Digital Commons Network^™

Moving Forward: Expanding The Digital Marketing And Information Technology Strategy Of A Thriving Nonprofit, R. Chance Witherspoon

Education Dissertations and Projects

The purpose of the project was to expand the digital marketing efforts and volunteer reporting and training processes of a thriving nonprofit healthcare organization. In 2015, the organization had an aging Web presence, disparate marketing systems, and inconvenient volunteer reporting and training processes. The project consisted of four central goals: improve website content management and update processes, improve website usability and digital marketing efforts, improve volunteer documentation and reporting processes, and improve volunteer training processes through accessible education resources.

Utilizing a modest budget, the project team sought to improve marketing and information technology processes within the organization by implementing modern …

A Farewell To Falsity Shifting Standards In Medicare Fraud Enforcement, Isaac ("Zack") D. Buck

Scholarly Works

For the better part of a decade, Americans have had a front-row seat to a fervent and turbulent debate over the future of their health care system. The passage of the Patient Protection and Affordable Care Act of 2010 (ACA), the most comprehensive health reform effort since the mid-1960s, ushered in a new era in health law and policy, granting millions of Americans access to health care. After multiple legal challenges and congressional efforts that ultimately failed to slay the law, the ACA had become entrenched by the end of the Obama administration, even though pieces of the law had …

2017-2018 Pediatric Subspecialty Trainees, Children's Mercy Hospital

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in allergy/immunology, child abuse pediatrics, child neurology, clinical child psychology, clinical pharmacology, developmental-behavioral pediatrics, hospice & palliative care, laboratory genetics & genomics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric anesthesiology, pediatric bioethics, pediatric cardiology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric ophthalmology, pediatric otolaryngology, pediatric pulmonology, pediatric radiology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, pediatric residency and med/peds residency.

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

Inclusion Of Social Workers In End-Of-Life Discussions In Intensive Care Units, Olivett D. Underwood-Mobley

Walden Dissertations and Doctoral Studies

Clinical social workers have roles in providing end-of-life care in the United States. Although clinical social workers are present in the intensive care unit (ICU) setting and have expertise to address end-of-life care dynamics, social workers are not consistently included in end-of-life discussions in the ICU setting. The purpose of this action research study was to explore the barriers that prevent clinical social workers from being included in end-of-life discussions in the ICU and how clinical social workers perceive their roles in end-of-life discussions in the adult ICU setting. Open-ended questions were used to gather data by facilitating 4 focus …

Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison

Walden Dissertations and Doctoral Studies

Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the …

The Legal Status Of Deep And Continuous Palliative Sedation Without Artificial Nutrition And Hydration, Jocelyn Downie, Richard Liu

Articles, Book Chapters, & Popular Press

Deep and continuous palliative sedation combined with the withholding or withdrawal of artificial nutrition and hydration (collectively termed “PSs̄ANH”) is an important aspect of high-quality end-of-life care. It is one means of alleviating suffering. Unfortunately, the legality of this practice has been under-researched and PSs̄ANH is not yet appropriately regulated in Canada. In this paper, we explore the legal status of PSs̄ANH where it (1) will not hasten death (Type 1 PSs̄ANH); (2) might, but is not certain to, hasten death (Type 2 PSs̄ANH); or (3) is certain to hasten death (Type 3 PSs̄ANH). It is clear that Type 1 …

Identifying Veterans With Opioid Use Disorder That Could Benefit From Referral For Evidence-Based Medication-Assisted Treatment, Emily Hampton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Current treatment guideline recommendations published by the American Society of Addiction Medicine for Opioid Use Disorder (OUD) include both psychotherapy and Medication- Assisted Treatment for optimal management of this chronic medical illness. Military veterans are at an increased risk for fatal outcomes related to opioid overdoses due to a higher prevalence of depression/Post-Traumatic Stress Disorder (PTSD) and self-medicated substance use compared to their civilian counterparts. Additionally, many have been diagnosed with OUD but are not being treated in accordance with current treatment recommendations.

In an effort to increase access to treatment and combat the opioid epidemic, the Lexington VA Medical …

Post Discharge Follow-Up Telephone Calls For Patients Who Received Hospital Based Palliative Care Services To Improve Quality Of Care And Outcomes: A Pilot Study, Katherine Adams

DNP Scholarly Projects

Background

There is a rising number of patients with chronic health conditions concurrent with an increasing number of hospital readmissions within 30 days and emergency department visits. Predominantly based in acute care facilities, palliative care services have been effective in improving the quality of life in patients with chronic health conditions. However, the largest population that could benefit from palliative care services is community based in the home setting.

Purpose

The purpose of this project was the implement and evaluate follow-up telephone calls made in addition to visiting nursing (VNA) services to detect in early decline in patients who have …

Evaluation Of Pharmacist Involvement In Outpatient Transitional Care Management, Katharine Lundy Pharmd

Pharmacy Residency

Presentation given at Great Lakes Pharmacy Residency Conference 2018

Home-Based Primary Care: Impact On Cost And Patient Satisfaction, Sarah R. Tupper

All Graduate Theses, Dissertations, and Other Capstone Projects

The aging American population means more people will need healthcare than ever before. Many of these people are or will be Medicare beneficiaries who are predicted to be completely or mostly homebound at some point in time. This literature review was conducted to investigate Home-based Primary Care (HBPC) and whether or not this care delivery model has impacts on cost and patient satisfaction when compared to traditional outpatient encounters. A comprehensive and robust search of the literature was conducted using four different healthcare literature databases. Relevant articles were included if the site of care was ambulatory or office-based and if …

