Medicine and Health Sciences Commons^™

Improving Utilization Of Clinical Pharmacy Services In A Health Professional Shortage Area, Samantha E. Tallman

Culminating Experience Projects

Background: Integration of clinical pharmacy specialists (CPS) into primary care has increased over the last decade. CPS are highly educated advanced practice providers and specialize in chronic disease and medication management, and offer additional support to both patients and PCPs. Despite their extensive training and expertise, the role of CPS is often unknown or misunderstood amongst PCPs and results in the underutilization of CPS services. As a result, referrals to their service remain low. The purpose of this quality improvement project is to increase referrals to embedded CPS and identify encounter types by associated diagnoses.

Objectives: Develop and implement a …

The Influence Of Dash Diet Education On Knowledge And Adherence In Primary Care: A Quality Improvement Project, Paige Bekker

Culminating Experience Projects

Background/Local Problem: A rural family practice was concerned about the number of

patients with uncontrolled hypertension, 19.86% n = 56, as defined by the Centers for Disease Control and Prevention (CDC). After several quality improvement (QI) initiates to lower the prevalence rate of uncontrolled hypertension, including proper measurement techniques and home monitoring, the modifiable risk factor of adapting one’s food intake was introduced using the Dietary Approach to Stop Hypertension (DASH) diet as an intervention. The DASH diet is an evidence-based approach for lowering blood pressure. The QI project was completed with the purpose of implementing DASH diet education and …

Improving Vaccination Rates In Pediatric Primary Care, Lauren E. Osbeck

Doctoral Dissertations

Objectives: In a small, rural pediatric primary care clinic, the effectiveness of electronic patient portal reminders were evaluated at improving vaccination rates for school required immunizations.

Methods: A quality improvement project was initiated utilizing The Social Ecological Model. All pediatric patients were sent reminders who were under-immunized. This QI project evaluated the effectiveness of vaccine reminders on the improvement of immunization rates in the clinic

Results: Total number of fully-vaccinated patients within the practice improved (2%) and patients under-immunized decreased by 1%. 87 immunizations were given to patients were given to patients who were under-immunized and an average of 10% …

Process Improvement To Reduce Route Of Medication Administration Errors In Patients With Enteral Feeding Tubes, Elizabeth Scott

Doctoral Projects

Advances in health information management in the form electronic health records, computerized provider order entry systems, and clinical decision support systems and tools have enhanced the productivity, effectiveness, and efficiency of healthcare. However, the cost of these positive effects does come at the expense of other factors. Along with the introduction of Clinical Provider Order Entry (CPOE) systems, organizations have experienced new possibilities for medication errors and risks to patient safety. Factors associated with these errors should be evaluated in detail in order to mitigate the causes of these types of errors and to plan strategies for prevention. Continued research …

An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter

Doctoral Projects

Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.

Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …

Improving Heart Failure Care Plan Coordination Across The Health Care Continuum, Amy Veltkamp

Doctoral Projects

Heart failure costs the United States 31 billion dollars each year, with much of those costs attributed to hospital admissions. Coordinating care across the health care continuum is a critical factor in improving heart failure care and reducing readmissions. An organizational assessment was conducted using the Burke and Litwin Causal Model of Organizational Performance and Change. The quality improvement project implemented a longitudinal plan of care (LPOC) across 10 hospitals and numerous ambulatory care sites at a large Midwestern health organization. Nurse care managers (NCMs) were the focus of this project due to their high-level of involvement in care coordination. …

Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney

Doctoral Projects

Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …

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

Doctoral Projects

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

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

Retention Of Registered Nurse Employees In Rural Community Hospitals Less Than 100 Beds, Joanne Urbanski

Masters Theses

Maintaining a stable nursing staff is critical to the effective operation of hospitals, therefore chief nurse executives must not lose sight of the importance of retention efforts. The purpose of this study was to identify factors that maintain or increase job satisfaction among registered nurses working in small, rural hospitals, thereby, motivating them to remain in a rural hospital practice setting. Four hundred and twenty-seven job satisfaction surveys were mailed to 13 rural community hospitals that had less than 100 beds. Two hundred and twenty completed surveys were returned (52%).; Sociodemographic characteristics of short-term (less than one year) and long-term …