Digital Commons Network^™

Implementing A Mobile Health System To Integrate The Treatment Of Addiction Into Primary Care: A Hybrid Implementation-Effectiveness Study, Andrew Quanbeck, David H. Gustafson, Lisa A. Marsch, Ming-Yuan Chih, Rachel Kornfield, Fiona Mctavish, Roberta Johnson, Randall T. Brown, Marie-Louise Mares, Dhavan V. Shah

Health and Clinical Sciences Faculty Publications

Background: Despite the near ubiquity of mobile phones, little research has been conducted on the implementation of mobile health (mHealth) apps to treat patients in primary care. Although primary care clinicians routinely treat chronic conditions such as asthma and diabetes, they rarely treat addiction, a common chronic condition. Instead, addiction is most often treated in the US health care system, if it is treated at all, in a separate behavioral health system. mHealth could help integrate addiction treatment in primary care.

Objective: The objective of this paper was to report the effects of implementing an mHealth system for addiction in …

The Use Of External Change Agents To Promote Quality Improvement And Organizational Change In Healthcare Organizations: A Systematic Review, Esra Alagoz, Ming-Yuan Chih, Mary Hitchcock, Randall Brown, Andrew Quanbeck

Health and Clinical Sciences Faculty Publications

Background: External change agents can play an essential role in healthcare organizational change efforts. This systematic review examines the role that external change agents have played within the context of multifaceted interventions designed to promote organizational change in healthcare-specifically, in primary care settings.

Methods: We searched PubMed, CINAHL, Cochrane, Web of Science, and Academic Search Premier Databases in July 2016 for randomized trials published (in English) between January 1, 2005 and June 30, 2016 in which external agents were part of multifaceted organizational change strategies. The review was conducted according to PRISMA guidelines. A total of 477 abstracts were identified …

Medical School Watercooler Newsletter - January 14, 2018, Lindsey Lyle

Watercooler Newsletter

This is the January 14, 2018 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• New Members Elected into USA GHHS
• 'I Can Power Walk Again!'
• Register Now: Quality Payment Program Education Session
• Mark Your Calendar: Transforming Clinical Practice Initiative TCPi Education Session
• Dr. Franklin Trimm Named Associate Dean for Diversity and Inclusion, Assistant Vice President for Medical Affairs

Obesity In The Workplace: Impact, Outcomes, And Recommendations, C. M. Yarborough, S. Brethauer, W. N. Burton, R. J. Fabius, P. Hymel, S. Kothari, R. F. Kushner, J. M. Morton, M. S. Roslin, J. Ording, +8 Additional Authors

Journal Articles

Copyright © 2017 American College of Occupational and Environmental Medicine. Objective: To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine whether a case can be made for surgical interventions and insurance coverage. Methods: We searched PubMed from 2011 to 2016, and CINAHL, Scopus, and Cochrane Registry of Clinical Trials for interventions addressing obesity in the workplace. Results: A total of 1419 articles were screened, resulting in 275 articles being included. Several areas were identified that require more research and …

An Evidence-Based Practice Assessment And Quality Improvement Initiative In Idaho's Critical Access Hospitals, Deena R. Rauch

Doctor of Nursing Practice Projects

Background: Health care providers and systems have been challenged to discard tradition-based care and outdated practices in lieu of evidence-based practice (EBP). Yet, little is known about the state of EBP, barriers and facilitators to EBP, and organizational readiness for EBP in Idaho’s Critical Access Hospitals (CAH). To affect positive change, it was necessary to understand whether providers in Idaho’s CAHs were using evidence as a foundation for practice—and, if not, what challenges existed in implementing EBP. Mitigating barriers and providing EBP education by way of webinar-based online technology has been proven to be practical and feasible. Providing EBP education, …

