Digital Commons Network^™

Addressing Social Determinants Of Health In Medication-Assisted Treatment Programs, Audrey Hunter

The Eleanor Mann School of Nursing Capstone Projects

Introduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions …

"Salir Adelante": Improving The Quality Of School Entrance Physicals For Immigrant Minors, Jennifer Sternberg, Elizabeth Morse

DNP Scholarly Projects

The purpose of this QI project was to improve the delivery of school physicals in the setting of an -friendly non-profit safety-net clinic by creating a patient-centered clinical pathway to improve focused screening and referrals for newly arrived migrant children and their families by routinely assessing and addressing behavioral health care (BH) and social determinants of health needs (SDoH).

Using QI methodology and Donabedian’s Structure Process Outcomes framework, the project team implemented a clinical pathway that included an immigration-focused history of present illness, systematic behavioral health (BH), and social determinants of health (SDoH) screenings embedded within an electronic health record …

A Global Perspective On Intersecting Social And Systemic Barriers Experienced By Grandparent-Caregivers: A Qualitative Systematic Review, Schola N. Matovu, Deborah M. Whitley, Heather M. Young

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Globally, many grandparents are taking on the caregiving role for their grandchildren without public or government interjection of support, particularly financial assistance for basic needs such as housing, health care and living expenses. This paper aimed to broaden understanding of social and systemic barriers experienced by grandparent-caregivers across the globe. Of the 2,828 relevant grandparent caregiving studies identified in the literature, 34 representing eight countries met our inclusion criteria to answer the research question and the focus of this paper: What are the social and systemic barriers experienced by grandparent-caregivers across the globe? We utilized Noblit’s and Hare’s (1988) meta-ethnography …

Historical Trauma And The Support Of Wabanaki Elders Caring For Indigenous Children, Susan Plissey

Non-Thesis Student Work

The Indigenous Wabanaki population in Maine have experienced centuries of trauma. In the United States removal of children from their parents and tribal communities in an effort of planned cultural genocide has continued for decades. In 2016, Maine and federal ICWA laws sought to protect Indigenous children from being separated from their families and communities. When Indigenous children require removal from their biological parents, the priority is placement within their Indigenous community, and care often falls onto elders. However, many Indigenous elders experience significant challenges when children are placed in their care as a result of the consequences of historical …

Improvement Of Hypertension Self-Care Management In African American Older Adults With Uncontrolled Hypertension Through Shared Decision-Making, Sigga Jobe, Deborah Behan

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Hypertension affects nearly half of the population in the U.S., with the prevalence disproportionately higher in African Americans (Centers for Disease Control and Prevention [CDC], 2023). Complications of uncontrolled hypertension, such as cardiovascular disorders and stroke, increase with age, prompting the importance of controlling high blood pressure in older adults. African American older adults are at higher risk of developing uncontrolled hypertension and related complications due to the lack of healthcare access, financial constraints leading to the inability to access healthier food choices, exercise capabilities, weight control, adherence to recommended medications, and knowledge deficit.

Methods: This project focused on …

Clinical Practice Guideline For The Management Of Depression In Primary Care, Estrella Catherine Villarreal

Doctor of Nursing Practice (DNP) Scholarly Projects

Abstract

Background: The prevalence of depression poses a significant challenge in primary care, emphasizing the urgent need to address this issue during patient visits. Primary care providers are at the forefront of managing depression, yet they encounter difficulties in screening, diagnosing, assessing, and treating this complex condition. Clinical guidelines serve as valuable tools for primary care providers and practices, offering support in identifying and addressing depression effectively. An evidence-based approach to treating depression in primary care, with a focus on collaborative interventions with behavioral health to enhance depression management for American Indian/Alaskan Native (AI/AN) communities.

