Digital Commons Network^™

Lung Cancer Screening: An Evidence-Based Practice Change Project, Robert Bland

Student Scholarly Projects

Practice Problem: Lung cancer is the leading cause of global cancer deaths and is a significant health issue in the US, claiming more than 155,000 lives each year. Lung cancer screening through low dose computed tomography (LDCT) can reduce lung cancer mortality by 20 percent but unfortunately, lung cancer screening is underutilized.

PICOT Question: The PICOT question that guided this project was: in a patient population eligible for LDCT lung screening (P), how does auditing of practice with feedback to the providers (I), compared to not doing the interventions as mentioned above (C), increase LDCT lung cancer screenings in the …

The Intra- And Inter-Rater Reliability Of An Arm Care Screening Tool In High School Baseball Coaches, Kyle A. Matsel, Stephanie N. Brown, Matthew C. Hoch, Robert J. Butler, Philip M. Westgate, Terry R. Malone, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time intensive testing procedures prevent high school coaches from accurately performing frequent movement screens on their players.

Purpose: To establish the intra-rater and inter-rater reliability of a novel arm care screening tool based on the concepts of the Functional Movement Screen (FMS™) and Selective Functional Movement Assessment (SFMA™) in high school coaches.

Study Design: Methodological intra- and inter-rater reliability study.

Methods: Thirty-one male high school baseball players (15.9 years ± 1.06) were independently scored on the Arm Care …

Understanding Colorectal Cancer: Increasing Screening Rates Amongst Young- And Middle-Aged Adults By Enhancing Prevention Potential, Sarah Agudelo

Nursing | Senior Theses

As nurses, working towards the best health outcomes for our patients is critical to our care. A large aspect of this care includes being knowledgeable of risk factors and precautions to take to avoid conditions and illnesses. Colorectal cancer remains to be a highly preventable disease, yet it is one of the top five leading causes of cancer deaths in the nation. Preventing colorectal cancer requires the efficient use of screening and education, while also addressing barriers of inconvenience and affordability. This senior thesis delves deeper into colorectal cancer prevention by asking the research question: For young and middle-aged adults, …

Digital Markers Of Autism, Ivonne Monarca, Franceli L. Cibrian, Monica Tentori

Engineering Faculty Articles and Research

Autism Spectrum Disorder (ASD) is a neurological condition that affects how a people communicate and interact with others. The use of screening tools during childhood is very important to detect those children who need to be referred for a diagnosis of ASD. However, most screening tools are based on parents' responses so the result can be subjective. In addition, most screening tools focus on social and communicative skills leaving aside sensory features, which have shown to have the potential to be ASD markers. Tactile processing has been little explored due to lack of tools to asses it, however with the …

The Role Of Healthcare Providers In Using The Knowledge Of Sickle Cell Trait To Mitigate Health Problems In African American Clients., Stella N. Udechukwu

Nicole Wertheim College of Nursing Student Projects

Abstract

Background: Sickle cell trait (SCT) for long has been regarded as a benign condition and as such healthcare providers do little to nothing to mitigate adverse health problems associated with sickle cell trait. An effective approach to improving health outcome for those with SCT is to educate providers on SCT, its complications and management. This study is aimed at evaluating the effectiveness of an educational intervention on providers’ knowledge, attitude and practice regarding sickle cell trait.

Method: A quasi experiment study was conducted in Jackson Health System on 30 providers belonging to internal medicine team to evaluate their …

Validity Of The American Diabetes Association Diabetes Risk Test As Screening For Prediabetes In A Sample Of Peruvian Workers, Victor Juan Vera-Ponce, Jorge Enrique Osada Liy, Mario J. Valladares-Garrido

Revista de la Facultad de Medicina Humana

Objective: To evaluate the validity of the risk test of the American Diabetes Association (ADA Test) as a screening for hyperglycemia in a sample of workers in Lima, Peru. Methods: Cross-sectional study of diagnostic tests. Secondary analysis of the data generated by the electronic health record of an occupational polyclinic, carried out in January and February 2020. The sample was made up of workers from different areas who attended for their occupational medical evaluation. Prediabetes was considered with a fasting glucose ≥ 100 mg / dl but less than 126 mg / dl. Results: 397 subjects were evaluated. The prevalence …

