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 21 - 30 of 305
Description
Purpose: The COVID-19 pandemic has increased depression among the population. Exercise is a useful coping mechanism for depression and high intensity interval training (HIIT) can be utilized.
Background: A community exercise facility provides HIIT exercises for gym members. The gym owner believed their HIIT program is a great tool for coping with depression.
Methods: The gym offered a 21-day free HIIT program. Those who signed up for the program, 18 years of age or older, and were able to exercise under the Physical Activity Readiness Questionnaire were offered to participate in the study. Participants were given a pre-survey before they started exercises. This survey utilized the Patient Health Questionnaire-9 (PHQ-9), a standard depression rating tool that determines depression symptom prevalence. After the 21-day program, participants were given a post-survey involving the same PHQ-9. The survey scores were compared pre- to post-program. The surveys were coded to exclude any identifying information.
Results: Mean PHQ-9 pre-test was 7.67, mean score post-test was 3. A paired t-Test resulted in a p=0.60, showed that it was not statistically significant.
Discussion: The goal of this study was to determine if HIIT training was an effective coping mechanism for depression. The data shows that participants had decreased PHQ-9 scores from the pre- and post-program surveys showing a clinical significance. This data can be used to provide those suffering from depression a coping mechanism.
ContributorsSmith, Kolter (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
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.
ContributorsTambala, Sandikonda (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Background: Advance Care Planning (ACP) conversations are discussions between patients, providers, and loved ones addressing key care decisions in the event of incapacity. Nearly twothirds of US adults have not completed an Advance Directive (AD), yet ACP conversations rarely occur in practice. The objective of this quality improvement project was to implement workflow changes with a reminder system to facilitate ACP conversations during Medicare Wellness Visits (MWV).
Method: Social Cognitive Theory describes the complex relationship between variables that can influence an individual’s decision to address ACP. Providers in a primary care office in the Southwestern United States participated in an ACP education session and confidence survey. Patients presenting for the MWV were screened for ACP, and visual reminders were attached outside the exam room for provider review. Aggregate data were used to evaluate provider surveys. Descriptive statistics were used to evaluate patient characteristics and the Chi-square Test of Independence, and Fisher’s test was used to compare the pre-and post-intervention advance directive documentation.
Results: Qualitative feedback from the survey indicates reminders and easily accessible resources may help facilitate ACP conversations. Of the 251 MWVs, 21 (8%) had an AD documented, significantly less than the nationally reported rate of 37.7% (p < 0.05, z = -2.39).
Conclusions: Healthcare providers face multiple barriers preventing or delaying ACP conversations in practice. System-level changes and provider education can improve the rate of ACP conversations and impact patients’ care at the end of life.
ContributorsSmith, E. Elizabeth (Author) / Reifsnider, Elizabeth (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Background: Breastmilk is the optimal source of nutrition for infants as recommended by the American Academy of Pediatrics and the World Health Organization (WHO). Despite proven benefits, rates of breastfeeding have shown to decrease drastically at six months of age.
Purpose: The purpose of this project is to assess the effectiveness of virtual peer support and infant education in increasing/improving a mother’s wellbeing and breastfeeding relationship. This project was guided by the theory of self-efficacy.
Methods: Participants were recruited utilizing flyers that were posted to social media and distributed at a breastfeeding center in Southwestern United States. Six breastfeeding mothers were recruited, and each participated in four, one-hour peer support sessions that were held weekly via Zoom. Participants completed the WHO Well Being Index and the Breastfeeding Relationship scale before and after the intervention. Pre- and post-implementation scores were compared.
Ethical Considerations: The research was approved by the IRB board at Arizona State University and was in compliance with ethical considerations and standards of the institution.
Results: Descriptive analysis conducted on the WHO Well-Being Index showed the same results or improvement for 80% of the questionnaire. Descriptive analysis conducted on the Breastfeeding Relationship Scale showed improvement on 81% of questions.
Conclusions/Discussion: Breastfeeding can be taxing and overwhelming for mothers leading them to discontinue earlier than planned. Peer support has been identified to be substantial to women going through this process in helping them initiate and continue to breastfeed their infant.
ContributorsLopez, Danielle (Author) / Reifsnider, Elizabeth (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Objective: Delirium frequently occurs in Pediatric Cardiac intensive Care Units (PCICU) of hospitals with critically ill patients. An inflammatory process of the brain causes neurotransmitters imbalances and neuronal alterations, leading to increased days on mechanical ventilation, length of stay in the ICU, and possible self -harm. Delirium can be reduced and controlled if detected early through frequent patient monitoring and screening. The purpose of this project is to evaluate the implementation of a delirium screening tool along with education on delirium
Study Selection: An education module on delirium and the Cornell Assessment of Pediatric Delirium (CAP-D) screening tool along with a non-pharmacological bundle was implemented on a pediatric cardiac intensive care unit for patients 2 to 18 years of age, admitted to an Arizona metropolitan children’s hospital. All nurses were required to attend the education session. Data was collected by using pre- and post-survey questions on delirium for those nurses who chose to participate in the study.
Data Synthesis: The results from the pre- and post-tests suggest there was an increase in education. The average score for the 15 nurses on the pre-test was 87.1% while the same nurses scored 100% on the post-test. Chart reviews of the CAP-D screening tool from November 2000 – February 2021 had 71 patients on the unit and had 8 patients scored on the CAP-D screening tool. Chart reviews after implementation of the education module from November 2021 – February 2022, were conducted and 118 patients were on the unit while only 23 patients were scored on the CAP-D screening tool.
Conclusion: So far, the use of an education module and implementation of a non-pharmacological bundle has proven some promising results in helping with delirium and its reduction in the PCICU.
