Digital Commons Network^™

Evaluation Of An Educational Training On Telehelath Utilization Rates And Hospital Readmissions In A Home Health Setting., Gabrielle A. Coomer

Doctor of Nursing Practice Papers

Background: Hospital readmissions are on the rise and continue to be a concern within healthcare due to their effects on the quality of care and healthcare costs. Telehealth strategies have been utilized across healthcare settings to improve hospital readmission rates.

Purpose: The purpose of this project was to evaluate the effectiveness of a telehealth training program in increasing telehealth utilization rates and reducing the acute care hospitalization rate within a single home health agency.

Intervention: A 30-minute PowerPoint presentation on the definition of telehealth, goals, and benefits of telehealth, patient eligibility, special considerations for clinicians, billing and coding guidelines, …

A Case Study In Program Evaluation, Sydney Wilcoxson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Evaluation is a critical component of a successful evidence-based health promotion program or intervention. In public health, evaluations ensure that interventions are achieving their intended objectives, provide feedback on program strengths and weaknesses, and serve as a mechanism of accountability and transparency to stakeholders so that they know their invested resources are being utilized in the most efficient manner. Without evaluation, it would be much more difficult to understand how well the intervention is working, and communication between stakeholders would be significantly affected.

A recently confirmed Methicillin-resistant staphylococcus aureus (MRSA) outbreak on a Fayette County Public Schools (FCPS) high school …

A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Evaluation is a helpful tool in public health to provide transparency about community interventions and programs. The following is a prospective evaluation of a case study, looking at a recently designed program by the Lexington-Fayette County Health Department, as a capstone project for the Health Management and Policy concentration of the Masters in Public Health program of the College of Public Health. The health department developed a series of online training modules to increase knowledge of Methicillin-resistant staphylococcus aureus (MRSA) and other similar organism outbreaks and how to respond to these outbreaks. The program targets were Fayette County Public School …

Program Evaluation Case Study: Infectious Disease Reporting Training Program Evaluation, Emily Sekkath Veedu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington-Fayette County Health Department (LFCHD) has developed an educational program aimed at Fayette County Public Schools (FCPS) health and athletics staff members to ensure timely reporting and action in the event of an infectious disease outbreak (4). The program was implemented after a methicillin-resistant staphylococcus aureus (MRSA) outbreak occurred in a Kentucky community, with a high school football team presenting several of the cases (4). It was noted by a school nurse that many people attending an informational session lacked knowledge regarding infection control, suggesting a need for intervention in this community. I have evaluated this program in the …

A Case Study In Evaluation, Laura Nagle

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Lexington – Fayette County Health Department is proposing a comprehensive evaluation of programming focused on preventing MRSA infections among high school athletes within Fayette County Public Schools. This document describes the recommended evaluation process.

Evaluating A Rapid Response Team Performance To Implement Best Practice In Rapid Response Team Protocol, Pansy Samuel

Doctor of Nursing Practice Projects

Background

Rapid Response Teams (RRT) provide clinical resources to improve patient safety outcomes at healthcare institutions. This team promptly responds to deteriorating patient conditions to prevent further deterioration and reduce mortality rates. Rapid response teams do not always perform optimally. Reasons for this performance failure include breakdowns in communication, team dynamics, or other variables that can often be adjusted when the team members understand the role these variables play in undermining the performance of the RRT. An understanding of the perceptions of the RRT members regarding their roles and potential areas of improvement did provide valuable data that was utilized …

Professional Behaviors On The Fieldwork Performance Evaluation: Perspectives Of Fieldwork Educators, Jessi S. Clark

Occupational Therapy Doctorate Capstone Projects

Occupational therapy (OT) students are assessed on their professional behavior skills during Level II fieldwork (FW) by fieldwork educators (FWEs) as measured by the Fieldwork Performance Evaluation (FWPE). Most of these professional behavior skills are not required components of entry-level OT education, therefore academic preparation may be variable. The purpose of this Capstone project was to study the perspective of FWEs regarding the seven professional behavior items on the FWPE, primarily the relative importance of and academic preparation for these items. Participants included FWEs who completed the FWPE in the last 15 years. They completed an online survey that utilized …

Health Management And Policy Capstone: A Case Study In Program Evaluation, Bradford Brewer

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Hypertension has risen steadily among adults in United States over the past 30 years. This increase has also been marked by a significant increase in reported prevalence rates of cardiovascular diseases. In response, the Centers for Disease Control and Prevention (CDC) funded the Lexington-Fayette County Health Department to deliver a hypertension self-management program for adults aged 35 and older. This manuscript follows the six steps of CDC program evaluation to aid Lexington citizens with uncontrolled high blood pressure (≥140/90 mmHg) in successful hypertension self-management. This evidence-based community intervention helps patients take responsibility for managing their hypertension with assistance from health …

The Future Of Community Health Center Executive Leadership A Mixed-Method Formative Evaluation, Lizbeth Bayardo Cardenas

CGU Theses & Dissertations

This is a formative evaluation study of the California Primary Care Association's (CPCA) Leadership Equity Program, developed in response to the need for greater alignment between the communities accessing care provided by Community Health Centers and the representativeness of their future executive leaders. Community Health Centers (CHC) are a critical network of primary healthcare systems that deliver high-quality, comprehensive healthcare services to patients predominantly from under-resourced and marginalized communities of color. The study used a mixed-method concurrent triangulation design to describe how participants perceived the program achieved its goals and objectives using Kirkpatrick's Model and systems thinking. The study integrated …

Adaptive Evaluation For Systems In Rapid Change Or Sustained Transition: Innovations And Applications Generated From A Community-Based Diabetes Prevention Program During The Covid-19 Pandemic, Amy Kuhn

CGU Theses & Dissertations

Program evaluation is a key part of the life cycle of public health and prevention science projects. But in complex environments or evolving situations, existing evaluation theory faces challenges in successful practical application. Process evaluation can track changes as a program runs, but when a program operates outside of its original design, questions can arise related to fidelity of implementation and interpretation of results. Outcome evaluation often requires a closed system without changes to determine actual effects of a program, but in times of complicated change that isolation can be difficult to achieve or to work around. In practice, systems …

Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert

Doctoral Dissertations

Interpretation of electronic fetal monitor (EFM) tracings is a critical clinical practice skill nurses and physicians perform during the intrapartum stage of pregnancy. However, if performed inaccurately can potentially jeopardize the well-being of the neonate. This risk is present because if concerning EFM tracings are not interpreted accurately, preventative care interventions to promote the well-being of the unborn child do not occur. The project was initiated by completing a scoping literature review on the methods for training and evaluating EFM interpretation competence, which revealed current EFM interpretation training and evaluation methods are lacking. A concept analysis defined nurse competence in …

Pharmacogenomics Translation In A Community Medical Context Using A Diffusion Of Innovations Framework: Provider Perspectives And Evaluation Implications, Sabrina Ewald Holley

Dissertations

Translation, in the context of medical research, is a process that describes how knowledge and innovation move and change into real world applications and outcomes. This study explores the translation of a medical innovation, pharmacogenomics (PGx), from research into clinical practice using the perspectives of medical providers in a community setting. PGx is the influence of a person’s genetics on drug response. Despite being available for over a decade, PGx testing is not widely adopted. Prior research primarily examined PGx translation in large academic medical centers, but not much is known about it in community practice settings. A better understanding …

Overlaps And Gaps Of Preterm Birth Programs In The Triangle Area Of North Carolina, Amber Bobbitt

Capstone Experience

Background: Preterm birth rates are a long-standing issue that has yet to be adequately addressed and prioritized. Nationally about 1 in every 10 infants are born prematurely in the United States. In the state of North Carolina, 1 in every 9 live births was preterm in the year 2020. The aim of the study was to determine the strategies organizations use in North Carolina to reduce preterm births in comparison to the CDC’s Five Strategy framework and to understand how the organizations address health equity and measure/evaluate the success of their initiatives.

Methods: Semi-structured one-on-one interviews were conducted with four …

Development And Implementation Of An Outcome Measure For Move Inclusive Dance, Morgan Sondergeld

OTD Capstone Projects

Due to the need for increased funding at MOVE Inclusive Dance, an outcome measure was created and piloted to display program efficacy. This outcome measure with collected data will illustrate to stakeholders and grant committees the value of MOVE Inclusive Dance. Furthermore, a revised sensory protocol was created to ease student transition from classroom to stage through the use of visuals and strategies. Lastly, an organized document was created for the owner of MOVE Inclusive Dance to continuously apply for grants over the coming years with increased ease.

Evaluation Of A Comprehensive Diabetes Mellitus Protocol At A Rural, Federally Qualified Health Center In Southern West Virginia, Hannah D. Davis

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetes mellitus is a chronic disease that affects nearly 34 million Americans. In rural Appalachia, the population is affected disproportionately at a rate of 14% compared to the national average of 10%. Diabetes is a lifelong, chronic condition managed best by a multidisciplinary team-based approach to achieve optimal disease control. Best practices in the care of diabetes support the use of evidenced based care protocols and leveraging technology to decrease the burden of disease. Type 2 diabetes mellitus (T2DM) is the most common type, making it the focal population for evaluation.

Purpose: The purpose of this project was to …

Characteristics And Regions Of Hospital Locations And The Risk Of Postpartum Hemorrhage., Zahra Shahin

Electronic Theses and Dissertations

Background: Postpartum hemorrhage (PPH) is one of the contributing factors to maternal morbidity and mortality that in addition to maternal risk factors, may be related to other factors such as obstetric practice and clinical management of postpartum hemorrhage. Therefore, this study aimed to explore the association of postpartum hemorrhage with characteristics and regions of hospital locations across the United States, as the outcomes may create opportunities to improve policies and protocols regarding PPH management more effectively. Method: A retrospective study was performed using the 2018 National Inpatient Sample (NIS) database. Low-risk delivery hospitalizations involving the third stage of labor with …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond

Doctoral Projects

The purpose of this DNP project was to create a tool to teach and evaluate student registered nurse anesthetists (SRNAs) at TheUniversity of Southern Mississippi (USM) on supraclavicular and femoral nerve blocks to promote safety in the clinical setting. An objective structured clinical evaluation (OSCE) for ultrasound-guided supraclavicular and femoral nerve blocks was created as the basis for this project. Best-practice techniques as identified by the AANA’s 14^thstandard of nurse anesthesia practice were researched and used in the development of the OSCE to promote a culture of safety for SRNAs and patients (AANA, 2019).

A culture of safety …

Development And Validation Of A Basic Ground Skills Assessment For Equine-Assisted Services, Sarah J. Andersen

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

The equine-assisted services program at Utah State University produced and validated an assessment process used to test equines for suitability for equine-assisted services. Equine-assisted services incorporate the interaction of humans who face mental, physical, emotional, and/or social challenges and equines for therapeutic purposes. Recreational, physical, mental, social, and/or emotional goals are met through various equine-assisted services such as therapies, equine-assisted learning, and horsemanship.

Due to the potential for human injury while interacting with equines, it is important to ensure equines are assessed for safe behavior prior to participation in equine-assisted services. This is why our group developed and tested the …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

Mothers Without Borders Program Evaluation: Establishing Effective Program Evaluation To Assess Holistic Orphan Care Initiatives In Zambia, Alyssa Baer

Undergraduate Honors Theses

This paper uses an interdisciplinary approach—combining theories and methodologies from the Social Impact and Public Health disciplines—to design an evaluation of Mothers Without Borders’ (MWB) programs in Lusaka, Zambia. Their programs aim to support communities as they care for children in crisis living in their communities—with a focus on communities with large populations of orphaned and vulnerable children (OVC) as a result of the HIV/AIDS epidemic. This paper provides an overview of the orphan crisis, international orphan care standards, and evaluation practices in order to understand and design an effective evaluation plan for the organization. This project aims to provide …

Program Evaluation Of Parent Engagement Activities In The Pediatric Cardiac Intensive Care Unit, Cheryl A. Bos

Doctoral Projects

Introduction: Leaders of a six-bed pediatric cardiac critical care unit identified the need to evaluate family engagement in patient care activities prior to implementing quality improvement initiatives. This program evaluation identified staff and family perception of barriers and facilitators to parent engagement in the Pediatric Cardiac Intensive Care Unit.