Patient And Clinician Characteristics That Predict Breast Cancer Screening Behavior In 40–49-Year-Old Women, Sarina Schrager, Claudia Evaristo, Terry Little, Lori Dubenske, Elizabeth S. Burnside

Journal of Patient-Centered Research and Reviews

Guidelines recommend that clinicians practice shared decision-making (SDM) with women in their 40s to discuss breast cancer screening. Traditionally, SDM includes discussion of values and preferences to help determine a decision that is congruent with what the patient desires. We analyzed 54 women’s breast cancer screening decisions after a SDM conversation with their clinician. We looked at both patient and clinician characteristics that predicted whether or not a woman would get a screening mammogram. Women with a family history of breast cancer or who had a previous abnormal mammogram had higher rates of screening. Screening rates also varied widely between …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Frequency Of Retinopathy Of Prematurity (Rop) In Infants Screened For Rop: Two Years Follow-Up Results Of A Single Center In Turkey, Adem Ugurlu

BioMedicine

Aim: The aim of this retrospective study was to determine the incidence of retinopathy of prematurity (ROP) in infants referred to our clinic for screening ROP.

Material and Method: The data of 729 infants who were referred to the ROP outpatient clinic of the Ophthalmology Unit of Erzincan Binali Yildirim University, Turkey between April 2018 and March 2020 were analyzed retrospectively. The gestational age and weight of the infants, stay in the neonatal intensive care unit, duration of oxygen therapy, and detailed ophthalmologic examination findings were recorded in the study.

Findings and Results: Of the 729 babies screened for ROP,122 …

Cognitive And Behavioral Domains That Reliably Differentiate Normal Aging And Dementia In Down Syndrome, Jordan P. Harp, Lisa M. Koehl, Kathryn L. Van Pelt, Christy L. Hom, Eric Doran, Elizabeth Head, Ira T. Lott, Frederick A. Schmitt

Neurology Faculty Publications

Primary care integration of Down syndrome (DS)-specific dementia screening is strongly advised. The current study employed principal components analysis (PCA) and classification and regression tree (CART) analyses to identify an abbreviated battery for dementia classification. Scale- and subscale-level scores from 141 participants (no dementia n = 68; probable Alzheimer’s disease n = 73), for the Severe Impairment Battery (SIB), Dementia Scale for People with Learning Disabilities (DLD), and Vineland Adaptive Behavior Scales—Second Edition (Vineland-II) were analyzed. Two principle components (PC1, PC2) were identified with the odds of a probable dementia diagnosis increasing 2.54 times per PC1 unit increase and by …

A Self-Sampling Collection Program As An Approach That Can Provide More Women Cervical Cancer Screening To Detect Hpv In Kazakhstan, Assem Suleimenova

English Language Institute

A potential for self-sampling Human Papillomavirus testing to include more of the female population in low- and middle- income countries in the cervical screening program (the example of Kazakhstan).

Distress Evaluation During Chemotherapy: The Real-Time Assessment Strategies For Oncology Nurses Among Asian Population In Outpatient Clinics, Ying Huang

DNP Qualifying Manuscripts

Background: Routine oncology visits failed to identify 50-94% of patient’s distress, which creates a considerable burden, impairs emotional well-being and reduces patients’ quality of life. Limited in-person visits during the COVID-19 pandemic have reduced access to care for many patients, further adding to their emotional distress. Untreated distress also leads to elevated stress levels, systemic inflammation, non-compliance with treatment, and higher mortality rates. Early distress screening and multidisciplinary care are recommended to reduce the impacts of distress.

Objectives: To identify the best outpatient practices to address newly diagnosed cancer patients’ unique needs due to distress.

Methods: Databases searched including CINAHL® …

Improving Mammography Rates Among The Hispanic Population: An Evidence-Based Project Utilizing A Promotora Intervention, Dawn Mirowski

Student Scholarly Projects

Practice Problem: Breast cancer is the leading cause of death in Hispanic women in the U.S., with mammography being the most effective means of reducing breast cancer mortality. Promotoras have been shown to improve health promotion, including mammography, among the Hispanic population.