Methods: The descriptive analysis was …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Dental Caries Screening For Food Insecure Children, John Joseph Kane

Doctor of Nursing Practice

Background. Dental caries is the most common childhood disease, disproportionally impacting minorities, and socio-economically disadvantaged children. Food insecurity impacts 23.6% of children in Texas; the majority being African American and Hispanic. Food insecurity screening rates are abysmal. Dental caries and food insecurity are significantly correlated and likely syndemic. Purpose. Implement oral examination and the “Hunger Vital Sign” screening tool in detecting dental caries and food insecurity at an urban pediatric urgent care center. Evidence. Food insecure children experience adverse health outcomes, impaired long-term health outcomes, developmental and cognitive delays, psychosocial delays, and oral health deficiencies including caries and malabsorption of …

Preserving The Force: A Quality Improvement Project To Reduce The Risk Of Opioid Use Disorder In The Military, Lecreshia S. Shields

Doctor of Nursing Practice

Military service members incur combat and noncombat related injuries which may lead to acute or chronic pain. Treatment of these conditions with opioids may place them at risk for opioid use disorder (OUD). Opioid related overdoses among the military community increased by 50% from 2010 to 2019. The Sole Provider Program (SPP) is recommended to address the risks of OUD among Veterans receiving care at military installations. The goal of this evidence-based project was to ensure that all persons who receive opioid prescriptions at a military facility were evaluated for inclusion into a SPP and prescribed naloxone. Objectives included: 1) …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Remote Blood Pressure Monitoring Program: Program Evaluation., Brittany Walker

Doctor of Nursing Practice Papers

The prevalence of hypertension is high at the local, state, and national levels. In 2021, 39% of Kentucky adults were diagnosed with high blood pressure (CDC, 2021). Primary care providers are utilizing remote blood pressure monitoring (RBPM) to assist with the management of hypertension. Literature reveals that remote BP monitoring alone, without the use of other interventions such as counseling and education, may not effectively control blood pressure (Uhlig K, et al, 2013). This project evaluated the RBPM program utilized at a federally qualified health center in Louisville, KY. Patient engagement within the RBPM program includes BP measurement, communication with …

Improving Postoperative Breast Augmentation Patient Education Delivery., Madison Callery

Doctor of Nursing Practice Papers

Background: Effective patient education promotes successful postoperative outcomes. Nurses in an outpatient surgery center lacked consistent patient education practices and materials.

Purpose: The purpose of the project was to implement an evidence-based multimodal educational strategy for patients who undergo breast implant surgeries.

Methods: At an outpatient plastic surgery center, pre- and post-intervention phone calls were tracked; post-intervention education, documentation, and patient satisfaction data were recorded. Nurses were educated on the new materials, delivery procedures, and electronic health record (EHR) documentation. All patients undergoing breast implant surgery received multimodal education at each postoperative appointment. Outcomes included (1) the number of patient …

Use Of Anticipatory Guidelines In Late Infants And Toddlers 12 To 24 Months In Primary Care, Claire E. Eller

Doctor of Nursing Practice Projects

Anticipatory guidance is a well-known and utilized method that has been implemented in a majority of pediatric primary care offices. As the need for efficiency grows and increasing patient volumes climb, there is a growing need for strategies to provide this information effectively and efficiently. Prior evidence can be utilized to identify the most critical knowledge caregivers and parents will require. Our findings indicate safety, communication, nutrition, social development, and behavior as cornerstone topics for anticipatory guidance. To increase the volume of education provided to parents and caregivers, alternate methods beyond verbal discussion could be used. After gathering scientific literature …

Examining The Effectiveness Of Physical Activity Patient Education In Improving Hba1c, Nadieh Samiaei

Doctoral Projects

Regular physical activity plays an important role in maintaining good health and managing and reducing HbA1c among type 2 diabetes patients. The goal of this study is to examine the effectiveness of physical activity in reducing the HbA1c among the type 2 diabetes patients of a local community health center in San Leandro, California. A quasi-experimental, pretest-posttest single site design project was conducted among a sample of 24 patients who had type 2 diabetes. The participants were selected to attend regular patient education classes promoting physical activity, diet, and lifestyle change as a measure of controlling diabetes. A paired sample …

Clinical Decision Support System For Standardization Of Disease-Specific Education, Paul Nava

Student Scholarly Projects

The evidence-based, contextually relevant, disease-specific health education materials aim to provide strategies for improvement in health literacy, disease management comprehension, and medication adherence. The health education materials address difficulties many adults experience in understanding health information. The health education system must remain a contextually relevant, patient-specific reference for standardizing disease-specific education according to the patient's mental capability (Fereidouni et al., 2019). Nurse-driven education material system addresses equity, diversity, and inclusion, tailored for all literacy degrees.

