Medicine and Health Sciences Commons^™

Improving Health Prevention Screening In A Rural Health Clinic, Shawn M. Mcnally

Culminating Experience Projects

Background: Health prevention screening has recently been highlighted in many initiatives from leading countries around the world. Breast cancer screening, cervical cancer screening and osteoporosis screenings are among the highest objectives for many of these initiatives as national health agencies focus on reducing morbidity and mortality by early detection.

Local problem: Baseline quality metrics reported for one clinic show the appropriate ordering of these health screenings is below the national benchmarks and the organizational benchmarks.

Methods: The project was designed as a quality improvement project based in a critical access region serving a rural population.

Interventions: The project intervention …

Adolescent Depression Management: An Inner City Federally Qualified Health Center Program Evaluation, Aurora Wernette

Culminating Experience Projects

Background: Within the state, approximately 119,000 adolescents aged 12-17 have depression, and it is estimated that 57.8% do not receive any mental health care (National Alliance on Mental Illness [NAMI], 2021).

Objectives: The purpose of this program evaluation is to evaluate the management of adolescent depression. This evaluation focused on adolescent depression screening rates, medication prescribing and adherence, counseling referrals and initiation, barriers to treatment, follow-up visits, and parent feedback about the care received.

Methods: All adolescents who did not have previously diagnosed depression or developmental delay were included in this program evaluation., A weekly manual chart review was used …

Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur

Culminating Experience Projects

Diabetes is a complex and chronic illness requiring continuous medical care with multifactorial risk reduction strategies (American Diabetes Association [ADA], 2021). More than 37 million Americans are suffering from diabetes and 90% of them have Diabetes Mellitus Type 2 (DMT2) (Centers for Disease Control and Prevention, 2021). The purpose of this article is to review the background, an organizational assessment, a literature review, and the results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included 16 patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, Body …

Brining Point-Of-Care Ultrasound To A Rural Primary Care Clinic, Caleb E. Migda

Culminating Experience Projects

Background and Objectives: In the rural primary care setting, the process for outpatient

ultrasound testing has multiple steps, all of which provide opportunities for delay in testing and diagnosis. Point-of-care ultrasound (POCUS) is a solution that allows the physician to perform same-day ultrasound in the primary care clinic. The objective of this program development project was to implement POCUS in a rural primary care clinic to reduce time to testing and diagnosis for those patients requiring ultrasound testing.

Methods: A 3-month chart audit was conducted to examine the average length of time required to complete ultrasound testing in the outpatient …

Type 2 Diabetes Nutrition: A Video-Based Education Approach, Erin Russell

Culminating Experience Projects

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease associated with life- threatening outcomes. To prevent such outcomes, people with diabetes must possess the knowledge and skills required to manage their chronic disease. Objectives: To evaluate the impact of video-based education (VBE) on participant Diabetes Self-Management Education Skills (DSMES). Methods: The experimental study was conducted in a primary care office in a Midwest state. A convenience sample of 55 participants was selected. Pre- and post-implementation surveys were administered to measure change in self-efficacy between DMSES scores after viewing the VBE intervention. The Wilcoxon Rank Sum test was performed using …

Development Of An Advanced Practice Provider Diagnostic Clinic Within An Oncology Practice, Abigail Jean Voss

Culminating Experience Projects

Background: The process of diagnosing cancer and the time to treatment can influence a patient’s experience with diagnosis of cancer at a later stage being associated with poorer cancer outcomes and decreased quality of life post-treatment. With increasingly complex oncologic imaging and pathology findings, effective interventions for early diagnosis of cancer requires a cohesive approach including referral, diagnosis, staging, and treatment phases. Objectives: The aim of this article is to outline the program development efforts initiated to apply current literature findings and organizational assessment to create a program development toolkit and business plan for an Advanced Practice Provider …

Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney

Culminating Experience Projects

Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).

Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.

Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Culminating Experience Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, An Evidence-Based Intervention, Kara M. Roman, Aaron Mestemaker

Culminating Experience Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Development Of A Point-Of-Care Ultrasonography Workflow Within A Rural Clinic, Lauren Myers

Culminating Experience Projects

Abstract

Background and Objectives: Healthcare has revolutionized with advancements in ultrasound technology. Among these advancements and the increasing availability of imaging modalities is point-of-care ultrasonography (POCUS) technology.

Problem: While POCUS has gained considerable ground in primary care, infrastructure to support its utility is deficient. The purpose of this project was to design, pilot, and evaluate a POCUS workflow to facilitate technology utilization and increase access to care.

Methods: Program development and evaluation involves the design, implementation, and evaluation of an evidence-based workflow for POCUS technology. The project was intended to address the needs of individuals in a rural setting. Participants …

Evidence-Based Recommendations For Assistive Technologies For Safety In Dementia Care, Lee A. Diener

Culminating Experience Projects

A Quality Improvement (QI) project in a Midwestern Continuing Care Residential Community (CCRC) was designed to examine the evidence-base of four assistive technology platforms marketed as safety platforms as means to improve outcomes for older adults residing in memory care environments. Using the Evidence-Based Design Model Socio-Technical Systems Theory, survey data and observational data collected from the organization were considered with respect to the evidence-base supporting each technology. Ten organizational priorities derived from collected data were used to develop an Evidence-Based Assistive Technology Fitness score for each of the AT platforms reviewed. This methodology provides a means to evaluate planning …