Medicine and Health Sciences Commons^™

A Partnership To Improve Health Care In Kosovo: Dartmouth Medical School And Kosovar Nurses Worked Together On A Two-Year Project To Rebuild Primary Health Care In The Postconflict City Of Gjilan, Fred C. Pond, Ellen Thompson, A. Laurie Harding, Mary Taylor, Cristina Hammond

University Libraries Faculty and Staff Publications

Partnership between a health municipality in Kosova, in the former Republic of Yugoslavia and Dartmouth Medical School, New Hampshire, to rebuild the primary care system after the war. The project, which included nurses from both countries, is described, focusing on the changing roles of nurses.

Improving The Management And Monitoring Of The Clinical Experiences Of Nurse Practitioner Learners, Barbara A. Rouleau

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

The transition of the degree requirements for nurse practitioners from a master’s degree (MS) to a doctor of nursing practice (DNP) degree will deliver a workforce of advanced practice nurses with the knowledge and skills necessary to meet the complex health care needs of patients and populations. The Institute of Medicine (2010) has forecasted an impending shortage of nurses by 2020, and one of the major challenges facing educational programs is lack of training sites.

The shortage of quality clinical sites and experiences for students in primary care is a national challenge as well as a local challenge (AACN, 2014). …

Promoting Utilization Of The Clinical Nurse Leader: Improving Quality Of Unit-Base Care, Jason T. Garbarino

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

The purpose of this project was to provide consultative services to health care organizations in the State of Vermont on the purpose and role of the Clinical Nurse Leader (CNL). In providing a thorough overview of the CNL role including their improvements to patient care and care delivery, the desired impact was an increase in utilization of CNLs in pre-existing practice settings. Education was provided to three health care organizations in the State of Vermont. The post evaluation forms collected from participants of the consultative services highlighted an overwhelming interest in having their health care organizations actively or further pursue …

An Interprofessional End Of Life Simulation Using A Movie/Discussion Format, Mary Val Palumbo, Christina S. Melvin, Nancy P. Lemieux, Deborah A. O'Rourke, Jean Beatson, Patricia A. Prelock, Kelly A. Melekis, Mary Alice Favro, Vicki Hart

College of Nursing and Health Sciences Faculty Publications

An Interprofessional End of Life Simulation Using a Movie/Discussion Format

Sigma Theta Tau International Nursing Research Congress

Cape Town, South Africa

July 25, 2016

Mary Val Palumbo, DNP, MSN, BS, APRN, GNP-BC¹ Christina S. Melvin, MS, BS, PHCNS, BC, CHPN¹ Nancy P. LeMieux, MSN, BSEd, RN¹ Deborah A. O'Rouke, PhD, MA, MClSc, BSc, PT² Jean Beatson, EdD, MS, RN³ Patricia A. Prelock, PhD, MA, BS, CCC-SLP, BCS-CL⁴ Kelly A. Melekis, PhD, MSW, LMSW⁵ Mary Alice Favro, MA, BS, CCC-SLP⁶ Vicki Hart, PhD⁷ (1)Department of Nursing, University of Vermont, Burlington, VT (2)Dept. …

Screening For Bulimia Nervosa In The Primary Care Setting: Educating Healthcare Providers On The Use Of The Most Valid And Reliable Screening Tools, Kasey Mary Cushman

College of Nursing and Health Sciences Nursing Master Project Publications

Abstract

There are currently no routine screening guidelines for eating disorders in the primary care setting, despite their high mortality rate. Bulimia Nervosa (BN) is one of the hardest eating disorders to diagnose due to the lack of physical features and its secretive nature. Primary care providers need to have knowledge of the most valid and reliable screening tools in order to better diagnose and treat BN. In order to assess the most valid and reliable screening tools for BN, current literature was appraised with the focus on tools specifically designed for detection of BN. The results of the literature …

Waiting Room Health Promotion For Older Adults In Rural Primary Care, Emma G. Kopecky

College of Nursing and Health Sciences Nursing Master Project Publications

Background: Advances in health care technology have lead to adults living longer than in previous decades. Longer life expectancy in combination with the aging of the Baby Boomer generation is predicted to result in rapid and exponential growth among the older adult population. Adults in the U.S. over the age of 65 have on average five or more chronic illnesses, many of which are often poorly managed. Older adults who experience chronic diseases often report decreased quality of life, limitations in functional ability, loss of independence, and periods of decline and increasing disability. Health promotion efforts can help in delaying …

