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Articles 1 - 25 of 25
Full-Text Articles in Medicine and Health Sciences
Pediatric Primary Care Concussion Evaluation And Management, Kaitlyn Layman
Pediatric Primary Care Concussion Evaluation And Management, Kaitlyn Layman
Doctoral Dissertations and Scholarly Projects
Concussions are an important and timely subject, especially within the pediatric population, as they are the most involved in extracurricular contact sports and are susceptible to concussions and their sequelae. The researcher performed a quasi-experimental pilot study in a pediatric primary care office where the researcher educated 15 providers on the HEADS UP concussion screening tool and management approach. The researcher gave providers pre- and post-intervention surveys to determine if providers’ comfort and knowledge regarding assessing and managing concussions within the pediatric primary care setting changed. Four providers participated in the study. The researcher conducted a chart review two months …
Implementation Of A Screening Protocol To Improve Provider Assessment Of Depression In Patients With Psoriasis, Marlee Bryant
Implementation Of A Screening Protocol To Improve Provider Assessment Of Depression In Patients With Psoriasis, Marlee Bryant
Doctoral Dissertations and Scholarly Projects
Patients with psoriasis are at an increased risk for depression. Despite this risk, many dermatology care providers do not screen for depression in practice, including providers at the target practice for this project. This evidence-based practice pilot project was purposed to increase dermatology providers’ assessment of depression in patients with psoriasis. This project involved implementing a depression screening protocol at one private dermatology practice and educating providers on the use of the protocol including the embedded depression screening tool, the Patient Health Questionnaire-9. The project leader used a quasi-experimental design and collected data utilizing retrospective chart reviews completed pre- and …
Increasing Advance Care Planning In The Primary Care Setting, Nicole Marie Coffey
Increasing Advance Care Planning In The Primary Care Setting, Nicole Marie Coffey
Doctoral Dissertations and Scholarly Projects
Evidence shows the many benefits of advance care planning (ACP) discussions, including; giving patients peace of mind, decreasing healthcare costs, increasing quality of care, and decreasing distress at the end of life. Due to the many proven benefits of ACP, the United States Department of Health and Human Services as well as many leading national health organizations are promoting ACP, even tying it to reimbursement. The best setting and time to initiate ACP is in the primary care setting as early as possible, before patients have any cognitive decline. In this context, patients have an established relationship with their provider, …
Telehealth And Diabetes Self- Management Education And Support For Improving Health Outcomes In Adults With Type 2 Diabetes: An Integrative Review, Monica Allen
Doctoral Dissertations and Scholarly Projects
With the increasing problem of access to health care, telehealth is an evidence-based service that uses a variety of technologies to provide quality healthcare. The use of telehealth services improves self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus after adults receive Diabetes Self-Management Education and Support (DSMES). Type 2 diabetes is the most common form of diabetes. If not self-managed, adults with type 2 diabetes are at increased risk of complications, which can be serious, costly and deadly. This integrative review provides an appraisal of the evidence published regarding the use of telehealth for the management …
Implementation Of A Scripted Education On Comfort Goals To Improve Patient Perception Of Pain Control, Vicki F. Mclean
Implementation Of A Scripted Education On Comfort Goals To Improve Patient Perception Of Pain Control, Vicki F. Mclean
Doctoral Dissertations and Scholarly Projects
Pain management is the culmination of physician, nurse, and patient expectations. Successful pain management is impacted by the patient’s perception and expectation of the provided interventions, as well as the perception of the care provider of the patient’s pain. Pain assessment tools have been utilized for decades and still pain control is rated as inadequate. Providing scripted education to the patient on the purpose and utilization of these tools impacts the patient’s perception of pain management. This project implemented the evidence-based practice intervention of education to improve the relationship of comfort goals to pain management. Nurses’ knowledge of pain management …
Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton
Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton
Doctoral Dissertations and Scholarly Projects
The addition of Nurse Practitioners (NPs) on the trauma service at night was examined to see if it has positively impacted healthcare utilization and satisfaction in trauma patients. This four-month evidence-based, quasi-experimental project took place on the Trauma Medical Surgical Unit (TMSU) at a level II trauma center in California. Retrospective analysis of medical records and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) satisfaction surveys were performed for those trauma patients located on the TMSU 60-days prior to NPs starting at night and 60-days after. The measured outcomes were LOS, readmissions within 30-days of discharge, LOS after readmission, …
An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter
Doctoral Dissertations and Scholarly Projects
Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …
Chart Audit And Educational Provider Feedback Intervention To Improve Appropriate Use Of Spirometry In Patients With Chronic Obstructive Pulmonary Disease, Ruth Demetros
Doctoral Dissertations and Scholarly Projects
Despite being a GOLD guideline and having documented benefits, confirming a COPD diagnosis with spirometry is not routinely done. The purpose of this project was to increase patient referrals for spirometry to confirm COPD diagnosis. A quasi-experimental design was incorporated in a primary care office. A retrospective pre-intervention chart audit and two post-chart audits, 30-days apart, compared the frequency of documented spirometry to confirm a COPD diagnosis. An educational intervention with a pre and post-survey examined provider behavior intention to order spirometry to confirm a COPD diagnosis. The pre-chart audit revealed that 27/50 (54%) of patients had spirometry documented to …
The Impact Of An Educational Intervention To Enhance Self-Management In Type 2 Diabetes Patients, Demetria Bates
The Impact Of An Educational Intervention To Enhance Self-Management In Type 2 Diabetes Patients, Demetria Bates
Doctoral Dissertations and Scholarly Projects
Type 2 diabetes mellitus is a chronic health condition that requires patients to be engaged in their health care. Knowledge of the disease and self-management skills are key components to improving health and outcomes in diabetes patients. Due to the lack of self-management skills, diabetes patients are at risk for diabetes-related health complications. Hemoglobin A1c is a measure that demonstrates the average blood glucose level, which is an indicator of diabetes control. Medical treatments and education are continuously improving and readily for type 2 diabetes. The purpose of this project was to enhance knowledge and self-management skills among chronic care …
Evaluating Impedance Monitoring To Reduce Hospital Readmissions For Patients With Heart Failure With Reduced Ejection Fraction: An Integrative Review, Abigail Newton
Doctoral Dissertations and Scholarly Projects
Congestive Heart Failure (HF) is a chronic progressive cardiac disorder with high mortality rates and is the number one reason for hospital readmission in the United States. More than 5 million Americans live with HF with more than 900,000 new diagnoses annually. The likelihood of developing HF increases with age making it the most common primary diagnosis for patients over age 65. HF has a significant impact on quality of life, with depression being a common comorbid condition. Thoracic impedance monitoring has shown to reduce exacerbations and hospitalizations in patients with HF. This project evaluated the literature related to impedance …
Enhanced Depression Screening In The Cardiac Rehabilitation Setting An Evidence-Based Project, Heidi Winslow
Enhanced Depression Screening In The Cardiac Rehabilitation Setting An Evidence-Based Project, Heidi Winslow
Doctoral Dissertations and Scholarly Projects
Depression is common amongst patients with cardiovascular disease. This evidence-based project was designed to evaluate the impact of a practice improvement intervention for screening and referrals in cardiac patients with depression. The American Heart Association Advisory Council recommends depression screening, treatment, and support to provide adequate diagnosis, treatment, and follow-up to patients. Cardiacrehabilitation (CR) is a coordinated effort of structured treatments with physical, mental, and social components, to favorably influence cardiac healing and resume optimal functioning. The problem is current depression screening and referrals are not being documented electronically in the cardiac rehabilitation (CR) setting limiting real-time communication amongst the …
Reducing Rehospitalizations From One Skilled Nursing Facility: A Quality Improvement Project, Victoria Ann Phillips
Reducing Rehospitalizations From One Skilled Nursing Facility: A Quality Improvement Project, Victoria Ann Phillips
Doctoral Dissertations and Scholarly Projects
The purpose of this quality improvement project initiated by a core project team in a large medical center was to investigate possible causes for increased hospital readmissions from one specific skilled nursing facility. The conceptual framework utilized was the Define, Measure, Analyze, Improve, Control (DMAIC) model from the Lean Six Sigma methodology. Data collection from chart audits, a staff survey, a system probe, and a process mapping project assisted to narrow the focus of the plan to improve communication among facilities by standardizing documentation and coordination of care as patients transitioned from the skilled nursing facility to the medical center’s …
Influence Of Smartphone Diabetic Messaging On Hba1c, Patricia Perryman
Influence Of Smartphone Diabetic Messaging On Hba1c, Patricia Perryman
Doctoral Dissertations and Scholarly Projects
Associated personal, financial, and societal costs of a diagnosis of Type 2 Diabetes Mellitus impacted over 22 million Americans at a cost of over $245 billion in 2012. The project provided evidence-based outcomes that demonstrated improved HbA1c levels in the intervention group and positive feedback on diabetes related text messages. Ongoing opportunities are available to expand text messaging within the physician network; the potential for replication studies; and the feasibility and effectiveness of text messaging for improving engagement in managing people with T2DM health are also findings within the study.
