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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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Childhood Drowning: How Can Healthcare Providers Help?

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Introduction: Drowning is the leading cause of death in children between 1 and 4 years of age; in Arizona drownings are double the national average for this age group. The goal of this Doctor of Nursing project was to educate and empower pediatric providers to give quality drowning prevention (DP)…

Introduction: Drowning is the leading cause of death in children between 1 and 4 years of age; in Arizona drownings are double the national average for this age group. The goal of this Doctor of Nursing project was to educate and empower pediatric providers to give quality drowning prevention (DP) anticipatory guidance (AG) to caregivers of children between 1 and 4 years of age at every well exam. Method: This quality improvement (QI) project included 32 providers from six pediatric clinics in Arizona. A one-hour education session focused on drowning prevention followed one month later by a a thirty-minute follow-up feedback session were conducted. Pre- and post- education surveys were administered at the first session to measure perceived previous and future intended DP AG practice. An additional follow-up survey was administered at the second session to evaluate perceived change. In addition, caregivers were contacted and surveyed one to three months post initial education to assess provider delivery of AG. Likert-scales and descriptive statistics were used to evaluate data sets. Results: Post-educational intervention, providers reported increased intention (p = 0.027) to provide water safety AG, and increased intention (p < 0.001) to connect water AG to developmental milestones. Post-intervention follow-up indicated an increased provision of developmentally specific water safety AG to caregivers (p < 0.001) and increased connection of developmental milestones in AG (p = 0.016). Barriers that prevent water safety AG were reported as time constraints and other perceived AG of higher priority. Implications: This QI project adds to the literature and demonstrates the benefit of education to invigorate and empower increased provision of quality DP AG from providers.
ContributorsDiMiceli, Carolyn (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-22

Team-Based Care in the Management of Type 2 Diabetes with Consideration for Social Determinants of Health

Description

The reactionary nature of the current healthcare delivery system in the United States has led to increased healthcare spending from acute exacerbations of chronic disease and unnecessary hospitalizations. Those who suffer from chronic diseases are particularly at risk. The dynamics of health care must include grappling with the complexities of…

The reactionary nature of the current healthcare delivery system in the United States has led to increased healthcare spending from acute exacerbations of chronic disease and unnecessary hospitalizations. Those who suffer from chronic diseases are particularly at risk. The dynamics of health care must include grappling with the complexities of where and how people live and attempt to manage their health and disease. Team-based care may offer a solution due to its interdisciplinary focus on proactive, preventative care delivered in outpatient primary care.

Studies examining the effects of team-based care have shown improvement in; HbA1c, blood pressure, lipids, healthcare team morale, patient satisfaction rates, quality of care, and patient empowerment. In an effort to improve type 2 diabetes health outcomes and patient satisfaction a team based care project was implemented. The setting was an outpatient primary care clinic where the patients are known to have limited social resources. The healthcare team was comprised of a DNP Student, Master of Social Work Student, Clinical Pharmacist, and Primary Care Physician, who discussed patient specifics during informal meetings and referral processes.

Adult patients whose HbA1c level was greater than 6.5% were eligible to participate, 183 were identified and invited. Fourteen (14) agreed to participate and seven (7) completed the initial screening with a mean HbA1c of 9.7%. Significant social needs were identified using the Health Leads Questionnaire. The diabetes and social needs were addressed by members of the team who met individually with patients monthly over the course of three months. Of those who completed the initial evaluation only two (2) returned for a follow-up and had a repeat HbA1c. Both participants had important improvements in their A1C with a decrease of 2.3%, and 3.4%. The others were lost to follow up for unknown reasons. Despite the small numbers of participants this project suggests that patients can benefit when an interdisciplinary team addresses their needs and this could improve health outcomes.
ContributorsCody, Erin (Author) / Moffett, Carol (Thesis advisor) / Velasquez, Donna (Thesis advisor)
Created2017-05-02