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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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Decreasing Burnout in Psychiatric Nursing

Description
Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as…

Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as well as exposure to patient’s trauma. The aim of this project was to decrease burnout among psychiatric nurses in a private practice out-patient family psychiatric facility using Rossworm and Larabee’s change model (Appendix D). The MBI-HSS was completed by 1 participant (n=1) at pre-intervention and post-intervention. Between the pre/post MBI-HSS questionnaire the participant was asked to partake in a mindfulness-based intervention utilizing the smartphone application Headspace to complete a 10-session meditation course over one week. The results conclude the participant’s burnout decreased overall from pre-intervention to post-intervention. Internal Review Board (IRB) was granted in September 2021, and the project was completed in November 2021. The impact of the project was projected to have a more thorough statistical influence, but due to the participant size, there is minimal impact of system or polices in the psychiatric facility.
ContributorsSteward, M. Shannon (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-30
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Depression and High Intensity Interval Training Exercise

Description
Purpose: The COVID-19 pandemic has increased depression among the population. Exercise is a useful coping mechanism for depression and high intensity interval training (HIIT) can be utilized. Background: A community exercise facility provides HIIT exercises for gym members. The gym owner believed their HIIT program is a great tool for coping…

Purpose: The COVID-19 pandemic has increased depression among the population. Exercise is a useful coping mechanism for depression and high intensity interval training (HIIT) can be utilized. Background: A community exercise facility provides HIIT exercises for gym members. The gym owner believed their HIIT program is a great tool for coping with depression. Methods: The gym offered a 21-day free HIIT program. Those who signed up for the program, 18 years of age or older, and were able to exercise under the Physical Activity Readiness Questionnaire were offered to participate in the study. Participants were given a pre-survey before they started exercises. This survey utilized the Patient Health Questionnaire-9 (PHQ-9), a standard depression rating tool that determines depression symptom prevalence. After the 21-day program, participants were given a post-survey involving the same PHQ-9. The survey scores were compared pre- to post-program. The surveys were coded to exclude any identifying information. Results: Mean PHQ-9 pre-test was 7.67, mean score post-test was 3. A paired t-Test resulted in a p=0.60, showed that it was not statistically significant. Discussion: The goal of this study was to determine if HIIT training was an effective coping mechanism for depression. The data shows that participants had decreased PHQ-9 scores from the pre- and post-program surveys showing a clinical significance. This data can be used to provide those suffering from depression a coping mechanism.
ContributorsSmith, Kolter (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
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Promoting Communication Strategies for Seniors during Pandemics

Description
Purpose: The COVID-19 pandemic government regulations and mandates have caused feelings of overload, isolation, anxiety, depression, and loneliness. This project aimed to evaluate the level of impact of social distancing and homestay mandates on seniors during the COVID-19 pandemic. The knowledge from the data guided the implementation of Information Communication…

Purpose: The COVID-19 pandemic government regulations and mandates have caused feelings of overload, isolation, anxiety, depression, and loneliness. This project aimed to evaluate the level of impact of social distancing and homestay mandates on seniors during the COVID-19 pandemic. The knowledge from the data guided the implementation of Information Communication Technology (ICT) as a focused intervention to address loneliness, social isolation, and depression among seniors. Methods: Quantitative reviews were employed to assess the impact of ICT on lonely seniors. A convenience sample of 5 seniors aged 65 and up from a local church congregating in worship center located in southwestern United States enrolled in this voluntary pre-and post-educational intervention project. Participants were informed of the confidentiality of the study and that the study had no known risks on participants. The participants willingly signed a consent for the study. The attendees received two one-hour education sessions on how to use WhatsApp and Zoom as communication strategies. The pre-and post-loneliness scale scores were collected using the Revised UCLA Loneliness Scale as a tool. Results were compared before and after the educational intervention using a paired Wilcoxon signed-rank test. Results: The results indicate significant reductions in reported loneliness from pre to post intervention (z = -2.02, p = 0.043). These results indicate that using ICT can help address loneliness in the seniors. Conclusion: Implementing communication strategies such as WhatsApp and Zoom effectively addresses social isolation and loneliness in seniors. The data reveals that integrating electronic communication in the life of the seniors can manage the social isolation problem. Future nursing practices may benefit from the project's data to address loneliness in the seniors.
ContributorsTambala, Sandikonda (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
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Healthcare Workers’ Attitudes Towards Patients Diagnosed with a Mental Illness

