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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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

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.
Created2022-04-26
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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

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.
Created2022-04-26
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Extracorporeal membrane oxygenation (ECMO) is a high-risk, but highly successful intervention for the survival of critically ill neonatal and pediatric patients. Patients supported by ECMO require continuous infusions of anticoagulant medications to prevent clotting of the ECMO circuit, thrombotic events in the patient, and other bleeding complications. Close monitoring, care,

Extracorporeal membrane oxygenation (ECMO) is a high-risk, but highly successful intervention for the survival of critically ill neonatal and pediatric patients. Patients supported by ECMO require continuous infusions of anticoagulant medications to prevent clotting of the ECMO circuit, thrombotic events in the patient, and other bleeding complications. Close monitoring, care, and management of the ECMO circuit and its components, with specific focus on systemic anticoagulation, is vital as many factors may influence the efficacy of the anticoagulant and ultimately the patient condition. Globally accepted guidelines exist for the correct management of anticoagulation while supported on ECMO; however, health care centers frequently deviate from these recommendations. This project report synthesizes the most current literature on anticoagulation management in the pediatric ECMO supported population, discusses the limitations in current research, and demonstrates the necessity to use standardized anticoagulation protocols for the safest and most successful outcomes. To implement these findings, this project report suggests the need for an evidence-based project that focuses on the quality improvement of current ECMO anticoagulation guidelines.
Created2021-04-26
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Introduction: The purpose of this project was to evaluate a tablet-based documentation application for massive transfusion protocols (MTPs). Methods: 13 trauma nurses at a level-one pediatric trauma center were randomly assigned to use paper documentation (n=5) or the tablet-based application (n=8) during simulated MTPs. Documentation completeness was compared using an

Introduction: The purpose of this project was to evaluate a tablet-based documentation application for massive transfusion protocols (MTPs). Methods: 13 trauma nurses at a level-one pediatric trauma center were randomly assigned to use paper documentation (n=5) or the tablet-based application (n=8) during simulated MTPs. Documentation completeness was compared using an independent t-test. Tablet users completed a system usability survey (SUS). Results: Documentation of blood product volumes and times significantly improved with the tablet (p=<0.001 and p=0.001 respectively). The tablet received a mean SUS score of 89%. Discussion: A tablet-based application has potential to improve real-time documentation of MTPs.
Created2021-04-28
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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

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.
Created2021-04-28
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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

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.
Created2021-05-03
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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

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
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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

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
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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

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.

ContributorsMunson, Megan A. (Author) / Bay, Sarah (Thesis advisor)
Created2018-04-30
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Type II Diabetes Mellitus has detrimental effects on the human body. A1C levels reflect the attachment of glucose to hemoglobin-the protein in red blood cells that carries oxygen. Elevated A1C levels are an indicator of how controlled diabetes is. Uncontrolled diabetes not only affects glucose levels, but has detrimental repercussions

Type II Diabetes Mellitus has detrimental effects on the human body. A1C levels reflect the attachment of glucose to hemoglobin-the protein in red blood cells that carries oxygen. Elevated A1C levels are an indicator of how controlled diabetes is. Uncontrolled diabetes not only affects glucose levels, but has detrimental repercussions in other organs of the body, causing peripheral vascular disease, risk of developing dementia, periodontal or gum disease, skin infections, neuropathy in lower and upper extremities, renal damage, erectile dysfunction, decreased blood flow, and cardiac conditions among others.

A diet low in calories positively affects glucose levels in the body. Type II Diabetes can be easily controlled when lifestyle modifications are included in the plan of care. Among those modifications, diet is an effective intervention for the management of this condition.
Establishing a diet among the patients that have an elevated A1C is the plan of care and ultimate goal for this project. The Mediterranean diet has demonstrated decreased blood glucose levels, improved weight control and enhanced quality of life.

ContributorsBurger, Ana Maria (Author) / Root, Lynda (Thesis advisor)
Created2019-04-26