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Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice
Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice
DNP Projects
Background: Adherence to diet is a challenging part of managing type 2 diabetes mellitus (T2DM). Guidelines recommend including a registered dietician and/or a diabetes educator. While this is the gold standard, there are barriers to implementation in primary care. The Starting the Conversation (STC) diet recall tool can aid primary care providers (PCPs) in providing brief nutrition counseling for patients with T2DM. Purpose: To evaluate the perceptions and practices of PCPs regarding dietary education and documentation for patients with T2DM after provider education and initiation of the STC tool. Methods: This was a quality improvement project using a quasi-experimental pretest …
Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams
Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams
DNP Projects
Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.
Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …
Evaluating Providers’ Knowledge, Attitudes, And Intentions Toward Utilizing First Post-Discharge Visit Checklist In Primary Care To Reduce Readmissions In Heart Failure Patients, Binu Bashyal
DNP Projects
Background and Significance: Heart failure (HF) affects approximately 6.2 million adults in the United States and 40 million people globally. HF is one of the leading causes of emergency department (ED) visits and hospitalizations in adults. Twenty percent of patients admitted for HF are readmitted within thirty days, and up to fifty percent are readmitted by six months. A First Post-Discharge Visit checklist could help mitigate the problem of readmission.
Purpose: The purpose of this DNP project was to evaluate primary care providers’ knowledge, attitudes, and intentions towards utilizing the First Post-Discharge Visit checklist to reduce hospital readmissions among …
Improving Tobacco Cessation Counseling Documentation In The Primary Care Setting, Brittany Roher
Improving Tobacco Cessation Counseling Documentation In The Primary Care Setting, Brittany Roher
DNP Projects
BACKGROUND: Tobacco cessation counseling and documentation of the counseling is insufficient in many primary care settings across the United States. This can lead to care gaps such as missed opportunities for interventions appropriate to the level of readiness for change with regard to tobacco cessation. In addition, there is a potential for loss of revenue due to missed opportunities to provide a service and/or not capturing the service when provided. The Medicare Access and CHIP Reauthorization Act (MACRA) in 2015 started a new payment approach known as the merit-based incentive payment system (MIPS) which identified tobacco screening and cessation …
The Effect Of A Sun Damage Simulation Photography App On The Skin-Protective Behavior Intentions Of Women With Children Age 18 Or Younger, James Bowlds
DNP Projects
Abstract
Background: Skin cancer is the most common form of cancer diagnosed in the U.S. annually, despite being a largely preventable disease through the limitation of ultraviolet radiation exposure. Attempts to decrease its incidence have focused on appearance-based interventions. These have been effective at improving sun-protective behaviors among various subpopulations including people of color. Anecdotal observations suggest mothers more frequently utilize sun protection for their children than on themselves.
Purpose: The purpose of this project was to gain an understanding of the sun protection practices and beliefs of Caucasian and African American mothers, to assess the response to an appearance-based …
Barriers To Screening For Intimate Partner Violence Among Aprns In Kentucky, Kathryn L. Strait
Barriers To Screening For Intimate Partner Violence Among Aprns In Kentucky, Kathryn L. Strait
DNP Projects
Abstract
Purpose:Intimate partner violence (IPV) occurs in at least one in every four females and one in nine men across the United States (Smith et al., 2017). While the prevalence of IPV is considerably high, the screening rates for IPV in primary care specifically average less than 12% (United States Preventative Services Task Force, 2013). Methods: In order to identify how to overcome the barriers to screening including time, knowledge of IPV, access to community resources, gender identity/sexual orientation, accuracy and availability of screening tools, and reimbursement for advanced practice nurses in Kentucky, a survey was sent to …
The Effect Of Provider Education On Copd Screening Rates In The Primary Care Setting, Kelli Craig
The Effect Of Provider Education On Copd Screening Rates In The Primary Care Setting, Kelli Craig
DNP Projects
BACKGROUND: Chronic Obstructive Pulmonary Disease is one of the leading causes of morbidity and mortality in the United States. With early detection, COPD is a treatable disease, highlighting the need for an effective screening measure. The COPD Population Screener Questionnaire (COPD-PS) is a valid, accurate questionnaire that can identify individuals likely to have COPD.
PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy and screening rates of COPD using the COPD-PS screening tool among primary care providers.
METHODS: This study was a single-center, pre/post implementation study to evaluate …
A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons
A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons
DNP Projects
Purpose: The overall aim of this project was to gather information from two groups of stakeholders, providers and patients, on the feasibility of implementing prevention practitioners in the primary care system to address overweight and obesity.
Methods: This study utilized a quantitative descriptive design through the use of electronic surveys. Provider surveys were explained and presented during a monthly provider meeting. Patient flyers were posted in exam rooms and surveys were accessible through a provided link and QR code.
Results: Providers (N=10) agreed that they saw a need for the use of a prevention practitioner (Mean=4.44, SD=.88) as well as …
Evaluation Of Depression Screening By Providers For Adult Patients With Type 2 Diabetes In Primary Care, Kristy M. Bryant
Evaluation Of Depression Screening By Providers For Adult Patients With Type 2 Diabetes In Primary Care, Kristy M. Bryant
DNP Projects
BACKGROUND: Depression in adults with type 2 diabetes can lead to non-adherence to self-management behaviors and treatment recommendations, and ultimately worse health outcomes. Currently, only 50% of adult patients with type 2 diabetes treated in the primary care setting are screened for depression. Without screening for depression, a diagnosis of depression and subsequent treatment is likely to be missed and the patient is more likely to experience worse health outcomes and worse quality of life.
PURPOSE: The purpose of this study was to evaluate impact of provider education on improving screening rates for depression in adult patients with type 2 …
Health Literacy In A Primary Care Setting, Ashley Newman
Health Literacy In A Primary Care Setting, Ashley Newman
DNP Projects
BACKGROUND: Low health literacy is prevalent in the United States. As a result, the Agency for Healthcare Research and Quality (AHRQ) developed universal health literacy precautions to improve patient understanding of health information. Using universal precautions and specific tools, such as teach-back, has been shown to decrease morbidity and improve patient outcomes.
PURPOSE: The purpose of this quality improvement project is to assess provider knowledge of health literacy in a primary care setting. A secondary purpose is to assess the use of patient education material for patients with diabetes, hypertension, and hyperlipidemia that meet universal precautions.
METHODS: This study was …
Appraisal Of Depression Among Individuals With T2dm Not On Insulin Therapy, Beverly Woods
Appraisal Of Depression Among Individuals With T2dm Not On Insulin Therapy, Beverly Woods
DNP Projects
Abstract
BACKGROUND: Type 2 diabetes (T2DM) is a complicated disease process that affects more than 15 percent of adults in the state of Kentucky, with a national average of 9.4%. Individuals with diabetes are at increased risk for micro and macro neurovascular complications. Depression is a common co-morbidity and potentially affects their ability to manager this complex disease.
PURPOSE: The purpose of this study was to examine the prevalence of depression in a group of patients with T2DM, not on insulin therapy. Further, relationships between depression and blood glucose monitoring, Hgb A1c, other co-morbidities, number of medications taken, and demographics …
The Effect Of A Provider Education Program On Tobacco Use In An Adult Population In The Primary Care Setting, Sunita Gurung
The Effect Of A Provider Education Program On Tobacco Use In An Adult Population In The Primary Care Setting, Sunita Gurung
DNP Projects
PURPOSE: The purpose of this study was to evaluate the effectiveness of an education session to promote adherence to the United States Preventive Services Task Force (USPSTF) recommendation and Clinical Practice Guidelines for Treating Tobacco Use and Dependence by providers.
