Digital Commons Network^™

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

Promoting Empowerment And Innovation: A Technology Initiative, Theresa Marcotte

Doctor of Nursing Practice Projects

Improving empowerment through a supportive organizational culture can lead to innovation in practice and promote positive outcomes. Supporting employee empowerment, through a supportive organizational culture and environment, provides opportunities to innovate and creatively meet desired outcomes. Using these concepts, an Associate Degree Nursing Program empowered faculty to address a strategic planning opportunity to improve practice. The innovation, a Technology Initiative, provides opportunities for evidence-based testing practices, leading to improved, first-time pass rates on the National Council Licensure Exam (NCLEX). Technology use in the classroom can improve dissemination of nursing knowledge and retention strategies and therefore improve program retention. The utilization …

Improving Nurse-Patient Communication Using The Teach-Back Method, Sheila Revis Smallwood

Nursing Theses and Capstone Projects

Effective nursing communication considers health literacy, the person’s ability to understand and make health decisions based on the information given. Health professionals often overestimate the health literacy of patients, thereby affecting patient outcomes. In a hospital environment, patients rate the ability of the nurse to explain things in a way patients understand by completing the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) after discharge. The HCAHPS results are converted to a score which is used in a formula to determine hospital reimbursement; the lower the score, the lower the reimbursement. The purpose of this project was to improve …

Stress Management And The Novice Nurse, Patrice Lawrency

Nursing Theses and Capstone Projects

The stress of the novice nurse impacts the quality of patient care, emotional, and physical wellbeing of the novice nurse and hospital costs. The aging of the Baby Boomer generation is impacting the nursing profession. These factors should be addressed to promote the retention of novice nurses in the profession. Research has shown that the mitigation of stress in the novice nurse can have a positive impact on the nursing shortage. An inundation of literature exists on the evolution process from the academic to the clinical setting, but few studies identified resources to provide support to the novice nurse. Strategies …

An Exploratory Study Of Military Management Practices, Physical Activity, And The Prevalence Of Shin Splints In Rotc Cadets, Jakayla Campbell

Electronic Theses and Dissertations

Medial Tibial Stress Syndrome (MTSS, Shin splints) is very common in military personnel accounting for up to 35% of incidences, which is almost twice the incidence seen in the average active individual. Each year there is in increase number of injuries in Army recruits. Though Army Reserve Officer Training Corps (ROTC) programs are known for commissioning approximately 60% of 2^nd Lieutenants and 40% of generals on active Army duty, no research has been done examining MTSS occurrences in relation to military management practices. Therefore, the purpose of this study is to explore the relationship between military management practices and …

Addressing Culturally Specific Mental Health Care Needs In The Us: The Asian American Population, Moira Lewerk

Honors Scholar Theses

As the fastest growing minority group in the US, Asian American health needs and disparities are becoming critical areas to address, particularly in the mental health domain (Leong, Park, & Kalibatseva, 2013). Currently, the culturally specific needs of this group are not being adequately met. This includes appropriately serving low English proficiency (LEP) patients who experience different healthcare quality and outcomes than other individuals. Additionally, recognizing culturally unique perspectives, emotional burdens, and immigrant experiences is crucial in developing culturally tailored mental health interventions and shifting mental health toward individualized care. This work aims to examine current policies surrounding culturally competent …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

Applying Transition Theory To Preparation Of Experienced Nurses For New Clinical Roles, Ann M. Gill

Nursing Capstones

No abstract provided.

A Model For Rigorously Applying The Exploration, Preparation, Implementation, Sustainment (Epis) Framework In The Design And Measurement Of A Large Scale Collaborative Multi-Site Study, Jennifer E. Becan, John P. Bartkowski, Danica K. Knight, Tisha R. A. Wiley, Ralph Diclemente, Lori Ducharme, Wayne N. Welsh, Diana Bowser, Kathryn Mccollister, Matthew Hiller, Anne C. Spaulding, Patrick M. Flynn, Andrea Swartzendruber, Megan F. Dickson, Jacqueline Horan Fisher, Gregory A. Aarons

Center on Drug and Alcohol Research Faculty Publications

Background

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.

