Medicine and Health Sciences Commons^™

Improving Adolescent Risk Behavior Screening: Implementation Of The I-Cloud Rapid Assessment Adolescent Preventive Screening (Raaps) Tool, Donna L. Rinker

Doctoral Projects

Adolescents are engaging in risky behaviors earlier contributing to 75% of adolescent morbidity and mortality with unintentional injuries listed as the most common cause of death among this population in the United States. It is reported that engaging in more than one risk behavior will lead to other risk behaviors resulting in the rise of indirect and direct costs in society today. The scholarly project was conducted in response to a midwestern Michigan primary care clinic need to improve the early identification and documentation of adolescent risk behaviors with evidence-based technology screening. The purpose of this quality improvement project was …

Care Of Adult Cancer Survivors, Kelsey Kloosterman

Doctoral Projects

As innovative cancer treatments emerge, more people are surviving cancer. Cancer survivors have multiple and unique healthcare needs due to their cancer and cancer treatments. Communication among those treating the cancer, primary care providers, and cancer survivors is necessary to coordinate care once treatment is finished. The development of a survivorship care plan that is reviewed with the cancer survivor is intended to facilitate communication among all stakeholders. This quality improvement project examined current practice in a survivorship clinic in a Midwestern health system cancer center that cares for a variety of types of cancer patients. By reviewing evidence in …

Evaluation Of Short Term Cognitive Behavioral Therapy Intervention In A Primary Care Setting, Kevin Hengeveld

Doctoral Projects

Introduction: Depression and anxiety are chronic recurring medical conditions that impact all aspects of health. When depression and anxiety are present with other comorbid diseases, mortality and health care costs are higher. Children and young adults are particularly vulnerable to mental health issues. Suicide is the 2nd leading cause of death for this demographic. Depression is common in adolescents with an incidence of 8 to 20 percent. Primary care provides 70 percent of mental health care in the United States, and the primary intervention offered is pharmacological. Evidence suggests that a combination of medication and psychotherapy provide superior relief of …

Creating And Conducting Intergenerational Learning In Higher Education, Andrea Lauren Holt

Honors Projects

The creation, conduction and revision of a one of a kind intergenerational course taught in the Grand Valley State University Fredrick Meijer Honors College. Elders and Traditional Honors College Freshman came together in a mixed classroom in order to bridge the gaps of communication and misunderstanding between generations.

Implementation Of A Multimodal Hand Hygiene Intervention At A Rural Critical Access Hospital, Amy J. Hopp

Doctoral Projects

Healthcare acquired infections are the most common complication of hospital care in the United States, with subsequent negative implications on the healthcare system. While hand hygiene has long been considered the single most important and cost-effective way of reducing healthcareacquired infections, compliance among healthcare professionals is low, and most efforts to improve it fail. When compared to single-component hand hygiene interventions, research demonstrates that tailored multimodal interventions are an effective way to improve compliance with hand hygiene practices among healthcare professionals. This Doctor of Nursing Practice project focused on implementing a multimodal hand hygiene intervention, tailored to fit the specific …

Evaluation Of A Health System’S Community Targeted Program For Individual’S With Increased Risk For Cardiovascular Disease And Diabetes, Phallon Lovelady

Doctoral Projects

Introduction: Lack of a program evaluation plan for a community targeted primary prevention program poses a risk for undefined program effectiveness. Conducting a systemic program evaluation helps determine program effectiveness and value. The purpose of this paper is to discuss the process of implementing a program evaluation during a Doctorate of Nursing Practice (DNP) scholarly project.

Objectives: The objectives of this project were to apply a scholarly approach to program evaluation utilizing evidence-based practice tools, demonstrate DNP Essentials and health systems leader competencies, and describe the steps taken during the process.

Methods: The CDC Framework for Program Evaluation (2011) was …

Mindfulness’S Effects On Undergraduate Nursing Students' Negative Mental Health Symptoms: A Systematic Review, Erin Sartorius

Honors Projects

Undergraduate nursing students endure unique stressors that potentiate negative consequences to their mental health. Mindfulness-based interventions may improve these negative mental health symptoms in nursing students. The objective of this review is to assess available research regarding the effects of mindfulness-based interventions on the negative mental health symptoms of undergraduate nursing students. The databases CINAHL Complete, PubMed, and PsycINFO were searched for relevant research. Search terms were brainstormed and individually assessed to determine relevancy to the research question. In order to be incorporated into this systematic review, all assessed studies needed to include (1) an intervention rooted in mindfulness, (2) …

An Enhanced Actualized Dnp Model To Improve Dnp Project Placements, Rigor, And Completion: A Research Brief, Marie Vanderkooi, Dianne Conrad, Sandra Spoelstra

Funded Articles

Doctor of nursing practice (DNP) projects are summative evaluations of enactment of the DNP Essentials. However, information about structure, process, and outcomes of DNP projects is scarce. Guided by an enhanced actualized DNP model, this study tested the effect of a PhD-DNP-site mentor model to guide DNP projects. Time-to-complete assignments, defense, and graduation improved; high satisfaction for students, mentors, and faculty were found; and a strengthened academic-practice partnership occurred, leading to additional student placements. Broader testing of the enhanced model in various size and types of academic-practice settings is needed prior to use.