Clinical decision-making is a complicated process influenced by a highly variable process that exponentially increases error rates, selection, or exclusion, unintended or not, by presenting …

Child Abuse From A Nursing Perspective: Assessment And Implications, Ashtyn Spring

Senior Honors Theses

Nurses experience the relationship dynamics between pediatric patients and their families firsthand. Being informed by the goals of holistic care, nurses should be assessing for unhealthy dynamics among pediatric patients and their caregivers so they can respond appropriately when a potential for abuse is present. Healthcare workers have the duty to provide safety and healing to their patients. Through the unique contact nurses have with patients, their training for accurate assessment skills, and their responsibility as healthcare workers, nurses are placed with the opportunity to help children out of abusive situations. Prompt identification of the potential for abuse can prevent …

Home Visitation To Prevent And Reduce Postpartum Depression, Anna Bauer, Madison Polley, Laura Boesken Dnp, Msn, Rn

Posters-at-the-Capitol

Postpartum depression (PPD) occurs in 13-19% of women worldwide, and is a stigmatized medical condition affecting maternal and infantile long term outcomes. The purpose of this evidence-based practice project was to determine if women at high risk for PPD are affected by home visitation programs from discharge up to three years postpartum. CINHAL Ultimate, Google Scholar, and Medline databases were used. Current evidence supports the use of home-visitation programs for postpartum women to decrease the prevalence and the symptoms of PPD by allowing nurses access into homes to provide early intervention for PPD. In addition to providing care for prevention …

A Roadmap To Safer Hyaluronic Acid Injections, Mandi Lonergan

Master's Projects

Non surgical aesthetic treatments have become increasingly more popular in the United States (2020 Plastic Surgery Statistics Report 2021). Hyaluronic acid (HA) fillers are the second most popular non-surgical aesthetic treatment behind Botulinum toxin injections (The Aesthetic Society, 2021). The increased use of these fillers has led to increased rates of complications With the release of new long lasting fillers in 2014, providers began to see an increase in delayed onset nodules (DON). A DON is considered in the aesthetic field to be a nodule that occurs 30 days to years after filler injection (Convery et al., 2021). A …

Estimulación Cognitiva Y De La Actividad Fisica En La Persona Mayor - Una Experiencia Desde La Práctica, Maria Victoria Rojas Martinez, Adriana Hernandez Bustos, Blanca Gregoria Melo Melo

Ciencias de la Salud

El trabajar con la persona mayor que presenta limitación física o mental, lleva a la aparición de grandes retos para el estudiante y futuro profesional de enfermería, más aún cuando el campo de acción es el hogar, porque el cuidado será compartido entre la persona, el cuidador o grupo familiar, dentro de su propio espacio, por lo tanto, se convierte en una intervención individual con el uso de recursos propios y generalmente con la participación directa del cuidador o acompañante. Para el cuidado en el hogar el autocuidado es base fundamental para el cumplimiento de metas en la salud de …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

The Haunted House Experience: Developing A Home Health Assessment Training Utilizing An Interprofessional, Interinstitutional Virtual Simulation, Angel Holland Dpt, Edd, Pamela Degravelles Phd, Rn, Debbie Knight Pharmd, Karen Dickinson Md, Kathryn Neill Pharmd, Duston Morris Phd, Wendy Ward Phd

College of Pharmacy Faculty Research ​and Publications

To meet the interprofessional education needs of students during the COVID-19 pandemic, universities transitioned to virtual options. For many universities, this transition was challenging and time-consuming. The Arkansas Interprofessional Education Consortium (ARIPEC) combined resources to create a novel learning experience for students with a focus on the skill of home assessment. An interinstitutional, interprofessional faculty project team was developed to create a learning experience, with each institution responsible for a portion of the virtual simulation development. This paper describes the process for creation and implementation of an interprofessional, interinstitutional virtual learning experience to support the growth of healthcare students across …

Improving Patient Satisfaction And Preventative Health Service Utilization For Limited English Proficiency Immigrants At Pearl Medical Centr, Chioma Holland

Graduate Theses, Dissertations, and Capstones

Background: Despite research efforts to address health disparities within immigrant communities, immigrant health continues to lack the attention from healthcare stakeholders it needs. Many immigrants already face dire health threats like extreme poverty, political unrest, and mental health concerns in their countries of origin, making them even more vulnerable to poor physical, mental, and social health outcomes upon arrival to the United States (U.S.). The purpose of this project was to improve patient satisfaction and increase immigrant use of preventative care by utilizing appropriate interpreter services. Method: The Quality improvement (QI) project involved surveying limited English proficiency (LEP) immigrants older …