METHODS: A retrospective and prospective record review was used to evaluate an education session for providers in tobacco use screening, providing cessation counseling, prescribing medication for tobacco cessation, and sending out referrals for tobacco cessation at one primary care clinic in Louisville, KY. Education sessions were held from August 1, 2018 to August 14, 2018. The sample consisted of 200 …
Evaluation Of Depression Screening Practices In Comorbid Patients In The Primary Care Setting, Kristyn L. Clark
Evaluation Of Depression Screening Practices In Comorbid Patients In The Primary Care Setting, Kristyn L. Clark
DNP Projects
SPECIFIC AIMS: To evaluate the current rates of depression screening using the PHQ-2/9 in patients with comorbid conditions at a single, urban primary care office; to explore barriers to depression screening among providers.
METHODS: A retrospective chart review was completed on a sample of 188 patients seen between January and June 2017. Patients were equally divided among four comorbid diagnoses- COPD, obesity, hypertension, and type 2 diabetes. A provider interview was conducted to identify depression screening barriers and typical treatments regimens.
RESULTS: A total of 70.2% of patients had a documented depression screening. Of 67 patients diagnosed with depression, 11.9% …
Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear
Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear
DNP Projects
PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.
METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19th through October 10th, 2017.
RESULTS: There were 37 patients eligible to participate …
Screening For Sleep Apnea In Patients With Hypertension Using The Stop-Bang Tool In A Primary Care Setting, Natalie R. Jennette
Screening For Sleep Apnea In Patients With Hypertension Using The Stop-Bang Tool In A Primary Care Setting, Natalie R. Jennette
DNP Projects
Obstructive sleep apnea (OSA) is a common cause of high blood pressure but often undetected in patients with hypertension. Screening tools for OSA exist but are underutilized. This project aimed to identify current practices and perceptions related to screening for OSA in patients with hypertension and improve primary care provider knowledge of OSA and screening rates using the STOP-BANG screening tool. The providers acknowledged the importance of screening patients with hypertension but there was no increase in screening after education was provided. Effective screening tools exist but effective strategies to bring this evidence to practice need to be explored further.
Compliance With The 2015 American Diabetes Association Screening Guidelines For Diabetes Mellitus Type 2 In Primary Care, Krista L. Johnson
Compliance With The 2015 American Diabetes Association Screening Guidelines For Diabetes Mellitus Type 2 In Primary Care, Krista L. Johnson
DNP Projects
Purpose: The purpose of this project was to evaluate provider use of hemoglobin (HgA1c) measurement as a method of screening for Type Two Diabetes Mellitus (T2DM) per the 2015 American Diabetes Association screening guidelines in a multidisciplinary primary care clinic in Kentucky.
Methods: A retrospective electronic medical record review was conducted in a large ambulatory care clinic. A master list was compiled of all patients aged 45-89 years who were seen for any reason the first week of November 2015. A total of 127 records that met inclusion criteria were randomly selected. The proportion of patients who were appropriately screened …
Increasing Healthcare Providers’ Documentation Of Advance Directives In A Primary Care Setting, Ashley Wellman
Increasing Healthcare Providers’ Documentation Of Advance Directives In A Primary Care Setting, Ashley Wellman
DNP Projects
Background: Advance directives (ADs) are a proactive, patient-centered tool to facilitate communication about end-of-life wishes between patients, family members, and healthcare providers. Increased importance on ADs is now emphasized in primary care settings; however, findings from recent studies indicate poor documentation of AD discussions or decisions in primary care.
Purpose: To assess current AD documentation practices in an internal medicine primary care department and to explore provider perceptions of facilitators and barriers for discussion and documentation of end-of-life preferences.
Methods: This descriptive study was conducted in three phases: 1) assessment of current state of AD documentation by retrospective chart review …
Baseline Of Copd Management In A Norton Healthcare Primary Care Clinic, Angela Goldring
Baseline Of Copd Management In A Norton Healthcare Primary Care Clinic, Angela Goldring
DNP Projects
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States (U.S), with rates in Kentucky among the highest in the nation. Quality care in the primary care setting is key to optimizing the health outcomes of those with COPD.