The Impact A Nurse's Work Environment Has On Breastfeeding, Ashley Dawn Hull

Nursing Theses and Capstone Projects

Breastfeeding is a global health initiative, as defined by the World Health Organization (WHO), because of its numerous health benefits to mothers and infants. Despite breast milk’s documented benefits to mothers and babies, many women are not choosing to breastfeed their infants. A lack of paid maternity leave policy within the United States influences postpartum responsibilities, physically, and psychologically. This paper presents nurses’ responses to the Workplace Breastfeeding Support Scale survey regarding their workplace environment support of breastfeeding. Nurses providing direct patient care for more than 50% of their shifts revealed 45.5% disagreed in some variance with their comfort in …

A Process Improvement For Depression Screening And Management In A University Health Clinic, Margaret H. Zoellers

Doctor of Nursing Practice Projects

Research indicates that among college students, there is a high prevalence of depression that is frequently undiagnosed and untreated, placing students at risk of impaired academic performance and suicidal behavior. The purpose of the evidence-based process improvement was: a) establish a depression screening and management protocol in the university health clinic, and b) increase university health clinic providers’ knowledge of evidence-based depression screening and management. Family nurse practitioner providers in the university health clinic (n=6) participated in a depression screening and management education program. Knowledge of evidence-based depression screening and management was measured prior to and after the program. A …

Investigating Aromatherapy As A Test Anxiety Intervention For Undergraduate Nursing Students, Brittany Graham

Education Dissertations and Projects

This project seeks to explore the concept of aromatherapy as an intervention for undergraduate nursing student test anxiety in greater depth. Test anxiety is significant in nursing education because of the high stakes weight of exams and difficulties associated with answering multiple choice and multiple response questions. Historically, the Hunt School of Nursing has not provided specific procedures or interventions to assist students with test anxiety; however, this project seeks to outline a pathway for the development and achievement of a successful aromatherapy program for undergraduate students. On an informal trial basis, the use of aromatherapy lotions prior to exams …

Simulation Outside The Silo: Allied Health Interprofessional Education Day To Improve Patient Outcomes, Eva Huneycutt Whitley

Nursing Theses and Capstone Projects

Since 2003, the World Health Organization (WHO) has identified working in interdisciplinary teams as a critical factor in providing patient-centered care. Simulationenhanced interprofessional education (Sim-IPE) has shown improved knowledge, skills, attitudes, and behaviors of teamwork required to improve patient outcomes. The purpose of this project was to determine whether a simulation-based interprofessional education day would improve these factors in senior allied health students in a small community college. The NLN Jeffries Simulation Theory was used as a theoretical framework for this project. The project administrator used the Interprofessional Socialization and Valuing Scale (ISVS) 9A pre-test to examine beliefs, behaviors, and …

Unpacking Action Research And Implementation Science: Implications For Nursing, Mary Casey, Denise O'Leary, David Coghlan

Articles

Aim

The aim of this study was to unpack the key concepts of action research and implementation science thereby enabling appropriate use of these methods in nursing.

Background

A key issue in action research is not so much the methodology employed to gather data/evidence but who decides the research agenda and who benefits from it. Implementation science is a way to ensure that evidence is translated into practice. The question arises as to how action research and implementation may be understood in relation to one another in nursing.

Design

Discussion Paper

Data sources

This discussion paper is based on our …

Nursing Perceptions Of Occupational Therapy For Delirium Management In The Intensive Care Unit, Emma Mcclellan

Occupational Therapy Doctorate Capstone Projects

Background: Occupational therapy (OT) has been identified in existing research as an appropriate profession for addressing cognitive impairments such as delirium common to intensive care unit (ICU) hospitalization. Purpose: This study hypothesized that cultural change must occur within the ICU setting regarding the importance of rehabilitation services for mental functioning and cognitive stimulation in addition to early mobility in the prevention and management of ICU delirium. The intent of this capstone project was to determine the perceptions of ICU nurses regarding the inclusion of and collaboration with OT for the management of ICU delirium. Theoretical Framework: The purpose and objectives …

Health Professions Students' Attitudes Toward Teamwork Before And After An Interprofessional Education Co-Curricular Experience, Shelley C. Mishoe, Kimberly Adams Tufts, Leigh Ann Diggs, James D. Blando, Denise Claiborne, Johanna M. Hoch, Martha L. Walker

Community & Environmental Health Faculty Publications

Background: Effective interprofessional collaboration may positively impact clinical outcomes, patient satisfaction, and cost effectiveness. However, educational silos and discipline-specific socialization have reinforced each health profession’s independent values, attitudes, and problem-solving approaches.

