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.

Collaborating Institutions:
College of Nursing and Health Innovation
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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.
Created2022-05-02
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Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The

Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The project was guided by the Health Belief Model. Methods: Consent was obtained from 15 participants working as nurse advocates for a large insurance company. Nurse advocates are tasked with improving the health of patients and connecting them to additional resources. A twenty-minute educational intervention focused on the impact cancer has on mental health and the benefit of multiple psychosocial supportive resources was delivered to the participants. Education included a comprehensive review of the resources available for cancer patients at the project site. Participants were then given 10 minutes to complete a retrospective post-then-pre survey, based on a Likert Scale. Results: Statistically significant improvements in survey scores were observed in each of the three KAB domains. Statistical analysis confirmed improvements in survey scores were significant and not likely due to random variation. Participants also referred more patients into a cancer support program following the intervention. Conclusion: A brief educational intervention was able to improve KAB scores among nurses. There was also an increase in the number of patients these nurses referred into a psychosocial supportive program. Nurses that better understand the mental health needs of cancer patients are more likely to connect them with psychosocial resources. This intervention will become part of standard training for new nurse advocates at the project site.
Created2022-05-02
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Description
Problem Statement & Purpose: Cervical cancer screening rates for a Federally Qualified Health Center (FQHC) in rural Northern Arizona is 78%, which is below the Healthy People 2030 goal of 84.3%. Identification of socioeconomic barriers unique to rural women through the use of an intake survey can improve cervical cancer

Problem Statement & Purpose: Cervical cancer screening rates for a Federally Qualified Health Center (FQHC) in rural Northern Arizona is 78%, which is below the Healthy People 2030 goal of 84.3%. Identification of socioeconomic barriers unique to rural women through the use of an intake survey can improve cervical cancer screening rates. This project was guided by the Social Cognitive Theory (SCT). SCT proposes that behavioral change is determined by environmental, social, personal, and behavioral elements. Methods: At a one-day well-woman event called, “See, Test, and Treat” hosted by the FQHC, an anonymous intake survey was implemented that identified participant demographics, basic cervical cancer knowledge, and perceived socioeconomic barriers to routine cervical cancer screening. Participants were recruited through the FQHC. Participant inclusion criteria: Arizona resident, uninsured, underinsured, 21-65 years old, English or Spanish speaking. Results: Descriptive statistics were utilized to evaluate the survey responses, reliability, and validity of responses unknown due to self-reported responses. A total of 18 surveys were completed with a final yield of (n = 10). Surveys didn’t identify barriers to routine cervical cancer screening; however, an unawareness of cervical cancer risk factors including multiple sexual partners (n = 5, 50.00%), sex at an early age (n = 4, 40.00%), and misperception that cervical cancer is genetic (n = 7, 70.00%) was identified. Implications for Practice: A need for cervical cancer education exists within the surveyed community. Providing rural women with knowledge regarding cervical cancer can improve screening rates.
Created2022-04-29
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Description
Purpose: Understanding the factors impacting communication between residents and peer staff in peer-run residential substance abuse treatment programs. The purpose of this paper is to explore male survival behaviors and cultural norms such as no snitching that impede communication to prevent relapse. Methods: The sample was male residents accepted into

Purpose: Understanding the factors impacting communication between residents and peer staff in peer-run residential substance abuse treatment programs. The purpose of this paper is to explore male survival behaviors and cultural norms such as no snitching that impede communication to prevent relapse. Methods: The sample was male residents accepted into a residential treatment facility in the southwestern United States. Stories of peer-staff’s personal struggles with the no snitching code videotaped and shown in group followed with a guided discussion of relapse triggers, communication, and behavior norms that impede treatment. An online confidential pre-post retrospective survey designed using the Drug Abstinence Self-Efficacy Scale. Results: Descriptive statistics run show Cronbach's alpha of 0.96. A two-tailed paired samples t-test was conducted to examine the Overall Confidence Pre-test and Post-test mean difference. The overall confidence post-test was not statistically significant, but it was clinically significant. Clinical significance evidenced by residents 3-point lower confidence post-intervention. Conclusions: How-to elicit behavior change is unique to every individual. The goal is behavior change to sustain recovery and better communication between clients and peer staff to prevent relapse.
Created2021-04-26
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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.
Created2021-04-29
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Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available

Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available community resources. Children residing in remote areas may experience more burdensome needs as they progress in the cancer treatment trajectory, which healthcare providers may not be aware of unless the information is specifically solicited or incidentally discovered. Use of an evidence-based needs assessment for families who reside in remote zip codes will aid in identification of unique needs and assist the multi-disciplinary care team to specifically tailor interventions to the family. Forty semi-structured interviews were conducted with parents of childhood cancer survivors using an expert-validated needs assessment tool. The purpose of this Doctor of Nursing Practice (DNP) project is to develop a needs assessment for children with cancer in order to identify which needs are amplified in a remote community in order to match and create resources to meet those needs.
Created2021-04-30
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Description
Background: Cancer impacts the lives of millions of patients, families and caregivers annually
leading to chronic stress, a sense of powerlessness, and decreased autonomy. Social support may improve health empowerment and lead to increased perception of well-being.

Purpose: The purpose of this project was to evaluate the effectiveness of social support provided

Background: Cancer impacts the lives of millions of patients, families and caregivers annually
leading to chronic stress, a sense of powerlessness, and decreased autonomy. Social support may improve health empowerment and lead to increased perception of well-being.

