Medicine and Health Sciences Commons^™

Drivers Of Being Unhoused And The Prevalence Of Health Conditions Among Unhoused Individuals In Asheville, Nc, Andrea K. Yontz, Amber Beane, Tessa Frank, Amy Upham, Dustin V. Patil, Dan Pizzo, Steve Buie, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background

During the COVID-19 pandemic, there was an increase in the number of unhoused individuals in Asheville, North Carolina resulting in more tent encampments.

Understanding the physical, mental, and socially determined health characteristics associated with being unhoused can help guide stakeholders with policy development, healthcare program planning, and funding decisions to support unhoused individuals.

Methods

In this study, we used an observational cross-section methodology. Using a convenience sample approach, we interviewed 101 participants who were receiving services from 2 emergency hotel shelters, a day center, and a resource center. Data were analyzed using descriptive statistics, and open-ended responses were collected …

Developing A Caregiver Educational Tool For Children With Behavior Issues, Grace Healy, Elise Arkills, Joshua Anderson, Emma Vetter, David Njeri, Avery Strieby

Nursing Leadership in Community Engagement Projects

Developing a Caregiver Educational Tool for Children with Behavior Issues

The team was tasked to create a health-based solution for problems facing a non-profit agency. The agency is a branch of an organization in King County, where providing critical familial needs, strengthening familial bonds, and preventing homelessness are the primary aims. Last year, the agency was able to assist 669 families, and the numbers are continuing to grow as more resources become available.

The team included six Seattle Pacific University nursing students, who are enrolled in a Nursing Leadership in Community Engagement course. After collaborative meetings with the managers at …

A Video Based Training Review, Sarah Kessel, Rachel Cyers, Alicia Johnson, Macky Juan, Malia Lafrance, Julia Zajac

Nursing Leadership in Community Engagement Projects

A Video Based Training Review

This project addresses the issue of homeless youth in Seattle by supporting those working with this population. Our intervention intends to provide staff with training materials to better support the homeless youth in Seattle. The agency that we are partnering with provides temporary housing for homeless youth and seeks to find permanent housing solutions. The purpose of our project is to help agency employees review and assess their knowledge on selected topics relevant to their initial training. This project compiles a collection of evidence-based training videos with knowledge competency quizzes to help strengthen understanding on …

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …

Reducing 30-Day Psychiatric Inpatient Hospital Readmission Of Mentally Ill Homeless Men With Substance Use Disorder By Using A Discharge Checklist, Chibuogwu E. Ogbuka

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Psychiatric inpatient readmission of mentally ill homeless men with substance use disorder is greater than that of the non-use population. Substance use disorder co-occurs with high prevalence among patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health, behavior, and medication non-compliance, resulting in hospital readmission.

Problem: In acute psychiatric facilities in Northern California, the greatest readmission after inpatient hospitalization occurs at 53% in a week and 74.8% within two weeks of discharge. For homeless individuals, substance use disorder exacerbates personal problems and decreases the likelihood of …

Mental Health And Parenting Among Young Adults Experiencing Homelessness With And Without Their Children, Rebecca Bergh

Dissertations & Theses (Open Access)

Background: Parent-child separation and custody loss are common among parenting young adults experiencing homelessness (YAEH). These experiences may be traumatic for YAEH, a population already vulnerable to mental health disorders and high levels of trauma. Little is known about how YAEH who have their children with them compare to YAEH separated from their children in terms of mental health and risk and resilience factors. Further evidence is needed to better understand the parenting and mental health support needs among YAEH, particularly surrounding parent-child separation.

Aims: This study aimed to examine the characteristics of (1) parenting YAEH living with their children …

Women’S Shelter Health Needs Assessment, Asmait Woldu, Kelly Dona, Anna Frediani, Andrea Herrejon-Duran

Nursing Leadership in Community Engagement Projects

Women’s Shelter Health Needs Assessment

Introduction

Homelessness is currently one of the biggest societal issues in the United States and evidence indicates it is increasing, particularly for women (McGeough et al., 2020). A group of nursing students from Seattle Pacific University teamed up with a women’s homeless shelter in a Metropolitan city. The agency provides shelter and warm meals as well as laundry, toiletries, bus tickets and more. But even with the resources that they do provide, the residents have other needs that are not fully met, particularly with regard to their health. This is due in large to a …

Developmental Boxes, Karina Ryabinina, Lauren Kelly, Marissa Bankey, Kaila Medeiros, Sammy Schultz

Nursing Leadership in Community Engagement Projects

Developmental Boxes

The assigned facility is a resource center that operates to assist families in need. Services offered include housing placement, homelessness prevention, securement of affordable childcare, after-school programs, and health education. The center has served the Mount Baker community for nearly three years and intends to continue partnering with public services to end the cycle of poverty and create brighter futures for those who need it most (Mercy Housing, 2021).