Methods and Findings: Students’ (N = 376) attitudes about teamwork were measured with the Interprofessional Attitudes Scale, Teamwork, Roles, and Responsibilities subscale using a pretest-posttest design. Experiential learning strategies and a case study approach were used to introduce students to the roles and responsibilities of the students’ disciplines. There was a positive mean difference in pretest-posttest measures (p < .001) with a moderate effect size (r = .27).

Conclusions: Providing opportunities for pre-licensure health sciences …

Provider Recommendation: Influence On Colorectal Cancer Screening, Trudy Istre

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Colorectal cancer is the third leading cause of cancer related death yet is one of the most preventable. The goal of the National Colorectal Cancer Roundtable and the United States Preventive Services Task Force is that 80% of eligible patients will be screened by the year 2018. Provider recommendation has a positive impact on colorectal cancer screening rates. Methods: Completion of colorectal cancer screening rates after use of a provider standard scripted recommendation versus usual care was compared. Post intervention retrospective chart review was conducted to evaluate the percentage of patients who completed colorectal cancer screenings. Design: A pre- and …

For Better Or Worse? : Exploring How Decentralization Shapes Local Expenditures And Health Service Utilizations In Indonesia, Adenantera Dwicaksono

Legacy Theses & Dissertations (2009 - 2024)

Decentralization has become one of the most important public-sector reform programs globally since the 1990s with mixed results. In this four-paper dissertation, I explored how decentralization reforms affect public goods and services delivery, by analyzing how post-decentralization institutional changes shape local expenditure decisions and health service utilizations in Indonesia. The main goal of this dissertation was to improve understanding on a better approach to studying public goods and services delivery under a decentralized governance. I used primarily quantitative methods in this dissertation. I started with a systematic review of quantitative studies on the impacts of decentralization reforms and health system …

Florida Blue Finding Aid And Container List, Thomas G. Carpenter Library Special Collections And University Archives, Allison Mason

Finding Aids and Container Lists

The collection contains numerous printed materials such as correspondence, annual reports, company newsletters, promotional and sales materials, and corporate strategy materials. Also included in the collection are photographs, various memorabilia, and numerous audiovisual materials such as VHS tapes, cassette tapes, CD's and reel to reel tapes. The collection spans 1944-2015, with a majority of the materials dated 1970-1999.

Decreasing Duration Of Mechanical Restraint Episodes By Increasing Registered Nurse Assessment And Surveillance In An Acute Psychiatric Hospital, Diane Allen

DNP Scholarly Projects

Background

Application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care in order to assure patient safety and expedite release at the earliest opportunity. While current regulations require that trained staff continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. This project builds on research that demonstrated a regulatory change requiring more frequent registered nurse assessments led to decreased duration of mechanical restraint episodes in an acute psychiatric hospital.

Purpose

The purpose of this project was to implement and evaluate a practice change that required increased frequency of registered nurse …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Cynicism About Change, Work Engagement, And Job Satisfaction Of Public Sector Nurses, Diep T. N. Nguyen, Stephen T. Teo, David Pick

Research outputs 2014 to 2021

This paper uses the job demands‐resources theory to examine the consequences of changes on nursing work. Data were collected from 220 public sector nurses in Australia to test the model. We conducted a two‐wave data collection process where independent variables (organisational change, workload, job control, nursing administrative stressors, cynicism about organisational change, and demographic variables) were collected in Time 1. The dependent variables (nursing work engagement and job satisfaction) were collected 6 months later. Changes to nursing work were found to cause high workload and an increase of administrative stressors that leads to an increase in nurses’ change cynicism. Job …

Increasing Influenza Vaccination Rates In A Primary Care Clinic: A Quality Improvement Study, Cassandra R. Roshel

DNP Projects

Background

According to the most recent CDC statistics, the influenza virus kills between 12,000 and 56,000 people per year in the United States. Although influenza vaccination is recommended each year, only about half of all Americans are actually receiving the vaccine annually. The goal of this quality improvement project was to increase influenza vaccination rates at a large academic medical center in Kentucky. At baseline, there was no standardized screening protocol in place prior to this study.

Methods

This study implemented a pre-test post-test design to evaluate the impact of a process change intervention on vaccination status from September 1, …

The Effects Of A Nurse Manager System Collaborative Council On Job Satisfaction, Intent To Leave, & Resilience, Heather Oliver

DNP Projects

Abstract

PURPOSE: The purpose of this project was to create a Nurse Manager System Collaborative Council (NMSCC) at Norton Healthcare and to determine the impact of participation in the NMSCC on job satisfaction, intent to leave, and resilience.

METHODS: This study employed a quasi-experimental, pre-test, post-test design to assess the effectiveness of the NMSCC at Norton Healthcare. Job Satisfaction was measured using the Warshawsky scale, Intent to Leave was evaluated using the Houser scale, and resilience was assessed using the Connor-Davidson CD-RISC scale.

RESULTS: Resilience increased after participation in the NMSCC for 6 months. Job satisfaction and intent to leave …

Pilot Of An Educational Module For An Adolescent Congenital Heart Transition Program In The Pediatric Setting, Katie J. Dust

DNP Projects

Abstract

PURPOSE:The purpose of this project was to pilot an educational module on a new congenital heart transition program to be instituted at a large Midwest medical system.The transition program is meant to assist pediatric cardiology patients in transferring from pediatric to adult care. An educational module was developed for inpatient health disciplines who will be involved in the transition program. Before offering the program throughout the medical system, a pilot was conducted to determine if the education was at the appropriate level. The educational module was modeled after the Got Transition Six Core Elements designed by the National Health …

A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery

All ETDs from UAB

Since 2009, the United States has experienced another wave of hospital mergers. Consequently, health systems are getting larger and increasing their market concentration. How patients benefit from hospital consolidation remains an open issue for policy-makers, economists, health care executives, community leaders, politicians, government agencies, and others. One measure of healthcare consolidation’s impact, and its potential benefit/detriment, is how mergers affect patient experience, which, since 2007, has been measured by the standardized HCAHPS instrument. Hundreds of studies conducted over the past 50 years have found mergers trigger an internal, socially-disruptive effect in the first 12 to 24 months following the event …

Psychosocial Job Stress And Oxidative Stress In Emergency Department Nurses, Rupkatha Bardhan

All ETDs from UAB

Job stress often causes work-related physical injuries and chronic exposure to such environment may lead to poor health outcomes. Job stress in recent years has grown significantly within the workforce due to performance pressure, long work hours and poor pay structures. Nurses work in the forefront to save patients’ lives. High job demand in this noble profession often leads to progressive decline in physical and mental health. There are existing reports that nurses in the United States (US) suffer from “burnout” syndrome which may also negatively affect patient care. There are very few studies that measured work-related stress in nurses …

The Process Of Adoption Of Disruptive Innovations In Local Health Care Agencies Delivering Primary Care, Aurora Aguirre Polanco

Open Access Theses & Dissertations

The current state of the U.S. health care system is complex and limit access to care to many consumers, thus compromising their health outcomes. The problems of limited access and questionable quality can be addressed by focusing on enhancing the primary health care field. Improvements in both the access and performance of primary health care agencies, derive in better health outcomes and cost savings to the system in the long-term. Disruptive innovations, that make products and services simpler and more affordable, are adopted in agencies and potentially improve access and performance measures. However, the adoption of disruptive innovations in local …

Forensic Patient Flow: An Imbalance Between Capacity And Demand, Versie J. Bellamy