Purpose: The purpose of this project was to evaluate the effectiveness of social support provided by a cancer support agency on health empowerment and perceived well-being in adults impacted by cancer.

Conceptual Framework: The Health Empowerment Theory maintains that perceived wellbeing is the desired outcome; mediated by health empowerment through social support, personal growth, and purposeful participation in active goal attainment.

Methods: Twelve adults impacted by cancer agreed to complete online questionnaires at
baseline and at 12 weeks after beginning participation in social support programs provided by a cancer support agency.
Instruments included: Patient Empowerment Scale, The Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and The Office of National Statistics (ONS) Subjective Well-Being Questions.

Results: Four participants completed pre and post surveys. An increase was seen in
empowerment scores (pre M = 1.78, SD = 0.35 and post M = 3.05, SD = 0.42). There was no
increase in perceived well-being: SWEMWBS pre (M= 3.71, SD= 0.76), post (M= 3.57, SD=
0.65); ONS pre (M= 7.69, SD= 1.36), post (M= 6.59, SD= 1.52).

Implications: The data showed an increase in health empowerment scores after utilizing social support programs, lending support to the agency’s support strategies. It is recommended that the measures be included in surveys routinely conducted by the agency to continue to assess the impact of programming on health empowerment, and perceived well-being.
ContributorsO'Rourke, Suzanne (Author) / Velasquez, Donna (Thesis advisor)
Created2017-05-03
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Description
According to The Joint Commission, most sentinel events in healthcare can be attributed to errors in communication. Thousands of medical students in the United States lack adequate communication training. Current literature illustrated that communication skills training programs increase confidence and communication skills of medical students and residents. These programs vary

According to The Joint Commission, most sentinel events in healthcare can be attributed to errors in communication. Thousands of medical students in the United States lack adequate communication training. Current literature illustrated that communication skills training programs increase confidence and communication skills of medical students and residents. These programs vary in techniques, with many including lectures and role play exercises. This project aimed to improve outcomes at a forensic facility in Arizona by utilizing a student role play intervention and lecture. Outcomes were measured utilizing developed pre- and post-intervention surveys. The surveys included a validated tool which measured four communication skill categories. A convenience sample consisted of pre-medical interns who participated in the project. The small sample size (four) led to descriptive statistics utilization to provide preliminary data. Prior to the intervention, communication skill average scores were as follows: listening (15), giving and getting feedback (12), sending clear messages (13.75), and handling emotional interactions (11.5). Post-intervention, the average scores for the communication skills were as follows: listening (18.25), giving and getting feedback (13), sending clear messages (16), and handling emotional interactions (12.75). Average scores for each category showed an increase after the implementation of the intervention. The survey was completed for four (100%) of participants, and 75 percent of participants stated they felt more confident with utilizing communication skills in their internship. A communication skills training program can enhance communication skills of medical trainees by providing structured support. Further research is needed on effective techniques to train medical trainees.
ContributorsIliescu, Michelle (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
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Description

Cancer survivorship has been identified as separate stage in cancer treatment posing unique issues that arise from the diagnosis of cancer, as well as late effects associated with treatments. Evidence shows that cancer survivors demonstrate suboptimal follow-up care, and report high levels of unmet needs related to their cancer experience.

Cancer survivorship has been identified as separate stage in cancer treatment posing unique issues that arise from the diagnosis of cancer, as well as late effects associated with treatments. Evidence shows that cancer survivors demonstrate suboptimal follow-up care, and report high levels of unmet needs related to their cancer experience. To improve care for the increasing number of cancer survivors in the United States, survivorship care plans (SCPs) have been proposed as way to strengthen care coordination and improve patient outcomes.

Research suggests that SCPs have favorable impact on patient satisfaction and quality of life, however little research to date investigates the utility of SCPs in improving patient outcomes, adherence to follow-up recommendations, or patients’ confidence in self-care management. To further understand the role of SCPs in survivorship care, a pilot implementation of SCPs in colon cancer patients was implemented to gather data on the identified gaps.

ContributorsRuegg, Lauren (Author) / Chifelle, Rochelle (Thesis advisor)
Created2018-04-29
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Description
Background: Communication is a critical healthcare skill; communication errors in healthcare settings have produced sentinel events and caused patient deaths. Situation, Background, Assessment, Recommendation (SBAR), a standardized clinical communication format, is being introduced in nursing education to support early development of successful inter-professional communication. Role modeling has been

Background: Communication is a critical healthcare skill; communication errors in healthcare settings have produced sentinel events and caused patient deaths. Situation, Background, Assessment, Recommendation (SBAR), a standardized clinical communication format, is being introduced in nursing education to support early development of successful inter-professional communication. Role modeling has been shown to be an effective way to teach students complex communication skills.

Method: Pre-licensure nursing students participated in a high fidelity simulation experience. One group of students viewed a video role modeling SBAR before beginning the simulation (N=20). Student communication using SBAR was evaluated after the simulation experience for both groups. The second group of students did not view the video role modeling SBAR until after completing the simulation (N=20).
Results: Viewing a role modeling video on SBAR before participating in a simulation had no effect on the students SBAR performance after the simulation. The students’ evaluation of the video reported the video provided a clear, helpful demonstration of the SBAR communication method.

Conclusion: Role modeling can be used to improve students’ ability to apply SBAR, however more research needs to be done to determine the most effective way to role model the behavior.
ContributorsDay, Kimberly (Author)
Created2016-03-31