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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The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese

The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese adolescents. Healthcare providers must continuously explore novel ways to empower teens to make healthy lifestyle changes. The Creating Opportunities for Personal Empowerment (COPE) Thinking, Emotions, Exercise, and Nutrition (TEEN) program was delivered to three adolescent participants in a primary care pediatric clinic in Southwest Arizona. The 15 sessions were provided weekly in the pediatrician’s office using the COPE TEEN manual. The participants completed the HABITS questionnaire and the Patient Health Questionnaire-9 (PHQ-9) before starting the program and after program cessation and kept confidential. The survey results were compared using descriptive analysis and paired t-tests to analyze the data collected. Due to a small sample size (n=3), statistical significance could not be calculated. However, clinical significance was found as evidenced by lower depression scores and improvement in healthy habits. A cognitive behavior skills-building program such as the COPE TEEN program has the potential to empower adolescents to make healthy decisions in life. These healthy choices lead to a long, happy life free from diseases caused by unhealthy choices. This program positively impacts the clinical care of adolescents who are overweight or obese by offering providers an alternative manner of educating adolescents.
Created2022-04-29
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Description
Background: Healthy People 2020, a government organization that sets health goals for the United States, has established the benchmark objective of 70% influenza vaccination coverage. National trends show immunization rates are a dismal 41.7% for the adult population. Persons
experiencing homelessness are a vulnerable population in which access to preventative health

Background: Healthy People 2020, a government organization that sets health goals for the United States, has established the benchmark objective of 70% influenza vaccination coverage. National trends show immunization rates are a dismal 41.7% for the adult population. Persons
experiencing homelessness are a vulnerable population in which access to preventative health care services is lacking. Prevention of acute illness, whenever possible, is crucial to maintaining the health of this population. The purpose of this project is to increase influenza vaccinations through staff education at a homeless clinic.

Methods: Eighty-eight volunteer staff, at a student led homeless clinic, received education on the influenza vaccinations. The education occurred at the first orientation meeting of the fall semester in 2016 and consisted of; the importance of immunizations, goals of Healthy People 2020, and an emphasis on addressing patient objections. The effectiveness of the program
compared the percentage of patients immunized from August - December 2016 to 2015.

Results: Post intervention, 44% of the clinic patients were immunized against influenza,
compared to 18% (pre-intervention). This finding resulted in a statistically significant increase in
vaccinations (Z= -5.513, p= < .001, Wilcoxon signed rank test). Eighty-eight volunteers were
present at the influenza vaccination educational intervention and 82 returned their surveys
(response rate 93%). The average score of the posttest was 96% (range 70-100%).

Conclusions: These findings support staff education on influenza vaccinations as a strategy for
increasing vaccination in the homeless population. Such interventions provide promise to
increase influenza vaccinations, however, they fall short of meeting the goals of Healthy People
2020. Identifying innovative interventions is critical to meet the goals of Healthy People 2020.
ContributorsVossoughi, Tiffany (Author) / Harrell, Liz (Thesis advisor)
Created2017-04-17
Description

Purpose: Assess provider perceptions on care coordination, collaboration, teamwork, and shared decision-making practices pre and post a brief educational intervention on interprofessional collaboration (IPC).

Background and significance: A lack of care coordination and active follow up in the outpatient setting of individuals living with mental illness places this population at high

Purpose: Assess provider perceptions on care coordination, collaboration, teamwork, and shared decision-making practices pre and post a brief educational intervention on interprofessional collaboration (IPC).

Background and significance: A lack of care coordination and active follow up in the outpatient setting of individuals living with mental illness places this population at high risk for developing various comorbidities. Care coordination across care providers and patients in a IPC, patient-centered treatment model of care is an intervention that can reduce this barrier to care.

Methods: At a behavioral health clinic in the southwestern United States (U.S.) twenty-two participants were assessed via the Collaborative Practice Assessment Tool (CPAT), before and after an educational presentation on IPC care. The CPAT is a tool that was developed to assess collaborative practice within teams and help identify needs for professional development.

Results: Statistical significance was found from pretest to posttest scores (t(21) = -1.936, p = .066). Statistical significance was found in two of the eight domains; mission, meaningful purpose, and goals (p = .009) and decision-making and conflict management (p = .058). Increases in posttest scores were seen in all eight domains.

Conclusions: Training behavioral health professionals in IPC practice and teambuilding may facilitate improved clinical team experiences and communication. Behavioral health professionals treating individuals living with serious mental illness (SMI), IPC training could prepare providers to work more effectively and efficiently in the delivery of patient-centered care in this population with complex health care needs.