Teach-Back Methodology To Improve Patient Satisfaction In An Urgent Care Setting, Candi Payne
Teach-Back Methodology To Improve Patient Satisfaction In An Urgent Care Setting, Candi Payne
Doctoral Dissertations and Scholarly Projects
The project used teach-back methodology to provide an evidence-based approach to improve patient satisfaction scores in an urgent care clinic. The teaching plan should include evaluation of patient teaching to determine effectiveness and patient understanding per The Joint Commission (TJC) for Ambulatory Care Center standards. The project was developed to assist nurses (N=12) with an evidence-based method to improve patient understanding and provide an opportunity to ensure comprehension to increase patient satisfaction scores from a one or two to a level three at the end of 30 days following implementation of teach-back. The scores revealed an increase of patient satisfaction …
Pots: Educating School Nurses, Stephanie Sherwood
Pots: Educating School Nurses, Stephanie Sherwood
Doctoral Dissertations and Scholarly Projects
The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …
Clustering Diabetes Appointments And Education, April Pugh
Clustering Diabetes Appointments And Education, April Pugh
Doctoral Dissertations and Scholarly Projects
Diabetes impacts the lives of millions of Americans, and the number is growing rapidly every year. Diabetes education has been demonstrated to have a positive impact of the self-management of this chronic disease and effective in the reduction of A1C, weight, and blood pressure. Barriers to attendance at both diabetes education classes and provider appointments are varied with lack of transportation and available time cited as two of the many reasons, especially in the rural and medically underserved regions of the country. The project assessed a process improvement intervention clustering diabetes education with provider appointments to increase attendance and decrease …
Knowledge And Attitudes Of Orthopedic Nurses Regarding Pain Management, Matthew Neumann
Knowledge And Attitudes Of Orthopedic Nurses Regarding Pain Management, Matthew Neumann
Doctoral Dissertations and Scholarly Projects
Nurses are at the forefront in the care of patient pain management; however, many nurses do not possess the knowledge, skills, and attitudes required for best pain management outcomes. Adequate pain management education is often infrequent in academic settings and in post-graduate health care environments. That shortcoming suggests a need to improve pain management education as advocated by The Joint Commission and U.S. Department of Health and Human Services. The purpose of this study is to measure 20 nurses’ knowledge and attitudes regarding pain and pain management while working in an orthopedic setting. It was an evidence-based practice project utilizing …
Educational Intervention To Improve Self-Efficacy And Self-Care In Patients With Heart Failure, Helen Parke
Educational Intervention To Improve Self-Efficacy And Self-Care In Patients With Heart Failure, Helen Parke
Doctoral Dissertations and Scholarly Projects
Heart failure is a high mortality, chronic disease that is economically and physiologically costly for patients, caregivers, and society. Heart failure teaching alone is insufficient in meeting the complex self-care needs of the heart failure patient. This project implemented evidence-based teaching methods that are skill-based and problem-solving based to educate heart failure patients in an outpatient setting. The theoretical foundation of this project was Bandura’s theory of self-efficacy and Orem’s theory of self-care. The level of self-care and self-efficacy was assessed before and after the multi-sensory teaching intervention. Self-care and self-efficacy have been studied and shown to be major components …
Provider Screening For Depression In Patients Post-Myocardial Infarction, Heather Vasioutovitch
Provider Screening For Depression In Patients Post-Myocardial Infarction, Heather Vasioutovitch
Doctoral Dissertations and Scholarly Projects
In this scholarly project, the project leader implemented a chart audit and provider feedback intervention with the aim of improving provider referrals for patients who screened positive for depression—a risk factor in the myocardial infarction (MI) population—with the Patient Health Questionnaire-9 (PHQ-9). The clinical question was developed in order to examine whether the depression-screening tool that was implemented improved provider referrals to the in-house licensed counselor or primary care physician after an educational feedback intervention, focusing on physicians, nurse practitioners (NPs) and physician assistants (PAs). The target population involved cardiology providers and adult patients who experienced a MI, including Non-ST …
Comparative Look At The Depression Treatment Modalities Of Cognitive, Teresa M. Page
Comparative Look At The Depression Treatment Modalities Of Cognitive, Teresa M. Page
Doctoral Dissertations and Scholarly Projects
This integrative review provides a comparative view of cognitive behavioral therapy (CBT) and pharmacotherapy (PCT) as treatment modalities for adult depression. The foci of this integrative review are to examine research articles on CBT and PCT to determine which therapy, monotherapy or combination therapy, provide a higher level of therapy for depression. The metrics utilized are depression symptom remission, response to therapy, recovery from depression, and quality of life. Individual preference and response to treatment vary. This makes the reader more aware that specific populations may be more receptive to one therapy instead of the other.
