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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Background: The COVID-19 pandemic has been causing high rates of hospitalization and death among the marginalized Asian American Pacific Islander (AAPI) community. Disaggregated data revealed low COVID-19 vaccine uptake among Korean Americans/Immigrants (KA/I) due to vaccine-related fears unaddressed by cultural and linguistic barriers. Prior evidence demonstrates that digital storytelling (DST)

Background: The COVID-19 pandemic has been causing high rates of hospitalization and death among the marginalized Asian American Pacific Islander (AAPI) community. Disaggregated data revealed low COVID-19 vaccine uptake among Korean Americans/Immigrants (KA/I) due to vaccine-related fears unaddressed by cultural and linguistic barriers. Prior evidence demonstrates that digital storytelling (DST) is an effective medium to improve recommended vaccine intent and uptake among AAPIs. Objective: This DNP project aimed to assess the effect of DST intervention on improving KA/I’s COVID-19-related vaccine hesitancy, intent, and uptake. Methods: A quasi-experimental design was conducted, with participants (n=4) self-identifying as KA/I adults with English or Korean fluency residing in the U.S. Participants were recruited online via convenience sampling from CARE (Collaborative Approach for AAPI Research and Education). Individuals who had already received COVID-19 vaccines were excluded. The intervention included two first-person audiovisual stories documenting the personal experience of receiving the COVID-19 vaccine. Outcomes were measured via a pre-post-1-month-follow-up survey utilizing a modified Vaccine Hesitancy Scale (? = 0.72) and Narrative Quality Assessment Tool (? = 0.78-0.81). Results: DST intervention had a marginally significant effect on lowering post-COVID-19 vaccine hesitancy scores (p = 0.068). Participants (n=2) who rated the DST videos with a higher score indicated vaccine uptake at one-month follow-up. Conclusion: This cost-effective, sustainable, and scalable DST evidence-based project has the potential to promote COVID-19 vaccination among KA/I and other AAPI groups with appropriate modification.
Created2022-05-01
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Purpose & Background: Nurses regularly have encounters with traumatic and stressful events which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention

Purpose & Background: Nurses regularly have encounters with traumatic and stressful events which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention would reduce burnout levels among registered nurses (RNs) working in in-patient settings. Methods: Participants enrolled in nursing programs from a local university were recruited for the project with the following inclusion requirements: (1) RNs working in an in-patient setting, (2) aged 18 years old or older; (3) fluent in the English language. Participants completed a pre-survey and then enrolled in a free mindfulness application via their phone or computer. Participants listened to one ten-minute mindfulness session for a consecutive ten days and then completed a post-survey. Results: Data collected from the pre and post surveys included the use of the following valid and reliable instrument tools: Copenhagen Burnout Inventory, Brief Resiliency Coping Scale, and Short Form Health Survey. Data was analyzed using descriptive statistics and the Wilcoxon Signed Ranks Test. The analyzed data showed that there was statistical significance in decreased burnout levels, increased resiliency, and increased health perceptions of the participants. Conclusion: By finding ways to cope with the experience of burnout in nurses, nurses’ mental health wellness can improve in order for nurses to continue to be an integral part of the healthcare system.
Created2022-05-06
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Introduction: Poor knowledge and negative perceptions regarding mental health disorders are barriers to parents seeking mental health care for their child. Mental health literacy comprises both the knowledge and ability to recognize mental health disorders, combat stigma, and obtain treatment. Research demonstrates increased mental health literacy increases parental help-seeking behaviors.

Introduction: Poor knowledge and negative perceptions regarding mental health disorders are barriers to parents seeking mental health care for their child. Mental health literacy comprises both the knowledge and ability to recognize mental health disorders, combat stigma, and obtain treatment. Research demonstrates increased mental health literacy increases parental help-seeking behaviors. Aim: To increase mental health literacy of parents in Maricopa County through increased access to evidence-based education and support. Methods: A local mental health organization utilized the Model for Improvement (MFI) Plan Do Study Act (PDSA) quality improvement framework to increase the number of parents attending an evidence-based, six-session educational class and bi-monthly support group. Interventions included 1) outreach and recruitment via social media and community partners, and 2) convening one six-week educational class and four support group sessions. Results: Parental awareness and attitudes toward mental health disorders were measured at Class One (N=11, M = 30.9, SD 5.15) and Class Six (N=5, M = 40.2, SD 1.64) and analyzed utilizing the Mann-Whitney U Test; results demonstrate improved awareness and attitudes (U =50, p = .001). Eleven parents attended a support group session; 91% (10) reported they learned new information about how to support their child; 82% (9) reported they improved their ability to access and advocate for mental health services. Conclusions: Findings suggest that participating in this organization’s educational classes and support groups increases mental health literacy. Barriers that prevent more parents from participating should be explored.
Created2021-04-27
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False accusations concerning the development of autism and other hazardous side effects have triggered parental vaccine hesitancy, leading to outbreaks of vaccine-preventable diseases. This opposition to vaccination risks the health of both individuals and entire communities. The purpose of this project was to determine the effectiveness of prenatal education on

