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Articles 451 - 480 of 1828
Full-Text Articles in Entire DC Network
Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters
Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters
DNP Projects
BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.
PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.
METHODS: Electronic health records of telehealth patients were reviewed in an …
Evaluating The Effect Of A Brief Mindfulness Intervention Designed To Reduce Compassion Fatigue On Staff Mindfulness, Catherine Siegel
Evaluating The Effect Of A Brief Mindfulness Intervention Designed To Reduce Compassion Fatigue On Staff Mindfulness, Catherine Siegel
DNP Projects
Background: Compassion fatigue is “stress resulting from exposure to a traumatized individual” and is described as “a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment” (Cocker & Joss, 2016, p. 1). Fifty-two percent of mental health workers are experiencing compassion fatigue (The Mental Health of Healthcare Workers in COVID-19, 2020). Behavioral health units have some of the highest turnover rates across hundreds of hospital systems (2019 NSI National Health Care Retention & RN Staffing Report, 2019). Compassion fatigue has been identified as a risk factor for turnover in nurses and statistics …
Improving Nursing Comfort In Relation To Difficult Conversations, Sarah Clifton
Improving Nursing Comfort In Relation To Difficult Conversations, Sarah Clifton
DNP Projects
Abstract
Background/Purpose
Conversations between care providers and patients are integral to medicine and are the most performed “procedure” (Luff et al., 2016). In Pediatric Intensive Care Units (PICUs) and Pediatric Cardiac Intensive Care Units (PCICUs), children of all ages with diverse diagnoses and needs are treated for critical illnesses and traumatic events. Therefore, providers frequently have difficult conversations with patients and their families. Pediatric critical care nurses are often invited to participate in these discussions. However, their role during, and after, these conversations is not always clear. The goal of this project was to evaluate the impact of an educational …
Implementation Of A Death Anxiety Screening Protocol Specific To Patients With Advanced Cancer In An Outpatient Palliative Care Setting, Olivia M. Sasdi
Implementation Of A Death Anxiety Screening Protocol Specific To Patients With Advanced Cancer In An Outpatient Palliative Care Setting, Olivia M. Sasdi
DNP Projects
Abstract
Background: Recent studies have shown that upwards of 80% of patients with advanced cancer suffer from death anxiety resulting in increased physical and psychological suffering. Despite death anxiety’s ubiquitous nature and negative impact, the literature regarding this condition consistently indicates that it remains under-identified and undertreated in patients with advanced cancer. The “Death and Dying Distress Scale” (DADDS) is a clinically validated tool used to identify, measure, and guide effective treatment modalities for death anxiety specifically in patients with advanced cancer, but is scarcely used routinely in practice. Incorporating this screening tool to be used regularly could improve identification …
An Exploration Of The Mental Health Experiences Of Young Women With Diminished Ovarian Reserve, Brittany M. Woods
An Exploration Of The Mental Health Experiences Of Young Women With Diminished Ovarian Reserve, Brittany M. Woods
All ETDs from UAB
Infertility is a reproductive disease resulting in the inability to conceive. One in six individuals will experience infertility in their lifetime. Diminished ovarian reserve (DOR) reduces the quantity and/or quality of a female's oocyte pool and is a known cause of infertility. Although this occurs during normal ovarian aging in the late 30s and early 40s, DOR can also impact younger women, increasing their risk for psychological distress from an unexpected diagnosis. The purpose of this dissertation is to develop a deeper understanding of the mental health experiences of young women with DOR through the generation of three manuscripts. Manuscript …
Pandemic Driven Mobility In Higher Education: The Good, The Bad And The Useful, Orly Calderon, Susan Penque, David Luhr, Caryn Nahum, Lauren Scardigno
Pandemic Driven Mobility In Higher Education: The Good, The Bad And The Useful, Orly Calderon, Susan Penque, David Luhr, Caryn Nahum, Lauren Scardigno
Nursing Faculty Publications
The purpose of this mixed method research study is to describe the experiences of faculty and students in post-secondary education institutions as they shifted to remote education at the start of the COVID-19 pandemic, and to understand these experiences in the context of previous research about pre-pandemic remote or mobile education. One hundred and two participants in the study include full-time and adjunct faculty, undergraduate and graduate students. A convergent mixed method survey queried about participants’ demographics, mobility experiences in terms of frequency of access to technology and a suitable learning/teaching environment and usefulness of various web and video conferencing …