PICOT: The PICOT question that guided this project was: In Hispanic women 40 years or older (P), how does the use of a promotora intervention (I), compared to no promotora intervention (C), affect mammography rates (O) within an 8-week period (T)?

Evidence: Twenty-one studies that met the inclusion criteria supported the use of promotoras to improve mammography …

Using The 4m Model To Screen Geriatric Patients In The Emergency Department, Martinus Megalla, Roopa Avula, Christopher Manners, Portia Chinnery, Lindsey Perrella, Douglas Finefrock

Journal of Geriatric Emergency Medicine

Several models of specialized geriatric care in the Emergency Department (ED) have been developed since the American College of Emergency Physicians (ACEP) began accrediting geriatric EDs in 2018. There is considerable variability in terms of both design and efficacy in regard to screening older patients in the ED and determining proper interventions The John A. Hartford Foundation and Institute for Healthcare Improvement (IHI) have developed the 4M Model for Creating Age-Friendly Health Systems which aims to provide high quality care to older patients by addressing four critical elements: Mentation, Mobility, Medication, What Matters. This article describes a screening tool for …

The Impact Of An Evidence-Based Multi-Component Intervention On Colorectal Cancer Screening In Primary Care At A Healthcare System, Ahnnya Slaughter

Student Scholarly Projects

Practice Problem: Colorectal cancer is the second leading cause of cancer death in the United States; many of the deaths are preventable with early detection. Adherence rates for colorectal cancer screening with fecal immunochemical test kits (FIT) was below the national benchmark at this facility.

PICOT: The PICOT question that guided this project was: Among veterans 50 – 75 years old requiring average risk colorectal cancer screening (CRCS) seen in primary care at a veterans affairs healthcare system facility (P), how does the use of a multi-component intervention (I), compared to the usual care (C), affect the number of …

Using The Multi-Theory Model (Mtm) Of Health Behavior Change To Explain The Correlates Of Mammography Screening Among Asian American Women, Manoj Sharma, Chia-Liang Dai, Kavita Batra, Ching-Chen Chen, Jennifer R. Pharr, Courtney Coughenour, Asma Awan, Hannah Catalano

Environmental & Occupational Health Faculty Publications

Globally, breast cancer is the most common malignancy affecting women. The incidence of breast cancer has been growing among Asian American women. Mammography is a screening procedure that provides early diagnosis for the timely treatment to reduce premature mortality due to breast cancer. However, there are no national data available that summarize the rates of mammography screening among Asian American women. Some small-scale studies have reported low rates of mammography uptake among Asian American women. This cross-sectional study utilized the fourth-generation, multi-theory model (MTM) of health behavior change to explain the correlates of mammography screening among Asian American women between …

Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis

Dissertations

Problem: The global pandemic of COVID-19 caused concern for immunocompromised individuals. The purpose of this quality improvement initiative was to assess the impact of social isolation on feelings of loneliness, depression, and social isolation experiences in HIV-positive individuals residing in a long-term care facility.

Methods: A mixed-method convergent design with a purposeful sample of HIV-positive adult residents residing in a long-term care facility was utilized. An evaluation of loneliness using the University of California Los Angeles (UCLA) Loneliness Scale (Version 3) and depression using the Patient Health Questionnaire-8 (PHQ-8) were completed. Personal experiences were also assessed with five predetermined open-ended …

Primary Care Screening For Adverse Childhood Experiences (Aces) In The Adult Population, Carrie Plisco

Dissertations

Problem: Exposure to Adverse Childhood Experiences (ACEs) is associated with chronic diseases in adulthood. Several studies found over 60% of adults have had exposure to one or more ACEs. While guidelines for ACEs screening exist, most primary care practices do not perform screening at this time. This results in a lack of referrals for adults with history of ACEs for proper behavioral health (BH) intervention.