ContributorsHernandez, Ricardo (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Objective: To understand and prevent adverse discharge events, the project assesses the needs and gaps of discharge care coordination for child(ren) with medical complexities (CMC). The National Survey of Children’s Health show 87.4% of CMC does not receive care in a well-functioning system, and 47.4% did not receive adequate care coordination 1. Therefore, does initiating measurement tools and communication before and after discharge identify and prevent discharge related adverse events?
Methods: After IRB approval, a mixed-methods approach project occurred at southwestern pediatric free-standing hospital. Through eight weeks of convenience sampling, CMC caregivers were recruited in the inpatient setting (n=5). Qualitative and quantitative data were obtained through: [Pediatric] Care Transitions Measurement Tool – 15 (CTM- 15), with a Cronbach’s alpha of .932; a demographics survey; a post-discharge survey; and electronic health records.
Results: The CTM-15 post-discharge score was 83.3 (N = 4, SD = 9.83, SE¬M = 4.92). CTM-15 qualitative data included: communication issues; rushed discharge; poor discharge anticipatory guidance; hospital policy concerns; follow-up appointment issues; and prescription errors. LOS average for all participants was 137.8 days (SD = 102.75, SEM = 45.95) with 40 unintended hospital days (SD = 41.55, SEM = 18.51). Issues encountered 30 days post-discharge included: prescription errors, follow-up issues, and home health issues.
Conclusion: Hospitalized CMC have an increased risk to encounter a discharge adverse event because of a complex intertwining of disciplines, services, medications, and needs. Communication, tools, and surveys did not capture all the problems encountered by families with CMC; however, it did identify areas of notable concern.
ContributorsChalla, Hannah (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
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.
ContributorsCortes, Holly (Author) / Esperas, Amanda (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Although estimated to be 50-60% more than in heteronormative populations, intimate partner violence (IPV) in LGBTQ+ populations is often unrecognized. This project aims to increase nurse practitioner (NP) IPV screening to facilitate early intervention and decrease LGBTQ+ IPV rates.
The researcher gathered information from 1:1 interview with LGBTQ+ IPV survivors (n=3) and produced a dramatization narrating experiences. Subjects were required to preregister and consent. Nurse practitioners (n=6) participated in a 1.5hr online educational intervention, viewing the video and a 45-min webinar.
The Physician Readiness to Manage Intimate Partner Violence Scale (PREMIS) and the LGBT Development of Clinical Skills Scale (LGBT-DOCCS) were administered as test-retest. The PREMIS measures (? =.963) readiness to screen for IPV, the LGBT-DOCCS measures attitude (?=.80), clinical preparedness (?=.88) and knowledge (?=.83). All participants in both groups were voluntary and recruited from e-lists and special interest groups. Cox’s Theory of Interaction and the Minority Stress Theory were the dual framework along with the ACE model of transformational knowledge to support methodology and outcomes.
Results
Statistically significant (p<0.05) improvements in readiness to screen for IPV, knowledge, and attitudes as measured by PREMIS domains (p= .006; p=.012) and LGBT-DOCSS (p = .028). Clinically significant improvement in mean scores for likelihood to screen for SOGI.
Supported by the theoretical framework and implementation model, increased readiness to screen, improved knowledge and improved attitude, will lead to better NP-patient interactions, decreased minority stress, increased NP screening and intervention, and decreased rates of IPV in LGBTQ+ populations.
ContributorsPhelps-Byam, Wendy (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Sleep deprivation is linked to poor mental and physical health outcomes for professional firefighters. The importance of sleep hygiene practices and health promotional activities may increase the amount of quality sleep firefighters get on their days off. As the adverse outcomes of circadian misalignment due to sleep deprivation becomes more apparent in firefighter wellbeing, the need for a sleep health program becomes more evident. The purpose of this paper is to examine and assess the effects of a sleep health program for firefighter wellness. Research emphasizing the relevance of poor health outcomes related to sleep disturbances is prevalent in the literature. The findings have prompted the development of an evidence-based sleep coaching program for firefighters in a local fire department guided by The Cognitive Behavioral Therapy Model (Brewin, C.R., 1996). and a knowledge-to-Action process framework for evidence-based-practice (Graham et al., 2006).
ContributorsAnon, Melanie (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
Objective: Chronic low back pain in adults is a global health and economic problem. Many with back pain experience compromised sleep. While Cognitive Behavioral Therapy (CBT) is a gold standard in improving sleep among individuals with pain, this approach requires trained staff. The sleep hygiene education and meditation techniques, components of CBT, were utilized in patients with chronic low back pain to improve sleep quality.
Methods: Twenty patients with chronic back pain volunteered to receive sleep hygiene education and meditation videos to practice for 12 weeks and participate in 4-weekly phone calls. Participants were assessed at baseline and post-treatment with the Pittsburgh Sleep Quality Index (PSQI). Participants were patients at a local pain clinic with chronic low back pain without untreated mental illness, sleep apnea, or restless leg syndrome. Informed consent was obtained from participants, along with demographic data. Participants received a brochure with education information to engage daily for 12 weeks. Participants were then contacted weekly by phone to review the learned information.
Results: 13 participants completed the post-intervention questionnaire (35 % attrition rate). Mean age was 55.15 yrs. and most were female (n=11). Paired t-test demonstrated that change in pre and post PSQI score, and Medication Use did not show statistical significance (p=0.372; p=0.502). However, Subjective Sleep Quality had clinical significance (p=.022) suggesting individuals thought their sleep have improved.
Discussion: Sleep hygiene education and meditation techniques is an approach for individuals considering non-invasive and cost-effective approach to improve sleep
ContributorsSong, Christine (Author) / Baker, Laurie (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29