Medicine and Health Sciences Commons^™

Undergraduate Student Attitudes On Concierge Medicine, Sushane Gupta

Honors Theses

The purpose of this thesis was to examine the opinions of undergraduate students on a field of personalized primary care known as concierge medicine, as well as assess their satisfaction with their current non-concierge healthcare providers. Concierge medicine aims to provide patients with a high level of customer service and satisfaction, and in exchange for an annual fee, they receive benefits such as lower waiting times for appointments, access to the physician by phone or e-mail, and a stronger patient-physician relationship focused on preventative care. The current literature on non-concierge healthcare reveals several deficiencies including poor insurance coverage, poor patient …

A Comparative Analysis Of Medical Pluralism In Fiji And The United States, Meaghan Jain

Honors Theses

Both indigenous Fijians and Americans practice a medically pluralistic style of healing that includes biomedicine, herbal medicines, and spiritual healing. People in both cultures use alternative medicinal styles to fill in around gaps left by biomedicine, but the reasons why they do this, and how they do this, are different. Urban indigenous Fijians supplement biomedicine with healing styles that utilize their social networks. Fijians have a sociocentric sense of self and the body; they feel uncomfortable with impersonal treatment by doctors and feel better about treatments that bring social support. Americans, on the other hand, follow a rhetoric strongly oriented …

Exploring Doctor-Patient Communication In The Context Of Complementary And Alternative Medicine, Eva Rachelle Zimmerman

Honors Theses

The introduction of Complementary and Alternative Medicine (CAM) in the United States has recently led to increased interest in this topic. CAM encompasses a range of health care approaches that attempt to maintain or prevent illness, such as herbal supplements and acupuncture. The integrative health care movement, which is the integration of CAM with conventional medicine, has been rapidly growing among both health care providers and health care consumers, because most consumers use both types of medicine. Despite this growth, there are barriers to the acceptance and integration of CAM, including the inability of doctors to communicate with patients about …

The Affordable Care Act Dependent Health Insurance Mandate's Effect On The Life Satisfaction Of Young Adults, Kirti Chakote

Honors Theses

On September 23, 2010, the dependent health insurance mandate of the Affordable Care Act (ACA) increased the family health insurance coverage of young adults up to age 26. The present study principally examined the effect of this mandate on life satisfaction of young adults, in addition to health care access, self-reported health, preventative care, and labor market outcomes. Through health insurance coverage, it is hypothesized that the ACA mandate will lead to a higher life satisfaction in young adults. Using the Behavior Risk Factor Surveillance System data of 2005 through 2013 to assess the effect of the ACA mandate, this …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Improving Hand Hygiene Compliance To Reduce Clabsi Rate In Oncology Icu, Lorenzo D. San Pedro

Master's Projects and Capstones

The aim of this project is to reduce the rate of central line associated blood stream infection (CLABSI) occurrence in oncology ICU by 50% by the last quarter of 2015. This study was conducted in ICU to assess adherence to the facility’s hand hygiene (HH) protocol among the staff nurses and allied healthcare workers. The facility is best known as a non-profit cancer treatment center and designated as a Comprehensive Cancer Center. Evidence showed that hand hygiene is the most effective way of preventing CLABSI, one of the most common types of infection in ICU microsystem. The project utilized The …

Implementation Of An Evidence-Based Educational Workshop And Toolkit: Menopausal Women's Healthcare Needs For The Primary Care Provider, Pamela Doerr-Kashani Dnp, Rn

Doctor of Nursing Practice (DNP) Projects

This evidence-based change of practice project involved the development of an educational workshop for primary care providers (PCPs). The intent of the project was to improve PCP’s knowledge of menopausal health, and to create their comfort level when discussing menopausal healthcare with clients. The workshop Menopausal Women’s Healthcare Needs for the Primary Care Provider (Doerr-Kashani, 2014) was created in response to an identified gap in knowledge among PCPs nationally on menopause-related health issues. The workshop was designed as a resource to support PCPs to competently address women’s menopause-related health issues, and enable them to provide comprehensive, evidence-based care within the …

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …

The Effect Of An Educational Intervention On Oral Anticoagulation Therapy Knowledge In Primary Care, Elizabeth D. Deck

Evidence-Based Practice Project Reports

It is estimated that three million people in the United States are on oral anticoagulation therapy (warfarin). Populations studied have been found in therapeutic range 64% of the time (Pernod, Labarere, & Bosson, 2008). The low percentage of therapeutic range is attributable to (a) adherence, (b) monitoring infrequency, (c) Vitamin K antagonists, and (d) the effects of aging and comorbidities. The purpose of this evidence-based practice (EBP) project was to examine whether an educational intervention would improve the knowledge of patients receiving warfarin therapy. Roy’s model for patient adaptation and the Stetler Model for EBP were used as frameworks for …