Description
Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and…

Healthcare workers may have poor attitudes, bias or feel unprepared when caring for patients with mental illness in the pediatric intensive care unit (PICU) setting. The aim of this project was to resolve these biases using education to increase quality of care for pediatric mental health patients using Rossworm and Larabee’s change model. The Questionnaire on Stigmatizing Attitudes Towards Children with Emotional and Behavioral Disorders (EBD) was completed by voluntary participants at pretest, posttest and at a one month follow up. Between pretest and posttest, participants engaged in three educational modules regarding mental health. Participants were voluntary, anonymous staff members at a pediatric hospital currently employed in the PICU. Results of the questionnaires pre M= 23 post M=11 and follow up M=9.5 indicates education improves attitudes, and decreases bias in PICU staff. Recommendation to obtain larger population of study with trial implementation. Recommend adding educational modules to annual education or to new hire orientation.
ContributorsMoore, W. Alexandra (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
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Can You See Me? Primary Care Provider Education to Satisfy the Visually impaired

Description
Vision impairment has affected 2.2 billion people globally, with 12 million people affected in the United States; more than 700,000 Californians experience visual impairment or blindness (VI/B). Causes of VI/B can be prevented with early identification and intervention. This project aims to identify perspectives of the VI/B, use this insight…

Vision impairment has affected 2.2 billion people globally, with 12 million people affected in the United States; more than 700,000 Californians experience visual impairment or blindness (VI/B). Causes of VI/B can be prevented with early identification and intervention. This project aims to identify perspectives of the VI/B, use this insight to build and improve the knowledge/skills of the primary care provider (PCP). A quantitative study, utilizing the Theory of Interpersonal Relations alongside the Star Model of Knowledge Transformation, incorporated pre-intervention questionnaires for the VI/B and the intention of pre- and post-intervention questionnaire for the PCP. After consenting, the VI/B completed the Patient Satisfaction Questionnaire-18 (α = 0.87) and Visual Functioning Questionnaire-25 (α = 0.95) surveys via telephone. An interventional video discussing visual acuity and screening, legal blindness versus visually impaired, leading causes of blindness, common ophthalmic drops and their side effects, helpful hints, and resources for the visually impaired was created. Deidentified results were analyzed with descriptive analysis and Pearson correlation. Currently, 30 voluntary, consented VI/B members have completed the pre-surveys. The overall average patient satisfaction score was 46.73 with financial aspect and communication with the most positive evaluation. Unfortunately, their PCPs have not responded. The PCP questionnaire will be distributed to the ophthalmologist partner’s healthcare organization. The needs of VI/B community are poorly identified and addressed in primary care; thus, the educational video was created to address the perceived gaps. Improved provider knowledge and enhanced patient care can enhance patient satisfaction with the delivery of care.
ContributorsVillayuran, Diane R. (Author) / Moffett, Carol (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-29
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Benefits of Medically Assisted Treatment in Opioid Use Disorder

Description
Introduction: For 2019 in the U.S. opioid overdose deaths neared 50,000 people. Increasing the number of Medication Assisted Treatment (MAT) programs available for the population is important to address this crisis (NIDA, n.d.). Objective: To evaluate if MAT improves retention rates for those with opioid use disorder (OUD) for…

