Medicine and Health Sciences Commons^™

Transition Of Care For Discharged Patients, Rolando Ramos

Student Scholarly Projects

Practice Problem: The 30-day readmission rate for patients discharged from the hospital and returned to their primary care in a clinical office setting (21%) was higher than the national average readmission rate (17%). The high readmission rate suggested patients were receiving transitional care that was fragmented and non-standardized. Therefore, the implementation of a collaborative transition of care practice was vital to reduce avoidable readmissions.

PICOT: The PICOT question that guided this project was, “In adult patients with chronic conditions, what is the effect of a transition of care practice, versus a non-standardized practice, on reducing 30-day readmissions, within a …

Early Diagnosis Of Alzheimer’S Disease In The Primary Care Setting, Raymond R. Romano

Theses and Dissertations (ETD)

The burden of Alzheimer’s disease (AD) affects not just the individual but also families, providers, and society. Early recognition and diagnosis of AD may reduce cost by reducing interaction with the health care system, earlier initiation of treatment, and prolonging time to long- term care. Primary care providers, the first contact for diagnosis of patients with AD, are not fulfilling the potential of early diagnosis for a variety of reasons. Biomarkers of AD emerge on average 15 to 20 years before clinical diagnosis, yet currently established biomarkers are not easily available in the primary care setting. A growing body of …

Improving Identification Of High-Risk Obstructive Sleep Apnea Patients In Primary Care: An Integrative Review, Lauren Ashley Paulson

Doctoral Dissertations and Projects

Obstructive sleep apnea continues to be an area that is underdiagnosed and therefore undertreated. Left untreated, the condition is associated with increased morbidity and mortality as it can amplify the risk of multiple health conditions. Due to the negative impact of obstructive sleep apnea it is necessary for healthcare providers to provide timely detection. Primary care providers are in a position to identify high-risk individuals and refer them for further follow up testing. High-risk identification can be accomplished by integrating validated screening tools into patient assessments. This integrative review provides an overview of current screening tools for use in the …

Pharmacogenomics In Primary Care: Barriers To Implementation, Joshua Michael Fleming

Doctoral Dissertations and Projects

As technology and research evolve it is essential that practitioners in healthcare remain aware and cognizant of the changes that are going on around them and how these advancements may aid them in providing the best care to the patients that seek care from them. The largest breakthrough in the field of genetics has been the complete sequencing of the human genome. This landmark has paved the way for innumerable insights into every part of how care is delivered and stands to change the landscape of medicine entirely. Pharmacogenomics testing exists as a subset of genetic testing, and pertains to …

The Impact Of Pre-Visit Contextual Data Collection On Patient Activation: Results From A Randomized Control Trial, Jeana Marie Holt

Theses and Dissertations

Background The majority of health indicators are outside of the healthcare system, and current electronic health records (EHR) do not capture those indicators. There is a compelling opportunity to test consumer informatics tools that integrate patient's life circumstances, goals, supports, risks, and care preferences into their EHR for point-of-care discussions.

Purpose To determine whether the use of a patient-generated contextual data (PCD) tool designed to enhance the capture and sharing of PCD influenced patient activation.

Design, Setting, and Participants A two-armed, non-blind, randomized control trial was conducted between May 2019, and October 2019 at two urban, academically affiliated primary care …

Implementing A Practice Strategy In Primary Care Using An Assessment Tool To Screen For Depression, Donna Snow

Doctoral Projects

Increased efforts are being made to move individuals with co-morbid medical and psychiatric diagnoses toward integrated care. Lack of consistent screening in primary care has caused missed opportunities to identify depression during a routine healthcare provider visit. This project sought to implement a practice strategy in primary care using an assessment tool to screen for depression. Interviews were used to ask patients to answer two questions related to the frequency of depressed mood in the last two weeks. The project was seeking to show by screening patients in primary care for depression, the number of referrals to behavioral health would …

Developing Lactation Support In A Primary Care Pediatric Office, Charlotte Minnema

Doctoral Projects

Background: Breast milk is known to be the best nutrition for infants, and experts recommend to exclusively breastfeed through the first six months of life and provide breastmilk through at least the first year of a child’s life (American Academy of Pediatrics, 2012). The United States is currently not achieving its breastfeeding goals set out in Healthy People 2020 by the US Department of Health and Human Services (U.S. Department of Health and Human Services, 2014). The integration of Internationally Board-Certified Lactation Consultants (IBCLC) into primary care pediatrics offices has been shown to increase all breastfeeding rates (Witt, Smith, Mason, …

Telehealth Visits For Common Concerns In A Primary Care Setting: Establishing A Protocol, Erin M. Leighton

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Barriers to accessing healthcare in Vermont include: weather conditions, rurality, lack of public transportation systems, and busy schedules. Telehealth mitigates these barriers, providing a safe and effective option on par with in-person visits, while lowering overall healthcare costs and increasing patient satisfaction. This project aimed to expand telehealth visits in a nurse practitioner-run primary care practice, via designing effective protocols and educating clinicians on telehealth use, requirements, documentation, and billing in order to complete telehealth visits successfully.

Methods: Infrastructure for telehealth: a workflow protocol, patient education materials, procurement of technological resources including iPads, and necessary, HIPAA compliant, secure accounts. …

Systematic Review: Barriers To Primary Care For The Transgender Individual, Charles David Mccormick

Walden Dissertations and Doctoral Studies

Representing a diverse group, the transgender community defies conventional norms expected by society resulting in discrimination and denial of essential goods and services necessary to maintain personal health, safety, and well being. The identification of the barriers to primary care faced by the transgender individual has the potential to reduce healthcare disparities and improve the compliance with national screening and treatment guidelines. The purpose of this project was to examine available literature incorporating the systematic review method to determine the barriers to primary care faced by the transgender individual. Using Leininger’s transcultural nursing theory to guide the process to determine …