Methods: This quality improvement (QI) initiative utilized a descriptive observational design. The Centers for Disease Control and Prevention (CDC) ACEs screening tool was administered to a convenience sample of adult patients aged 18 years and …

The Role Of Cardiovascular Ct In Occupational Health Assessment For Coronary Heart Disease: An Expert Consensus Document From The Society Of Cardiovascular Computed Tomography (Scct)., Ahmad M Slim, Emilio Fentanes, Michael K Cheezum Md, Iain T Parsons, Christopher Maroules, Billy Chen, Suhny Abbara, Kelley Branch, Prashant Nagpal, Nishant R Shah, Dustin M Thomas, Todd C Villines, Ron Blankstein, Leslee J Shaw, Matthew Budoff, Ed Nicol

Parkview Heart Institute

No abstract provided.

Preventing Complications Of Undiagnosed Diabetic Peripheral Neuropathy In Rural Healthcare Settings, Kendra Ward Harris

Doctor of Nursing Practice Projects

Background: Diabetic peripheral neuropathy (DPN) affects the lives of approximately 50% of all persons diagnosed with diabetes. Patients who are minorities, residents of rural communities, low income, or non-compliant with treatment, have a higher risk of developing DPN. The long-term effects interfere with the patient’s abilities to carry out activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Patients incur debt from medical expenses, depression from the inability to perform self- care, and became withdrawn because of their distorted body image.

Purpose: The purpose of this project was to use the Michigan Neuropathy Screening Instrument (MNSI) …

Microbial Screening Reveals Oral Site-Specific Locations Of The Periodontal Pathogen Selenomonas Noxia, Jaydene Mcdaniel, Steven Mcdaniel, Beanca Jhanine Samiano, Matthew Marrujo, Karl Kingsley, Katherine M. Howard

Dental Medicine Faculty Publications

Introduction: Selenomonas noxia (SN) is an important periodontal pathogen, associated with gingivitis and periodontitis. Many studies have found associations between SN and indicators of poor health outcomes, such as smoking, low socioeconomic status and obesity. However, less is known about the prevalence of this organism and more specifically about other oral site-specific locations that may harbor this organism. Methods: Using an existing patient repository (n = 47) of DNA isolated from saliva and other oral sites (n = 235), including the dorsum of the tongue, lower lingual incisor, upper buccal molar and gingival crevicular fluid (GCF), molecular screening for SN …

The Contribution Of Dysphagia To Acute Stroke Morbidity And Mortality In Nigeria: A Prospective Study, O O. Olajide, Philip Adebayo, F T. Taiwo, M O. Owolabi, A Ogunniyi

Faculty of Health Sciences, East Africa

Background:

The assessment of time-trend morbidity and mortality in acute stroke is critical to clinical policy decisions and resource allocation.

Objectives:

To determine the prevalence of dysphagia in acute stroke and the impact of dysphagia on short term stroke outcome (30 days post-stroke).

Methods:

This was a prospective longitudinal study. Bedside screening for dysphagia modified Rankin score (MRS) and Barthel Index (BI) were performed on acute stroke patients on day 1, day 7, day 14 and day 30 after stroke to determine the frequency of dysphagia. Patients with dysphagia were then compared with age- and gender-matched controls (stroke patients without …

Reflections Of An Earliest Established Screening And Testing Facility For Covid-19 In The Largest Metropolis, Pakistan, Fatima Kanwal, Karishma Kanhya Lal, Asra Qureshi

Department of Family Medicine

As the world struggles to deal with the COVID-19 pandemic, this article talks about the experience and findings of the first COVID-19 screening facility in a tertiary care hospital in Karachi, Pakistan. Department of Family Medicine at Aga Khan University (AKU) took initiative where COVID-19 screening of stable patients first began in a dedicated area. Since testing kits were limited and community spread had not started, nurses would screen every walk-in patient based on the presence of fever, cough, travel history and exposure to COVID-19 positive patient in the last 14 days, and advise swab testing if indicated. Out of …

Increasing Depression Screening And Treatment, Emma De Louw, Md, Michael Danielewicz, Md, Michael Haines, Md, Molly Allanoff, Md, Elizabeth Clark, Md, Michael Bozzi, Md, Natalie Antosh, Md, Catherine Guariglia, Md, Yael Horvath, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Increase response to depression advisory in EHR from 39% (January 2021) to 60% or greater (March 2021)
• Increase referrals to behavioral health from baseline of 39/month (January 2021) by 25% (March 2021)