Methods

The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the …

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 …

An Education Intervention To Increase Rounding And Toileting And Reduce Falls In A Hospital Acute Care Of The Elderly (Ace) Unit, Amelia Grayson

Doctoral Projects

Introduction: Falls are the most common accident reported in acute care hospitals and patients who are 65 and older are the most vulnerable. Falls can lead to physical and emotional injury, reduced mobility and functioning, increased length of hospital stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) has eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. Research on fall prevention in adult acute care found multifactorial interventions that address multiple risk factors for falls are the most successful at prevention. This …

Abstracts From The 24th Annual Health Care Systems Research Network Conference, April 11–13, 2018, Minneapolis, Minnesota

Journal of Patient-Centered Research and Reviews

Founded in 1994, the Health Care Systems Research Network (HCSRN) is a consortium of 18 research centers that are housed in community-based health systems. The organization's annual conference serves as a venue for research teams to disseminate scientific findings, stimulate new collaborations, and share insights about conducting research in real-world care-delivery settings. Abstracts accepted for presentation at HCSRN 2018 are published within this supplement of the Journal of Patient-Centered Research and Reviews.

Increasing Cervical Cancer Screening In Hiv Positive Women By Introduction Of A Provider Prompted Algorithm Tool: A Quality Improvement Project, Aubri B. Hickman

Doctoral Projects

Continuous quality improvement projects and appropriate documentation are an essential component to continue to receive Ryan White grant funding. Compliance with mandated aspects of quality improvement is an extremely important concept-specifically for a clinic setting that cares for the largest HIV positive population in the state of Mississippi. The Health Resources and Services Administration (HRSA) provides directives mandating that quality improvement projects should be applicable to areas of need and provide for outcomes that ensure quality care for HIV positive individuals (2016).

Initially, this clinic’s rate of compliance with the HRSA Cervical Cancer Screening Performance Measure was subpar to the …

Proposal Defense: Improving Patient Portal Adoption In Primary Care, Melissa Wagner

Doctoral Projects

Introduction: Stage three of Meaningful Use (MU) is currently underway and is focused on promoting patient portal use. If the electronic medical record patient portal use is less than 25%, primary care providers face reductions in value-based reimbursements. National adoption rates from portal use remain under 27% with some providers averaging well below the needed 25%. The following practice question is proposed, “In a low-income urban adult clinic, how does an interactive electronic education intervention compared to no education intervention affect patient portal adoption rates?”

Objectives: The purpose of this project is to identify whether an electronic patient educational video …

Structure, Process, And Outcomes: The Foundation For Continuous Quality Improvement In Primary Care, Mark A. Contreras

Doctoral Projects

Healthcare within the United States is notoriously fragmented and inefficient. Contemporary innovations for policy, reimbursement, and care delivery are consistently directed towards the promotion of value based care (Bates, 2010). These initiatives routinely coalesce around the promising potential of a robust primary care system. The Patient-Centered Medical Home (PCMH) model is increasingly becoming the standard of quality care and use of this model by healthcare providers is poised to bring about a paradigm shift towards value-based care (Henderson, Princell & Martin, 2012).