Theses and Dissertations

Background: The United States (U.S.) has an ever-growing incarcerated population. The sheer volume of this population coupled with inefficient patient flow through the judicial and health care systems, create a large imbalance between the high demand for services and the capacity to deliver them. The delay in criminal defendants accessing mental health services is impacted by the lack of patient flow, which creates barriers to entering and exiting the forensic hospital system. The increasing demand for inpatient forensic services, coupled with a static supply of resources, warrants further intervention by treatment and service providers. Identifying and removing barriers to patient …

Examining Faith-Based Communities As Leverage Points For The Prevention Of Childhood And Adolescent Obesity, Caroline Glagola Dunn

Theses and Dissertations

Faith-based research and partnerships are becoming more popular as an approach to address the health of underserved populations including racial and ethnic minorities and rural populations. Despite growing interest in faith-health partnerships, little research is available assessing faith-based interventions as potential leverage points for the prevention of childhood and adolescent obesity and the promotion of healthy behaviors. This research aimed to examine the potential for such partnerships within the context of ongoing research partnerships in South Carolina. Specifically, the first study assessed current peer-reviewed literature to determine reporting of reach, effectiveness, adoption, implementation, and maintenance (RE-AIM elements) in faith-based nutrition …

Getting On The Same Page: A Grounded Theory Study Of Nurse And Physician Collaborative Practice Development, Julie Cerese

Dissertations

The movement toward an integrated approach to healthcare professionals' education, interprofessional education (IPE), has been advancing over the past 60 years in the United Kingdom, Canada, and more recently in the United States. Support for IPE as a mechanism to positively impact collaborative practice and patient outcomes comes from international and national healthcare and educational leadership agencies as well as professional medicine and nursing thought leaders. Theories have evolved to explain the linkages among IPE, collaborative practice, and positive patient outcomes. Researchers have found support for the short term positive impact of IPE on attitudes, perceptions, clarity about roles and …

Implementation Of Provider And Workflow Strategies To Increase Adherence To Tqip Guidelines In Traumatic Brain Injury, Regina Thompson

Theses and Dissertations

Traumatic brain injury (TBI) is a leading cause of death and permanent disability worldwide. The American College of Surgeon’s Trauma Quality Improvement Program (TQIP) has developed a set of recommendations for the management of trauma-related injuries, including TBI. The objective of this evidenced-based practice project was to implement provider- and workflow-based strategies to improve adherence to TQIP recommended guidelines for the placement of intracranial pressure (ICP) monitors. The primary outcome measured was number of ICP monitors placed post-intervention.

The author reviewed available literature and found six articles pertaining to guideline implementations. Analysis of the literature was performed utilizing Melynk and …

Best Practices For Sepsis Patients: A Quality Improvement Project, Kevin Mark Smith Jr

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sepsis is a complication caused by the overwhelming and life-threatening response of the body to an infection. Sepsis can lead to tissue damage, organ failure, and death (Center for Disease Control and Prevention, 2016). Sepsis is the leading cause of death in U.S. hospitals. Mortality from sepsis increases 8% for every hour that treatment is delayed. Each year, 258,000 people die from sepsis in the U.S. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment (Sepsis Alliance, 2016). This project seeks to improve the ability of the transfer unit to screen patients, improve early …

Improving Workers' Safety And Health In The Zimbabwean Mining And Quarrying Industry, Bernard Mabika

Walden Dissertations and Doctoral Studies

Lack of effective occupational safety and health (OSH) strategies is a reason that

workplace accidents in the mining and quarrying industry remain high, making the

industry one of the riskiest operations worldwide. The purpose of this multiple case study

was to explore successful strategies mining and quarrying leaders in Zimbabwe used to

improve OSH. The key research question addressed successful strategies leaders in the

mining and quarrying industry use to improve employee occupational safety and health in

Zimbabwe. Six successful business leaders from 3 mining and quarrying mines in

Zimbabwe demonstrated an exception to unsafe practices, particularly through their

exceptional …