Increasing Continuous Positive Airway Pressure Compliance With Various Telemedicine Interventions: An Integrated Literature Review, Tracy Partington

Doctor of Nursing Practice (DNP) Projects

Aims and Objectives. This literature review's objective was to synthesize evidence from previously published literature on telemedicine interventions' effectiveness on CPAP (Continuous Positive Airway Pressure) therapy compliance.

Background. It is estimated that 22 million Americans suffer from a form of Sleep Apnea (SA), and those up to 80 percent of the cases of moderate to severe Obstructive Sleep Apnea (OSA) are undiagnosed (Sleep Apnea, n,d). The first-line therapy for OSA is CPAP. However, CPAP therapy is associated with low compliance rates.

Design. Systematic review.

Method. A multi-database literature search was conducted to identify published literature between 2009 and 2020. …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue

Doctor of Nursing Practice

Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive …

Evaluation Of Telemedicine As An Option For Providing Safe, Accessible, Care To Young Adults In A University Setting, Diane Lynch

Seton Hall University Dissertations and Theses (ETDs)

Previously underutilized, telemedicine has been implemented within a wide variety of health settings as a safe and efficient way of delivering healthcare during the COVID-19 pandemic. Maintaining operations during the pandemic made implementation of telemedicine an important aspect of college and university health center reopening plans. The purpose of this project was to evaluate the acceptance and quality of a telemedicine program implemented at the health center of a medium sized private university.

Data were collected via patient and staff surveys to measure satisfaction with the program and a retrospective review of electronic medical records was conducted to obtain data …

Distress Evaluation During Chemotherapy: The Real-Time Assessment Strategies For Oncology Nurses Among Asian Population In Outpatient Clinics, Ying Huang

DNP Qualifying Manuscripts

Background: Routine oncology visits failed to identify 50-94% of patient’s distress, which creates a considerable burden, impairs emotional well-being and reduces patients’ quality of life. Limited in-person visits during the COVID-19 pandemic have reduced access to care for many patients, further adding to their emotional distress. Untreated distress also leads to elevated stress levels, systemic inflammation, non-compliance with treatment, and higher mortality rates. Early distress screening and multidisciplinary care are recommended to reduce the impacts of distress.

Objectives: To identify the best outpatient practices to address newly diagnosed cancer patients’ unique needs due to distress.

Methods: Databases searched including CINAHL® …

Technological Change And The Practice Of Healthcare Communication: Implications For Patient-Centered Care, From A Communication Ethics Perspective, Emmalee Torisk

Electronic Theses and Dissertations

Written in a historical moment marked in many ways by the COVID-19 pandemic and the changes it has wrought, including the increased availability and use of telehealth services, this project attempts to consider the implications of the continued integration of technology into health care, centering on the following essential question: How do technological changes affect the contemporary practice of healthcare communication, particularly that which occurs between the patient—the consumer of health care—and their provider? This dissertation thus considers the ways in which such linkages of technology and health care seem to fit into a larger shift within health care …

Telehealth Assessment In The Elderly Using The 4m'S, Janet Obonyo

Nursing Capstones

COVID-19 has accelerated an already urgent need for telehealth in the United States. While health care systems have been providing telehealth for years, the number of providers and patients who need to participate in telehealth has ballooned overnight. Though telehealth has been in use for a while, the geriatric population seems to be disadvantaged, especially those who reside in rural settings. Due to increased COVID 19 cases among the elderly population in North Dakota, the Geriatric Workforce Enhancement Program (GWEP) allocated a grant to the University of North Dakota to promote telehealth in the elderly receiving homecare services in rural …

Telehealth Assessment In The Elderly Using The 4m'S, Witeh Esoe

Nursing Capstones

COVID-19 brought unprecedented challenges in accessing healthcare services. The lack of accessibility to healthcare drastically impacted older adults, especially those in rural America, who experienced multiple issues accessing quality care with an increase in healthcare cost leading to a significant increase in morbidity and mortality rate from COVID-19. Consequently, the usage of telehealth services skyrocketed during the pandemic. As a result, the Geriatric Workforce Enhancement Program (GWEP) emerged with the aim to promote the use of telehealth services to reduce COVID-19 exposure to older adults in rural North Dakota (ND). Thereby keeping older adults safe at home and still having …

