Medicine and Health Sciences Commons^™

Diabetes Health Education For South Jersey Communities, Heaven Chu, Sarah Tamous, Ashhabal Kavvi, Amin Khan

Rowan-Virtua Research Day

Diabetes is a chronic health condition that hinders the body’s metabolic process using insulin to maintain glycemic homeostasis. It is prevalent worldwide, with about 10% of the global adult population affected. Socio-economic and cultural factors and determinants make diabetes and diabetes management more of a health risk for certain populations rather than others. The prevalence of diabetes in the United States is higher than the global average and the risk factors disproportionately affect disadvantaged communities.

This study was designed to investigate health disparities in diabetes among a diverse population sample. The study included researching the disparities of diabetes patients in …

Planetary Health: Helping Providers And Patients Prepare For Climate Change, Chellam Nayar

Family Medicine Clerkship Student Projects

Climate change has been called the greatest global health threat of the 21st century. The effects of changing temperatures and increasing pollution have been shown to increase the incidence and mortality of cardiovascular diseases, affect respiratory health, increase the risk of new infectious disease outbreaks, affect mental health, and exacerbate inequities between those with means and those without. In Vermont, climate change is leading to an increase in average temperatures, more extreme heat events, shorter winters, more storms, poor air quality due to wildfire smoke, an increase in cyanobacteria blooms, and a longer tick season, among others. This project will …

Education For Primary Care Providers On Advance Care Planning: A Systematic Literature Review, Lindsey Ward

DNP Qualifying Manuscripts

Background: Healthcare providers in primary care treat patients at various stages of life. As patients age, it becomes necessary for providers to support their older patients throughout the aging process and address patient care even into life’s end stages. Primary care providers (PCPs) are well-positioned to provide this support and can do so through incorporating end-of-life (EOL) conversations in practice. Such discussions are called advance care planning (ACP). Though PCPs can play a crucial role in their patients’ EOL care decisions, providers report their limited knowledge of ACP as a barrier to its application.Consequently, further education for providers on utilizing …

Application Of Teaching Regarding Injury Appearance In Darker Pigmented Skin Patients: A Quality Improvement Project, Tiffany Akiba

DNP Projects

Significance and Background: The skin is the largest organ of our body, and skin injury prevention begins with accurately inspecting skin. Current practices stress on looking for any signs of redness which often signify that the skin is possibly injured or compromised. However, darker skin tones do not appear red when injured. Assessing for redness is a practice that is suited better for lighter skin tones.

Purpose: Provide education to providers on current skin assessment practices of darker skin tones.

Methods: The IHI Model of Improvement was used for this project, and the Plan-Do-Study-Act cycle was used to test for …

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

Evaluating Kentucky Advanced Practice Registered Nurses’ Confidence, Comfort, And Knowledge Levels Regarding Dermatology Care After A Web-Based Video Training, Victoria Hayden

DNP Projects

Background: It can take an average of 38.9 days to see dermatology from referral to initial appointment. As a result, delays in diagnosis and treatment of life-threatening conditions such as malignant melanoma could occur. Primary care providers frequently refer patients for benign conditions that can be appropriately managed in the primary care setting; often due to lack of knowledge or confidence in their clinical management skills. Educational resources equip providers with the knowledge and tools to feel confident in their management of various skin conditions in a primary care setting. Purpose: The purpose of this project was to …

Improving Access To Snowmobiling Safety Information, Sean Taylor

Family Medicine Clerkship Student Projects

Snowmobiling is a common activity for rural people in areas like the North Country of New York state. There are inherent risks associated with an activity like snowmobiling, and a primary care office is a location at which patients and their families can be informed of recommendations from professional associations, state laws regarding the activity, and recommendations on safer practices and safety courses that are available. I modified an informational flyer that caters to patients in the Plattsburgh area of New York to try to encourage safer snowmobiling, especially for children.

Empowering Providers To Treat Menopause, Aranshi Kumar

Family Medicine Clerkship Student Projects

This project created a brochure designed to empower providers to sift through the myths surrounding prescribing for the treatment of menopause.

Healthy Living In Washington County, Colleen Mccarthy

Family Medicine Clerkship Student Projects

No abstract provided.

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.