Our team conducted a windshield survey of the community served by the facility and determined there to be limited access to childcare in the area as well as minimal …

Reducing 30-Day Hospital Readmission Among Mentally Ill Homeless Men With Substance Use Disorder, Chibuogwu Ugbana

DNP Qualifying Manuscripts

Abstract

Background: Psychiatric inpatient readmission of mentally ill homeless men is greater than that of the overall population. Substance use disorders co-occur with high prevalence in patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health behavior, and medication non-compliant, resulting in hospital readmission.

Problem: In an acute care psychiatric facility in Northern California, the greatest readmission after inpatient hospitalization occurs at 53.9% in a week and 74.8% in two weeks of discharge. For homeless individuals, substance use disorder complicates personal problems and decreases the likelihood of a long-term …

The Clinical Healthcare Provided To Homeless Communities Across The United States: A Literature Review, Saylor Sisemore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Homelessness has become a global public health concern as it results in poorer physical and mental health than age-matched people living in permanent housing (Ortiz & Roser, 2017). The area that comprises Northwest Arkansas (NWA), like other areas of the United States experiencing rapid growth, has seen a marked increase in the number of people experiencing homelessness in recent years. The homeless population is one of the most vulnerable and underserved groups of individuals in NWA and beyond. Public health nursing as a discipline is dedicated to providing compassionate care and exceptional service for all members of communities, with special …

The Effects On Pregnancy In Homeless Women, Kristin F. Rucker, Carlie R. Lyons

Epsilon Sigma at-Large Research Conference

Abstract

BACKGROUND: The number of homeless pregnant women is continuing to increase around the world. Homeless women are experiencing difficulties with their pregnancy that others may not face, including birth abnormalities and not seeking appropriate care due to cost and stigmatization. Nurses need to educate homeless pregnant women on what is needed for a healthy pregnancy and childbirth. OBJECTIVE: This exploratory research describes the needs for advocacy in women who are experiencing homelessness while pregnant and how homelessness affects pregnancy, childbirth, and postpartum care. LITERATURE REVIEW: The search methods used was CINAHL and ETSU Library. Keywords: homelessness, …

Self-Healing With Reiki For Homeless Individuals Suffering From Past Traumatic Events, Kathryn Piha

Theses and Graduate Projects

Living with symptoms that resemble PTSD from past trauma can be detrimental to health, healing, and quality of life. Symptoms that resemble PTSD are intrusive and disruptive to daily life and can cause anxiety, vivid flashbacks and nightmares, and intense memories. Homeless individuals navigate challenges and are at increased risk for developing symptoms that resemble PTSD. This project explored Reiki as a healing modality to improve health, healing, and quality of life from the negative implications of past traumatic experiences. Guided by Martha Roher's SUHB Theory, this project connects Reiki with energy as healing. Understanding energy and energy fields can …

Integration Of Sexual Assault Nurse Examiners (Sane’S) Care Program, Erin B. Mehta

Theses and Graduate Projects

Sexual assault is a public health issue, especially for individuals experiencing homelessness, violence, and victimization. Barriers to post-sexual assault health care must be addressed to ensure individuals experiencing homelessness receive effective and adequate care. Traditionally found in Emergency Departments, Sexual Assault Nurse Examiners (SANEs) offer patient-centered, comprehensive health care to sexual assault survivors. To reduce barriers for individuals experiencing homelessness, SANEs must be accessible where health care services are utilized. Guided by Jean Watson’s Theory of Human Caring and trauma-informed principles, this project aims to embed a SANE program into a homeless-specific Midwest Health Care Center. The SANE program will …

Screening For Human Trafficking: Best Practice Guidelines And Recommendations For Health Care Providers, Bernadette Portillo

Student Scholarly Projects

Human trafficking (HT) is a federal and international crime and is regarded as one of the most pressing human rights issues. Adult and minor victims are trafficked by force (rape, beatings, confinement), fraud, and coercion resulting in profound physical and psychological injuries (Chisolm-Straker et al., 2019, p. 72; Department of Homeland Security, 2020; Vera Institute of Justice, 2014, p. 6). Most clinicians fail to recognize HT victims (Egyud et al., 2017; Leslie, 2018; Mason, 2018; McDow & Dols, 2020; Mostajabian et al., 2019; Patient Safety Monitor Journal, 2017; Stevens & Dinkle, 2020). This policy brief’s purpose is to provide health …