The Sbirt Method For Alcohol Misuse Screening And Treatment, Blake Coulter Mcknight

College of Nursing and Health Sciences Nursing Master Project Publications

Heavy episodic drinking, or “binge drinking”, is a significant behavioral health problem on American college campuses. It is associated with numerous physical, social, and legal consequences in this population, including but not limited to intoxicated driving, physical and sexual assault, accidents, alcohol poisoning, compromised academic performance, criminal justice system involvement, exclusion from athletic competition, and expulsion from student housing. The Screening, Brief Intervention, and Referral to Treatment method, or “SBIRT”, has gained increasing recognition in recent years as an effective, validated tool for screening for and intervening in behavioral health problems generally and problematic alcohol use in particular. The purpose …

Expanding Hearts And Minds: The Impact Of Transgender And Gender Non-Conforming Educational Interventions On Nurse Practitioner Students’ Knowledge And Comfort, Calvin Louis Gilbert

College of Nursing and Health Sciences Nursing Master Project Publications

Transgender and gender non-conforming (TGNC) populations are at a higher risk for discrimination and inadequate services while receiving health care. Some of this results from providers’ knowledge deficits regarding TGNC-specific health care needs or lack of experience and comfort with TGNC clients and the subsequent impact on an open-minded approach to gender identity. There is often little or no curriculum included in health care providers’ education pertaining to TGNC specific health risks, health care needs and approaches to clinical visits.

The purpose of this project is to promote awareness, provide education, and increase provider comfort around TGNC health care discrepancies, …

The Role Of The Community Health Worker: An Educational Offering, Kameron Escajeda

College of Nursing and Health Sciences Nursing Master Project Publications

Reducing health disparities among underserved and minority populations are an ongoing challenge for the United States’ health care system. The Affordable Care Act proposes the addition of a Community Health Worker (CHW) to the health care workforce to serve as a liaison between community and health services as a possible solution to improve quality and health outcomes in underserved populations. The newly formed health care team created in collaboration with the Visiting Nurse Association of Chittenden and Grand Isle Counties will welcome the CHW as a new team member to help improve the care and coordination of services for New …

Health Maintenance And Goal Setting For Women Joining And Re-Joining The Workforce, Tess Barbach

College of Nursing and Health Sciences Nursing Master Project Publications

Abstract

Poverty is a major health barrier in the United States which disproportionately affects women, who earn lower wages than men and are often single mothers responsible for the care and wellbeing of their families. Chronic socioeconomic depression is a cyclic, multigenerational problem that can make it difficult for women to adequately engage in healthy behaviors such as eating well and exercising. Poor self-care practices can in turn lead to cycle of poor health outcomes across the board, including depression, cardiovascular disease, diabetes and more. Poor health may subsequently pose a challenge for women trying to find the energy to …

A Continuing Education Program On Entrepreneurial Skills For Nurse Practitioners Considering Owning A Private Practice, Christine E. Lamar

College of Nursing and Health Sciences Nursing Master Project Publications

Entrepreneurial education is often lacking for nurse practitioners which can impact their ability to successfully run nurse practitioner owned practices. Nurse practitioners lead busy lives and often learn important business skills as they navigate the business start-up process for their practices. An online educational module was created including some key entrepreneurial skills for nurse practitioners to help alleviate the burden of learning business skills for those nurse practitioners hoping to open their own practices. A link to a 50-minute online module covering introductory entrepreneurial skills for nurse practitioners was sent to the faculty and graduate students in the University of …

Developing A Vermont Nurse Triage Line: A Systems Improvement Project, Andrew D. Kehl

College of Nursing and Health Sciences Nursing Master Project Publications

Nurse Triage Lines (NTL) have been utilized since the 1970s as a healthcare service delivery model. The efficacy of their utilization has been proven in non-acute, mainly primary care settings. During the 2009 H1N1 pandemic in the United States, NTLs proved their efficacy in an acute emergency event. The Minnesota FluLine, the exemplar case study, showed a significant reduction in unnecessary healthcare resource utilization as well as a significant economic cost savings.

