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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.

Collaborating Institutions:
College of Nursing and Health Innovation
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Policy to Practice Change: The Development and Implementation of Sedation Policy and Protocols

Description
Sedation exists along a continuum; and, it is impossible to predict a patient’s exact response to a medication administered to induce any level sedation. Under the direction of a licensed independent practitioner (LIP), registered nurses (RN) in the Emergency Department (ED) have been permitted to administer propofol for time-sensitive,…

Sedation exists along a continuum; and, it is impossible to predict a patient’s exact response to a medication administered to induce any level sedation. Under the direction of a licensed independent practitioner (LIP), registered nurses (RN) in the Emergency Department (ED) have been permitted to administer propofol for time-sensitive, moderate sedation procedures (e.g. orthopedic reductions). In 2019, this changed when a Board of Nursing (BON) in the Southwestern United States posted an Advisory Opinion (AO) limiting the circumstances under which acute care RNs could administer propofol. The purpose of this doctoral project was to revise the 2019 AO to remove specific medication names and to generate recommendations for aligning hospital-based adult sedation policies and procedures (P&P) with the revised AO. In May 2020, the BON enacted the revised AO. Enactment endorses RNs practicing at the top of their scope and justifies amending existing hospital-based sedation P&Ps. Not restricting nurses’ scope of practice according to medication name supports medication selection based on patient condition and clinical situation and safeguards provision of timely, personalized healthcare to communities statewide.
ContributorsBonefield, Brittany A. (Author) / Tharalson, Erin (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-18
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Evidence-Based Algorithm to Prevent the Misdiagnosis of Attention-Deficit Hyperactivity Disorder in Preschoolers

Description

There is an increased risk of misdiagnosis of Attention Deficit Hyperactivity Disorder (ADHD)
in preschoolers due to the lack of validated diagnostic tools and provider knowledge of normal behavior and development. The goal of this project was to standardize the diagnostic process by adopting an evidence-based ADHD algorithm protocol for preschoolers…

There is an increased risk of misdiagnosis of Attention Deficit Hyperactivity Disorder (ADHD)
in preschoolers due to the lack of validated diagnostic tools and provider knowledge of normal behavior and development. The goal of this project was to standardize the diagnostic process by adopting an evidence-based ADHD algorithm protocol for preschoolers (3-5 years). In an urban military pediatric clinic, five pediatric care clinicians were provided with an educational ADHD algorithm.

Pre/posttest surveys were used to assess provider knowledge and perceptions of care. Chart audits determined preschooler ADHD diagnosis prevalence pre- and post-implementation of the algorithm. The rate of ADHD diagnosis in preschoolers reduced significantly from 78.6% pre-audit to 22.6% post-audit. In addition, providers improved their accuracy in diagnosing alternative disorders and behaviors that mimic the symptomology of ADHD (Z=-2.0, p=0.046). The rate of misdiagnosis of ADHD in preschoolers decreased because of the use of an evidence-based ADHD algorithm.
ContributorsBranch, Nancy (Author) / Jacobson, Diana (Thesis advisor)
Created2017-05-01