Implementation Of Night Shift Rounding To Improve Nursing Communication And Reduce Days Of Intubation In The Intensive Care Setting, Lisa Wilkinson
Implementation Of Night Shift Rounding To Improve Nursing Communication And Reduce Days Of Intubation In The Intensive Care Setting, Lisa Wilkinson
Walden Dissertations and Doctoral Studies
Multidisciplinary rounds are the gathering of various health care providers who have a shared interest in a patient’s well-being to discuss the plan of care and the patient’s progress through their hospital stay. This multidisciplinary group of staff can be the providers, the nurse, charge nurse, social worker, pharmacist, dietician, respiratory, chaplaincy, and occupational and physical therapists. On night shift at the project site, this rounding process did not occur, leaving the staff feeling they were not involved in the plan of care. The purpose of this quality improvement evidenced-based project was to create a process change, introduced to the …
Improving Handoff Communication In The Emergency Department, Amy Shepherd
Improving Handoff Communication In The Emergency Department, Amy Shepherd
Doctor of Nursing Practice Projects
Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …
Using A Nurse Manager Prep Course To Spark Interest In Nurse Manager Succession Plan Participation, Sharon Pettiford
Using A Nurse Manager Prep Course To Spark Interest In Nurse Manager Succession Plan Participation, Sharon Pettiford
Doctor of Nursing Practice Projects
Hospitals strive to become Magnet-accredited facilities. Having Magnet status indicates an institution has high standards regarding nurse work environments and positive patient outcomes. The American Nurses Credentialing Center (ANCC) created the Magnet program criteria in 1994 (Dierkes et al., 2021). Obtaining Magnet accreditation is a coveted goal for hospitals. The target organization is currently not a Magnet-accredited hospital, nor does it have a nurse manager succession planning program. In preparation to achieve this accreditation, the target organization needed to implement a succession plan for nurse leaders. Institutions with successful succession planning programs pay careful attention when selecting participants for succession …
Measuring Success: Program Fidelity Of Queensland's Child Health Home Visiting Services. A Document Analysis, Nicole Latham, Jeanine Young, Josephine Wilson, Michelle Gray
Measuring Success: Program Fidelity Of Queensland's Child Health Home Visiting Services. A Document Analysis, Nicole Latham, Jeanine Young, Josephine Wilson, Michelle Gray
Research outputs 2022 to 2026
Background: The Family CA.R.E. (Community-based Assistance Resourcing and Education) program was introduced in Queensland two decades ago. It aimed to redress health inequalities for infants from families experiencing specific social stressors. The program has been locally adapted over time and has not been evaluated against the original program. This study assessed the extent to which selected hospital and health services in Queensland, Australia have modified the original Family C.A.R.E. program. Methods: Altheide's model was used to facilitate a critical document analysis of policies and guidelines for adapted Family C.A.R.E. home visiting programs in use by hospital and health services (target …
Nursing Students Doing Gender: Implications For Higher Education And The Nursing Profession, Lesley J. Andrew, Ken Robinson, Julie Dare, Leesa N. Costello
Nursing Students Doing Gender: Implications For Higher Education And The Nursing Profession, Lesley J. Andrew, Ken Robinson, Julie Dare, Leesa N. Costello
Research outputs 2022 to 2026
The average age of women nursing students in Australia is rising. With this comes the likelihood that more now begin university with family responsibilities, and with their lives structured by the roles of mother and partner. Women with more traditionally gendered ideas of these roles, such as nurturing others and self-sacrifice, are known to be attracted to nursing as a profession; once at university, however, these students can be vulnerable to gender role stress from the competing demands of study. A qualitative research design, guided by Gadamer's hermeneutic philosophy, explored the gendered behaviours and experiences of 22 women nursing students, …
A Scoping Review Of Nurse-Led Randomised Controlled Trials, Marion Eckert, Kate Kennedy, Kim Neylon, Claire M. Rickard, Samantha Keogh, Richard Gray, Sandy Middleton, Caroline Homer, Lisa Whitehead, Greg Sharplin
A Scoping Review Of Nurse-Led Randomised Controlled Trials, Marion Eckert, Kate Kennedy, Kim Neylon, Claire M. Rickard, Samantha Keogh, Richard Gray, Sandy Middleton, Caroline Homer, Lisa Whitehead, Greg Sharplin
Research outputs 2022 to 2026
Background: Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse-led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife-led trials will be reported elsewhere. Aim: To quantify number, type and quality of nurse-led randomised controlled trials registered between 2000–2021. Design: …