This project performed an organizational assessment for the Vermont Department of Health (VDH) focused on implementing an NTL. Through qualitative semi-structured interviews with key informants, key themes surround …

Safe Provision Of Oxygen To Infants In Low-Resource Settings, Martha Ming Whitfield

College of Nursing and Health Sciences Nursing Master Project Publications

This project explored best practices for the provision of oxygen to infants in low-resource settings, culminating with the development of a script for the future production of a training video by the Global Health Media Project (GHMP). A review of the literature included practice guidelines and current research related both to the topic of oxygen delivery, and to the creation and dissemination of educational healthcare materials. Discussion with content experts helped to guide the review and script development. The script focused on young infants with evidence of respiratory distress who require supplemental oxygen, and was aimed at teaching assessment skills …

Care Team Education On The Use Of Sensory Resources In Inpatient Psychiatry, Salsabil Hoque

College of Nursing and Health Sciences Nursing Master Project Publications

Sensory processing is the way the nervous system receives, organizes, and understands sensory information gained through our body’s senses and physical environment. The deprivation of sensory processing, or the inability of one’s nervous system to use meaningful sensations, can lead to negative outcomes such as anxiety, stress, depression, withdrawal and reduced motivation, or agitation and disturbed behavior. Dr. Ayres' Sensory Integration Theory was used as the guiding framework for this project. Research literature indicates that sensory modulated approaches are an effective treatment approach for patients who are distressed, anxious, agitated, or potentially aggressive, and can be used as an alternative …

The Electronic Health Record Scorecard: A Measure Of Utilization And Communication Skills, Ashley E. Leamon

College of Nursing and Health Sciences Nursing Master Project Publications

As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in …

Options Counseling And Abortion Education In Undergraduate Nursing School Curricula, Abigail S. Foster

Graduate College Dissertations and Theses

Background: Over one half of all pregnancies in the United States are unintended. Nurses are on the frontlines of the health care work force and often encounter women with unintended pregnancies in the clinical setting. They may find themselves responsible for options counseling and helping these women to explore their options of pregnancy, adoption and abortion. Discussing these three options in a non-judgmental, well-informed manner allows the woman to consider all possibilities. Leading this type of conversation requires specific skills and knowledge as well as the ability to deliver this information in a therapeutic, nonbiased manner.

Purpose: The intent of …

Minimizing Antibiotic Exposure In Infants At Risk For Early Onset Sepsis., Rachel Sooter

Graduate College Dissertations and Theses

ABSTRACT

Current guidelines published by the Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) recommend empiric antibiotics for all neonates born to mothers with a diagnosis of chorioamnionitis due to the risk of early onset sepsis (EOS). EOS is difficult to diagnose due to nonspecific symptoms and a lack of reliable tests, can progress quickly, and is potentially fatal or have neurodevelopmental consequences for survivors.

Antibiotics are frequently prescribed in the hospital and are lifesaving in the setting of a serious infection. Conversely, overuse of antibiotics has potential negative effects to individuals and the population …

Childhood Sexual Abuse Screening And Prevention In The Primary Care Setting: A Survey Of Pediatric Healthcare Providers In The State Of Vermont, Kelley Eileen Groll

Graduate College Dissertations and Theses

ABSTRACT

Background. Childhood sexual abuse (CSA) is a silent, but pervasive concern across the United States, the prevalence of which is often vastly underestimated. Some research indicates that as many as one in four girls and one in six boys become victims of CSA. CSA is classified as an adverse childhood experience (ACE), which has been shown to have serious longstanding negative physical, emotional, and mental health impacts. The pediatric primary healthcare provider is well posed to intervene to detect and prevent the occurrence of CSA.

Objective. The overall goal of this study is to gain an understanding of the …

Correlates Of Adherence To An Adolescent Weight Management Program: A Secondary Data Analysis, Meredith Walker Hanson

Graduate College Dissertations and Theses

The aim of this study was to determine the relationship between HRQOL and

adherence to an adolescent weight management program and identify variables predictive of increased adherence which are critical to motivating engagement in weight

management. This study was a non-experimental, retrospective secondary analysis from

aggregate data collected as part of the REWARD Teens program, a weight management

program for overweight and obese adolescents. Data from 37 subjects were included in

this study. Subject adherence to the program was the primary outcome variable. There

was no significant relationship between baseline adolescent or parent-proxy sub-scale or total HRQOL scores with program …

Nurse Practitioners' Discussion Of Sexual Identity, Attraction And Behavior, Sarah J. Mclaughlin

Graduate College Dissertations and Theses

ABSTRACT

Background: Sexual orientation is comprised of distinct components, including sexual identity, sexual attraction and sexual behavior. Lesbian, gay and bisexual adolescents are at an increased risk of experiencing poor health outcomes compared to non-sexual minority youth. Health care professional organizations recommend that health care providers discuss each component of sexual orientation at every adolescent health supervision visits in order to best assess the adolescent's health risks and needs for intervention and education.

