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- All Subjects: Education
- Member of: Doctor of Nursing Practice (DNP) Final Projects
Description
Healthcare organization leaders greatly rely on evidence-based practice (EBP) to guide the delivery of care and support clinical decisions on patient care. EBP is a process of assessing and implementing best evidence, patient values, and clinical expertise to make clinical decisions on patient care. Engagement in EBP is an opportunity to overcome the barriers that lead to poor patient and system outcomes. However, EBP implementation can be difficult due to barriers such as lack of time, lack of EBP knowledge, lack of leadership support, and difficulty accessing resources. Several studies support educational programs for nurses to strengthen EBP beliefs and implementation. The purpose of this project was to increase participation in EBP for nurses practicing at Mayo Clinic Arizona. The project involved planning for redesign of existing EBP courses along with new types of support and educational sessions. DNP students participated in the initiative through searching for and synthesizing evidence, collecting and analyzing survey data, and presenting recommendations for program development and outcome measurement to nursing leaders in the organization.
Keywords: evidence-based practice, hospital, nurses, engagement, continuing education
ContributorsVea, Davina; Espinosa, Gloria (Author) / Hagler, Debra (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
Description
Introduction: Pre-exposure prophylaxis (PrEP) is a critical development in HIV prevention, yet females at risk of contracting HIV have lower rates of PrEP use compared to their male counterparts. Insufficient knowledge on PrEP indications for women has been a key barrier in health care providers (HCP) utilization of PrEP in this population. Prior research has revealed educational interventions improved providers’ use of PrEP in at risk populations.
Methods: A 1-hour, educational session was developed for eleven HCPs at a university-based clinic. The educational session was guided by the Cognitive Learning Theory and included information on clinical practice guidelines for PrEP implementation in women. The effects of the intervention were analyzed using a pre/post-survey design, with post surveys delivered at two and eight weeks. The 16-item survey evaluated outcomes including provider discussion and prescription rates of PrEP with female patients and perceived knowledge and perceptions of PrEP in women, utilizing a Likert scale. All procedures were given exempt status by the university IRB.
Results: Paired sample t tests were used to analyze provider reported conversations and prescription rates, while matched ordinal data were analyzed utilizing Wilcoxon signed rank tests and descriptive statistics. At two-weeks post intervention there was a significant increase in provider’s reported likelihood of prescribing to at risk cis gender females in the next six months (Mdn= 2 [pre-survey], Mdn = 3 [post-survey], α= 0.05, V = 0.00, z = -2.53, p = .011). At eight weeks postintervention, there was a statistically significant decrease in provider’s beliefs that HIV risk assessment was an essential component of a primary care visit for female patients (Mdn = 3.00 [pre], Mdn = 2.00 [eight-week], α= 0.05, V = 10.00, z = -2, p = .046). The results of the data analysis have been shared with the leadership team of the health clinic and used to inform future practice on provider educational sessions on PrEP.
Conclusion: Women at risk of contracting HIV are a key demographic missed for the utilization of PrEP. Limited statistically significant findings from the intervention have prompted further research to focus on interventions that promote long-term behavior change and improve providers implementation practices of the preventive measure in at-risk female identifying patients.
ContributorsSnyder, Emily (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25
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 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.
ContributorsPope, Kristen (Author) / Moffett, Carol (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-29
Description
Human trafficking affects men, women, and children, of all races, and incomes. Healthcare providers can work directly with those who are trafficked when they come into the emergency room or clinic to seek care. The identification of those who are trafficked is key to assisting those who need help obtain resources and get the help they need to move forward in their lives. Unfortunately, many healthcare providers do not have the knowledge to identify or the time it takes to pick up on cues that a patient is being trafficked. Currently, there is no set education or curriculum to teach healthcare providers. This has resulted in increased lack of identification of those who are trafficked. An evidence-based quality improvement practice change was implemented. The purpose of this project was to educate healthcare professionals about the red flags that trafficked individuals might exhibit and to implement a screening tool in the emergency department. A brief educational Power Point on human trafficking was provided. A pre-test, post-test and a post-survey was utilized to evaluate awareness and knowledge. After the implementation of the human trafficking screening tool, 1,749 patients were screened, for a screening rate of 71%.
ContributorsRosch, Lisa (Author) / Chifelle, Rochelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-03
Description
The landscape of healthcare is changing. All health providers in varying disciplines and roles must collaborate and function in teams for effective patient and care outcomes to take place. Collaborative practice starts in the academic environment through adoption of Interprofessional Education (IPE). Fostering IPE increases learner confidence and communication but requires a team-based approach to eliminate known learner barriers. These barriers include attitude toward collaboration, role delineation, team development and patient delivery and outcome. While IPE opportunities and activities can be looked at as unique, developing structured curricular standards can be applied to all IPE experiences. Healthcare Participants (HCP’s) (N=15) from two organizational settings participated in an online IPE experience using best practice IPE interventions and structured design formatting focusing on older adults. The course consisted of an online pre learning activity followed by one online session to work as teams on case studies alongside mentorship guidance. The previously validated and reliable ICCAS and RIPLS survey tools were used to measure outcomes of readiness for IPE and professional development. Though no statistically significant changes were noted on the dependent variables, there was clinical significance found in professional development.