Introduction: For 2019 in the U.S. opioid overdose deaths neared 50,000 people. Increasing the number of Medication Assisted Treatment (MAT) programs available for the population is important to address this crisis (NIDA, n.d.). Objective: To evaluate if MAT improves retention rates for those with opioid use disorder (OUD) for one Arizona organization’s (AZOrg) seven treatment facilities. Methods: ASU IRB approval obtained, and de-identified data were abstracted from the electronic records of AZOrg, for a year, March 2020 to February 2021. The data included patient age, sex, date of admission, length of stay, substance abused, and if MAT (buprenorphine, naltrexone, Methadone) was prescribed. Intellectus statistical package was used for analysis. Results: Among 3261 patients with a mean age of 35.81(18-82) years, 1528 (46.85%) were admitted for OUD that included 371 (24.28%) females, 686 of whom (44.9%) received MAT. For those treated with MAT mean length of stay was 35.78 (SD 30.34) days compared to a mean of 27.46 (30.79) days for those without MAT treatment. This finding was significant, for all forms of MAT, based on a two-tailed Two-Tailed Independent Samples t-Test test, p<.001. Discussion/Conclusion: Increasing awareness about OUD and MAT is needed when providing care to patients with OUD. Providing organization-specific information regarding MAT benefits can enhance the adoption of this intervention and aid in the recovery of those being treated for OUD. This analysis did not include the possible confounding factors such as a history of incarceration, duration of OUD before admission, or structural differences of individual facilities.
ContributorsChevelwala, Turab (Author) / Moffett, Carol (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-29
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Making an Impact on Skin Cancer Prevention and Strategies for Sun Safety

Description
Skin cancer is the most prevalent form of cancer diagnosed in America. No formal educational program for skin cancer prevention and sun safety previously existed at a Southwest University. As a result, a sun safety educational intervention sought to address this gap. For this co-ed young adult population, an education…

Skin cancer is the most prevalent form of cancer diagnosed in America. No formal educational program for skin cancer prevention and sun safety previously existed at a Southwest University. As a result, a sun safety educational intervention sought to address this gap. For this co-ed young adult population, an education video outlining sun safety measures was developed and delivered. An evidence-based review of the literature supported the intervention design inclusive of pre-and post- descriptive surveys, distributed via Survey Monkey. Data collected included sun safety behaviors, intent for behavioral change, and attitudes towards sun safety. Twenty-eight students completed both the pre-and post-survey. Based on the findings, it is clear that students are more likely to adhere to sun-safe behaviors following this video-based education, potentially decreasing their risk of skin cancer development.
ContributorsPope, Kristen (Author) / Moffett, Carol (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-29
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An Innovative Literacy-Supportive Education Pilot for Wound Self-Care

Description

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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Advancing Nursing Practice in Vietnam: An International Collaboration to Improve Quality

Description
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

Diabetes Self-Management Education Through Technology

Description

The purpose of this project was to evaluate the utilization of a smartphone application for diabetes self-management education (DSME) into a family practice office. Cochrane review of technological options for DSME identified the smartphone as the most effective option. All patients with diabetes presenting in a family practice office for…

The purpose of this project was to evaluate the utilization of a smartphone application for diabetes self-management education (DSME) into a family practice office. Cochrane review of technological options for DSME identified the smartphone as the most effective option. All patients with diabetes presenting in a family practice office for appointments with the clinical pharmacist or the physician were asked if they would participate in the project if they met the inclusion criteria including the diagnosis of diabetes, owning a smart-phone, and over 18 years old. Exclusion criteria were pregnancy, end-stage kidney disease, or use of an insulin pump.

The goal was to enroll at least 10 patients and have them utilize the smartphone application Care4life for education and blood glucose tracking. HbA1c, heart rate, blood pressure, weight, and body mass index were collected at the initiation of the trial in addition to a demographic survey. A survey was obtained at the end of the trial. Ten patients were enrolled in the project; 50% women. One patient discontinued participation after enrollment. Six patients returned their surveys.

The feedback was primarily positive with individuals liking the text messaging reminders and ability to track their matrix (blood pressure, blood glucose, weight, medication adherence, exercise). Continued utilization of the smartphone application within the practice is likely for those patients who enjoy the technology as a reminder. Further opportunities for implementation would be in a hospital setting where patients face a delay post discharge for an appointment with a diabetes educator. Additionally, due to the complexity of the disease this application could be used to educate caregivers.
ContributorsSchaub, Kate (Author) / Moffett, Carol (Thesis advisor)
Created2017-05-05