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.
Collaborating Institutions:
College of Nursing and Health Innovation
Displaying 41 - 50 of 305
Description
BACKGROUND: Strokes remain the number one cause of long-term disability in the United States. Delays in reperfusion after a stroke increase a patient’s risk for unfavorable outcomes. PURPOSE: The purpose of this project is to decrease the time from patient’s arrival to the emergency department (ED) to interventional radiology (IR) for mechanical thrombectomy intervention by educating nurses on how to identify IR-qualifying strokes using specific screening tools. Bandura’s self-efficacy theory will serve as an essential model to guide this project. METHODS: A PowerPoint presentation and brochure were distributed to all ED nursing staff via email at a large urban teaching hospital in the Southwestern United States. These documents discussed the vision, aphasia, neglect (VAN) and balance, eyes, face, arm, speech, time (BE-FAST) screening tools which have high rates of reliability and validity in detecting large vessel occlusions (LVOs) and posterior circulation strokes. Included was a 5-question survey to assess for completion of provided material. Data on the facilities door-to-interventional radiology (IR) times were collected for two months and compared to data from the previous two months prior to the intervention. IRB approval was obtained from the project site. RESULTS: Average door-to-IR times at project site decreased by twenty-eight minutes after ED nurses received stroke screening tool education. DISCUSSION/CONCLUSION: The ability to recognize stroke symptoms consistent with LVOs and posterior circulation strokes upon arrival to the ED allows for timely IR intervention which supports better patient outcomes.
ContributorsEaton, Summer (Author) / Denke, Nancy (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Lack of prenatal care or delayed onset of prenatal care has been shown to demonstrate poor health outcomes such as pre-term delivery for pregnant women and/or low-birth weight for their babies. A community-based pregnancy center’s lack of a process improvement plan for increasing engagement with their online educational classes results in patients not receiving the benefits of prenatal care resources intended to improve their pregnancy health outcomes. Community-based pregnancy centers, bridge the gap for vulnerable populations by offering needed prenatal care and resources in local communities. Incorporation of social media, two-way text messaging and mobile phone applications for patient engagement are low-risk, low-cost interventions that could be timely and measurable components of a process improvement plan to ensure continued prenatal care. This paper critically appraises and synthesizes evidence-based research related to interactive communications on patient engagement. The evidence synthesis guided the development of an intervention piloting a texting service to send clients two-way messages. Increased engagement with the Center’s educational programs was evaluated by tracking class registrations, text responses, opt out rates and usage of the material resource program. Clients’ perception of confidence in problem-solving will be assessed pre- and post-implementation of texting.
ContributorsHodge, E. Mary (Author) / Sanborn, Heidi (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Introduction: Electronic cigarettes (e-cigarettes) among youth has increased drastically in recent years. E-cigarettes are being used with nicotine which can lead to dependency. Healthcare providers (HPs) are in a unique position to advise against the use of e-cigarettes. Recent studies report a lack of formal education among HPs about e-cigarettes. The purpose of this quality improvement project is to examine how increasing e-cigarette awareness among HPs can change their behavior on patient counseling against e-cigarette use. Methods: A modified E-cigarette Knowledge, Beliefs and Attitude Questionnaire was proctored before and after a virtual educational training about e-cigarettes. All advanced HPs employed, in a Southwestern state, at the organization were invited to participate by email. Results: 29 participants completed the pre-survey, and 4 participants completed the post-survey. While 90% of the participants reported that they first learned about e-cigarettes through informal sources, 72% of the participants reported interest in learning more about e-cigarettes to enhance their practice. Further, a two-tailed Mann-Whitney U test was significant on the “e-cigarettes are helpful aid for smoking cessation” statement based on an alpha value of 0.05, U = 12, z = -2.69, p = .007. Conclusions: Increasing the knowledge about e-cigarettes among HPs is critical in decreasing nicotine use among the public. This project will help in the fight against the use of tobacco products, and adds to the literature on how formal education about e-cigarettes among HPs can increase their intention to screen and counsel patients.
ContributorsWelch, Analuisa (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
Objective: Substance use disorder (SUD) is an epidemic in the United States. Current standard of care for SUD continues to produce a 40-60% relapse rate. Treatment for SUD is costly and is not obtainable for many individuals. The purpose of this project is to implement mindfulness as an adjunct treatment for SUD to reduce relapse.