Improving A Discharge Process To Decrease Readmission Rates, Erni Ensing

Master's Projects

No abstract provided.

A Quality Protocol For A Federally Qualified Health Center: A Pilot Project, John K. Dekock

Doctoral Projects

Federally Qualified Health Centers (FQHCs) have become a vital part of access to care for low socioeconomic status individuals. The federal government has allocated funds to be distributed to FQHCs via Medicare and Medicaid reimbursement based on insurance claims and through the Health Resources and Service Administration (HRSA) via grants and incentives based on Uniform Data System (UDS) reporting. Federally Qualified Health Centers must complete annual uniform data system (UDS) reporting on quality indicator metrics to receive grants and incentives from HRSA. The Health Resources and Service Administration (HRSA) funded health centers are expected to have ongoing quality assurance and …

Implementing Evidence-Based Fall Reduction Interventions In An Urban Emergency Department, Nichole L. Schmidt

Master's Projects

The patient population that is falls in the emergency department (ED) tends to differ from population that falls on inpatient units. However, there is no validated fall risk assessment for the ED setting. In an ED in a western Michigan hospital a fall reference card was designed and trialed by a small group of ED nurses on twenty-five ED patients. The fall reference card was created as a quick-reference guide for the assessment of fall risk, and the implementation of evidence-based fall risk interventions. The card utilized interventions supported by literature as the most common reasons for ED falls. The …

Hospital Acquired Pressure Injury Gap Analysis, Mary Lou Hall

Master's Projects

Hospital acquired pressure injuries (HAPIs) were identified as an area for a quality improvement (QI) project in a progressive care unit (PCU) in a Midwestern Hospital. In order to reduce HAPIs and provide the best possible preventative care, a gap analysis between the current care practices on the progressive care unit and the best evidence-based practice recommendations for HAPI prevention in the areas of risk/skin assessment, surface support, nutrition and hydration, repositioning/movement, moisture management, and prophylactic dressings was conducted. The Model for Improvement (MFI) was the QI framework that guided this pressure injury gap analysis.

The goals of this gap …

Increasing Use Of A Tobacco Cessation Quitline In A Rural Prenatal Population, Rachel T. Schleenbaker

Master's Projects

This paper addresses prenatal smoking rates within in a rural northern Michigan district health department (HD) through a Master of Science in Nursing (MSN) quality improvement project. The paper provides a detailed microsystem assessment of the Maternal Infant Health Program (MIHP) at the district HD describing the clinical problem and identifying a practice gap in care of prenatal smokers. The literature review describes the three most effective prenatal smoking cessation interventions: counseling, incentives, and feedback. The literature review also addresses the effectiveness of and barriers to smoking quitlines. The clinical protocol followed the Model for Improvement framework with the completion …

Applying Process Standardization And Health Literacy Precautions To Increase Older Adult Patient Satisfaction With Medication Teaching, Casie N. Sultana

Master's Projects

The purpose of this paper is to describe a quality improvement (QI) project with the goal of creating an evidence-based, standardized process for nurses to teach older adult patients about newly prescribed medications.

Improving Adolescent Risk Assessment In A Primary Care Setting, Kristin N. Vanderwell

Doctoral Projects

Adolescent risk-taking behaviors contribute significant risk to the current and future health of adolescent patients and have a significant annual cost to society. A primary care practice in western Michigan had no standardized practice related to the screening, evaluation, and response to adolescent-risk taking behaviors. As a result, only three of the fourteen providers were consistently following national guidelines for screening, evaluating, and responding to adolescent risk-taking barriers. The providers cited lack of time and lack of knowledge as barriers to following guidelines. The purpose of this quality improvement project was to address the health care needs of the adolescent …

Implementation Of Standardized Heart Failure Educational And Documentation Processes Within An Outpatient Heart And Vascular Clinic, Mallory Myslenski