ContributorsFlom-Racoma, Kehart (Author) / Uriri-Glover, Johannah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-03
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
Description
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.
ContributorsLeyba, S. Edward (Author) / Harrell, Liz (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Objectives: Asthma education is essential for every pediatric asthma management plan. This Doctor of Nursing Practice (DNP) Quality Improvement (QI) project, guided by the Social Cognitive Theory, aims to explore effective and innovative interventions for asthma management and determine if telehealth is an effective way to deliver asthma education to parents.
Methods: Parents (n = 5) of children with asthma at an urban pediatric primary care clinic were recruited to attend four weekly, 60-minute asthma education sessions over Zoom®. Participants were recruited with flyers and clinic referrals. Participants answered pre- and post-intervention online questionnaires following informed consent, including the Parental Asthma Management Self-Efficacy Scale (PAMSES), the Asthma Control Test (ACT), and a parent program evaluation. Paired sample t-tests were conducted to analyze data and measure mean differences in pre-and post-parent self-efficacy and asthma control in their child.
Results: The results include a statistically significant change in pre-intervention and post-intervention mean PAMSES scores. There was no significant difference between pre-intervention and post-intervention ACT scores; however, there was an increase in mean ACT scores from baseline.
Conclusions: Telehealth is a practical and cost-effective way to address gaps in asthma education and improve patient outcomes. The use of telehealth may be an effective way to address gaps in parent/patient education regarding the prevention of and management of asthma symptoms. Ongoing assessment is needed to evaluate if asthma telehealth education can be effective in other settings, languages, and age groups.
ContributorsFlores, M. Cynthia (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
The purpose of this Doctor of Nursing Practice (DNP) project is to develop and implement a culturally tailored educational program into a community clinic in a northern border community in Mexico to prevent and combat childhood obesity. In Mexico, 33.2% of children are overweight or obese and numbers are continuing to rise, which has a significant impact on physical and psychological health and can lead to diabetes, fatty liver disease, thyroid disease, cardiovascular disease, cancer, depression, and other chronic diseases. Guided by Bandura’s theory of self-efficacy, weekly education sessions were delivered to members of the community clinic for two weeks. Content included both a nutrition component and an exercise component. An emphasis was made on increasing physical activity, increasing water consumption, decreasing sugar sweetened beverages, and increasing fruit and vegetable consumption. Videos were developed for each education session. Worksheets and handouts were developed to enhance learning and give participants a tangible reference for individual learning. Content was taken from the CDC and adapted to fit the needs of the community. All content was culturally tailored for low literacy levels and translated to Spanish. Knowledge, behavior change, and self-efficacy were measured by pre and post surveys. Self-efficacy showed statistically significant change from pre and post intervention. These findings suggest that healthy eating and exercise education can potentially increase knowledge, promote behavior change, and enhance self-efficacy, which can, in turn, prevent and combat childhood obesity and related disease states.
ContributorsBahena, Sara (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Purpose/Background: Children exposed to adverse childhood experiences (ACEs) and toxic stress have an increased risk of developing chronic illness and early death in the absence of protective factors. Many providers feel inadequately prepared to screen for and treat ACEs. This quality improvement project, based on the Health Belief Model, investigated if providing ACEs education before a screening program is effective in improving attitudes, knowledge, and the number of completed screenings. Method: The project was conducted at a pediatric primary care practice in the southwestern United States. All providers voluntarily consented to attend four education sessions: 1) Trauma overview, 2) Trauma physiology, 3) Trauma-informed care, 4) Screening tool/referral process. An anonymous pre/post-education Likert-Scale survey was completed to assess knowledge and attitudes about ACEs and screening. The number of completed ACEs screening tools and referrals made were collected four- and eight-weeks post-implementation. Results: Data were analyzed using Intellectus Statistics SoftwareTM. There was a significant increase in ACEs knowledge from the pre-test (p= .011, ?=.05). There was not a significant change in attitudes from the pre-test (p=.066, ?=.05). However, the mean pre- to post-survey scores increased for both categories, indicating improved attitudes. Over the first four weeks, 75% of eligible children were screened and 6% were referred to an ACEs resource program. In the second four weeks, 56% of children were screened and 8.6% were referred. Discussion: A comprehensive education program for providers can improve knowledge about ACEs screening, leading to improved screening practices, early identification, and the introduction of protective resources.
ContributorsChaisson, Charlotte (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29