Purpose: The objective of this study was to establish a baseline of COPD patient care in a primary care clinic. The specific aims of this study were to: 1) describe the demographic and health-related characteristics of patients with COPD who have a primary care provider (PCP) at one Norton Healthcare primary care clinic; 2) …
Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer
Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer
DNP Projects
Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.
Methods: A retrospective chart review of male and female patients between the ages of …
Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel
Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel
DNP Projects
The purpose of this capstone is to investigate the potential for hemolytic uremic syndrome (HUS) risk reduction in children through the evaluation of current evidence as well as pediatric primary care providers' knowledge and experience with children at risk for HUS. The goals of this capstone are to 1) evaluate the current literature to determine best practice for prevention of HUS, 2) assess primary care provider knowledge of HUS and experience with children with acute watery, and 3) develop a guideline for the initial management and referral of these children at risk for HUS.
Examining The Effectiveness Of An Intervention To Increase Provider Assessment Of Overweight And Obesity In The Primary Care Setting, Kristena R. Lea
Examining The Effectiveness Of An Intervention To Increase Provider Assessment Of Overweight And Obesity In The Primary Care Setting, Kristena R. Lea
DNP Projects
Obesity is an epidemic among adults in the United States, leading to a multitude of co-morbidities and billions of dollars in annual healthcare expenditures. Although primary care is the ideal setting for identification and treatment of overweight/obesity, it is often overlooked by providers. This capstone project was formed by three manuscripts, which were written to explore the lack of overweight/obesity identification and treatment in the primary care setting. Emphasis was made throughout the three manuscripts on the importance of providers using body mass index (BMI) as an objective means to discuss overweight/obesity with patients. The first manuscript is an integrative …
Dnp Practice Inquiry Project Report: Depression Screening In Primary Care, Mary Kathleen Stafford
Dnp Practice Inquiry Project Report: Depression Screening In Primary Care, Mary Kathleen Stafford
DNP Projects
Depression affects many people worldwide and is a leading cause of disability. National guidelines and recommendations have been created that support screening for depression in the primary care setting, however due to many barriers depression screening is often not performed or documented. This capstone project consists of three manuscripts, which evaluate the lack of depression screening in the primary care setting. The first manuscript is an integrative review of the literature to support depression screening in primary care and to address barriers to depression screening. The second manuscript is a guideline analysis of a national guideline published by the Institute …
Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani
Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani
DNP Projects
Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.
Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.
Results: All surveyed providers were aware and …
Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman
Delivery Of Evidence-Based Tobacco Use Interventions In Primary Care, Amber Silberman
DNP Projects
This capstone report presents three manuscripts which focus on tobacco use interventions in the primary care setting. The first manuscript presents a critical analysis of the Public Health Service guideline on Treating Tobacco Use and Dependence. The second manuscript presents a literature review pertaining to interventions that increase primary care provider compliance with guideline recommendations. The literature obtained from these first two manuscripts led to a descriptive study, which examined the documentation and implementation of specific guideline recommendations in a primary care clinic. The third and final manuscript details this study, and presents some practical implications for improving documentation …
Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser
Assessment Of Pediatric Primary Care Providers Behaviors And Procedures Regarding Pediatric Overweight And Obesity, Jessie N. Meiser
DNP Projects
CAPSTONE INTRODUCTION
Childhood overweight/obesity is a critical public health problem with devastating consequences. Many factors have combined to create the epidemic, and primary care providers can play an important role in addressing the problem by identifying overweight/obese children and encouraging them to engage in healthy behaviors. However, providers face a number of competing priorities making it difficult for them to provide these services effectively without outside support.
Obesity has reached an epidemic proportion in the nation’s youth. The Data Resource Center for Child and Adolescent Health (2011) found that 35.7% of children age 10 – 17 in Kentucky are overweight …