False accusations concerning the development of autism and other hazardous side effects have triggered parental vaccine hesitancy, leading to outbreaks of vaccine-preventable diseases. This opposition to vaccination risks the health of both individuals and entire communities. The purpose of this project was to determine the effectiveness of prenatal education on maternal vaccine hesitancy and infant immunization rates. In a pretest posttest design, pregnant mothers greater than or equal to 30 weeks gestation were recruited by The Arizona Partnership for Immunization (TAPI) and virtually educated about infant immunization. A voice-over PowerPoint presentation was delivered to the participants virtually and focused on vaccine knowledge, intention to vaccinate, and vaccine hesitancy. These outcomes were evaluated virtually pre- and post-intervention with the Parent Attitudes about Childhood Vaccines (PACV) survey (⍺ = 0.84), and the infants’ vaccination records were compared against the recommended immunization schedule at two months of age. Using the Wilcoxon Signed-Ranks test, data analysis revealed vaccine hesitancy was significantly reduced between pre- and post-intervention (Z = 27.70, p = .000), and 100% of the 2-month-old infants were fully immunized with the recommended vaccines. The effect size (d = 12.807) also indicated a strong relationship between pre- and post-intervention vaccine hesitancy. Vaccine hesitancy remains a threat to public health. With prenatal education, pregnant mothers will likely become more knowledgeable of vaccine benefits and better prepared to make informed decisions. Confident vaccination will decrease vaccine hesitancy and improve immunization rates, while promoting individual and societal health.
Created2021-04-27
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Secondary traumatic stress (STS) is the natural, consequent behaviors and emotions that result from the individual’s knowledge about traumatizing events experienced by another. Psychiatric registered nurses (RN), due to the nature of their jobs, are frequently exposed to significant amount of secondary trauma during nurse-patient interactions. Secondary traumatic stress impacts

Secondary traumatic stress (STS) is the natural, consequent behaviors and emotions that result from the individual’s knowledge about traumatizing events experienced by another. Psychiatric registered nurses (RN), due to the nature of their jobs, are frequently exposed to significant amount of secondary trauma during nurse-patient interactions. Secondary traumatic stress impacts the physical and emotional health of the nurse, compromises patient outcomes and organizational success. Evidence acknowledges the significant extent of secondary traumatic stress among nurses and is insistent on the necessity for effective interventions to mitigate the impacts of secondary trauma on healthcare professionals. A review of literature suggests that knowledge is a protective factor against secondary traumatic stress, and that nurse resilience also moderates the effects of secondary trauma and other work related stressors. These findings have led to the initiation of an evidence-based project that seeks to assess the efficacy of a resilience-oriented educational intervention in decreasing secondary traumatic stress scores and improving resilience among hospital-based psychiatric registered nurses. This project was guided by the Theory of Cognitive Appraisal and Rosswurm and Larabee’s model for evidence-based practice. Results from this project, despite being non-statistically significant, showed a decrease in STS scores from time-point zero (T0) to time-point one (T1) and increased resilience scores from time-point one (T1) to time-point two (T2), and from time-point zero (T0) to time-point two (T2). This project highlighted a deficit in knowledge of concepts of ST, STS and resilience among psychiatry RNs and inspired an open discussion on STS and other types of work-related stress among psychiatry RNs.
Created2021-04-28
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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.
Created2021-04-29
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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.
Created2021-04-29
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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
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
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Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy which is being used increasingly to promote mental health in

Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy which is being used increasingly to promote mental health in both adults and children. This study sought to build and deliver an evidence-based, family-centered equine assisted learning program aimed at promoting family function, family satisfaction and child social-emotional competence, and to measure its acceptability and preliminary effect.

Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.

Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.

Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.
ContributorsSolarz, Allison (Author) / Chen, Angela (Thesis advisor)
Created2019-05-02