4ms Framework For Aging Healthcare, Christine Zaki

Nursing Capstones

Background: At the beginning of the pandemic, primary care clinics in North Dakota (ND) had just a trickle of daily telehealth encounters. Over time, these encounters increased, primarily for the youngest seniors (55 – 70 years old). Due to increased COVID-19 cases among the elderly population in ND, the Geriatric Workforce Enhancement Program (GWEP) allocated a grant to the University of North Dakota (UND) to promote telehealth use in the elderly residing in rural ND and receiving home care through the desired home care agency. This project aims to promote telehealth to reduce exposure to COVID-19 among the geriatric populations …

Telehealth Assessment In The Elderly Using The 4ms, Melissa Koehl

Nursing Capstones

The current 2019 novel coronavirus, or COVID-19, has presented new threats and challenges in healthcare, especially when attempting to conduct wellness exams amongst the most vulnerable. Older adults with underlying medical conditions are at great risk for exposure and infection of COVID-19. The Geriatric Workforce Enhancement Program (GWEP) grant was given to the University of North Dakota (UND) to create a geriatric telehealth team and implement a telehealth project, promoting the use of telehealth technologies amongst older adults utilizing the 4Ms (mentation, medication, mobility, and what matters). A modified wellness assessment tool was created and administered through telehealth technology to …

Implementation Of Telehealth Education In A Pre-Licensure Bsn Nursing Program In Rural Southeast Kansas, Anna Beth Gilmore

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to facilitate the implementation of a successful telehealth education program in a pre-licensure nursing program at a regional university in the Midwest. The project took place at Pittsburg State University Irene Ransom Bradley School of Nursing. Participants included eighty-six undergraduate senior students in their last semester of nursing school enrolled in Community Health Nursing preparing to begin their nursing career. The group completed a 20-hour self-paced telehealth educational program offering made available through a partnership with Dr.’s Carolyn Rutledge and Tina Gustin of Old Dominion University Center for Telehealth Innovation, Education and Research (C-TIER). …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Decreasing The Impact Of Diabetes In The Adult And Older Adults Rural Health Population Utilizing Phone Calls As Part Of The Chronic Care Management Program, Adrienne Shambray

Doctor of Nursing Practice Projects

This quantitative study was developed in order to evaluate the impact of phone calls on patient outcomes using the Chronic Care Management program (CCM). In January 2015, the Centers for Medicare and Medicaid Services (CMS) implemented the (CCM), with the goal of improving health and quality of care for high-risk patients. The administration and physicians at the clinic of focus for this project recognized a need for the facility to help improve and manage these patients’ care to prevent issues such as hospital readmission. This project aimed at following patients in the program with the chronic condition of diabetes mellitus …

Telehealth Breastfeeding: Best Practice Guideline, Laura Amabile

Doctor of Nursing Practice Final Manuscripts

Background: Only 24.9% of United Stated infants are exclusively breastfed through six months. Healthy People 2020 breastfeeding goals include increasing the proportion of infant breastfed through six months to 60.6%. The Surgeon General’s Call to Action identified increasing access to International Board-Certified Lactation Consultants as a priority to improve breastfeeding percentages.

Purpose: Implementation of an evidence-based telehealth breastfeeding guideline, will provide mothers with consistent education regarding breastfeeding practices and guidance to overcome common obstacles, which will then result in increased confidence levels regarding breastfeeding and increase breastfeeding durations.

Study and Design: The Iowa model was utilized to guide this project. …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Transitioning From Onsite To Online Psychotherapy Visits During The Covid-19 Crisis, Michael Angello Negron, Dnp

Doctor of Nursing Practice Final Manuscripts

Background: On March 19, 2020, the governor of the State of California, Gavin Newsom, issued executive stay-at-home order due to the coronavirus disease (COVID-19) pandemic (State of California, 2020). In a private psychiatric practice in southern California treating patients with anxiety and depression, psychotherapy treatment was abruptly affected by that order. The purpose of this project was to transition from onsite to online psychotherapy visits to ensure the continuity of care and facilitate patients’ progress in dealing with mental illnesses during the COVID-19 crisis.

Aims: The proposed solution to the problem of decreased access to care during the pandemic was …

Optimizing Best Telehealth Practices Among Advanced Practice Registered Nurses, Karen Swafford

Doctor of Nursing Practice Final Manuscripts

Abstract

Optimizing best clinical telehealth practices among APRNs

Abstract Title: Optimizing best clinical telehealth practices among APRNs through a survey that gauges their preparedness in core competencies and their recommendations.

Background: In April 2020, about half of all Medicare primary care visits were done through telehealth due to the COVID-19 pandemic. Telehealth evoked a strong positive response among patients, which created a new niche in healthcare. To effectively leverage its value, one of its key goals is the promotion of best clinical practices (Agrawal, 2020). However, very little information was found about programs that address NP training in telehealth. …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Evaluating Va Nurse Acceptance Of Virtual Healthcare Technology During The Coronavirus Outbreak, Francesca Bryan-Couch

Doctor of Nursing Practice Scholarly Projects

At a regional Veterans Administration (VA) hospital, nurses performing case management were unable to perform face-to-face visits with patients due to coronavirus. Care coordination and discharge planning efforts occurred through telephonic case management to preserve personal protective equipment and reduce transmission rates through social distancing. Trust and rapport between patients and nurses were reduced without personal contact. Peplau’s theory of interpersonal relations described six nurse roles and three phases of relationship development required to create therapeutic nurse-patient relationships. Connectedness was a key concept considered to be the path to a successful meaningful therapeutic nurse-patient relationship (Hrabe, 2005).

To evaluate current …

Efficacy Of Diabetes Self-Management Education Administered Via Telehealth For Adults With Uncontrolled Diabetes, Tanner Free

Evidence-Based Practice Project Reports

Patient’s with a diagnosis of diabetes require significant lifestyle modification and education. The need for patient education has led to the development of diabetes self-management education (DSME) classes. Unfortunately, utilization of DSME classes is only 5% among Medicare beneficiaries and 6.8% among privately insured patients (Centers for Disease Control [CDC], 2018). The purpose of this evidence-based practice (EBP) project was to implement DSME via telehealth and assist with goal formation to help patients with uncontrolled diabetes achieve glycemic control by increasing access to crucial education. The intervention consisted of bi-weekly calls for a period of 3 months. Participant data were …

Implementing Telemental Health To Improve Access To Mental Healthcare In Rural Vermont, Julia Mcdougal Ronconi

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Mental health access in rural areas is a national problem. Of strategies to increase access, telemental health has the highest level of evidence.

PURPOSE: This project aimed to implement a telemental health program in rural Vermont to: (a) increase the number of rural-dwelling patients who enter treatment for anxiety and depression, (b) evaluate the effectiveness of telemental health for depression, anxiety, and overall functioning, and (c) evaluate patient satisfaction with the accessibility, quality, and affordability of the service.

METHODS: Adult psychiatric diagnostic evaluation, medication management and psychotherapeutic interventions were delivered via telemental health. The service was marketed to Health …

Using Quality Improvement (Qi)-Focused Evaluation To Redesign Direct Home- And Community-Based Services During The Covid-19 Public Health Emergency:, Marcia Moriarta, Anthony Cahill, Heidi Fredine

Developmental Disabilities Network Journal

Like many UCEDDs in the Developmental Disabilities (DD) network, the Center for Development and Disability at the University of New Mexico offers direct service programs in home and community settings. Before the start of the COVID-19 pandemic, services were delivered in-person to about 1,000 families across the state including clients with intellectual or developmental disabilities and/or from at-risk communities. In March 2020, due to the spread of COVID-19, a public health emergency was declared in New Mexico and home and community services were stopped throughout the state. This meant direct service programs at the Center had to turn to telehealth …

Implementation Of Cognitive Testing Via Video-Telemedicine, Lindsay Mills Holland, Rosemary Dale, Mary Val Palumbo

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Early diagnosis and timely follow-up of cognitive decline are essential to preserve individual function and memory, improve quality of life, and decrease healthcare costs. Many barriers to in-person assessment exist, the most recent one being COVID-19. Video-telemedicine has been studied as a solution with promising results. Most notably, research shows that the Mini Mental State Examination (MMSE) administered via video-telemedicine has comparable results to in-person assessment.

Purpose: The purpose of this project was to implement cognitive testing via video-telemedicine for follow-up management of cognitive impairment and dementia.