Learning A Healthy Rhythm: An Intervention To Increase Children’S Resources For Stress Management, Kristin Haglund, Amanda L. King, Abir K. Bekhet, Mauricio Garnier-Villarreal, Karen Olson, Rashs Atshan, Angela Ortiz, Johanna De Los Santos, Ruth Ann Belknap
Learning A Healthy Rhythm: An Intervention To Increase Children’S Resources For Stress Management, Kristin Haglund, Amanda L. King, Abir K. Bekhet, Mauricio Garnier-Villarreal, Karen Olson, Rashs Atshan, Angela Ortiz, Johanna De Los Santos, Ruth Ann Belknap
College of Nursing Faculty Research and Publications
This article describes a pilot test of a community engaged, culturally relevant, arts-based intervention. The purpose was to increase children’s personal protective buffering resources. Protective buffering resources help children cope with stressful stimuli, reduce activation of their systemic stress response, mitigate allostatic load, and promote optimal health. The “Learning a Healthy Rhythm” intervention included a stress management component and an ongoing Afro-Latino percussion program for 18 children ages 9–11. The stress management component included educational content about stress, self-assessment of stress symptoms, and stress management techniques. A mixed-method intervention evaluation design was used. Qualitative data, quantitative data, and biometrics including …
The Flame, 2022-2023, Mennonite College Of Nursing
The Flame, 2022-2023, Mennonite College Of Nursing
The Flame (1985-present)
The Flame is a newsletter of Illinois State University's Mennonite College of Nursing
Evidence-Based Guidelines For Intrapartum Maternal Hydration Assessment And Management: A Scoping Review, Lauren Kearney, Alison Craswell, Nellie Dick, Debbie Massey, Rachael Nugent
Evidence-Based Guidelines For Intrapartum Maternal Hydration Assessment And Management: A Scoping Review, Lauren Kearney, Alison Craswell, Nellie Dick, Debbie Massey, Rachael Nugent
Research outputs 2022 to 2026
Problem: Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons. Background: Labor and birth are physically demanding, and adequate nutrition and hydration are essential for labor progress. A lack of clear consensus on intrapartum hydration assessment and management during labor and birth currently exists. In addition, there is an inconsistent approach to managing hydration, often including a mixture of intravenous and oral fluids that are poorly monitored. Aim: The aim of this scoping review was to identify and collate evidence-based guidelines for intrapartum hydration assessment and management of …
Mental Health Services: Improving Utilization In Homeless Populations, Gurdeep Mann
Mental Health Services: Improving Utilization In Homeless Populations, Gurdeep Mann
DNP Qualifying Manuscripts
Emergency shelters provide a unique location to offer easily accessible services for unhoused individuals experiencing mental distress and serious mental illness. Housing First interventions do not improve mental health or social integration. It is important to consider alternative approaches to providing care for homeless individuals. This integrated review was undertaken to evaluate existing evidence of interventions that improve mental health awareness and utilization of mental health services among unhoused populations living in shelters. Assertive outreach is an important strategy that was shown to improve effectiveness of mental health programs in shelters; reconnect individuals with family; and help with psychological integration. …
Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary
Engaging Rural Providers About The Potential Of Low-Earth Orbit Internet Satellite Supported Rural Telehealth Programs, Joshua M. Cleary
Doctor of Nursing Practice (DNP) Projects
Abstract
This paper describes a DNP project that was designed to address the issue of rural mental telehealth implementation barriers. One of the main barriers to rural telehealth programs has been a technical infrastructure incapable of adequately hosting the telehealth programs. Low-Earth orbit (LEO) internet technology has emerged as a way to solve the rural telehealth conundrum by offering an improved rural technical infrastructure. An integrated review was completed based on the following PICOT question: In rural providers, how does an educational outreach compared to no educational outreach affect provider adoption of new technologies? The evidence showed educational sessions as …
A Process Evaluation On The Health Care Transition Process For Youth With Osteogenesis Imperfecta With Special Health Care Needs, Janet Amirkhanian
A Process Evaluation On The Health Care Transition Process For Youth With Osteogenesis Imperfecta With Special Health Care Needs, Janet Amirkhanian
Doctor of Nursing Practice (DNP) Manuscripts
With medical, surgical, and technological advances, children with childhood diseases with special health care needs (SHCNs) are surviving and living into adulthood (Cohen et al., 2014). Health care transition (HCT) should be a process through which youth are expected to achieve the skills necessary to manage their health as adults (Sawicki et al., 2017). HCT should be a purposeful, organized, and coordinated process involving the youth, family, and health care team (Stringer et al., 2015; Gabriel et al., 2017; White et al., 2018). Evidence supports that adolescents and young adults with SHCNs are often unprepared for transition (Jensen et al., …