The Effect Of Implementing A Generalized Anxiety Disorder Protocol For Anxiety And Depression Symptoms In The Primary Care Setting, Bailey J. Hinman

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is very prevalent in the United States with 5.7% of citizens affected (National Institute of Mental Health [NIMH], 2017). This number is expected to be even higher because individuals avoid care due to stigma of mental illness (Andrews et al., 2018). GAD can have significant implications such as decreased ability to function, decreased quality of life and increased risk of suicide (Fong, 2018; Lizarondo, 2018). The purpose of this project was to improve outcomes for adult patients with GAD in the primary care setting by improving treatment to follow best practice recommendations. The Johns Hopkins Evidence …

Healthcare Altruism And Dysconscious Healthism In The Delivery Of Integrated Healthcare Services To Individuals Who Are Deaf, Hard Of Hearing, And Deafblind, Jaime A.B. Wilson, Michael John Gournaris

JADARA

Healthcare altruism and dysconscious healthism are terms proposed to recognize the barriers to healthcare access faced by not only individuals with hearing loss but also all minority populations. The implications of an integrated healthcare model to provide services to individuals who are d/Deaf, hard of hearing, or DeafBlind (D/HH/DB) are explored. Unique insights are then offered regarding existing barriers to healthcare access and the next steps.

Assessing Stroke Awareness, Preparedness, And Preferred Communication Modalities, Dana I. Allison

Family Medicine Clerkship Student Projects

Stroke is currently the fifth leading cause of death and is recognized as one of the most expensive chronic diseases in the United States, generating 30 billion dollars annually in medical costs and lost earnings. In this exploratory research study, we examine patients’ knowledge of stroke features, associated risk factors to enhance communication, and educational practices of for primary care clinicians to enhance patient preparedness and stroke outcomes for patient populations with risk factors for stroke.

Addressing Covid-19 Vaccine Hesitancy, Aram S. Garewal

Family Medicine Clerkship Student Projects

COVID-19 vaccine hesitancy in the United States is a major roadblock in the fight against a raging pandemic. Education on mRNA vaccine technology, efficacy, and safety may help reduce public hesitancy. An educational handout was created and distributed at the Brookfield Family Practice to help alleviate COVID-19 vaccine hesitancy in the local community.

Implementing An Intimate Partner Violence Screening At A Connecticut Family Medicine Practice, Nikkole Turgeon

Family Medicine Clerkship Student Projects

Intimate partner violence (IPV) is a significant public health problem throughout the United States. The aim of this project was to implement a validated IPV screening form into the work flow of the Newtown Primary Care office and increase awareness about IPV throughout the office. The Hits, Insults, Threatens, Screams (HITS) screening form was implemented and resources from local domestic violence agencies were obtained for the office. A system was set up for patients who screen positive to be referred to the in-house therapist and to local domestic violence agencies. Future steps could include further training and education for the …

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Easily Digestible: Addressing Food Literacy With Short Educational Videos, Kalle J. Fjeld

Family Medicine Clerkship Student Projects

Food literacy is the knowledge and skills needed to select and prepare food as well as determine food intake. These skills are necessary for a healthy diet, which is a major contributing factor to chronic disease prevention and management. People with diseases such as diabetes and cardiovascular disease can have great benefit from improving diet quality through increasing at-home food preparation and consumption of fruits and vegetables. In partnership with a Food Farmacy pilot program at Hudson Headwaters Health Network in Glens Falls, NY this project sought to use web-based food literacy education for a population of 40 patients with …

Narrative Medicine: Perspectives On Opioid Maintenance, Noorin Damji

Family Medicine Clerkship Student Projects

People who experience opioid addiction often feel marginalized by healthcare workers, or stigmatized by the medical system. Additionally, there are not enough medical providers to meet the needs of people who struggle with opioid addiction. These factors create barriers that prevent the medical establishment from effectively meeting the needs of people who experience addiction. This project compiles rich perspectives of patients on opioid maintenance treatment to share with medical students and providers to foster greater empathy for these patients, and positive attitudes toward managing substance use disorder among future medical providers.

Identifying Barriers To Sunscreen Use And Sun Safety Education, Seneca Hutson

Family Medicine Clerkship Student Projects

No abstract provided.

Assessing The Need And Desire For Nutritional Education, Marc Robert Hammond

Family Medicine Clerkship Student Projects

Many people suffer from health conditions that may be affected directly by diet and nutrition including diabetes, hypertension, hyperlipidemia, iron deficiency anemia, obesity, coronary artery disease, and cerebrovascular disease. Education of providers and patients alike may help decrease the prevalence of these health issues and their sequalae. The St. Albans Community has slightly poorer health and nutrition when compared to the entire state of Vermont. Patients in an outpatient primary care clinic in St. Albans, VT were provided with a survey that would assess:

The patient’s confidence in their nutritional skills and knowledge

Their willingness to go to a nutrition …

Barriers To Exercise: Patients With Diabetes In Washington County, Joshua Bruce Taylor

Family Medicine Clerkship Student Projects

According to the Vermont Department of Health physical inactivity is one of the three main behaviors that predisposes patients to cancer, heart disease/stroke, lung disease, and type 2 diabetes, which result in over 50 percent of deaths among Vermonters. Washington County has a higher rate of overweight adults than the statewide average, making exercise an important component to healthier living. Barriers to exercise, especially among patients with diabetes, impose serious health ramifications for the residents of Washington County, and avenues must be made available to circumvent these barriers.

Blood Pressure Management Education, Lauren G. Gernon, Cara Rathmell

Family Medicine Clerkship Student Projects

The expansion of telehealth with COVID-19 and recent recommendations to use at-home blood pressure monitoring to diagnose and monitor hypertension have increased the need for materials and education for clinicians and patients. A pilot project in Primary Care Internal Medicine UVM in Essex, VT, produced an electronic medical record dot phrase and compiled educational materials to initiate nurse visits for at-home BP measurements. Materials and experience with this pilot was researched for initiation of a similar program at UVM Family Medicine Hinesburg.

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

Retinopathy Screening: Assessing Knowledge & Educating Diabetic Patients In Caledonia County, Vermont, Ian J. Mcclain

Family Medicine Clerkship Student Projects

Diabetic retinopathy is the most common cause of severe vision loss in US adults. It is estimated that less than 50% of patients with diabetes consistently receive annual eye exams. Diabetic patients in rural communities may face additional barriers towards receiving recommended eye care as these communities generally have lower incomes, lower insurance rates and older populations. This project sought to educate diabetic patients about eye disease in a rural Vermont primary care practice using an active learning modality.

Family Medicine Resident Education On Perioperative Management Of Patients On Anticoagulation, Hanna Mathers

Family Medicine Clerkship Student Projects

Family Medicine residents at CMMC in Lewiston, Maine manage patients in an outpatient clinic as well as on an inpatient family medicine teaching service. Many patients in the community are anticoagulated for native valve atrial fibrillation and undergo surgical procedures both in the inpatient and outpatient setting. Residents are often asked on to determine the necessity and timing of anticoagulation discontinuation for patients that they see. With patients on newer oral anticoagulants and various degrees of risk, it can be a challenge to make an informed choice. Residents have found that they would feel more confident in perioperative management of …

Osteoporosis: What To Be Aware Of As A Patient, Jonathan H. Borden

Family Medicine Clerkship Student Projects

The prevalence of Osteoporosis is increasing with the growing elderly population in our nation. Studies show that the incorporation of osteoporosis risk screening into primary care intake protocols significantly decreases the rate of osteoporotic fractures in patients. This project aimed to increase osteoporotic screening within a primary care office in St. Albans VT via the development and distribution of an “Osteoporosis: What to be aware of as a patient” brochure to patients that met the criteria for being at risk of being osteoporotic (women ages 65+, women who are post-menopausal but younger than 65, men ages 70+).

Education And Expectations For Patients With Viral Upper Respiratory Infections, Kathryn Thomas

Family Medicine Clerkship Student Projects

Non influenza viral upper respiratory illnesses are responsible for a significant percentage of sick visits to primary care physicians. Patients who expect antibiotics are more likely to be given them, and this contributes to growing antibiotic resistance. Setting appropriate expectations for the course of a typical upper respiratory infection can reduce repeat visits, and reduce the number of antibiotic prescriptions. Additionally, many over the counter cold and flu remedies do not have a significant impact on cold duration or symptoms. The flyer produced in the course of this project details the average time course for an upper respiratory infection, instructs …

It's Not Tmi: Causes And Risks Of Vaginal Discomfort, Olivia Harrison

Family Medicine Clerkship Student Projects

Many people with vaginas feel uncomfortable discussing vaginal discomfort with their health care providers. Not disclosing symptoms such as pain, itching, dyspareunia, etc can lead to long term complications such as PID and significantly impact quality of life. I designed a pamphlet to help normalize talking about one's vagina to one's health care provider. This pamphlet outlines common causes and risks of vaginitis.

Promoting Medical Education At Cabot School, Dore E. Grier

Family Medicine Clerkship Student Projects

As a Cabot School alumni, I returned to Cabot School to talk to the students about opportunities in medicine. Cabot School is considered environmentally disadvantaged by the Agency of Education. By definition, "the individual comes from an environment that has inhibited him/her from obtaining the knowledge, skill and abilities required to enroll in and graduate from an undergraduate or graduate school." The percentage of students achieving proficiency in math and reading/language arts is lower than the Vermont state average for the 2016-17 school year. The goal of this project was to share my journey to medical school with the Cabot …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …