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: Tharalson, Erin
- Creators: Santerre, Jennifer
Falls are prevalent among those aged 65 years and older and may result in minor to debilitating injuries in this vulnerable population. Frailty, unsteady gait, and medication side effects all contribute to fall risk as well as dementia, a type of cognitive impairment that disrupts memory and judgment leading to an underestimation of fall risk. Fall prevention evidence suggests that interventions aimed at decreasing fall rates begin with a fall risk assessment and tailored fall prevention measures that promote safety.
To examine the effectiveness of a fall prevention program in dementia care, an evidence-based pilot was conducted in a long-term care facility focused on dementia care. A convenience sample of 16 nurses received a fall prevention education intervention. A fall prevention knowledge instrument measured pre and post-fall prevention knowledge. There was a significant increase in fall risk knowledge from the pre-test (p < .001). The participants then conducted a fall risk assessment of 50 dementia patients using the Morse Fall Scale.
Of the 50 dementia patients, 28 were identified as high risk for falls. The nurses then instituted tailored fall risk prevention measures for those high risk for falls. As a result of the pilot, 40 fall events were noted within a three-month time period, reflecting a significant reduction in falls (p < .001) from the previous year. The institution of a fall prevention program in dementia care incorporating nursing education, a fall risk scale, and measures to promote safety can reduce fall risk in dementia patients.
Obtaining a comprehensive sexual health history is an important part of the patient history taking process and is essential to providing high-quality, patient-centered, and accessible healthcare. Information gathered from the sexual health history guides delivery of appropriate education about prevention, counseling, treatment, and care. A federally qualified health center (FQHC) reported that they did not have a standardized comprehensive sexual health history taking process. To address this concern, a literature review was conducted to survey current evidence regarding both patient and healthcare provider perspective on sexual health history taking. While it is recommended for a sexual health history to be performed routinely, both healthcare providers and patients have reported sexual health is not discussed at most visits.
The findings led to the initiation of an evidence-based project implementing a comprehensive sexual health history taking tool at the FQHC. The tool assists in obtaining a comprehensive sexual history and provides an understanding of the sexual practices of the patients. If healthcare providers become aware of the sexual practices of their patients, they are better able to provide evidence-based education that could lead to better health outcomes. The participants reported they liked being asked about their sexual health, did not find the questions too personal, and reported the questionnaire addressed their sexual health concerns, and was worth their time. Taking a comprehensive sexual health history is a fundamental skill that all healthcare providers must strive to improve for the general health of their patients and the community.
People who inject drugs (PWID) are at high risk for disease transmission and bacterial invasion of the blood and/or skin. PWID are a marginalized population who often delay medical treatment or substitute self-care treatment due to increased fear, barriers, or stigmatization in traditional healthcare settings. These delays often create multifaceted complications that eventually cost the healthcare system billions of dollars. This leads to poorer health outcomes in PWID. There is evidence that community-based interventions are effective in reaching this population of people in order to promote better health outcomes.
To address this gap in care, an evidenced based project centered on increasing the confidence levels of community lay workers when providing general wound education to PWID was conducted. The project was implemented at a rural harm reduction agency site in Northern Arizona. Utilizing the theoretical framework of the Adult Learning Theory, a convenience sample of 22 participants received a general wound education intervention consisting of a PowerPoint presentation with a written brochure over multiple sessions.
Adapted questions from the new general self-efficacy (NGSE) scale, which has demonstrated valid internal consistency, were utilized to measure confidence levels of participants and a scored checklist was used to measure teaching performance. Confidence levels significantly increased from baseline to week four (p = .001). Teach-back performance scores also increased from baseline to week two and four. Providing a general wound education intervention to community lay workers improved confidence levels and teaching performance which can promote better health outcomes in PWID.
Gestational diabetes mellitus (GDM) is a well-established predictor for the development of type II diabetes mellitus (T2DM) later in life. The incidence of GDM has been on the rise over the past 30 years and is the leading co-morbidity during pregnancy (Ferrara, 2007). Physical activity (PA) in combination with nutritional therapy has been shown to achieve glycemic control in women with GDM and is therefore first line therapy for management (American College of Obstetrics and Gynecology [ACOG], 2017; Center for Disease Control and Prevent [CDC], 2018).
Recommendations for PA in pregnancy include 150 minutes of moderate intensity exercise most days of the week (ACOG 2015; U.S. Department of Health & Human Services, 2018). Because of this, an innovative project was created to determine the feasibility of adding a walking plan into GDM care. Participants in the project received verbal and written instruction on an unsupervised structured walking plan set up for a beginner to gradually increase PA to the recommended time of 150 minutes per week for a total of four weeks. Eight women were interested, recruited, and enrolled in the project.
Results show that overall, participant PA increased. One hundred percent agreed that the walking plan was useful and increased their awareness about PA. The addition of a walking plan in GDM teaching is an effective strategy to lower serum blood glucose (SBG) levels and for meeting PA recommendations during pregnancy.