Dance Program To Encourage Movement, Sarah Termure, Morgan Timmons, Lydianne Botelho, Lorraine Zhou, Isatou Manneh

Nursing Leadership in Community Engagement Projects

Dance Program to Encourage Movement

Homelessness is a growing concern across the United States of America. One agency in the Belltown district located in Seattle, Washington, is a place where homeless women can go to access and obtain needed resources (see Appendix A). A group of Seattle Pacific University (SPU) Nursing Students used primary and secondary prevention methods by creating a movement program that was aimed at the women at the agency. The goal of the project was for the women at the agency to participate in the dance program, to help decrease the chances of developing problems (i.e. diseases …

Homeless Population Enumeration, Ji-Soo Jennifer Choi

Undergraduate Student Research Internships Conference

There is currently very limited information on homeless population including, population size, demographic, geological location, and such; these are all vital information that are required to create resources and supports that helps to meet the needs of homeless population (Forchuk, 2021). Dr. Richard Booth’s ongoing research on homeless population enumeration aims to generate accurate quantitative representation of the homelessness incidence. It will be undertaking the form of a scoping review by reviewing relevant literatures to explore and synthesize various enumeration processes and conceptualization of construct of ‘homelessness’.

Improving Care Coordination For The Homeless Population Using Systematic Quality Improvement, Rutendo Nyasvisvo

Doctoral Projects

Background and Objectives: Care coordination for the homeless population is challenging due to the complexity of healthcare and the uncertain life circumstances of the homeless individual. Objectives were developed to guide care coordination for the homeless by utilization of the free clinic to create PCP referrals, appointments and tracking follow-up care to increase appointment attendance and improve health outcomes for the homeless individual.

Design: A quality improvement project.

Setting: A faith-based non-profit homeless shelter organization in the Midwestern United States.

Participants: Participants include 25 homeless guests, 5 staff members including a clinic coordinator, 3 registered nurses and 1 licensed practical …

Evaluating The Impact Of Federal Mental Health Policy: An Analysis Of How Federal Deinstitutionalization Impacted Persons With Severe Mental Illness, Jillian K. Douglas

Doctor of Nursing Practice Projects

This policy evaluation project evaluated how federal mental health policy changes impact individuals diagnosed with severe mental illness through analyzing how institutionalization and deinstitutionalization policies impact persons with severe mental illness (SMI). In order to determine how federal policy changes impact outcomes for people diagnosed with SMI, psychiatric hospitalization rates per 100,000 from 1850 to 2015 are compared to the life expectancy, incarceration rates per 100,000, and percentage of unhoused population with SMIs in the United States (U.S.) during the same years. Research compiled for this paper found that decreasing the numbers of psychiatric beds correlates within creased rates of …

Is Street Medicine Effective In Improving Access To Healthcare?, Kaitlyn Meehan

Student Research Poster Presentations 2021

No abstract provided.

Long-Acting Reversible Contraception Education For Street-Involved Youth: Impact On Knowledge, Attitudes, And Behaviors, Lizzie Simon

Doctor of Nursing Practice Projects

Despite evidence that long-acting reversible contraception (LARC) is safe, appropriate, and highly efficacious for people under age 25, this younger population is under-represented among LARC users in the US. At the Orion Clinic in Seattle, Kaiser Permanente offers primary care to street-involved young people between the ages of 12 and 24. Since opening in 2016, young patients at the Orion Clinichave initiated LARC at low rates, which reflects national trends. The aims of this project are to understand the reasons for this population’s underuse of highly effective contraceptive methods; to increase participants’ knowledge and positive attitudes toward LARC; and to …

A Proposal To Implement Assertive Community Treatment Into A Primary Care Shelter Clinic, Julie Churcher-Fields

Theses and Graduate Projects

Individuals who are experiencing homelessness and severe mental illness have a difficult time accessing healthcare systems. Without mental health treatment and stable housing, individuals develop multiple needs that must be addressed during an individual visit. Without treatment for mental health symptoms, individuals may experience a negative impact on their quality of life and the ability to get basic needs met. Community organizations have an obligation to provide integrated care with a goal to improve overall health for this population. As nurse leaders there is an opportunity to be advocates and implement innovative ideas to improve care. In a large adult …