Methods: A protocol for conducting the MMSE via Zoom was developed. Next, …

Telehealth Use During The Prenatal Period: Strengths And Limitations, Adrian M. Goblisch, Tessa L. Hand

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this paper is to examine the risks and benefits of telehealth use during the prenatal period. With the increasing use of technology to provide healthcare, especially during the COVID-19 pandemic, it is critical to examine the implications this care modality has on individuals and the community. Theoretical Framework: Katharine Kolcaba’s Comfort Theory was applied to the topic of telehealth use in the prenatal period. This theory explains that there is an immediate experience of strengthening when relief, ease, and transcendence are met and that an individual is more likely to exhibit health-seeking behaviors when comfort in …

Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas

Walden Dissertations and Doctoral Studies

AbstractHeart failure (HF) is a progressive and life -threatening disease that places a large burden on the health care systems worldwide with increased rates of re-hospitalization, readmissions, and outpatient visits. With the use of telehealth monitoring and support from nursing case managers, HF patients are able to manage this disease at home. The focus of this project was to evaluate a home health agency (HHA) telehealth program, exploring if there was an improvement in 30-day readmission rates, and patient satisfaction scores for the HHA telehealth program one year after revising the program incorporating nursing virtual case managers. This project used …

Telehealth Coaching To Improve Exercise Self-Efficacy In Diabetics, Oby C. Ikoro

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and Review of Literature: Exercise is essential to the self-management of Type 2 Diabetes Mellitus (T2DM). The literature reveals that many patients with difficulty in the self-management of exercise improve with coaching. The literature also reveals that an adequate exercise routine results in improved blood glucose control and the prevention of complications.

Purpose: This DNP project aims to demonstrate the positive effect of low-cost telehealth coaching to improve self-efficacy in an exercise regimen for T2DM patients.

Methods: A one-group pretest-posttest design was used in this project. Telephone calls and text messaging were used to coach patients to improve …

Satisfaction Of Telehealth For The 55+ Population, Cynthia Schweizer

Doctor of Nursing Practice Projects

There is a primary care need for the 55+-year-old population related to the increasing aging population, physician shortages, and, more recently, Coronavirus Disease 2019 (COVID-19) to implement Telehealth care. The Telehealth project will include the 55+ population to provide more participants for the project at an internal medicine clinic. Telehealth's contribution and interventions will affect causal factors such as moderating or mediating factors of health problems. Some of those factors include insufficient primary care coverage due to decreasing numbers of primary care providers (PCP), the increasing older population, complex health issues that come with aging, the need for frequent follow-up …

Evaluating The Use Of Telehealth To Manage Hypertension In Primary Care, Alexandra M. Wiesner

DNP Projects

Background: Hypertension remains one of the most common chronic conditions in the United States leading to several health complications and immense financial burdens, yet it remains grossly undertreated despite the availability of evidence-based treatment options. The 2017 guidelines from the American College of Cardiology and American Heart Association recommended the use of home blood pressure monitoring with a telehealth component as an adjunct to regular hypertension treatment; however, implementing this into practice can be difficult depending on the setting, available resources, and the knowledge and skills of the providers. Aims: The purpose of this investigation is to evaluate patient adherence …

Feasibility Of Online Nutritional Counseling And/Or Remote Self Weighing In Pregnant Women With Obesity, Rebecca Mattson

Dissertations

Purpose

The purpose of this feasibility study is to determine the magnitude of effect using a combination of weekly weights and an online registered dietician to control excessive gestational weight gain in pregnant women with obesity using a pilot randomized controlled trial.

Specific Aims

There are three specific aims. Aim 1: Describe the study population in terms of sociodemographic influences (e.g., ethnicity, age, weight, and height) and obstetrical influences (i.e., parity and pregnancy weight). Aim 2: Measure participant satisfaction with the study interventions of weekly weighing and online nutrition counselling. Aim 3: (a) Explore the differences in gestational weight …

An Integrative Review: Best Practices In Advanced Practice Registered Nurse (Aprn) Telehealth Services To Improve Outcomes For Children With Chronic Health Conditions, Tamara Sue Moyer

Doctoral Dissertations and Projects

Telehealth is a rapidly growing field that affords individuals the opportunity to receive access to specialty providers, reduce expenses and travel, break down geographic barriers, deliver equality of care, and improve patient outcomes. Equality of healthcare for pediatric patients with chronic health conditions in rural areas face geographic barriers to delivery of care, resulting in poor patient outcomes, and increased costs. An integrative review was completed to identify and describe research findings in an attempt to answer the clinical questions proposed and identify areas in research that can lead to improved patient outcomes. The need to receive access to specialty …