Removing Obstacles To A Peaceful Death, Kathy L. Cerminara, Barbara A. Noah

Faculty Scholarship

We all will die, but the American health care system often impedes a peaceful death. Instead of a quiet death at home surrounded by loved ones, many of us suffer through overutilization of sometimes-toxic therapeutic interventions long past the time when those interventions do more good than harm. This article proposes revisions to health professional training and payment policy to eliminate as much as possible physical and existential suffering while progressing through the terminal phase of illness. The solution lies in seamless progression from treatment with integrated palliative care to hospice before death, but provider attitudes and payor practices must …

Nicu Nurses' Suggestions For Improving Obstacles In End-Of-Life Care, Rebecca Faye Isaacson

Theses and Dissertations

Background: Approximately 25,000 pediatric deaths occur in hospitals in the United States each year with over 50% of these deaths occurring in Newborn Intensive Care Units (NICU). NICU nurses are frequently involved in end-of-life (EOL) care and face unique obstacles. Objective: The objective of this study was to obtain NICU nurses suggestions for improving obstacles in EOL care in NICUs. Methods: Suggestions were obtained through mailed survey research in qualitative study design. Returned surveys yielded 121 nurse respondents who gave a total of 138 suggestions.Results: A total of 10 cohesive themes were identified: (1) environmental design issues, (2) improved communication …

Gerontological Social Work Roles In Disaster Preparedness And Response, Nancy Kusmaul, Allison Gibson, Skye N. Leedahl

Human Development and Family Science Faculty Publications

No abstract provided.

How Is Chaplaincy Marginalised-By Our Faith Communities And By Our Institutions And Can We Change It?, Jeffrey Cohen

Medical Papers and Journal Articles

This paper reviews the issues confronting chaplaincy/spiritual care in the 21st century. It looks at how faith communities are changing their view of chaplaincy as well how institutions respond. The paper looks at two qualitative studies and what can be learned from them in confronting the questions raised at the beginning. It concludes with the question of how the evidence base can be expanded to make chaplaincy/spiritual care more relevant over the next few years.

Physician-Assisted Suicide And Euthanasia: Emerging Issues From A Global Perspective, Charles L. Sprung, Margaret Somerville, Lukas Radbruch, Nathalie Steiner Collet, Gunnar Duttge, Jefferson P. Piva, Massimo Antonelli, Daniel P. Sulmasy, Willem Lemmens, E Wesley Ely

Medical Papers and Journal Articles

Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn’t be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and violated, including administering lethal drugs without patient consent, absence of terminal illness, untreated psychiatric diagnoses, and nonreporting; 2. Lack of self-determination: Psychological and social motives characterize requests for PAS-E more than physical symptoms or rational choices; many requests disappear with improved symptom control and psychological support; 3. Inadequate palliative care: Better palliative care makes most patients …

Economic Burden And Mortality Associated With Prescription Opioid Use, Hilary A. Aroke

Open Access Dissertations

Prescription opioid use and misuse poses a significant public health challenge to the United States. In this dissertation we use the three-manuscript format to address some the areas of unmet research. Each manuscript has an abstract, introduction, background, methods, results, discussion, and conclusions sections.

Manuscript 1: We used a retrospective cohort design to examine the association between the patterns of initial prescription opioid use for non-cancer pain and risk of all-cause mortality among an insured opioid-naïve patient population in the U.S. Multivariable Cox regression model was used to estimate the association of initial pattern of opioid use with all-cause mortality, …

Amyotrophic Lateral Sclerosis And A ‘‘Death With Dignity’’, Jennifer A. Andersen

Department of Sociology: Faculty Publications

The Oregon ‘‘Death With Dignity’’ Act (DWD Act) allows a terminally ill patient with 6 months to live to ask a physician for medication to end their life. To receive the medication, the DWD Act requires the patient to verbally request the prescription twice 2 weeks apart as well as in writing. Patients with amyotrophic lateral sclerosis have three main barriers to using DWD: (a) the ability to communicate their informed consent as the disease progresses further, (b) the possibility of dementia which may affect their decisional capacity, and (c) given the nature and speed of amyotrophic lateral sclerosis, limited …

Narratives Of Baby Boomers: Envisioning Late Life Spiritual Resources, Jane A. Kuepfer

Theses and Dissertations (Comprehensive)

ABSTRACT:

In this narrative inquiry, first-wave baby boomers (six males and six females born between 1946 and 1955) reflected on their lives and envisioned living into old age. While literature has focused on trends in baby boomer spirituality, issues of aging, and spiritual needs and tasks among elders, this study listened for “spiritual resources.” Initially defined broadly as that which has sustained a person throughout their life and will sustain them in the future, spiritual resources came to be understood as those things, both internal and external, that address deep human need for such spiritual values as love, hope, peace, …

Patient Experiences Of A Physiotherapy-Led Multidisciplinary Rehabilitative Intervention After Successful Treatment For Oesophago-Gastric Cancer, Annemarie Bennett, L. O'Neill, D. Connolly, E. M. Guinan, L. Boland, Suzanne Doyle, J. O'Sullivan, J. V. Reynolds, J. Hussey

Articles

Purpose To qualitatively explore the perceived impact of a 12-week rehabilitative intervention for oesophago-gastric cancer survivors on their physical, mental and social wellbeing. Methods Of the 21 participants who completed the intervention, 19 took part in a semi-structured focus group interview. Four audio-taped focus groups were held, ranging in size from two to eight participants. Focus groups were transcribed and analysed using a descriptive qualitative approach. Results At recruitment, participants were 23.5 ± 15.2 months post-surgery and all had suboptimal fitness levels. Participants reported improvements in their physical capacity and ability to carry out activities of daily living during the …