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Full-Text Articles in Medicine and Health Sciences
A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse
A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse
Walden Dissertations and Doctoral Studies
Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …
A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse
A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse
Walden Dissertations and Doctoral Studies
Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …
Clinical Practice Guideline For Palliative Care Referral, Samantha Jones
Clinical Practice Guideline For Palliative Care Referral, Samantha Jones
Walden Dissertations and Doctoral Studies
Palliative care is a type of specialty care that focuses on the improvement of the quality of life and prevention of suffering of those with progressive serious illnesses by addressing the physical, emotional, and spiritual needs of patients and families. There are many misperceptions about palliative care by providers, patients, and their families. Inconsistent interventions and a lack of palliative care education for providers results in delayed palliative care involvement. Delayed involvement results in patients with unmet palliative care needs. The purpose of this project was to develop clinical practice guidelines to ensure appropriate care based on the best available …
Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout
Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout
Walden Dissertations and Doctoral Studies
Nonsurgical aesthetic procedures continue to grow in popularity; however, evidence-based clinical practice guidelines that can assist providers when performing aesthetic treatments are lacking. This gap in practice can result in the increased prevalence of side effects from treatments that can compromise patient safety and result in increased litigation. The goal of this project was the development of a clinical practice guideline (CPG) that can be used by aesthetic providers to standardize care when performing nonsurgical aesthetic procedures that can ultimately improve provider knowledge, which would improve patient safety. This CPG sought to answer the practice-focused question involving whether the development …
Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer
Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer
Walden Dissertations and Doctoral Studies
AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …
Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown
Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown
Walden Dissertations and Doctoral Studies
Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …
Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Harbaugh, Diane Whitehead
Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Harbaugh, Diane Whitehead
Journal of Excellence in Nursing and Healthcare Practice
Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and a lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients have been shown to improve quality care, decrease complications, increase the efficiency, and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which are recognized risk factors for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the northeast United States. The purpose …
Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens
Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens
Walden Dissertations and Doctoral Studies
Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescentsâ individual characteristics and beliefs as well as their readiness to …
Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak
Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak
Walden Dissertations and Doctoral Studies
The Amputation Coalition indicates that there were approximately 2 million people with limb loss in the United States primarily caused by peripheral vascular disease in 2019. Those with amputation related to vascular disease have a 5-year mortality rate. The gap in clinical practice at the facility used for this project is that there were no comprehensive program guidelines for nurse practitioners and other health care professionals working with people who are at risk for vascular intervention or limb loss. The practice-focused question was answered that an interprofessional team did develop a prototype for a comprehensive peripheral vascular program that serves …
Family Functioning During Deployment And Reintegration Of Military Members, Heather Graham
Family Functioning During Deployment And Reintegration Of Military Members, Heather Graham
Walden Dissertations and Doctoral Studies
Military members and their families face unique stressors related to separation and reintegration. These life-changing events can lead to domestic violence, divorce, depression, suicide, and behavioral problems within the family. It was unknown whether the implementation of a nursing clinical practice guideline (CPG) would help nurses to identify family functioning concerns or psychosocial issues enabling earlier interventions. The purpose of this doctoral project was to create a CPG that can be used at military treatment facilities (MTFs) to screen military members and their families to identify family functioning concerns so that the provider can make referrals as needed. The circumplex …
Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes
Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes
Walden Dissertations and Doctoral Studies
A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …
A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks
A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks
Walden Dissertations and Doctoral Studies
Managing heart failure patients in the outpatient setting can pose a challenge for nurses and health care staff due to the need to educate patients on self-care skills and management of disease. Several factors, including health literacy and numeracy, need to be considered when developing an education program for heart failure patients to promote self-care management. The purpose of this project was to provide nursing staff with a clinical practice guideline (CPG) that incorporated health and numeracy literacy assessment into an individualized education program. The Johns Hopkins nursing evidence-based practice (EBP) model, the situation-specific theory of heart failure (HF) self-care, …
Addressing Bullying Behavior In Pediatric Patients Using A Clinical Practice Guideline, Barnitta Latricia Moses
Addressing Bullying Behavior In Pediatric Patients Using A Clinical Practice Guideline, Barnitta Latricia Moses
Walden Dissertations and Doctoral Studies
Childhood bullying can lead to adverse physical and mental health outcomes for both the victim and the bully. Risk factors for bullying can be related to gender, race, sexual preference, and having any type of disability. A pediatric primary care clinic in a large, metropolitan area, the focus for this project, did not have an evidenced-based clinical practice guideline (CPG) for providers to facilitate the management of children who presented with reported bullying. The project, guided by the Tanner's integrated model of clinical judgement, addressed the question whether a CPG would facilitate the early recognition and treatment of bullying in …
A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan
A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan
Walden Dissertations and Doctoral Studies
Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and …
Transitional Care For The Cardiac Surgery Population: Development Of A Clinical Practice Guideline, Sheila Davies
Transitional Care For The Cardiac Surgery Population: Development Of A Clinical Practice Guideline, Sheila Davies
Walden Dissertations and Doctoral Studies
Recovering from a cardiac surgery procedure and the transition to home can be an overwhelming experience for patients and caregivers. A tertiary care hospital's cardiothoracic surgery department suspended a nurse-practitioner-coordinated transitional care program in the 1st quarter of 2016. Following this decision, the readmission rate increased from its previous rate of 15.6% in quarter 1 to 20% in quarter 3. The purpose of this scholarly project was to develop a clinical practice guideline (CPG) that can bridge the gap in the transitional care process. The transitional care model informed the design of the project. A draft guideline was distributed to …
Clinical Practice Guideline For Differentiating Risk Factors For Avoidable And Unavoidable Pressure Ulcers., Vivian Suarez-Irizarry
Clinical Practice Guideline For Differentiating Risk Factors For Avoidable And Unavoidable Pressure Ulcers., Vivian Suarez-Irizarry
Walden Dissertations and Doctoral Studies
Pressure ulcers (PUs) present intrinsic risk factors that are not consistently identified by clinical assessments. The objective of this project was to develop a clinical practice guideline (CPG) to provide nurses with guidance in identifying and differentiating how intrinsic and extrinsic risk factors are associated with populations at risk for developing avoidable and unavoidable PUs. CPG development followed a systematic method to search the literature, organize findings, and assess the strength of the resulting evidence and its applicability to the CPG. Quality of the CPG was assessed by a panel of 8 health care professionals using the Appraisal of Guidelines …
Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá
Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá
Walden Dissertations and Doctoral Studies
There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand …