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The Effects Of Social Determinants On Renal Care Among Eskd Patients In The Philippines: Rural Vs. Urban Areas, Melanie Rojas 2021 Dominican University of California

The Effects Of Social Determinants On Renal Care Among Eskd Patients In The Philippines: Rural Vs. Urban Areas, Melanie Rojas

Nursing | Senior Theses

From a Public Health Nursing (PHN) perspective, populations who are diagnosed with chronic disease or illness are the most vulnerable to end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). The International Society of Nephrology (ISN) states that the mortality rate for ESKD amounts to roughly 7 million individuals worldwide. In examining causes of ESKD throughout both history and the lifespan, high mortality rates are attributed to the lack of access to life-sustaining therapies such as dialysis or transplantation. The lack of access to therapy or healthcare services has been an immense Public Health crisis in the last few decades ...


Examining A Fatigue Management Model That Identifies Risk Factors And Consequences Of Fatigue In Older Individuals, Maral Torossian 2021 University of Massachusetts Amherst

Examining A Fatigue Management Model That Identifies Risk Factors And Consequences Of Fatigue In Older Individuals, Maral Torossian

Doctoral Dissertations

Fatigue is experienced by 40-74% of older individuals living with a chronic disease. Despite advances in scientific knowledge around risk factors and consequences associated with fatigue, a comprehensive model that can serve as a guide for healthcare providers caring for older individuals with fatigue is lacking. Thus, the purpose of this study was to examine a fatigue model based on the Theory of Unpleasant Symptoms (TUS). The model included psychological, physiological, and situational risk factors of fatigue, as well as fatigue outcomes, such as physical, social, and cognitive performances, perceived health, and quality of life (QOL). This was a secondary ...


Communication Strategies To Promote Infection Control Compliance: My Health Is In Your Hands, Ezra Macabio 2021 The University of San Francisco

Communication Strategies To Promote Infection Control Compliance: My Health Is In Your Hands, Ezra Macabio

Master's Projects and Capstones

Abstract

Problem: The facility has less than 70% adherence to handwashing hygiene every week. Moreover, staff does not comply with the required PPE, affecting their infection-control performance and compliance to circumvent COVID-19. Furthermore, the microsystem lacks information flow and communication systems focusing on hand hygiene, and PPE usage significantly affects the healthcare staff's ability to perform such vital practices.

Context: Herman Health Care Center provides multiple services to its residents depending on medical needs after patient hospitalizations, such as short-term rehabilitation and long-term skilled nursing services. The COVID-19 pandemic had a remarkably negative impact on the skilled nursing facility ...


Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch 2021 University of San Francisco

Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch

Master's Projects and Capstones

Section I: Abstract

Problem: Skilled nursing facility (SNF) patients are vulnerable, aging, and have complex medical histories. Readmissions from an SNF impact healthcare costs and hospital resources and indicate poorly coordinated transitions home. Patients discharging from SNFs are at risk for higher social determinants of health (SDOH) disparities, such as limited caregiver support, transportation, housing insecurity, and food access. These SDOH risks can significantly increase an SNF patient's risk for hospital readmissions. Assessing and addressing SNF patients' social needs to reduce 30-day post-SNF readmissions can improve health outcomes and positively impact healthcare costs and a patient's financial liabilities ...


Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao 2021 University of San Francisco

Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao

Master's Projects and Capstones

Abstract

There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is ...


Osteoporosis Implications For The Aging Adult, Grace Alford 2021 Otterbein University

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.


The Right Premtm: Rasch Analysis Of A New Patient Reported Experience Measure For Use By Older People In Hospital, Louise Heuzenroeder, Jyoti Khadka, Alison Kitson 2021 Barwon Health

The Right Premtm: Rasch Analysis Of A New Patient Reported Experience Measure For Use By Older People In Hospital, Louise Heuzenroeder, Jyoti Khadka, Alison Kitson

Patient Experience Journal

Healthcare rights exist to protect older people from harm and to empower older people to participate in their care with independence, choice and control. Multiple investigations revealing abuse provide evidence that older people’s rights are being breached. Older people must have the opportunity to report on their experience of care against their rights. The Right PREMTM is a new instrument designed to measure older people’s experience of care against their healthcare rights. The objective of this cross-sectional validation study was to assess the psychometric properties of a new instrument to measure the experience of care consistent with ...


Reduction Of Inpatient Fall Rate In An Adult Acute Care Setting, Manjusha Maprel 2021 University of St. Augustine for Health Sciences

Reduction Of Inpatient Fall Rate In An Adult Acute Care Setting, Manjusha Maprel

Student Scholarly Projects

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries.

PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 ...


Intraoperative Dexmedetomidine For Reduction Of Postoperative Delirium In The Elderly: A Scoping Review, Gregory B. Harris BSN, RN, SRNA, Brooke N. Hatchell BSN, RN, SRNA, Davelin D. Woodard BSN, RN, SRNA, Dwayne Accardo DNP, APRN, CRNA 2021 University of Tennessee Health Science Center

Intraoperative Dexmedetomidine For Reduction Of Postoperative Delirium In The Elderly: A Scoping Review, Gregory B. Harris Bsn, Rn, Srna, Brooke N. Hatchell Bsn, Rn, Srna, Davelin D. Woodard Bsn, Rn, Srna, Dwayne Accardo Dnp, Aprn, Crna

Doctor of Nursing Practice Projects

Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain.

Methods: The authors developed eligibility criteria for inclusion of articles and performed ...


Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr 2021 University of Missouri-St. Louis

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample of ...


Nurse-Delivered Shoe-Lacing Intervention: Effect On Comfort And Toe Pressures For Active Community-Dwelling Adults (Age 65+), Mary C. Clayton-Jones 2021 University of Massachusetts Amherst

Nurse-Delivered Shoe-Lacing Intervention: Effect On Comfort And Toe Pressures For Active Community-Dwelling Adults (Age 65+), Mary C. Clayton-Jones

Doctoral Dissertations

Significance: Problems with shoe fit are endemic, affect gait and balance and lead to falls. Falls are physically, emotionally, and economically costly. Low-cost, easily implemented interventions, that reduce pain and improve balance meet the “triple aim” of the Institute for Healthcare Improvement.

Purpose: Evaluate the impact on community-dwelling adults (65+) of two nursing interventions involving foot repositioning and shoe relacing.

Outcome measures: Toe pressures, experiences of pain and comfort.

Method: Repeated-measures, mixed-methods lab-based study. Walk #1 Control. Intervention #1, participant’s heel secured to back of shoe, the participant’s chosen lacing pattern snugged. Intervention #2, heel secured to back ...


「認知障礙症照顧者的需要及社會支援」研究 = Study On The Needs And Social Support Of Caregivers For People With Dementia, Mun Yu, Vera TANG, Chak Kwan, Dickon CHAN, Mei Ling LEE, Chak Lung LAM 2021 Lingnan University

「認知障礙症照顧者的需要及社會支援」研究 = Study On The Needs And Social Support Of Caregivers For People With Dementia, Mun Yu, Vera Tang, Chak Kwan, Dickon Chan, Mei Ling Lee, Chak Lung Lam

APIAS Research Report 研究報告

香港認知障礙症(dementia)患者個案持續上升,他們大都在接受家庭成員的照顧。本研究旨在了解照顧者面對的困難及在福利服務制度以外獲得甚麼非正規支援(informal support)以協助他們應付有增無減的照顧工作。研究團隊以半結構性訪談(semi-structured interview)的方法,與18位非正規照顧者(informal caregivers)及20位服務提供者(service providers)進行深入訪談。研究發現照顧者面對的困難包括欠缺私人空間、因健康狀況差而難以獨自應付照顧工作、照顧開支帶來沉重的經濟負擔,以及照顧工作造成的心理及人際關係問題。研究結果顯示因應照顧者身處的人際網絡,他們獲得分別來自兄弟姊妹、子女、朋友、鄰里、教友、教會同工或大廈保安員提供不同的非正規支援。他們除了為照顧者提供情感支持外,也分擔了部份的照顧工作,讓照顧者得以「喘息」。部份人士更協助照顧者處理家居問題及應對突發事件,是獨力或年長的照顧者之重要支援者。研究亦發現,除了部份家人能夠分擔患者的起居生活照顧外,其他非正規支援的提供者只能提供周邊工作的支援、情感支持、以及危機應對。主要的起居生活照顧工作,仍由主要的照顧者承擔。研究團隊建議擴大照顧者津貼計劃的對象及提高津貼金額,並加強支援照顧者的服務,包括推行「長者社區保姆」及「家庭托顧」服務、加強宣傳及改善照顧者身心健康的支援服務及、為患者家人提供家庭輔導。此外,研究團隊建議提供培訓給支援人士及團體以增加對認知障礙症患者及其照顧者需要的知識及技巧,透過這些正規服務的承托,寶貴的社會資本可繼續累積及發揮社區互助精神。


