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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.

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College of Nursing and Health Innovation
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Stroke Screening Education for Emergency Department Nurses

Description
BACKGROUND: Strokes remain the number one cause of long-term disability in the United States. Delays in reperfusion after a stroke increase a patient’s risk for unfavorable outcomes. PURPOSE: The purpose of this project is to decrease the time from patient’s arrival to the emergency department (ED) to interventional radiology (IR)…

BACKGROUND: Strokes remain the number one cause of long-term disability in the United States. Delays in reperfusion after a stroke increase a patient’s risk for unfavorable outcomes. PURPOSE: The purpose of this project is to decrease the time from patient’s arrival to the emergency department (ED) to interventional radiology (IR) for mechanical thrombectomy intervention by educating nurses on how to identify IR-qualifying strokes using specific screening tools. Bandura’s self-efficacy theory will serve as an essential model to guide this project. METHODS: A PowerPoint presentation and brochure were distributed to all ED nursing staff via email at a large urban teaching hospital in the Southwestern United States. These documents discussed the vision, aphasia, neglect (VAN) and balance, eyes, face, arm, speech, time (BE-FAST) screening tools which have high rates of reliability and validity in detecting large vessel occlusions (LVOs) and posterior circulation strokes. Included was a 5-question survey to assess for completion of provided material. Data on the facilities door-to-interventional radiology (IR) times were collected for two months and compared to data from the previous two months prior to the intervention. IRB approval was obtained from the project site. RESULTS: Average door-to-IR times at project site decreased by twenty-eight minutes after ED nurses received stroke screening tool education. DISCUSSION/CONCLUSION: The ability to recognize stroke symptoms consistent with LVOs and posterior circulation strokes upon arrival to the ED allows for timely IR intervention which supports better patient outcomes.
ContributorsEaton, Summer (Author) / Denke, Nancy (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
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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
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The Innovative Environment of the Engaged Nurse Scholar: Setting the Stage for a Nurse Scholar Program

Description
Background: The purpose of this project was a culture assessment on nurses’ perception about evidence-based practice (EBP) prior to creating an EBP training program. EBP improves patient outcomes, job satisfaction and retention, and decrease healthcare costs. Methods: A descriptive study design was used. Nurses at a hospital and outpatient…

Background: The purpose of this project was a culture assessment on nurses’ perception about evidence-based practice (EBP) prior to creating an EBP training program. EBP improves patient outcomes, job satisfaction and retention, and decrease healthcare costs. Methods: A descriptive study design was used. Nurses at a hospital and outpatient cancer center were sent a voluntary anonymous survey through work email. 630 nurses were invited to participate, and 245 completed the survey with a response rate of 38.9%. The survey consisted of 3 instruments developed by Melnyk, along with demographic information. Results: Most nurses surveyed answered “strongly agree” or “agree” to questions pertaining to EBP knowledge and implementation. “I believe that EBP results in the best clinical care for patients,” resulted in 93.9% answering “strongly agree” or “agree.” For questions referring to the organizational culture towards EBP, the results were less positive. Only 59.6% answered, “strongly agree” or “agree” to “My organization provides EBP mentors to assist clinicians in implementing EBP.” Discussion: Strengths and current EBP beliefs and practices can be identified through organizational assessment. This project will spur further discussion and knowledge growth of EBP practice, inspiring the nursing organization to examine current culture to create an innovative community. Conclusions: Along with areas of strength including a positive knowledge and use of EBP in the organization, barriers to implementation such as leadership support were identified. These factors will influence further development of mentors and education and the formulation and implementation of the fellowship program.
ContributorsWarren, Jason (Author) / Denke, Nancy (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02