Medicine and Health Sciences Commons^™

How Increasing Personal Care Service Might Delay Or Prevent Nursing Home Placement, Sandra L. Spoelstra, Charles W. Given, Tracy Dekoekkoek, Monica Schueller

Peer Reviewed Articles

There is a pressing need to retain dually eligible elderly Medicare and Medicaid beneficiaries in the community. The objective of this study was to examine median personal care services (PCS) hours, and how increasing PCS to the median (for those below), might delay nursing home placement (NHP) and save cost. Methods: Retrospective study of PCS hours, costs, and NHP in a statewide home and community based waiver program in the Midwest serving 6525 dually eligible Medicare-Medicaid beneficiaries aged 65 and older. Two Minimum Data Set-Home Care assessments and Medicaid claim files were examined to identify PCS hours and cost. A …

Protecting The Skin Of Older Adults Through Surveillance And Pressure Ulcer Prevention Beginning In Emergency Services, Jennifer L. Zoeteman

Doctoral Dissertations

ED (emergency department) personnel are admitting to inpatient services increasing numbers of elderly clients who are at risk for skin breakdown. The ED environment is designed for short term care in response to emergent situations. Pressure related injuries originating in the ED lead to both physical suffering and financial burdens. Pressure relief strategies have been actively employed on an inpatient basis without translation to the ED environment. Evidence for best practice in PUP (pressure ulcer prevention) in the ED is not widely embraced. Prevention of PUs is primarily within the scope of nursing practice and amenable to improvements in the …

Perceptions Of Residential Elders Following Facilitated Advance Care Planning, Teresa M. Boersma

Doctoral Dissertations

The purpose of this project was to explore the perceptions of residential elders following a facilitated advance care planning (ACP) conversation. While literature is available regarding ACP and advance directives (ADs), there is minimal knowledge of first hand experiences from those who complete ACP and live in a residential or retirement community. Five residents of a retirement community who participated in facilitated ACP conversations also participated in a focus group interview to explore their perceptions of facilitators of and barriers to ACP and completing an AD. The interview was audio recorded and transcribed verbatim. Then the transcript was reviewed for …

An Evidence-Based Evaluation Of Medication Barcode Scanning Acceptance In A Community Hospital, Marie M. Vanderkooi

Doctoral Dissertations

Barcode scanning during medication administration is a powerful tool to prevent errors and support patient safety. In spite of the significant patient safety benefits, there is a lack of adoption and acceptance of barcode scanning. The purpose of this project was to implement an evidence-based assessment, utilizing a survey instrument based on the technology acceptance model, to understand adoption and acceptance of barcode scanning at a community hospital. Forty-four people, 38 nurses and 8 respiratory therapists, participated in the survey. Data analyses were performed using descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Spearman's rho tests. The subscales for the intention to …

The Effectiveness Of A Psychoeducational Intervention On Health Promoting Behaviors And Physical Health Of Adult Patients (18 And Over) On Antipsychotic Medications, Alice O. Mwanda

Doctoral Dissertations

Individuals on antipsychotic medications have been found to be disproportionately affected by overweight and obesity which increases their cardiometabolic risk. Psychoeducation has been found to be an effective strategy for risk reduction of cardiometabolic risks. This intervention examined the effectiveness of a psychoeducational intervention in adults (aged 18 and above) with severe mental illness. The four session, 8 week intervention encouraged an increase in fruit and vegetable intake and engagement in physical activity. The conceptual frameworks included the Health Promotion Model and Chronic Care Model. Outcome measures included nutrition, physical activity and health promoting behaviors. Biological outcomes included weight, BMI, …

The Influence Of Supportive Nursing Leadership In Staff Nurse Retention, Theresa L. Dawson

Doctoral Dissertations

Based on the increasing need to retain healthcare’s greatest assets, work environments must provide positive relationships and RN empowerment in an effort to improve staff nurse retention. A variety of factors can influence a registered nurse’s intent to stay, however supportive nursing leadership is thought to have the greatest impact on improving work environments resulting in greater job satisfaction. The purpose of this organizational assessment was to determine the current culture of supportive nursing leadership, RN perceptions of supervisory support, and themes that appeared to require nursing leadership development intervention. Based on these findings a series of leadership development workshops …