Doctoral Projects

Heart failure is a prevalent, high-risk condition associated with high mortality and frequent hospitalizations. Heart failure is characterized by acute exacerbations of signs and symptoms, and affects almost six million Americans leading to one of the most costly illnesses in the United States. Management of heart failure is complex and individualized relying on appropriate education, self-care management, medications, and adequate follow-up to succeed in treatment. Many organizations have initiated evidence-based heart failure management or educational programs that provide easy-to-learn education on diagnosis, medication, and self-care behaviors. Research has shown that these programs help patients to better manage their symptoms at …

An Education Intervention To Increase Rounding And Toileting And Reduce Falls In A Hospital Acute Care Of The Elderly (Ace) Unit, Amelia Grayson

Doctoral Projects

Introduction: Falls are the most common accident reported in acute care hospitals and patients who are 65 and older are the most vulnerable. Falls can lead to physical and emotional injury, reduced mobility and functioning, increased length of hospital stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) has eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. Research on fall prevention in adult acute care found multifactorial interventions that address multiple risk factors for falls are the most successful at prevention. This …

Increasing Post-Acute And Long Term Care Coding For Advance Care Planning In An Outpatient Setting, Emily M. Mccloskey

Doctoral Projects

Today’s healthcare landscape is saturated with an aging U.S. population that is living longer and with more chronic conditions. One way to manage care for this aging population, especially those with chronic conditions, is through advance care planning (ACP). Healthcare providers are capable of engaging patients in these important healthcare discussions, yet use of methods to appropriately document and code for these services are lacking. There are Current Procedural Terminology (CPT) codes in existence that would be applicable for these services; however, they are not widely understood nor routinely used in clinical practice. Administrators at a large Midwestern healthcare organization’s …

Prevention Of Central Line-Associated Bloodstream Infection (Clabsi) In Adult Oncology Patients, Christina Winkelman

Doctoral Projects

Central Line-Associated Bloodstream Infection (CLABSI) is a preventable issue in healthcare. CLABSI contributes to negative patient outcomes and increased healthcare cost. Research demonstrates that many interventions are effective in reducing the rate of CLABSI. The implementation of CLABSI bundles can significantly reduce the occurrence of CLABSI. This quality improvement project implemented a CLABSI bundle that specifically targeted identified areas of weakness in CLABSI prevention at an organization with a focus on adult oncology care. The three part CLABSI prevention bundle focused on: (a) registered nurses (RN) changing and documenting endcaps in the electronic health record after blood administration, (b) RNs …

Nursing Student Perceptions Of Study Abroad, Emma Branch

Honors Projects

Following the author's own study abroad in Cusco, Peru in May 2017, a literature review was conducted on nursing students who studied abroad and its effect on their ability to provide culturally competent care. Based on that review, the author created a standardized survey tool to be used on other nursing students who study abroad. This tool includes pre-travel and post-travel questions. It collects demographic data, data on the logistics of the trip, and open-ended questions about the experience. The tool was distributed to the GVSU nursing students who went to Ghana, Africa in March 2018. The data from that …

Structure, Process, And Outcomes: The Foundation For Continuous Quality Improvement In Primary Care, Mark A. Contreras

Doctoral Projects

Healthcare within the United States is notoriously fragmented and inefficient. Contemporary innovations for policy, reimbursement, and care delivery are consistently directed towards the promotion of value based care (Bates, 2010). These initiatives routinely coalesce around the promising potential of a robust primary care system. The Patient-Centered Medical Home (PCMH) model is increasingly becoming the standard of quality care and use of this model by healthcare providers is poised to bring about a paradigm shift towards value-based care (Henderson, Princell & Martin, 2012).

This scholarly project incorporated an evidence based approach to establishing continuous quality improvement in a primary care office …

Improving The Patient Handoff From Or To Picu In Children Who Have Undergone Cardiac Surgery Using A Standardized Handoff Tool, Amanda Taylor

Doctoral Projects

Inpatient hospitalizations for children are often costly. Children often transition from one setting to the next while hospitalized, therefore their provision of care is also transferred from one care team to the next. This transition presents a vital time for the child, that may be associated with adverse events and medical error. Adverse events can lead to poor outcomes for the child. Despite efforts to improve patient handoffs, communication failures are still abundant in healthcare. Research indicates that the use of a standardized handoff tool from one setting to the next is an effective method for improving the patient’s transition. …

Implementation Of Evidence-Based Culturally Adapted Interventions, Collaborative Care, And Change Management For Improved Mental Health Outcomes In A Community-Based Safety-Net Clinic, Laura E. Hall

Doctoral Projects

Mental health disorders are prominent and devastating in the United States. They are more prevalent in low-socioeconomic and minority groups with lower rates of diagnosis and treatment in these populations. Primary care settings are the foremost location for screening, diagnosis, and treatment for common mental health disorders but do not always provide adequate care due to limitations of time, knowledge, and resources. Evidence has shown that collaborative care models can provide more effective treatment for behavioral health services through a team-based approach to holistic patient care. This project focused on implementing culturally adapted, collaborative care models to improve mental health …