Methods: Voluntary program offered at a residential treatment center designed as a team-based project. The combined project includes exercise, wellness, and mindfulness. Adults over the age of 18, male or female with a diagnosis of SUD were eligible. Program consisted of three hourly sessions a week, for a total of three weeks. Sessions included one session of exercise and wellness, one session of mindfulness training, and a combined session. Mindfulness sessions included learning the seven pillars of mindfulness followed by guided meditation. Participants were given a mindfulness journal for daily exercises. Five Facet Mindfulness Questionnaire (FFMQ) was completed before program and on completion. Results: 11 of 22 participants completed the program. FFMQ total scores were analyzed with paired t-test with Wilcoxon signed rank to account for small sample size. Statistical significance was based on an alpha of 0.05, V=10.50, z=2.00 and p=0.45.
Conclusion: This project has the potential to decrease relapse rates by increasing mindfulness in individuals with SUD. Mindfulness training reduces cravings and negative thought processes. Implementing mindfulness training with current standard of care can be cost effective and recommended for all individuals with SUD.
ContributorsRouston, K. Courtney (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
Background: Current standard of care practices for substance use disorder is inadequate in reducing relapse, with rates persistently 40-60% within one year of treatment. Unconventional approaches must be explored to reduce the risk of relapse, climbing rate of overdoses, and healthcare expenditures exceeding $740 billion annually. The purpose of this quality improvement project demonstrates how an evidence-based group exercise intervention, used as adjunctive support to standard addiction treatment, can reduce relapse and promote long-term recovery during a global pandemic. Methods: Aims of this project sought to enhance quality of life scores. Participants were recruited upon admission to a residential treatment center. Pre-posttest design utilized the World Health Organization Quality of Life Abbreviated scale to assess program impact on quality of life. Pre-program descriptive questions and a survey assessing prior addiction treatment were collected. Group exercise and wellness education sessions were delivered twice weekly in a live, interactive, virtual format with on-site participants. Upon completion, a post-program survey was utilized to capture the qualitative experiences of participants and impact of project to instill confidence to execute long-term sobriety. Results: Pre and post scores, as well as domain scores were clinically and statistically significant. Additionally, 80% of participants reported feeling more prepared to achieve long-term sobriety secondary to their participation in this project. Discussion and Conclusion: Results from this project demonstrate the positive impact that group-based exercise and lifestyle interventions can have on quality of life and long-term recovery. Peer support exercise programs may offer means to enhance addiction treatment and reduce overall healthcare expenditures globally by defying the odds of relapse.
ContributorsAvino, M. Hayley (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
Objective: Obesity is the fifth leading cause of global death and is preventable. It affects all body systems and causes major chronic illnesses such as diabetes, heart diseases, stroke, and some cancers. The goal of this transtheoretical stages of changes (TSOC) theory-based project are as follows: To educate the participants of the project to be aware of obesity and its complications; motivate them to use community resources, and improve their body mass indexes (BMI), waist circumference (WC), motivation, quality of life (QOL) and lifestyle.
Methods: Twenty-three participants were recruited in a primary care clinic. Six participants dropped out during the project. All the randomly selected participants who met the criteria of obesity signed written informed consent and were provided a 4-digit code to maintain anonymity. Participants were motivated and educated using a handout, two pre-and post-project in-person nursing visits, and five telemedicine weekly nursing follow-ups visits. Pre- and post-surveys collected during in-person visits include data such as weight, BMI, WC, demographic data, comorbidities, lifestyle, motivation, QOL, TSOC, and utilization of community resources.
Results: Descriptive analysis and paired t-test is done utilizing Intellectus statistics software to measure the outcome. The results show improvement in dietary choices, physical activity, motivation, QOL, use of community resources, decrease in BMI, and WC. In paired t tests, results show clinical and statistical significance in BMI, WC, MOT and clinical significance in QOL. There was increase in the revenue at the project site due to reimbursement of the services provided for the patients.
Conclusion: The results are expected to develop practice change in preventing and treating obesity. More evidence-based projects and studies with large sample size are needed to develop improvement in the knowledge base of providers and current practice.
ContributorsCherian, Ribi (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28