Improving Colon Cancer Screening Rates In An Ambulatory Resident Clinic, Ashima Oza, Md, Tina Boortalary, Md, Elizabeth Chin, Md, Tudor Sturzoiu, Md, John Wallis, Md, Sonia Bharel, Md

Health Equity and Quality Improvement (HEQI) Summit

In the US, colorectal cancer (CRC) is the third leading cause of cancer-related deaths. According to the 2018 CDC Behavioral Risk Factor Surveillance System survey, 68.8% of US adults between 50 and 75 were up to date on colorectal screening (CRCS) across all screening modalities. In light of the COVID-19 pandemic, screening has dropped even further and is still 50% below pre-pandemic levels. At Jefferson, our CRCS rate is below the national average at 55.4%. Given the importance of regular screening for CRC prevention, this is clearly inadequate. There are several barriers to completing an invasive screening modality like a …

Evaluation Of Multi-Level Barriers And Facilitators In A Large Diabetic Retinopathy Screening Program In Federally Qualified Health Centers: A Qualitative Study, Ana Bastos De Carvalho, S. Lee Ware, Tamara Belcher, Franceska Mehmeti, Eric B. Higgins, Robert Sprang, Cody Williams, Jamie L. Studts, Christina R. Studts

Ophthalmology and Visual Science Faculty Publications

BACKGROUND: Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could expand access and increase adherence. Despite this potential, studies have observed high variability in TDRS rates among clinics and over time, highlighting the need for implementation supports. Previous studies of determinants of TDRS focus on patients' perspectives, with few studies targeting upstream multi-level barriers and facilitators. Addressing this gap, this qualitative study aimed to identify and evaluate multi-level perceived determinants of TDRS in Federally Qualified Health Centers (FQHCs), to inform …

Identifying Gaps In Follow-Up Care Among Adults In An Occupational Health Setting: A Retrospective Ebp Pilot, Ginny Meyerhuber, Msn, Rn

Doctor of Nursing Practice Final Manuscripts

The Aim of this Evidence-Based Project (EBP) was to find a gap in care among adults working in a large financial institution who had the presence of elevated blood pressure at an onsite health clinic visit in the previous 3 years. Background: Screening for elevated blood pressure in an occupational health setting identified adults with one of the most common chronic medical conditions. Additionally, almost one-half of all adults in the United States have hypertension (HTN); a preventable risk factor for strokes and heart disease (Office of the Surgeon General, 2020). This Surgeon General’s report revealed that HTN control …

Identifying Adverse Childhood Experiences (Aces) In A Federally Qualified Health Center Using The Pediatric Aces And Related Life Events Screener, Melody Albarran-Slovin, Bsn, Rn

Doctor of Nursing Practice Final Manuscripts

Background: Evidence links adverse childhood experiences (ACEs) to health issues later in life. Most research has been conducted in adults but there is a lack of recent research on the impact of ACEs in the pediatric population particularly in relation to mental health conditions. Utilizing the Pediatric ACEs Screener (PEARLS) health care providers can screen for ACEs at earlier ages.

Purpose: The aim of this evidence-based project is to determine if there is an increase of newly diagnosed mental health related disorders when using PEARLS compared to not using PEARLS in the previous months before implementation.

Methods: ACEs were identified …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

Anal Cancer Screening At Truman Health Services, Peter D. Tran, Harshdeep Babbar

Quality Improvement/Patient Safety Symposium

Anal Papanicoloau Screening at Truman Clinic

Anal cancer is a squamous cell cancer associated with human papillomavirus (HPV), the same virus that is associated with cervical cancer. Although vaccination against HPV has been shown to be effective in reducing overall rates of infection, the number of new anal cancer cases has been rising for many years. In HIV-infected men and women, the incidence is even higher of anal cancer than in the general population. Current rates in an HIV-infected MSM population have been estimated to be as high as 70-144 per 100,000, with some studies of HIV-infected individuals showing that …