Emergency Department Homeless And At Risk Homeless Screening Benchmark Study, Emily Mulder

MSN Capstone Projects

Individuals experiencing homelessness drastically overutilize emergency department (ED) services compared to non-homeless individuals (Ku et al., 2014). Many unhoused individuals have serious medical and psychosocial needs, which are chronic in nature, and become exacerbated due to poor management while living on the streets (Ku et al., 2014). The health needs of such individuals would be best managed through primary care continuity. However, care coordination becomes complex when a patient does not have a physical address or knowledge of available community resources (Mitchell, León, Byrne, Lin, & Bharel, 2017). By understanding the unique barriers that homeless and at risk homeless patients …

Street Medicine And Its Implications, Dylon Hess

Student Research Poster Presentations 2020

No abstract provided.

Hepatitis C Education, Testing, And Treatment In Homeless Shelters: Models For Linkage To Care In High-Risk Populations, Erin H. Higley

All Electronic Theses and Dissertations

Background: With the increase of IV drug use, Hepatitis C viral (HCV) infections have increased considerably among the homeless population. The introduction of direct-acting antiviral (DAA) medications has made treating marginalized populations much easier. However, getting homeless patients and people who inject drugs (PWID) linked to care remains a challenge worldwide. More research is needed to ensure that all persons with HCV are able to access treatment regardless of social or economic status. Purpose: The purpose of this critical review of research is to identify models of care for treating HCV among the homeless. This review was done to support …

Improving The Rate Of Hand Hygiene Immediately Before And After Wound Care In The Street Nurse Microsystem, Amanda Ramos Sandoval

Master's Projects and Capstones

The street nurse team of Sacramento, CA provides many services to patients who are experiencing homelessness, including a substantial amount of wound care. While the street nurses were performing hand hygiene (HH) prior to and after wound care, they would often not be performing it immediately prior and post-wound care. Because the nurses hike to their patients (who are living on the streets or in out of the way camps) the street nurses would often perform hand hygiene while at their cars prior to going to the patient and again when they returned to their cars after performing wound care. …

Improving Diabetic Foot Screening In A Primary Care Clinic For Homeless Adults: A Quality Improvement Project, Theresa Causa

Doctor of Nursing Practice

The purpose of this project was to increase the adherence of clinic providers at the homeless primary care clinic by implementing the American Diabetes Association Clinical Guidelines for the evaluation and management of Type 2 diabetes with foot care. Type 2 diabetes is a chronic condition that affects 13% of the Texas adult population (Centers for Disease Control and Prevention, 2014). The homeless person's main method of transportation is walking. The complications of undiagnosed foot problems include reduced mobility, pain, lower limb amputations, and difficulty controlling chronic diseases including diabetes and depression. Provider responsibilities include screening for diabetes in all …

Pathways To Homelessness: Exploring The Mental Health Experiences Of Refugees Experiencing Homelessness In Canada, Bridget Annor

Electronic Thesis and Dissertation Repository

BACKGROUND: Homelessness among refugees continues to be a growing issue in Canada. Recent reports indicate the rapidly growing population of refugees, most especially refugee claimants, accessing emergency shelters in Canada. Research to date has been limited on how the diversity of factors, such as refugee’s mental health experiences, could potentially play a role as pathways to shelter. The purpose of this study therefore is to explore the mental health experiences of refugees through their pathways to homelessness in Canada.

METHODS: This study, a secondary analysis, is framed within the critical theoretical perspective and an intersectional lens. The study sample …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

Screening, Brief Intervention And Referral To Treatment (Sbirt): Process Improvement In A Nurse-Managed Clinic Serving The Homeless, Ryan Kerrins, Ryan Kerrins, Jean Hemphill Phd

Ryan Kerrins

Social Inclusion For Women Experiencing Homelessness, Jenna Richards

Electronic Thesis and Dissertation Repository

Background: People experiencing homelessness have been described as one of the most socially excluded groups in society due to their inequitable access to basic necessities (Everett 2009; Labonte, 2004). Particular consideration regarding social inclusion should be given to the unique vulnerabilities of sub-populations of those experiencing homelessness, such as women (Wesely & Wright, 2005) due to their increased rates of ‘hidden homelessness’ (Walsh et al., 2009) and experiences of violence and discrimination (Roschelle, 2017; Weiser et al., 2009). Community participation, particularly sports activities, have been cited as one method towards increasing social inclusion among people experiencing homelessness. However, differential access …