Life Course In Hearts: Enhancing Telehealth Resilience And Mindfulness Intervention In Older Adults Experiencing Abuse And Trauma-A Conceptualization, Mary Dioise Ramos 2021 Kennesaw State University

Life Course In Hearts: Enhancing Telehealth Resilience And Mindfulness Intervention In Older Adults Experiencing Abuse And Trauma-A Conceptualization, Mary Dioise Ramos

Faculty Publications

Advances in research and evidence-based practice improve the prevention and treatment of diseases, but the marginalized seems to be left behind. The purpose of this paper is to conceptualize a telehealth intervention aimed to improve the health and health span of older adults. More particularly, we articulate the conceptual framework underlying our intervention, Telehealth Resilience Mindfulness (TRM) Intervention, which will be delivered via text messaging (for those who have phones or smartphones), video conferencing such as Zoom (for those with internet connectivity), or in-person (when it is practical) to older adults to enhance HEARTS (health, experiences of abuse and trauma ...


"It's The Way You Sing It": Translating Music Therapy For Isolated Older Adults Affected By Covid-19 To The Television Screen, Eunice Wong 2021 Lesley University

"It's The Way You Sing It": Translating Music Therapy For Isolated Older Adults Affected By Covid-19 To The Television Screen, Eunice Wong

Expressive Therapies Capstone Theses

The current Covid-19 pandemic has increased the likelihood of loneliness and social isolation among older adults due to the restrictions on movement and visitations in care facilities. Loneliness and social isolation have consistently been identified as risk factors for poor mental and physical health in older people. Meanwhile, a growing number of older adults are utilizing technological resources to enhance their interpersonal relationships and overall quality of life. In the winter of 2020/2021, an innovative music therapy-informed television program was designed and produced for isolated older adults in need of mental and emotional support. This project, produced jointly by ...


Standardized Education On Physician Orders For Life Sustaining Treatment (Polst) Conversations, Venessa Oteniya 2021 University of San Diego

Standardized Education On Physician Orders For Life Sustaining Treatment (Polst) Conversations, Venessa Oteniya

Doctor of Nursing Practice Final Manuscripts

According to research literature, 15% of Medicare beneficiaries spend more than 7 days in the intensive care unit before they die. These Medicare beneficiaries receive aggressive, life-prolonging medical treatments that might not be in agreement with their wishes. Approximately 13% of SNF residents have improperly completed POLST forms that can result in intensive treatments that patients did not want. One barrier to the lack of POLST completion in SNFs is staff difficulty with understanding and explaining the form, a result of inadequate education.

In August 2020, the San Diego Coalition for Compassionate Care formed an education program to provide virtual ...


How Various Exercise Modalities Impact Quality Of Life, Physical Activity, And Program Adherence In Patients With Copd, Hannah Brookshire, Sarah Barnes, Natalie Cagle, Nancy Starnes, Elia Schaefer 2021 Kennesaw State University

How Various Exercise Modalities Impact Quality Of Life, Physical Activity, And Program Adherence In Patients With Copd, Hannah Brookshire, Sarah Barnes, Natalie Cagle, Nancy Starnes, Elia Schaefer

Symposium of Student Scholars

How Various Exercise Modalities Impact Quality of Life, Physical Activity, and Program Adherence in Patients with COPD

Background: Chronic obstructive pulmonary disease (COPD) is a group of diseases that causes breathing difficulty due to airway obstruction. Adherence to physical activity recommendations for those with COPD is often problematic and leads to worsening dyspnea and quality of life. Due to the prevalence of COPD, it is important to understand how different exercise modalities impact quality of life and adherence to physical activity.

