Digital Commons Network^™

The Affordable Care Act’S Medicaid Expansion And Food Insecurity Rates, Mary Moran

Muskie School Capstones and Dissertations

Many Americans face difficult financial decisions, often regarding the allocation of limited resources. Household resources may be split among the costs of food, clothing, housing, transportation, childcare, utilities, and health care. For some households, this allocation may present a challenge to purchasing sufficient food, leading to food insecurity. Defined by the United States Department of Agriculture (USDA) as “a household-level economic and social condition of limited or uncertain access to adequate food” (2017), food insecurity may decrease when other financial-related aspects of life improve. An improvement in access to affordable health care, as seen through the recent Medicaid expansion under …

Direct Care Nursing Aide Turnover In Long-Term Care Facility, Qilian Luo

Muskie School Capstones and Dissertations

This capstone project, Direct Care Nursing Aide Retention in a Long-Term Care Facility, will uses both qualitative and quantitative analyses to identify the possible contributors to high nursing aide turnover rates in Maine. The quantitative analyses of this project are based on the staffing payroll data of one Maine assisted living facility. The final product of this capstone project will be shared with the study facility, in the hope that they may find uses for its content.

Palliative Players: Project Development And Initial Implementation, Eliza Eager

Muskie School Capstones and Dissertations

The Palliative Players are screened and trained hospice volunteers who provide a low-cost, sustainable, role-playing resource for use teaching communication skills to healthcare workers who discuss serious illness with patients and their families. The Palliative Players project was conceived and developed in early 2017 by Dr. Lauren Michalakes, Medical Director of Palliative Care at Coastal Healthcare Alliance (CHA); Sarah Dwelley, RN; Flic Shooter, Director of Hospice Volunteers of Waldo County (HVOWC); and Eliza Eager, Project Coordinator; to provide believable, emotive simulated patients (SPs) for role-play in workshops teaching healthcare workers communication tools and skills for use in conversations with patients …

A Guide For Assessing Older Adults’ Needs On Maine Islands, Beatrice Byrne

Muskie School Capstones and Dissertations

This template may help Maine island communities identify older adults’ needs and island resources, in order to allow older adults to age in the island communities.

Three interviews with island health leaders, one community conversation with older islanders, and one pilot test provided information about what to include in the template.

The template includes a demographic survey, guides for conducting semi-structured interviews and group conversations with older adults and caregivers, a guide and worksheet for analyzing the data, a guide for assessing community resources, a guide for dissemination, and a list of additional resources.

A Secondary Analysis In Support Of The Community Health Needs Assessment For Oasis Free Clinics, Jillian Wheeler

Muskie School Capstones and Dissertations

Oasis Free Clinics offer free medical and dental services to uninsured, low income adults living in Sagadahoc County, Maine (with the exception of the town of Richmond) and the towns of Brunswick, Freeport, and Harpswell in Cumberland County and Durham in Androscoggin County. Oasis has filled a critical need in providing affordable health care to the working poor with the absence of Medicaid expansion in the state of Maine. The clinic offers wellness checks, women's wellness, prenatal care, chronic disease management, limited mental health counseling, a prescription assistance program and dental care.

Oasis Free Clinics will conduct a Community Health …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

An Assessment Of The Health Needs Of Maine Veterans And Their Access To Veterans Administration Health Care Services, Kristin Brawn

Muskie School Capstones and Dissertations

On a state level, only a few assessments have been conducted, which indicate that Maine veterans are also experiencing similar mental and physical health issues; however, it does not appear that the adequacy of Maine’s VHA services to meet the needs of Maine’s veterans has been comprehensively evaluated. It is unknown whether the physical and mental health needs of Maine’s veterans are currently being met. Therefore, this project proposes to determine if there is a similar problem among Maine’s veterans in regard to health issues and lack of access to VHA health services, as has been reported at the national …

Variables To Predict Risk Of Hospital Readmission, Julie I. Carroll

Muskie School Capstones and Dissertations

As the healthcare industry transitions toward accountable care and payment reform, creative approaches to healthcare is imperative. Poorly coordinated care and shorter hospital stays have resulted in higher rates of readmissions. This has large implications for hospitals and health systems.

Managing Social Security Disability & Other Public Benefits: Development Of A Guide For Consumers And Providers, Stephanie L. Derochers

Muskie School Capstones and Dissertations

One in five Americans has a disability, making it the largest minority group in the U.S. (Soffer, McDonald, & Blanck, 2010). In 2011, 13.4 million working-aged adults received a disability cash benefit from the Social Security Administration (Kregel, 2012).

The Social Security Administration (SSA) is the federal agency responsible for managing, executing and overseeing retirement, survivor, old-age and disability benefits. There are over 1,500 Social Security offices and over 65,000 employees nationwide (SSA, 2013). SSA manages at least five disability benefit programs: Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Disabled Widow(er) Benefit (DWB), Childhood Disability Benefit (CDB), though …

Improving Nursing Home Patient Safety In Maine: A Review Of The Ahrq Patient Safety Culture Survey Implementation Process, Andrea Fenner-Koepp

Muskie School Capstones and Dissertations

An organization’s patient safety culture has a powerful influence on the behaviors, strategies, and clinical outcomes of healthcare organizations. The Agency for Healthcare Research & Quality (AHRQ) Patient Safety Culture Survey has been deemed an effective tool for assessing patient safety culture and driving improvement initiatives. There has been little done to assess the quality of patient safety culture in long-term care facilities and, specifically, Maine has not collectively established baseline measures of patient safety culture in nursing home. This capstone reviews the implementation process of the AHRQ Patient Safety Culture Survey in five rural nursing facility pilot sites.

Walking And Cycling In Waterville: Bike And Pedestrian Planning For An Active Community, Scott E. Workman

Muskie School Capstones and Dissertations

This is an initial plan for the City of Waterville focused on making realistic headway in building a safer city that accommodates even the most vulnerable transportation system users. While it makes strides to capture every needed improvement and opportunity, it is by no means a complete document and should be accepted as a first of a continuing effort. Future efforts will make evaluations of accomplishments and failures of this plan, and continue this effort.

Using Pen Source Data Inputs To Map Food Insecurity In Cumberland County, Maine, Daniel Wallace

Muskie School Capstones and Dissertations

In 2010, Mapping Food Insecurity’s Project Director (PD) participated in “The Campaign to Promote Food Security in Cumberland County, Maine.” The Campaign drew together a 60 member coalition to address rapidly increasing food insecurity challenges in the county. It produced a report with a series of recommendations grouped under six strategic community goals. One of the recommendations called for the use of ‘mapping and connectivity software to determine location of vulnerable populations and services in order to plan best future delivery and use of food access services in Cumberland County