Patient Perceptions Of The Caring Environment, Kathryn M. Miller
Patient Perceptions Of The Caring Environment, Kathryn M. Miller
Doctoral Dissertations and Scholarly Projects
As health management information system technology at the point of care increases to ensure greater efficiency, effectiveness and patient safety, the impact of such technology needed to be explored for impact on the nurse-patient dyad, and patient perception of the caring environment. This evidence-based practice pilot project based on the Iowa Model of Evidence- Based Practice to Promote Quality Care utilized quasi-experimental methodology to measure implication of mobile computer workstations at the point of care and sought to answer if an evidence-based practice change of ergonomic use surrounding technology improved patient perceptions of the caring environment. Significance of the pilot …
Health Literacy Assessment And Chronic Disease: An Integrative Review, Dana S. Woody
Health Literacy Assessment And Chronic Disease: An Integrative Review, Dana S. Woody
Doctoral Dissertations and Scholarly Projects
Health literacy is a matter of grave concern in health care today. Defined as more than the ability to read and write, it involves obtaining, processing, and understanding health information. Yet it is a concept often misunderstood and overlooked in the environment of professional care. Specifically, low health literacy in the setting of chronic disease has proven to be a challenging and costly phenomena. Given the high prevalence of chronic disease, there is a pressing need for health care providers to acknowledge this subject matter in care delivery. This integrative review provides a synthesis of published evidence identifying and clarifying …
Reducing Medication Errors In The Acute Care In-Patient Setting: An Integrative Review, Ronni T. Rothwell
Reducing Medication Errors In The Acute Care In-Patient Setting: An Integrative Review, Ronni T. Rothwell
Doctoral Dissertations and Scholarly Projects
Promoting a culture of safety in healthcare organizations has become a necessary goal to ensure that patients are safe, well cared for, and satisfied with the services they receive. One of the areas recognized as a major safety concern across hospitals in the United States and abroad are medication errors, which continue to occur at a staggering rate. This integrative review seeks to serve two purposes to combat this pandemic problem. First, the project will attempt to determine if an appropriate intervention or strategic initiative exists that can reduce medications errors for adult patients on an acute care patient unit …
Horizontal Violence Effect On Nurse Retention, Victoria M. Cox
Horizontal Violence Effect On Nurse Retention, Victoria M. Cox
Doctoral Dissertations and Scholarly Projects
Horizontal violence is known by a variety of terms such as lateral violence, bullying, and incivility. Christie and Jones (2014) describe lateral violence as a problem in nursing where a behavior is demonstrated through harmful actions that occur between nurses. Studies have revealed how horizontal violence affects nurse retention. Horizontal violence is a relevant issue in the healthcare community, yet often goes undiscussed. Walrafen (2012) explains that an outcome of horizontal violence in nursing is directly proportional to a decrease in retention of nurses. Sherman (2012) proclaimed that nurses who are subjected to horizontal violence have low self-esteem, depression, excessive …
Implementation Of Teamstepps, Trynequa S. Jones
Implementation Of Teamstepps, Trynequa S. Jones
Doctoral Dissertations and Scholarly Projects
This scholarly project focused on implementing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) in an emergency room (ER). The aim of TeamSTEPPS is to improve patient outcomes by educating healthcare professionals on communication and teamwork skills. TeamSTEPPS teaches healthcare professionals leadership skills, shared mental models, mutual trust, and closed loop communication. The purpose of the scholarly project was to improve teamwork and communication. The study method was descriptive analysis of 51 pre and posttest questionnaires, specifically looking for increased knowledge of TeamSTEPPS tools. The participants included: ER physicians, ER nurses, ER certified nursing assistants/health unit coordinators, …