Objective: The purpose of this systematic review was to determine if patients with COPD have a better quality of ...


The Effect Of Alternative And Personalized Therapy In The Treatment Of Depression In Older Adults Living In Long-Term Care Facilities, Amber Davis, Olivia Gilbert, Kayla Kelley, Mitch Elliot, Deanna Hebert 2021 Kennesaw State University

The Effect Of Alternative And Personalized Therapy In The Treatment Of Depression In Older Adults Living In Long-Term Care Facilities, Amber Davis, Olivia Gilbert, Kayla Kelley, Mitch Elliot, Deanna Hebert

Symposium of Student Scholars

Abstract

Title: The effect of alternative and personalized therapy in the treatment of depression in older adults living in long-term care facilities

Background: In older adults, depression can lead to changes in memory, physical pain, fatigue, sleep disturbances, and even suicidal ideations. Due to the shortage of healthcare workers in long-term care facilities, older adults have a difficult time receiving treatment. Therefore, alternative treatment methods and personalized therapy are becoming more important when treating patients in long-term care facilities.

Objectives: This systematic review set out to determine whether personalized therapy and alternative treatment methods may significantly reduce the symptoms of ...


Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers 2021 Seton Hall University

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual ...


Understanding The Meaning Of Well-Being In Older Adults: A Mini-Phenomenology, Francesca Ezeokonkwo, Rick Zoucha, Kathleen Sekula 2021 Duquesne University

Understanding The Meaning Of Well-Being In Older Adults: A Mini-Phenomenology, Francesca Ezeokonkwo, Rick Zoucha, Kathleen Sekula

Graduate Student Research Symposium

Title: Understanding the Meaning of Well-being in Older Adults: A Mini-phenomenology

Background and Objective: Loneliness is a major concern in older adults, the fastest-growing segment of society, due to age-related losses. As the aging population continues to rise, so will their vulnerability to loneliness. Previous studies suggest that promoting well-being is a potential strategy to prevent or reduce loneliness. The aim of this mini-study was to explore the meaning of well-being in older adults.

Methods: A qualitative descriptive mini-phenomenological research design was utilized for this study. Four older adults ages 72 to 78 (mean age of 74.3) participated in ...


A Quality Improvement Initiative To Decrease Fall Risk In Community Dwelling Elderly, Michele Shearer 2021 Duquesne University

A Quality Improvement Initiative To Decrease Fall Risk In Community Dwelling Elderly, Michele Shearer

Doctor of Nursing Practice (DNP) Manuscripts

Falls are a health concern for the elderly and are the leading cause of fatal and non-fatal fall injuries in this population (Burns & Lee, 2016). Meijers, et al. (2012) found that one in three community dwelling elderly will experience at least one fall per year with an even higher rate in adults greater than 80 years old. Numbers of falls are expected to increase as this population ages. This increase in falls and their consequences will produce an enormous economic burden on the United States health care system (Burns & Lee, 2016). The purpose of this program was to engage community dwelling elderly in a fall risk reduction program to decrease their fall risk. This program was implemented in an independent living facility. Eighteen residents participated in the “Steady on Your Feet” program. Using the Stop Elderly Accidents Death and Injury (STEADI) algorithm (Centers for Disease Control (CDC), 2019), “Stay Independent” (CDC, 2017) fall risk assessment tool, and the development of an individualized action plan, residents were asked to implement their action plan interventions by the program’s completion. The sample was not normally distributed; therefore, the Wilcoxon W statistical test was performed. All measurement outcomes were achieved. Analysis of the fall risk reduction program data pointed toward decreasing fall risk and the data reflected that the intervention was related to the results. This provides confirmation that an evidenced-based multifactorial fall risk reduction program with an individualized action plan supports a decrease in fall risk in community dwelling elderly.


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