The Health And Health Care Needs And Experiences Of Mexican Heritage Individuals In A Nonmetro Location: An Ethnonursing Study, Karla Adu
Electronic Theses and Dissertations
Introduction: The population of Mexican heritage individuals has grown significantly in nonmetro, emerging communities. The purpose of this study was to explore the health and health care needs and experiences of this population in the Midwest. Methods: Leininger’s Culture Care Theory and Ethnonursing Research Methods were used as the guiding theory and methodology for the qualitative study. Interviews were conducted with 27 informants. Recordings were transcribed and analyzed according to Leininger’s phases of data analysis. Results: Three themes emerged from the data: 1. living a better life in a nonmetro community with and for family, 2. barriers to understanding …
Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard
Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard
Master's Projects and Capstones
The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …
Home Health Workplace Safety During The Covid-19 Pandemic: A Cross-Sectional Descriptive Analysis Of Home Health Agencies In Arkansas, Kelly M. Neal Taylor
Home Health Workplace Safety During The Covid-19 Pandemic: A Cross-Sectional Descriptive Analysis Of Home Health Agencies In Arkansas, Kelly M. Neal Taylor
ATU Theses and Dissertations 2021 - Present
Abstract
Workplace safety is a continual concern for home healthcare workers that provide medical care in a patient’s home environment. Healthcare workers, such as registered nurses, licensed practical nurses, and nursing aides, make up the largest group of home care providers. Before the COVID-19 Pandemic, home healthcare providers had to navigate job safety issues related to clutter in the home, unsanitary conditions, pest infestations, fumes, pets, and aggressive family members (Gershon et al., 2008). The pandemic brought about additional safety concerns, such as the implementation of isolation policies and limited supplies of personal protective equipment, to name a few. This …
The Mediating Effect Of Caregiving Relationship Quality On The Association Between Caregiving Stressors And Mental Health Problems Among Older Spousal Caregivers, Fei Wang, Elliane Irani
The Mediating Effect Of Caregiving Relationship Quality On The Association Between Caregiving Stressors And Mental Health Problems Among Older Spousal Caregivers, Fei Wang, Elliane Irani
Faculty Scholarship
Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect =.14, p =.016). Moreover, role overload was positively associated with caregiver mental health problems, …
Topics And Sentiment Surrounding Vaping On Twitter And Reddit During The 2019 E-Cigarette And Vaping Use-Associated Lung Injury Outbreak: Comparative Study, Dezhi Wu, Erin Kasson, Avineet Kumar Singh, Yang Ren, Nina Kaiser, Ming Huang, Patricia A. Cavazos-Rehg
Topics And Sentiment Surrounding Vaping On Twitter And Reddit During The 2019 E-Cigarette And Vaping Use-Associated Lung Injury Outbreak: Comparative Study, Dezhi Wu, Erin Kasson, Avineet Kumar Singh, Yang Ren, Nina Kaiser, Ming Huang, Patricia A. Cavazos-Rehg
Publications
BACKGROUND: Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. OBJECTIVE: This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) …
Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre
Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre
Doctoral Projects
The opioid epidemic is affecting Mississippi’s young to middle-aged adult population in a profound way. Pharmacotherapy for opioid use disorder (OUD) is the gold standard treatment. Despite the FDA-approved evidence-based treatment of pharmacotherapy for OUD, rural areas often lack providers available who will initiate and provide maintenance of this life-saving medication. For this doctoral project, a 36-question survey was developed based on a preliminary literature review. The survey was disseminated to advanced practice registered nurses (APRNs) in the family and psychiatric specialties across Mississippi to assess the barriers to APRNs filling the gap in pharmacotherapy prescribing for OUD. A continuing …
Exploring Workplace Incivility And Bullying In Healthcare Workers In A South Florida Community Hospital, Nada Wakim, Natalie Bermudez, Claudia C. Sabogal-Rodriguez
Exploring Workplace Incivility And Bullying In Healthcare Workers In A South Florida Community Hospital, Nada Wakim, Natalie Bermudez, Claudia C. Sabogal-Rodriguez
Nursing & Health Sciences Research Journal
Introduction: Workplace incivility and bullying are concerning issues in healthcare with detrimental consequences for healthcare workers (HCW) and healthcare organizations. Organizational leaders’ recognition of incivility/bullying within healthcare organizations, and their sources, is imperative to prevent and/or address issues by creating “zero tolerance” work environments. The purpose of this cross-sectional, descriptive study was to explore HCWs’ experiences with incivility and bullying at a South Florida community hospital.