This scholarly project incorporated an evidence based approach to establishing continuous quality improvement in a primary care office …

Improving The Patient Handoff From Or To Picu In Children Who Have Undergone Cardiac Surgery Using A Standardized Handoff Tool, Amanda Taylor

Doctoral Projects

Inpatient hospitalizations for children are often costly. Children often transition from one setting to the next while hospitalized, therefore their provision of care is also transferred from one care team to the next. This transition presents a vital time for the child, that may be associated with adverse events and medical error. Adverse events can lead to poor outcomes for the child. Despite efforts to improve patient handoffs, communication failures are still abundant in healthcare. Research indicates that the use of a standardized handoff tool from one setting to the next is an effective method for improving the patient’s transition. …

Hutchinson-Gilford Progeria Syndrome Vascular Pathology: A Focused Review, Danielle M. Eschedor

Senior Honors Theses

Hutchinson-Gilford Progeria is an accelerated aging disorder caused by a de novo point mutation in the LMNA gene which codes for an intermediate filament of the nuclear lamina called lamin A. The point mutation at c.1824C>T causes a 50-amino-acid deletion that removes the binding site for Zmpste24, a metalloprotease responsible for defarnesylating prelamin A and producing mature lamin A. Without the ability to be defarnesylated, the mutated protein, called progerin, is more lipophilic and has a myriad of cytotoxic effects. As cardiovascular disease is the most common cause of death in HGPS patients, it is important for both healthcare …

Dinamika Keterlibatan Stakeholders Pada Perencanaan Strategi Pemasaran Sosial Di Smile Train Indonesia

Jurnal Ilmu Kesejahteraan Sosial

This research discusses the dynamics, obstacles, and challenges that occur in the stage of social marketing strategy planning process undertaken by the management of Smile Train Indonesia with the organizational stakeholders as well as the efforts made by the organization management to overcome those. This research is a qualitative research with descriptive design. The results conclude that there is rarely conflicts between organizations and stakeholders in the organization’s social marketing planning process because of good conflict management and collaboration. But acknowledged by the stakeholders, there are several obstacles and challenges that are faced during the planning process. This research suggests …

Use Of Quality Improvement Strategies Among Small To Medium-Size Us Primary Care Practices, Bijal A. Balasubramanian, Miguel Marino, Deborah J. Cohen, Rikki L. Ward, Alex Preston, Rachel Springer, Stephan R. Lindner, Samuel Edwards, John Mcconnell, Benjamin F. Crabtree, William L. Miller, Kurt C. Stange, Leif I. Solberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Improving primary care quality is a national priority, but little is known about the extent to which small to medium-size practices use quality improvement (QI) strategies to improve care. We examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US states to improve quality of care for heart health and assessed factors associated with those variations.

Chbe 9230 - Community-Based Public Health Program Planning And Evaluation, Andrew Hansen

College of Public Health: Faculty Syllabi (2014-2021)

This course introduces students to the theory and application of community-based program planning and evaluation. Concepts in community assessment, organization, and mobilization for the purposes of addressing identified public health concerns will serve as the foundation for the public health planning process. Appropriate techniques of partnership building, planning strategies, data collection, data analysis, and evidence-based decision-making will also be introduced.

Cohe 6130 - A:Research Methods In Health Science, Stacy W. Smallwood

College of Public Health: Faculty Syllabi (2014-2021)

Introduces students to research methods in health science. Development and presentation of practicum and research proposal will be the focus of the course. Additional emphasis will be placed on Community- Based Participatory Research for Health.

Cohe 7237 - Rural Community Health Issues, Ashley Walker

College of Public Health: Faculty Syllabi (2014-2021)

A study of social, economic, political, and cultural influences that impact the health of individuals and families in rural communities. Designed for health professionals, this course focuses on improving health status and developing culturally appropriate and effective interventions and services in rural settings.

Phld 9133 - Health Organization Communications, Bettye A. Apenteng

College of Public Health: Faculty Syllabi (2014-2021)

This course examines the structure and functioning of the communication process in health organizations. Health organizations including public health, hospitals, long-term care, ambulatory care, managed care, private and public insurance, integrated delivery systems, and other health care organization providers will be discussed within the context of the communication environment that includes communication models, climate, culture, and interpersonal conflict. The course also examines key communication challenges and analyses related to decision making within the principles of management processes and how they are applied to public health organizations amid a dynamic/changing environment.