Formalized Diabetes Education In A Safety-Net Clinic, Haley N. Wanic

Doctoral Dissertations

Uncontrolled diabetes mellitus in a Hispanic population can be helped through a quality improvement project focused on progressive verbal and written diabetes self-management education (DSME) Purpose of this article is to review the background, an organizational assessment, a literature review, results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included four patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, minimal workflow adjustments for providers, completed microalbumins, and written education given to patients. In conclusion, the quality improvement project showed positive trends in outcome measures over …

The Use Of Distraction Techniques During Painful Procedures In Pediatric Patients, Bethany Hayward

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Increasing Healthcare Providers' Intent To Utilize Alternative And Complementary Pain Management With Their Patients, Holli Boyles

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project is to increase the willingness of healthcare providers to introduce alternative and complementary pain management to their patients. Two patient video tools were constructed and offered to healthcare providers to evaluate and potentially utilize the final products in their practice. One tool introduced music therapy, the other mindful meditation, along with resources for patients to investigate and learn from on their own. A total of seven healthcare providers responded to the project with a commitment to potentially utilize the final video and provided their feedback on the video tools. No changes were made to …

Screening For Human Trafficking: Best Practice Guidelines And Recommendations For Health Care Providers, Bernadette Portillo

Student Scholarly Projects

Human trafficking (HT) is a federal and international crime and is regarded as one of the most pressing human rights issues. Adult and minor victims are trafficked by force (rape, beatings, confinement), fraud, and coercion resulting in profound physical and psychological injuries (Chisolm-Straker et al., 2019, p. 72; Department of Homeland Security, 2020; Vera Institute of Justice, 2014, p. 6). Most clinicians fail to recognize HT victims (Egyud et al., 2017; Leslie, 2018; Mason, 2018; McDow & Dols, 2020; Mostajabian et al., 2019; Patient Safety Monitor Journal, 2017; Stevens & Dinkle, 2020). This policy brief’s purpose is to provide health …

Expansion Of A Comprehensive And Standardized Well-Woman Exam Program In A University-Based Clinic, Gabriela Trevino

Doctor of Nursing Practice

Background. Well-woman exams are an opportunity for women to receive focused screening, counseling, education, and care from a healthcare provider. Studies have found that 68% of women received well-woman exams between 2010 and 2016. During COVID-19 well-woman exams decreased by 80% in the United States. Standardized, comprehensive exams facilitate identification of the need for lifesaving care. Objective(s). The purpose of this quality improvement project was to expand a comprehensive and standardized well-woman exam program in a university-based clinic. Methods. Processes were implemented to promote well-woman exams, patient comfort measures, and completion of an evidence-based standardized comprehensive exam …

Pediatric Health Literacy, Morgan E. Sapper, Grace G. Lloyd

Senior Honors Projects, 2020-current

Abstract

Background: Unless you are a healthcare provider or licensed healthcare professional, understanding the United States healthcare system and its accompanying medical jargon can be confusing and overwhelming to try to navigate. Even more difficult is comprehending what resources are available to specific populations and how to gain the most benefit from these offered resources. Limited health literacy skills have been identified as the largest barrier in identifying an individual’s health outcomes. Health affects every stage of life. The purpose of this paper is to analyze what health literacy implementations look like as well as the age and developmental stage …

Eastern European Orthodox Christian Immigrant Women: A Pilot Study And Needs Assessment, Kimberly A. Babich-Speck

Doctor of Nursing Practice Scholarly Projects

The healthcare perceptions of the Eastern European Orthodox Christian immigrant women (EEOCIW) to the United States (U.S.) are under-represented in the literature. Although they appear similar to Americans, their cultural and religious traditions are outside the mainstream American culture. This pilot study and health needs assessment examines the women’s healthcare perceptions of 14 EEOCIW and identifies similarities and differences with 25 U.S. born Orthodox Christian women (USOCW). Between September and November 2020, interviews were conducted with Orthodox Christian immigrant women from Eastern Europe and Orthodox Christian women born in the U.S. Questions covered the perceptions of women’s healthcare, factors influencing …