post- education surveys measuring vaping knowledge before and after viewing an evidence based online educational video. Participation was voluntary, open to all clinic HCPs, and informed consent was provided before the intervention. Data analysis was completed with Intellectus Statistics using descriptive and inferential statistics.
Results: Results of the paired samples t-test was significant based on "?=.05" , t(7) = -3.56, p = .009. The mean of the post-education survey (12.38) was significantly higher than the mean of the pre-education survey (9.62). Descriptive statistics found 85.71% of HCPs reported increased intent to counsel for vaping and 57.14% of HCPs reported increased implemented vaping counseling with their adolescent patients four-weeks post intervention.
Conclusions: HCP vaping knowledge rates and vaping-related counseling and surveillance significantly increased after viewing the educational video. Implementing mandatory HCP vaping education training could increase adolescent vaping prevention interventions and counseling within primary care settings.
ContributorsMarks, Brianna (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Introduction: Most melanoma cases are directly related to harmful ultraviolet exposure (UV). An adolescent athlete spends close to four hours per day outdoors, which equates to over one thousand hours of sun exposure every year. Athletes are typically unaware that extended periods of UV exposure can cause melanoma and therefore an education regarding sun safety is needed. The Social Cognitive Theory depicts the studied behaviors for this project showcasing external factors that may contribute to an adolescent not using proper sun protection.
Methods: Athletes on the swim team at a Phoenix High School (n=6) were surveyed to determine their current sun protection habits. An education intervention about sun safety and melanoma risk/identification was then implemented. The student athletes were then re-surveyed two weeks post intervention to determine if their sun protection habits and melanoma knowledge had changed. Descriptive statistics were run to compare the pre- and post-survey results.
Results: There was no change between baseline and post-intervention sun safety/melanoma knowledge when descriptive statistics were run. Amongst the six athletes, sun safety habits and knowledge identifying melanoma did not change after the education intervention.
Discussion: Adolescents are unaware of the consequences their lack of safe sun habits can cause on their skin. Most adolescents do not have the proper education from schools or sporting teams to teach them about the dangers of poor sun safety practices. Education alone cannot serve as the sole influence as to whether adolescent athletes increase sun protection habits.
ContributorsRyan, Alexandra (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.
Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys
questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This
study was conducted in a residential treatment center (RTC) with the institutional review board's
approval from Arizona State University. BHTs aged 18 years and above, working at this RTC
were included in the study.
Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.
Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).
Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.
ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-12
Description
Childhood traumatic experiences are a prevalent public health issue. Children exposed to trauma
often exhibit behaviors that make educating them challenging. Preschool teachers at a
southwestern United States preschool receive no training related to childhood trauma and
resilience. The purpose of this project was to educate preschool teachers on trauma and
resilience to improve attitude related to educating children with trauma. Following Arizona State
University Internal Review Board approval, preschool teachers were recruited from a non-profit
metropolitan preschool. Project included two pre-training questionnaires (Adult Resilience
Measure-Revised [ARM-R] and Attitudes Related to Trauma Informed Care scale [ARTIC]),
one two-hour training via Zoom on childhood trauma and resilience, and post-training ARTIC
questionnaire at two and six weeks. Seven teachers (n=7) participated in pre-training
questionnaires, and three of these teachers (n=3) participated in both post-training
questionnaires. All participating teachers were female and Caucasian. Average age of
participants was 49.43 years (SD=8.40, range 36-60), and experience average was 17.17 years
(SD=10.15, range 3-30). AMR-R average score was 72.29 (SD=8.28, range 61-83). Pre-training
ARTIC score average was 3.87 (SD=0.16). Post-training ARTIC scores at two weeks and six
weeks post-training were 3.65 (SD=0.22) and 3.86 (SD=0.25). Clinical significance included
improved teacher awareness of childhood trauma and improved ability to interact with children
exposed to trauma. Teachers exhibited high resilience scores. Additional research needed
related to further address educating preschool teachers related to trauma informed care, related to
building resilience in children, and related to the impact of teacher resilience on trauma informed
care.
ContributorsChristmas, Melissa (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-12
Description
Purpose: To assess the burnout levels of mental health workers and to evaluate the effectiveness
of promoting self-care practices in improving their well-being and resiliency.
Background and Significance: Burnout is highly prevalent among mental health workers due to
the nature of their work and the population of patients they serve. Turnover has been a
significant problem within this specialty for decades. Before the COVID-19 pandemic, the
mental health workforce was projected to experience shortage by 2025. The pandemic will likely
worsen this. Evidence from literature supports the effectiveness of promoting self-care towards
the development of resiliency and well-being in addressing burnout among healthcare workers.
Methods: The Maslach Burnout Inventory – Human Services Survey (MBI-HSS) was used to
assess the burnout levels of mental health workers in a psychiatric hospital in Arizona pre- and
post-intervention. Educational modules were provided for each participant to review. They were
asked to perform at least one self-care activity and to utilize the tools in the Provider Resilience
application every week for four weeks.
Results: Pre-intervention surveys indicated moderate levels of emotional exhaustion (m=20.71)
and depersonalization (m=9.29) and high levels of personal accomplishment (m=28.71).
Improvements were seen on emotional exhaustion (m=18.86), depersonalization (m=6.43), and
personal accomplishment (m=33.86) were seen post-intervention.
Conclusion: Although the results were not statistically significant due to small sample size, the
improvements seen on two out of three components of burnout (emotional exhaustion and
depersonalization) indicated that awareness of burnout levels and self-care practices contribute to
improving the well-being of mental health workers.
ContributorsLim, Jerica Elaine M. (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-26
Description
Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in ADHD and if a brief education on sex differences in ADHD affects the primary care setting's screening rate.
Design/Methods: With the Arizona institutional review Boards' approval, primary care providers (PCP) in a Southwest family practice in Arizona (n=35) are provided with virtual education on sex differences in ADHD. Pre- post-intervention surveys were electronically administered to five PCPS. Data were deidentified. A two-tailed paired t-test was conducted to examine the mean difference of responses.
Results: Analysis of responses demonstrate that primary care providers are well aware of sex differences in ADHD but screened less for ADHD before the education intervention. Major themes emerged from provider comments on ADHD symptom recognition, time constraints, and increased screening to identify girls in the primary setting. A significant increase in ADHD screening is seen four weeks post-intervention t(4) = -6.32, p = .003.
Conclusion: Future research is needed to identify other factors that could strengthen ADHD screening during well-child visits overall. Also, the use of a pediatric screener which can highlight inattentive symptoms would assist in the process of identifying girls with ADHD.
ContributorsO'Connell, Roseann (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Objective
Health care transition (HCT) for adolescents without special health care needs in the primary care setting has received inadequate attention, as represented by national surveys, when compared to adolescents with special health care needs. Barriers to transition such as lack of knowledge and preparation have been known to hinder HCT despite the knowledge gap and weak evidence related to non-special needs adolescent transition. Application of anticipatory guidance education related to care transition may improve transition readiness scores of adolescents without special health care needs.
Methods
Utilizing Meleis’ transition theory with the Plan-Do-Study-Act framework, a quasi-experimental study was conducted comparing transition readiness scores between baseline and intervention groups of adolescents 14 years or older attending their well checks at a small pediatric primary care site. The intervention consisted of two videos developed from Got TransitionTM's (n.d.) Six Core Elements for specific adolescent age ranges.
Results
Statistical analysis reveals that the subgroup and overall transition readiness scores for both age groups, 14-15 and 16-18 years of age, when comparing the baseline groups to the intervention groups, have mixed significance (p = .419, p = .074, respectively). However, when asking the respondents about their understanding of the transition process and their role in that process, 75% and 62.5%, respectively, at minimum agreed the intervention was helpful.
Conclusion
The findings were mixed, indicating the educational videos did have a short-term impact on adolescent transition readiness scores for the 16-18 years old group only. Future focus on long-term follow up throughout the adolescent period may yield better data.
ContributorsJones, Benjamin Keith (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Preventing deaths from uncontrolled bleeding remains a national priority, as mass causality events in communities and schools continue to rise. National initiatives have been set in motion by the Department of Homeland Security, to teach laypersons hemorrhage control techniques while waiting for emergency personnel to arrive. A full and growing body of evidence supports the use of hemorrhage control training classes among adult laypeople and is growing steadily in the adolescent population. With the majority of shooting events occurring at high schools, the implementation of a hemorrhage control training curriculum can increase survival rates among high school students in the event of an active shooter. The purpose of this paper is to investigate current knowledge and hemorrhage control practices among high school students and the implication of implementing a hemorrhage control educational intervention by evaluating current knowledge of hemorrhage control as well as their willingness, confidence, and perceived value in hemorrhage control education. This evidenced-based assessment is proposed utilizing the Social Learning Theory and Rosswurm and Larrabee’s implementation framework.
ContributorsMaddaluna, Christina (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-03
Description
As the incidence of acute and chronic wound conditions rises and wound dressing protocols become more complex, uninsured patients lacking access to specialty wound care are challenged to manage their own wounds. Understanding multistep dressing change protocols may be inhibited by low health literacy. Low health literacy is associated with reduced disease knowledge and self-care. Little evidence of health literacy effects on wound patients is available nor are literacy-sensitive educational interventions that address wound knowledge and self-care. Improved outcomes occur in all health literacy levels in other diseases with the use of literacy-sensitive educational interventions that incorporate more than one literacy strategy over multiple sessions. To examine the effectiveness of a literacy-sensitive wound education intervention on wound knowledge and self-care, an evidence-based pilot project was conducted in an urban wound clinic.
A convenience sample of 21 patients received a literacy-sensitive wound education intervention consisting of spoken and written communication over several sessions. Instruments measured health literacy level, wound knowledge, dressing performance, and wound healing status. There was a significant increase in wound knowledge scores in all literacy groups from baseline to visit two (p < .01) and four (p < .01). Dressing performance scores remained consistently high through visit four in all literacy levels. All participant’s wounds progressed toward wound healing significantly from baseline to visit two (p < .01) and four (p < .01). Incorporation of a literacy-sensitive education intervention with supportive literacy aids over several sessions supports improved wound knowledge and dressing self-care and can affect healing in patients of all health literacy levels.
ContributorsTharalson, Erin (Author) / Root, Lynda (Thesis advisor)
Created2018-04-20
Description
International partnerships offer opportunities for healthcare professionals to promote evidence-based nursing in underdeveloped countries. When international collaboration is utilized among nurses in developing countries the clinical outcomes may be improved. This project focused on collaboration with nurse colleagues in Hanoi, Vietnam to support an internally identified quality improvement process and leadership development. Collaboration occurred in a large inpatient medical center between the author and nursing shared governance team members representing the General Surgical, Neuro Surgical, and Intensive Care Units. The nursing collaboration over 9 months concluded with an onsite visit by 5 members of a diverse group from the United States. The shared governance team reported an overall increase in nursing knowledge and skill regarding urinary catheter maintenance and care.
ContributorsRobles, Darlene (Author) / Root, Lynda (Thesis advisor)
Created2018-05-03