Date of Award

Spring 6-2021

Scholarly Projects

Projects: SPU Access Only

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chair

April Morgenroth

Faculty Reader

Heidi Monroe

Executive Summary

Executive Summary

Introduction: Continuing education is an integral part of nursing that enhances professional development and ensure the changing needs of the population’s health are met. Many developing countries, such as Vietnam, lack the opportunity to participate in continuing education programs due to inadequate funding, low economic status, decreased or insufficient resources, and nurses without higher education or training. Distance learning can be a valuable tool to educate nurses in rural and underdeveloped counties (Willott, Sakashita, Gendenjamts & Yoshino, 2018). Distance learning is capable of bridging the gap and providing nurses with opportunities to advance knowledge of evidence-based practice. In turn, this will serve to provide efficient, evidenced-based, and quality care to patients, thus improving overall health outcomes. With a large number of nurses at the forefront, nurses are in an ideal position to provide education to patients on preventable noncommunicable diseases such as heart or lung disease. Although nurses are in a prime position to provide health information, the majority of the population in Vietnam report that their primary source of health information and is through the media such as television (Ha & Nuntaboot, 2016). Healthcare personnel need to gain knowledge and confidence in patients. Nearly seventy percent of the nurses in Vietnam have a two-year degree (Ha & Nuntaboot, 2016). Vietnam lacks in the number of nurses with advanced education, which negatively impacts up to date evidenced-based practice and inability to provide continuing education. Distance learning is a method to deliver education to countries without proper resources (Willott, Sakashita, Gendenjamts & Yoshino, 2018).

Problem and Purpose Statement: Currently, the nurses in Vietnam tend to be task-oriented and have self-reported that they do not have the knowledge and confidence to think critically. With the rise in noncommunicable diseases, nurses need to be able to provide education to help disease prevention and increase health outcomes. Hospitals in Vietnam lack the resources to provide adequate continuing education to the nurses (Pham, Kim, Nguyen & Hoang, 2019); therefore, utilizing distance learning to educate nurses to improve patient care and health outcomes. By creating and implementing a distance learning education plan for nurses in Vietnam, nurses will have the opportunity to increase knowledge and confidence to provide better care patients with improved health outcomes.

Methodology: The project uses the Malcom Knowles Adult Learning Theory as well as the Institute for Healthcare Improvement: Plan, Do, Study and Act cycle. The project was accomplished using distance learning technology to educate nurses in Vietnam on information regarding heart failure. The educator was in Seattle, Washington presenting the information via Zoom while the participants were nurses in a hospital in Vietnam. The participants were in a learning room in the hospital where the participants watched and interacted with the educator via Zoom. Participants took a pretest and survey as well as a post test and survey to determine effectiveness of knowledge and confidence of participants.

Results/Outcomes: The result indicated an increase in overall number of correct answers from the pretest to the posttest. The pretest average was 40% while the post test score was 55%. This can suggest the participants gained knowledge related to heart failure management.

The result from the survey ranged from -0.143 to +0.268 in each individual questions. From the presurvey and post surveys participants did not have a significant change in the confidence in heart failure management. Furthermore, the change from the pretest and posttest was mainly negative, meaning participants had less confidence in heart failure management after the education session.


Many countries do not have the resources to educate nurses. Distance learning is a tool to help provide education to nurses that are unable to receive education by other means. This program will allow nurses to gain knowledge and confidence in heart failure management that results in improved patient care. Currently, countries such as Vietnam lack resources to provide nurses with current best practices. This program will help bridge the knowledge gap for nurses in developing countries such as Vietnam to improve patient health outcomes. The distant education model is transferable for other countries without resources for continuing education.


In the past medical mission programs from the organization have attempted to travel to Vietnam to provide education to the medical professional in Vietnam to increase knowledge and confidence. The trips consumed time and money. Due to increase time and money, only two trip

s from the sponsoring organization were completed in the past without continuation and sustainability. With distance learning, information and education can be done without travel time and expenses. Currently, the University of Washington Medical Center Heart Institute Clinic hosts a monthly teleconference for cardiac diseases such as adult congenital heart disease, advanced heart failure, and ventricular assisted devices. In addition to the monthly education sessions, an annual workshop conference will be held in Vietnam once a year to exchange ideas to improve the distance learning program as well as a continued needs assessment.


Ha, D. T., & Nuntaboot, K. (2016). How nurses in hospital in Vietnam learn to improve their own nursing competency: An ethnographic study. Journal of Nursing & Care, 5(5) doi:10.4172/2167-1168.1000368

Pham, B. D., Kim, B. G., Nguyen, T. T. H., & Hoang, V. M. (2019). Exposure to messages on risk factors for noncommunicable diseases in a rural province of Vietnam. BioMed Research International, 1–8.

Willott, C., Sakashita, R., Gendenjamts, E., & Yoshino, Y. (2018). Distance learning for maternal and child health nurses and midwives in Mongolia: a qualitative evaluation. International Nursing Review, 65(4), 577–585.

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