ContributorsVioletta, Tina (Author) / Harrell, Liz (Thesis advisor)
Created2016-05-04
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Stress is the direct source of some health issues and the precursors to many illnesses. The effects of stress are felt by the majority of the population and is usually undertreated or overlooked as a norm of life rather than a potential source of illness. Though everyone has different thresholds

Stress is the direct source of some health issues and the precursors to many illnesses. The effects of stress are felt by the majority of the population and is usually undertreated or overlooked as a norm of life rather than a potential source of illness. Though everyone has different thresholds of stress, chronic or constant stress is debilitating for some and can manifest itself in limitless ways. For adults with substance use disorders (SUDs), research supports that mindfulness based interventions (MBIs) could be beneficial for stress management. The techniques incorporated in mindfulness based practices can decrease the baseline stress of its practitioners by increasing their awareness and mindfulness within daily life and during stressful situations.

This increase in awareness and mindfulness has shown numerous benefits that may be crucial in increasing the likelihood of sobriety for those with SUDs. Some of these benefits may include, improved stress management, improved mitigation of craving symptoms, reduced incidences of relapse, and a better quality of life. A 4-week self-help mindfulness pilot program was conducted twice within two separate residential substance recovery settings. The participant’s satisfaction and the internalization of mindfulness concepts were measured within the pre and post implementation of a self-help mindfulness class. In the pilot program, participants rated high satisfaction of the mindfulness class and showed increased levels of mindfulness through the use of the client satisfaction questionnaire (CSQ-8) and the five facets of mindfulness questionnaire (FFMQ-39).

ContributorsKwon, Min (Leo) (Author) / Harrell, Liz (Thesis advisor)
Created2018-05-01
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Introduction: The objective of this study is to emphasize the significance of exclusive breastfeeding (EB) and investigate methods to encourage and sustain it within a hospital environment. Using the self-efficacy theory, the study seeks to improve the current support system for breastfeeding mothers and their families. Methods: The project was

Introduction: The objective of this study is to emphasize the significance of exclusive breastfeeding (EB) and investigate methods to encourage and sustain it within a hospital environment. Using the self-efficacy theory, the study seeks to improve the current support system for breastfeeding mothers and their families. Methods: The project was approved by the university IRB and facility IRB; guidelines were maintained. The project takes place in a non-profit organization in the southwestern United States. Education was conducted at a required staff meeting for Women and Infant Services (WIS) floor about supporting breastfeeding mothers. A pre- and post-education Breastfeeding Knowledge Scale (BKS) survey was performed, effectiveness was measured using a two-tailed t-test. The reliability of the BKS scale is 0.83 and the validity of the scale is reported to be strong. The hospital measures the EB rates of patients that are greater than 37 weeks gestation without need for neonatal intensive unit care and the mom requests to breastfeed. Results: The goal was 42% rate of EB in the first 48 hours after birth. After education the average rate of EB was 39.6%, lower than the goal but higher than the 33.7% rate before education. A two-tailed paired sample t-test (n=27) was used for BKS and the results were significant based on an alpha value; thus, showing significant knowledge gain. Conclusion: Consistent staff education improves breastfeeding support for moms in the hospital, leading to successful exclusive breastfeeding. This project benefits various settings, such as pediatric, postpartum, labor and delivery, and pediatric offices.
ContributorsHudson, Jennifer (Author) / Esperas, Amanda (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
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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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Due to complexities surrounding healthcare for the homeless, continuity of care is virtually nonexistent. Continuity of care refers to individualized, comprehensive health care services that are timely, accessible, and coordinated. Health care continuity has been demonstrated to reduce mortality and improve health outcomes. A literature review determined access to mobile

Due to complexities surrounding healthcare for the homeless, continuity of care is virtually nonexistent. Continuity of care refers to individualized, comprehensive health care services that are timely, accessible, and coordinated. Health care continuity has been demonstrated to reduce mortality and improve health outcomes. A literature review determined access to mobile phones could improve health care continuity among homeless individuals. LifeLine is a state and federal program providing free phones and phone service to impoverished Americans. Enrollment into LifeLine can be challenging for the homeless, who lack access to even the most basic necessities. A project was developed to assist homeless individuals with enrollment into LifeLine in order to increase mobile phone access and improve care continuity. For four weeks, LifeLine enrollment assistance was offered to homeless clients of a mobile health outreach organization in San Francisco, California. Original, anonymous pre- and post-intervention surveys were administered to collect data regarding phone access and healthcare utilization patterns among this population. All 13 participants endorsed mobile phone access; only one participant completed enrollment into LifeLine. Seventy percent of participants reported health care continuity was directly improved by phone access, endorsing consistent healthcare visits and low hospitalization rates. Ninety-two percent of participants reported preexisting awareness of LifeLine, which likely contributed to low program enrollment. This project yielded clinically significant results indicating access to mobile phones can improve health care continuity for the homeless. Improving health care continuity for this population has both ethical and economic implications and remains a public health priority.
Created2021-04-26
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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