Effect On Opioid Use Following The Implementation Of Evidence-Based Pain Management, Kathryn L. Ellens

Doctoral Projects

Pain is the most common reason people seek healthcare. Initiatives to prevent the undertreatment of pain have resulted in overreliance on opioids to treat pain. Despite significant increases in opioid use, pain is more prevalent than ever. Additionally, devastating consequences from opioid use have resulted, such as dependence, addiction, and increasing opioid-related deaths. Research demonstrates multimodal analgesic therapy is an effective alternative to the overreliance on opioids to treat pain. Multimodal analgesia is the synergistic use of two or more analgesics with different mechanisms of action. Multimodal analgesia produces significantly more effective and efficient pain management than opioid-only therapy. This …

Improving Care For Children With Down Syndrome: Nursing Interventions, Hannah Burt

Honors Projects

Down Syndrome (DS) is a genetic disease that affects thousands of families. Children with DS often require more medical care since there are over 100 anomalies associated with DS (Philips & Boyd, 2015). Without proper knowledge of DS, it is difficult for healthcare workers to provide effective and relevant care. This paper will focus on physical differences of people with DS, emotional coping in families of children with DS, along with interventions for physical and behavioral health that nurses can implement.

Evidence Based Toolkit To Improve Oncology Referrals To Palliative Care, Katelyn M. Gettel

Doctoral Projects

As cancer related mortality decreases, the number of patients living with cancer symptoms and the side effects of cancer treatment will continue to grow. In 2016, over 1.5 million Americans were newly diagnosed with cancer (American Cancer Society, 2016). Several major medical organizations including the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN), and the World Health Organization (WHO) endorse the integration of palliative care into cancer care (Ramchandran, 2015). Although many cancer centers report offering palliative care, this remains largely limited to inpatient services.

The stakeholders of the hospice and palliative care division of a …

A Multidimensional Approach To Improve Cardiovascular Quality Measure Documentation In A Native American Population, Jessica A. Mastbergen

Doctoral Projects

Native Americans are more likely than white counterparts to be diagnosed with heart disease (Office of Minority Health [OMH], 2017). The scholarly project was conducted in response to the need for improvement in cardiovascular lifestyle interventions for Native Americans and their documentation to meet Government Performance Results Act quality measures. The clinical question addressed was: what is an evidence-based multidimensional approach to improve cardiovascular quality measure documentation in a Native American primary care clinic? The multidimensional interventions included educational sessions for Community Health Representatives (CHRs), a provider education session on appropriate documentation in order to satisfy quality measures, chart review …

Feasibility Trial Intervention “Let’S Move Away From Screen”, Oksana K. Lidke

Doctoral Projects

“Let’s Move Away From Screen” was a six-week quality improvement project implemented in one of West Michigan’s after school programs among students attending 6th and 7th grades. The purpose was to implement physical activity and health education (nutrition, physical activity, and recreational screen time) with major intentions to (a) establish healthy lifestyles and decrease recreational screen time in the after school program and (b) evaluate the project’s acceptability and sustainability by students, parents, volunteers, and the organization. The project’s need was driven by the health needs assessment conducted in February 2016 by the school’s health center. One of the biggest …

Relationship Between The Cortisol-Estradiol Phase Difference And Affect In Women, Karyn Butler

Funded Articles

Affective disorders impact women’s health, with a lifetime prevalence of over twelve per cent. They have been correlated with reproductive cycle factors, under the regulation of hormonal circadian rhythms. In affective disorders, circadian rhythms may become desynchronized. The circadian rhythms of cortisol and estradiol may play a role in affective disorders. The purpose of this study was to explore the temporal relationship between the rhythms of cortisol and estradiol and its relationship to affect. It was hypothesized that a cortisol-estradiol phase difference (PD) exists that correlates with optimal affect. A small scale, comparative, correlational design was used to test the …

Reference Notes For Palliative Care Consultation, Robert F. Johnson

Open Textbooks

The interprofessional health care specialty of palliative care employs holistic evaluation and person-centered communication in the care of people with life-threatening illness. Palliative care clinicians are consulted for one or more of the following reasons:

• Symptom assessment and management
• Assistance with making difficult decisions about continued use or withdrawal of life-sustaining interventions
• Communication for planning the most appropriate care setting to meet person/family goals for end-of-life care
• Assessment of suitability and eligibility for hospice care

This resource is a compilation of previously published documents and tools useful to palliative care clinicians in preparing for and conduction these consultations. In addition, …