Methods: A convenience sample of HCWs at a South Florida community hospital were recruited to voluntarily complete the Nursing Incivility Scale.
Results: A sample of 325 HCWs responded to the survey. The results showed …
Ed To Telemetry Bed: Optimizing Nurse Communication & Decreasing Team Frustration, Harmandeep (Harm) S. Madra
Ed To Telemetry Bed: Optimizing Nurse Communication & Decreasing Team Frustration, Harmandeep (Harm) S. Madra
Master's Projects and Capstones
PROBLEM: According to the Institute of Medicine, boarding inpatients in the emergency department (ED) can result in an increased risk for medical errors, delay in treatments, and decreased quality of care. The goal is to move the patient to the hospital bed within 60 minutes from when an order is written for admission. The current average monthly compliance for ED throughput and admission to the inpatient bed is at 45% compared to the target of 70%. Lack of standardization during handoff can lead to delays, miscommunication and causes team frustration.
CONTEXT: In 2022, this community hospital’s ED microsystem had limited …
Mental Health Navigators Bridging The Gap Of Care For Clients With Schizophrenia: A Review, Valentina Loreto-Ashley, Valentina Loreto-Ashley
Mental Health Navigators Bridging The Gap Of Care For Clients With Schizophrenia: A Review, Valentina Loreto-Ashley, Valentina Loreto-Ashley
DNP Qualifying Manuscripts
Background: Schizophrenia is a thought disorder. As such it affects an individual level of function, and often leads to acute hospitalization. When clients with schizophrenia disorders are discharged, they are a great risk for suicide and danger to others. Services aimed at bridging patients from an acute facility to their community setting could be essential in helping the client in treatment to reach functional recovery and avoid relapse.
Objective: This article explores the role of mental health peer navigators in improving treatment adherence for adult clients with schizophrenia spectrum disorder being discharged from a psychiatric facility into their unique community …
Using Debriefs To Reduce Nursing Burnout In Nurses Caring For The Oncology Population, Courtney M. Wilkes
Using Debriefs To Reduce Nursing Burnout In Nurses Caring For The Oncology Population, Courtney M. Wilkes
MSN Capstone Projects
Nurses are a critical part of healthcare and make up the largest section of healthcare professionals in the United States. According to the World Health Organization (2020), there are approximately 29 million nurses and midwives globally. The increasing need for nurses is not a new discovery. According to the American Association of College of Nurses, more registered nursing jobs will be available through 2022 than any other profession in the United States. The number of nurses leaving the workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 in 2020. Nursing burnout is a known …
Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux
Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux
MSN Capstone Projects
Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …
Contributing Factors And Solutions For Inappropriate Use Of The Emergency Department, Lesia M. Kozych
Contributing Factors And Solutions For Inappropriate Use Of The Emergency Department, Lesia M. Kozych
Honors Capstones
Emergency departments are overwhelmed with the sheer quantity of patients, many of which are there for the non-emergent reasons. The purpose of this project is to identify factors that contribute to emergency department (ED) misuse, initiatives or programs that have been successful in decreasing ED misuse, and ED personnel’s opinions on contributing factors and potential solutions. A literature review followed by semi-structured interviews of ED personnel produced the necessary information. Common themes were drawn from participant responses in the interview portion. A major barrier to appropriate use of the emergency department is access to primary care. Others include: lack of …