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: Carson, Sheri C.
- Creators: Colao, Deirdre
Children often present to the emergency department (ED) for treatment of abuse-related injuries. ED healthcare providers (HCPs) do not consistently screen children for physical abuse, which may allow abuse to go undetected and increases the risk for re-injury and death. ED HCPs frequently cite lack of knowledge or confidence in screening for and detecting child physical abuse.
The purpose of this evidence-based quality improvement project was to implement a comprehensive screening program that included ED HCP education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument. After a 20-minute educational session, there was a significant increase in ED HCP knowledge and confidence scores for child physical abuse screening and recognition (p < .001). There was no difference in diagnostic coding of child physical abuse by ED HCPs when evaluating a 30-day period before and after implementation of the screening protocol.
In a follow-up survey, the Escape Instrument and educational session were the most reported screening facilitators, while transition to a new electronic health system was the most reported barrier. The results of this project support comprehensive ED screening programs as a method of improving HCP knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse. Efforts should also be made to standardize child abuse screening programs throughout all EDs, with the potential for spread to other settings.
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.