Methods: Data were collected through quantitative and qualitative methods. Surveys collected staff baseline and parent pre-/post-hospital perception of the role of family engagement in caring for the child.

Results: The Questionnaire of Factors That Influence Family Engagement survey of 58 registered nurses indicated the nurse workflow (τb = .579, p = …

Are Effort And Helpfulness Ratings Of Session Activities Associated With Improved Outcomes In Web-Based Acceptance And Commitment Therapy (Act) For Caregivers?, Hannah R. Cragun

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Family caregivers for people with dementia are providing care for up to ten years because people with dementia are living longer. This role can be demanding because the person with dementia can have behavioral and psychological symptoms that can be stressful for the caregiver to witness and manage. Acceptance and Commitment Therapy (ACT) in its traditional face-to-face format has strong scientific support in helping caregivers to be less depressed and better cope with the stress associated with taking care of their loved one. However, because caregiving is a time-demanding role, caregivers can struggle with accessing face-to-face therapy, making online ACT …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

Deepcon-Pre: Improved Protein Contact Map Prediction Using Inverse Covariance And Deep Residual Networks, Nachammai Palaniappan

Theses

As with most domains where machine learning methods are applied, correct feature engineering is critical when developing deep learning algorithms for solving the protein folding problem. Unlike the domains such as computer vision and natural language processing, feature engineering is not rigorously studied towards solving the protein folding problem. A recent research has highlighted that input features known as precision matrix are most informative for predicting inter-residue contact map, the key for building three-dimensional models. In this work, we study the significance of the precision matrix feature when very deep residual networks are trained. Using a standard dataset of 3456 …

Pilot Evaluation Of Oneworld's Education Sessions On Sexually Transmitted Infections For Adolescents And Young Adults In The South Omaha Community, Mariela Bahena

Capstone Experience

Background. Rates for sexually transmitted infections (STIs) in Douglas County, specifically gonorrhea and chlamydia, are among the highest in the nation. Adolescents and young adults between the ages of 15 and 24 are one of the most at-risk groups for acquiring either STI. Though not fatal itself, gonorrhea and chlamydia can lead to serious complications and physical discomfort in both males and females. Evidence-based and age-appropriate sexual health education has been proven to reduce the risk of STIs. Studies have shown that comprehensive education programs with a focus beyond abstinence are effective in promoting safe sex practices.

Aim. This project …

Evaluation Of A Simulation-Based Nurse Residency Program, Cheri A. Van Wyngarden

Doctoral Projects

Upon completion of nursing school, new graduate nurses sit for licensure examination to demonstrate the minimal knowledge necessary to practice safely as an entry level nurse. Despite satisfactory completion of this examination, many new graduate nurses lack the competency and confidence to safely practice (Jung, Lee, Kang, & Kim, 2016 & Liaw, Palham, Chan, Wong & Lim, 2014). Traditional models of preceptorship with orientation are not adequately preparing new graduate nurses for practice. Nurse residency programs narrow the gap between demonstrated knowledge and competent practice. Varying types of nurse residency programs have successfully replaced traditional nursing orientation methods across the …

Psychometric Evaluation Of Lung Cancer Stigma Among Lung Cancer Survivors In South Carolina, Lisa A. Webb

Theses and Dissertations

Background: Despite the improved screening and treatment modalities, lung cancer is the second leading cause of cancer and accounts for 27% of all cancer deaths in the United States. Survivors of lung cancer experience physical, social, and particularly psychological challenges. Lung cancer stigma is a formidable challenge for survivors of lung cancer that complicates their physical, psychological and social well-being.

The Cataldo Lung Cancer Stigma Scale is the first instrument adapted to measure lung cancer stigma. This instrument was adapted from Berger’s HIV Stigma Scale. HIV stigma and lung cancer stigma share similarities. These health-related stigmas reflect behaviors that …