Primary Care Assessment And Interventions To Improve Physical Activity Among Insufficiently Active Adults Ages 18 Through 64 Years Old, Thomas A. Sanchez

Doctoral Dissertations

A number of chronic and debilitating conditions such as cardiovascular disease, stroke, hypertension, anxiety, depression, pain, osteoporosis, and falls are known to be delayed, improved, or prevented by increasing physical activity (PA) levels. The numbers of those affected form a substantial portion of the US population. As of 2011, for example, 26 million adults in the U.S. were diagnosed with diabetes mellitus (DM) alone. Another 79 million people had elevated blood glucose measurements putting them at risk for DM. Despite knowledge of the connection with chronic disease, PA levels are not consistently and quantitatively assessed during primary care office visits. …

Enhancing Communication, Satisfaction, And Self Efficacy In High-Risk Prenatal Women Using ‘Ask Me 3’, Cynthia A. Betterly

Doctoral Dissertations

Despite the recent advances in health care related to the patient-centered medical home, meaningful use, and the Affordable Care Act, the health care system has failed the vast number of patients who do not understand basic health information providers or educational materials designed to communicate to them. For the purpose of this project, low health literacy is framed as a barrier to patient and provider communication. Unfortunately, low health literacy often leads to adverse outcomes. These poor outcomes make improving health literacy a priority by acknowledging and evaluating health literacy interventions. The purpose of this project is to evaluate the …

Use Of The Cope Intervention For Depressed Adolescents, Lindsey R. Jelsma

Doctoral Dissertations

Depression disorders often present during adolescence. Depression can lead to difficulties with relationships, problems in school, and associated high risk behaviors. The goal is to identify and treat depression as soon as possible. The purpose of this project is to implement a cognitive– behavioral based intervention called Creating Opportunities for Personal Empowerment (COPE) to depressed adolescents. Previously, the COPE program has been implemented in outpatient and school settings. This intervention was implemented to adolescents in an inpatient psychiatric hospital. Effectiveness, acceptability, and feasibility were evaluated.

Twenty-five adolescents, majority female, ages 12-18 participated in this project. The participants completed all seven …

School-Based Nurse Managed Health Centers, Sylvia J. Simons

Doctoral Dissertations

School-based health centers (SBHCs) are a directed approach for providing health services to students who may otherwise lack them. Over the past 40 years, the number of SBHCs has olved from targeting public health concerns to the development of a specific collaborative model of care that is responsive to the unique needs of children. The purpose of this project was to develop a sustainable model for the creation and implementation of a school-based nurse-managed health center (SB-NMHC) with the capacity to improve health access and quality, and to reduce cost, while also mitigating present and future health disparities within a …

Using A Mental Health Board Game Intervention To Reduce Mental Illness Stigma Among Nursing Students, Anna Kristina Wassink

Doctoral Dissertations

Mental illness stigma can be displayed by anyone including those working in the health care field. Bachelor of Science in Nursing (BSN) students are one group within the health care field. The purpose of this project is to explore attitude change among BSN students related to mental illness stigma. The question guiding this project is whether a creative game implemented in conjunction with the existing educational and clinical experiences is helpful in reducing mental illness stigma in BSN students. Thirty-eight participants, 5 males and 33 females, a majority of whom were 20-21 years old, participated in this project. The intervention …

An Evidence-Based Approach For The Implementation Of An Osteoporosis Educational And Exercise Intervention Among Perimenopausal Women, Joanne Maura Cecile Finazzi

Doctoral Dissertations

According to the osteoporosis criteria developed by the World Health Organization, 10 million individuals residing in the United States are estimated to have osteoporosis, and 8 million of these individuals are women (National Osteoporosis Foundation [NOF], 2009). Educational and exercise interventions (Bohaty, Rocole, Wehling, & Waltman, 2008) have been developed in an effort to prevent osteoporosis. However, medical record reviews reveal that only 18% of patients receive counseling regarding osteoporosis educational interventions and exercise preventive measures during health care visits (Lee, Zuckerman, & Weiss, 2002).

The purpose of the pilot study was to examine the effectiveness of a 4-week, 4- …