Subclinical Atherosclerosis Vascular Evaluation (Save): Nurse Practitioner Barriers To And Facilitators Of Research Utilization Regarding Screening For Subclinical Atherosclerosis, Gina Pritchard

DNP Projects

The project identified factors affecting implementation of evidence-based non-invasive screening tests to identify early stage cardiovascular disease (CVD). The use of coronary artery calcium scores and carotid intima media thickness testing improves accuracy of risk stratification over risk factor scoring systems alone. The purpose of this project was to identify NP’s perceived barriers to and facilitators of utilization of evidence-based non-invasive CVD screening tests and to make recommendations for improvements in implementation. The SAVE project consisted of a cross-sectional survey of 64 nurse practitioners, recruited using a multi-pronged strategy, using Funk’s barriers instrument plus two additional qualitative questions regarding intent …

Improving Neonatal Resuscitation Readiness, Benay Johnson

Seton Hall University DNP Final Projects

According to the AHA and the AAP, approximately 10% of newborns require some assistance to begin breathing at birth; less than 1% need extensive resuscitative measures to survive (2015). There is an abundance of evidence-based literature on the need for neonatal resuscitation readiness. However much of this literature is targeted toward teamwork efforts during the act of resuscitation. This DNP scholarly project is to take a step back to improve the actual set-up component required for neonatal resuscitation. There can be instances in which equipment is not properly set-up or the set-up is not appropriate for the gestational age of …

Using Safety Checklists Outside Of The Operating Room, Annabelle Gerhardt

Doctor of Nursing Practice Scholarly Projects

Abstract

The use of a Time Out checklist for patient safety in non-operating room procedural areas is equally important for positive patient outcomes as in the operating room (OR). In this busy southwestern United States hospital, the procedural teams in the non-operating room areas were reported to not be fully engaged during the performance of the Time Out pre-procedural pause prior to gastroenterological (GI) procedures. This study was conducted to improve compliance with the scripted Time Out checklist and promote full engagement of the GI procedural team during the Time Out thus reducing risks of wrong site surgery. Literature has …

2017 Well Being Trust Annual Report, Well Being Trust

Articles, Abstracts, and Reports

Tyler Norris, writing in the 2017 Well Being Trust Annual Report:

This is a promising moment for our nation, as the importance of mental health and well-being become obvious to growing numbers of Americans and awareness of mental health disorders, addiction and related conditions are emerging from the shadows and moving onto the front page. For a long time, diseases of despair— depression, anxiety, addiction, thoughts of suicide—have been stigmatized as character flaws or moral failures, and even today are widely viewed as a personal matter, something to be covered up, kept out of sight, never talked about. The responsibility …

A Multidimensional Approach To Improve Cardiovascular Quality Measure Documentation In A Native American Population, Jessica A. Mastbergen

Doctoral Projects

Native Americans are more likely than white counterparts to be diagnosed with heart disease (Office of Minority Health [OMH], 2017). The scholarly project was conducted in response to the need for improvement in cardiovascular lifestyle interventions for Native Americans and their documentation to meet Government Performance Results Act quality measures. The clinical question addressed was: what is an evidence-based multidimensional approach to improve cardiovascular quality measure documentation in a Native American primary care clinic? The multidimensional interventions included educational sessions for Community Health Representatives (CHRs), a provider education session on appropriate documentation in order to satisfy quality measures, chart review …

Evidence Based Toolkit To Improve Oncology Referrals To Palliative Care, Katelyn M. Gettel

Doctoral Projects

As cancer related mortality decreases, the number of patients living with cancer symptoms and the side effects of cancer treatment will continue to grow. In 2016, over 1.5 million Americans were newly diagnosed with cancer (American Cancer Society, 2016). Several major medical organizations including the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN), and the World Health Organization (WHO) endorse the integration of palliative care into cancer care (Ramchandran, 2015). Although many cancer centers report offering palliative care, this remains largely limited to inpatient services.

The stakeholders of the hospice and palliative care division of a …