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Uptake And Outcomes Of A Novel Community-Based Hiv Post-Exposure Prophylaxis (Pep) Programme In Rural Kenya And Uganda, James Ayieko, Maya L. Petersen, Jane Kabami, Florence Mwangwa, Fred Opel, Marilyn Nyabuti, Edwin D. Charlebois, James Peng, Catherine A. Koss, Laura B. Balzer

Biostatistics and Epidemiology Faculty Publications Series

Introduction Antiretroviral-based HIV prevention, including pre-exposure prophylaxis (PrEP), is expanding in generalized epidemic settings, but additional prevention options are needed for individuals with periodic, high-risk sexual exposures. Non-occupational post-exposure prophylaxis (PEP) is recommended in global guidelines. However, in Africa, awareness of and access to PEP for sexual exposures are limited. We assessed feasibility, acceptability, uptake and adherence in a pilot study of a patient-centred PEP programme with options for facility- or community-based service delivery. Methods After population-level HIV testing with universal access to PrEP for persons at elevated HIV risk (SEARCH Trial:NCT01864603), we conducted a pilot PEP study in five …

Enabling Patients In Opioid Detox To Pursue Long-Term Recovery, Duny Damas

Doctor of Nursing Practice (DNP) Projects

Background/Purpose: High readmission rates of individuals in need of opioid detoxification demonstrate that opioid detoxification alone may be insufficient to promote changes in behavior and prevent relapse. There is a critical need for improvement in treatment approaches along with efforts from healthcare professionals to lead opioid-dependent patients toward long-term recovery. Such a care improvement is feasible through the delivery of adequate education to providers regarding patients suffering from opioid addiction to facilitate a change in attitude and more effective treatment. Methods: Data collected through a pre-test survey assessed provider’s knowledge about opioid use disorder, the availability of screening …

Promoting Sleep Health Through Identification And Management Of Obstructive Sleep Apnea, Melissa Vuolo

Doctor of Nursing Practice (DNP) Projects

Background: There is a high prevalence of obstructive sleep apnea in the United States, which left untreated can lead to increased cardiovascular risk. The current practice standard is to use a questionnaire to evaluate a patients’ sleep health, but this is not done regularly in every clinical setting. This DNP project aimed to bridge the gap in practice by implementing regular screening of obstructive sleep apnea in an urgent care center in Massachusetts.

Methods: This DNP project was conducted by having adult patients complete the Epworth Sleepiness Scale to determine the presence of a sleep health issue. The patients …

Hiv Education And Empowerment A Program For The Women Of Kiryabicooli, Uganda, Emily Rymland

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: HIV continues to be a serious health, social and economic burden in Uganda. Early in the epidemic, the government’s rapid response brought the HIV infection rates from 30% in the 1990s to 4% by 2000, however rates are rising with some district’s reporting the HIV rate rising up to 7.8%. Myths surrounding transmission, disease progression and treatment compound the country’s vulnerability. The goal of this Quality Improvement project is to educate women with children under 13 years old about the facts of HIV, in the hopes that with that knowledge they can take action to decrease their own …

Managing Patients At High-Risk For Breast Cancer: An Elearning Module For Primary Care Providers, Erin Chaney

Doctor of Nursing Practice (DNP) Projects

Women at high-risk of developing breast cancer must be screened appropriately and educated about breast cancer reduction strategies much earlier than those of average risk. The National Comprehensive Cancer Network (NCCN) (2017) has identified guidelines for the care of this group. This project focused on the development of education for providers, specifically an eLearning module, to help translate guidelines into practice. Providers of adult primary care (including internal medicine and family practice) from four clinics in Snohomish County, Washington, were asked to participate in an eLearning module regarding the care of patients at high-risk for breast cancer. Repeated measures surveys …

An Evaluation Of The Feasibility Of Implementing The National Institute Of Children’S Health Quality (Nichq) Physical Activity And Nutrition Survey In Pediatric Primary Care, Candice Greene

Doctor of Nursing Practice (DNP) Projects

Pediatric obesity is a growing problem in the United States of America causing both immediate and long-term health implications including: cardiovascular disease, diabetes, bone and joint problems, sleep apnea, and social and psychological problems (Centers for Disease Control and Prevention, 2015). The purpose of this quality improvement project is to implement and evaluate an evidence-based screening tool for identifying modifiable risk factors for childhood obesity in children in a pediatric primary care office. The National Institute for Children’s Health Quality (NICHQ) Physical Activity and Nutrition Survey (Appendix A) was administered to 25 pediatric patients ages 2-18 presenting to their primary …

Oral Sex And Hsv-1 Knowledge Among College Freshmen Females, Karen Hendry

Doctor of Nursing Practice (DNP) Projects

Herpes simplex 1 (HSV-1) disease transmission to the genitals has life long health consequences for young women. The aim of this DNP project was to assess knowledge among female college freshmen regarding HSV-1 transmission to the genitals during oral sex.

A voluntary and anonymous online survey was e-mailed to 648 female college freshmen using their college e-mail account. A 19% (N=121) survey response rate was achieved. Seventy-three percent of the college females reported receiving oral sex. Ninety-five percent of the college females knew the possible risk of HSV-1 transmission during oral sex. Ninety-six percent of the female students …

An Evaluation Of An Educational Program For Improving The Accuracy Of Ecg Interpretation In Athletes By Primary Care Clinicians, Stephen F. Segatore Jr

Doctor of Nursing Practice (DNP) Projects

Background: In order to identify athletes at risk for sudden cardiac death (SCD), comprehensive screening that includes ECG interpretation is needed. Many primary care providers, including physicians and nurse practitioners, have reservations about including electrocardiograms (ECG) in the screening process because they lack confidence in their ability to correctly identify normal variants in the ECG of an athlete.

Method: An educational program with previously validated interpretation criteria for normal variants of the athletic heart was presented to providers at a university based healthcare clinic the Northeast. A pre and post design was used to compare the accuracy of ECG …

Preventing Dysfunctional Behaviors Of Those With Dementia Based On The Progressively Lowered Stress Threshold Model, Mary Chrabaszcz

Doctor of Nursing Practice (DNP) Projects

Abstract

Dementia is a disease that impacts millions of people worldwide. Amongst the complications of this disease are behaviors that affect not only the individual with dementia but also their caregivers. These behaviors can be challenging especially for formal caregivers and it is important that they are taught how to prevent them. Long-term care facilities are the perfect settings for this type of education. For this reason, an educational program, including a needs assessment, PowerPoint presentation, and on-site support, was brought to a locked, assisted-living unit of Jewish Geriatric Services in Longmeadow, Massachusetts. The educational program was inspired and supported …