Objective: This survey assessed the frequency with which nurse practitioners (NPs) in the state of Vermont discussed sexual identity, attraction and behavior with adolescents during annual health …

Long-Acting Reversible Contraceptives In Vermont: A Survey Based Assessment Of Current Knowledge Of Providers Of Women Of Reproductive Age, Erin O'Brien

Graduate College Dissertations and Theses

Unintended pregnancies are a long-standing public health issue nationally, with percentages hovering around 50% for at least the last five years. Vermont is doing slightly better than the national average, but is faced with it's own challenges due to it's rural nature. Agencies and organizations, such as the World Health Organization, March of Dimes and the Vermont Department of Health have made decreasing unintended pregnancies one of their priorities to improve maternal and fetal health outcomes, as well as social and economic opportunities for families. Current evidence-based guidelines call for long- acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and …

The Experience Of Health Care Providers Who Care For The Refugee Population, Ashley Patricia Macdonald

Graduate College Dissertations and Theses

Refugees resettling in the United States face many challenges; especially within the health care setting. The purpose of this research was to add to the increasing body of knowledge about improving health care for the refugee population through investigating providers' lived experience caring for them. This study utilized qualitative research methods with a descriptive phenomenological approach. Five healthcare providers, one Nurse Practitioner, three Pediatricians and one Family Medicine Attending, were interviewed face to face through semi-structured interviews, utilizing twelve questions about their lived experience caring for the refugee population. The data from the five participants interviewed revealed three themes that …

Patterns Of Asthma Exacerbation Related To Climate And Weather In The Northeast Kingdom Of Vermont, Quincy Mckenzie Campbell

Graduate College Dissertations and Theses

Asthma is a chronic respiratory disease characterized by long- and short-term inflammation and bronchospasm susceptible to multiple triggers that affects patients across the lifespan. Asthma management is a primary care priority in Vermont, where there continues to be an above-average prevalence of asthma among both children and adults as compared to other states. However, many of Vermont's children and especially adults with asthma are not participating in regular check-ups for asthma management that would best prevent exacerbation of asthma symptoms. Several climate and weather elements including, but not limited to, extreme temperatures and particulate matter are known asthma triggers. Vermont's …

Reducing Preventable Hospitalizations: A Study Of Two Models Of Transitional Care, Jessica Morrison

Graduate College Dissertations and Theses

Purpose: Transitional care is an emerging model of health care designed to decrease preventable adverse events and associated utilization of healthcare through temporary follow-up after hospital discharge. This study describes the approach and outcomes of two transitional care programs: one is provided by masters-prepared clinical nurse specialists (CNS) with a chronic disease self-management focus, another by physicians specializing in palliative care (PPC). Existing research has shown that transitional care programs with intensive follow up reduce hospitalizations, emergency room visits, and costs. Few studies, however, have included side-by-side comparisons of the efficacy of transitional care programs varying by health care providers …

Childhood Vaccine Perceptions And Practices Among Naturopathic Physicians, Katherine Bloom Whitman

Graduate College Dissertations and Theses

Purpose: Parental decisions to vaccinate their children may be impacted by the advice of health care providers practicing complementary and alternative medicine (CAM). Available literature suggests an association between vaccine delay or refusal and CAM use, decreased vaccination status of naturopathic patients, and increased vaccine hesitancy among naturopathic students. Some naturopathic physicians state that their approach towards discussions about childhood vaccinations may support families in choosing partial vaccination over complete refusal, ultimately contributing to an overall increase in vaccinations.

Methods: Using a modified Health Belief Model as a theoretical framework, this online survey of naturopathic physicians assessed childhood vaccine-related perceptions …