Anal Cancer Risk Factor Management Practices And The Barriers And Facilitators Of Addressing Anal Health In The Hiv Primary Care Setting, Crystal Martin Walker

Theses and Dissertations (ETD)

Background: The incidence of anal cancer is only 1-2 per 100,000 people in the general population, but in people living with HIV and AIDS (PLWHA), the incidence is far greater by about 80 times. This is a striking disproportion, and it is vital for the healthcare provider and healthcare system to become more attentive to the risk of anal cancer in high-risk populations such as PLWHA. There are a number of modifiable risk factors for anal cancer in PLWHA such as smoking, non-adherence to antiretroviral therapy (ART), and risky sexual behaviors. The HIV primary care provider (HIV PCP) plays a …

Implementation Of An Advance Directive Protocol In A Primary Care Setting, Gloria Dillman

Evidence-Based Practice Project Reports

Despite the passage of the Patient Self-Determination Act in 1992, only 15% of the United States population has completed an advance directive (AD). This statistic will be exaggerated with the future growth of older adults in the year 2030, at which time this portion of the population is expected to double to 72.1 million people. Without an AD, patients lose their autonomy and may be subjected to costly, life prolonging treatments that they would never choose for themselves. The unnecessary costs and unwanted treatment are preventable with an AD, and primary care providers are in a prime position to initiate …

The Effects Of Nutrition And Physical Activity Education On Knowledge And Glycemic Control Among Persons With Type 2 Diabetes, Alexandra Harris

Evidence-Based Practice Project Reports

Diabetes affects millions of people worldwide. Approximately 29.1 million people or 9.3% of the United States population has diabetes (Centers for Disease Control (CDC), 2014). Diabetes was the seventh leading cause of death in the United States in 2010 and is projected by the World Health Organization (WHO) to be the seventh leading cause of death globally by 2030. The purpose of this evidence-based project was to provide nutrition and physical activity education in an effort to improve diabetes knowledge and glycemic control among persons with type 2 diabetes. Hemoglobin A1c levels and Diabetes Knowledge Test scores were compared from …

An Analysis Of The Effects Of The Carbohydrate Intake And Hydration On Feeling Of Exertion Throughout A Marathon, Kristine M. Baumann, Kaitlyn Proulx

All Electronic Theses and Dissertations

The popularity of marathon running has grown exponentially since the 1970s (Noakes, 2003). This major gain in popularity has led to an increased interest in hydration and nutrition for marathon runners (Tucker et al 2009). The effects of dietary factors such as carbohydrates (CHO) and water on endurance has been extensively studied related to performance, but few studies have examined nutrition’s effect on feelings of exertion. The current study aimed to determine how the in-race nutrition and hydration habits of marathon runners affect their feelings of exertion throughout a 26.2-mile race. Individuals running Grandma’s Marathon in Duluth, MN on June …

The Effect Of Education On Folic Acid In Women On Childbearing Age And Low Socioeconomic Status, Macey I. Bentley, Anna R. Goetsch, Courtney L. Perpich

All Electronic Theses and Dissertations

The purpose of this study was to investigate the effect of education to women of lower socioeconomic status about the importance of folic acid use before and during pregnancy. Previous research has shown the significance of folic acid in preventing neural tube defects; however, research has shown that women of lower socioeconomic status are not equipped with proper education regarding folic acid usage periconceptionally. An educational session was provided to three women’s shelters regarding folic acid, and questionnaires were used to gauge knowledge on folic acid before and after the sessions. The statistical analysis was consistent with our hypothesis in …

Concussion Education In High School Athletes, Nathan A. Birno, Larson Davick, Kyle Oostra

All Electronic Theses and Dissertations

This paper examines concussion education in high school athletes. Specifically, it examines how educationally beneficial a concussion presentation is for high school athletes. The study examined eighteen-year-old participants from two Minnesota high schools participating in Minnesota State High School League (MSHSL) sanctioned spring sports. A presentation on concussion definitions, signs/symptoms, and adverse effects was presented to the participants. A pre and posttest questionnaire was used to evaluate participants’ baseline knowledge on concussion related topics and their knowledge gained after hearing the presentation. Data was analyzed via a comparison of the mean score differences using a paired t-test of within group …

Analysis Of Lean/Six Sigma Production Model In A Tertiary Care Asthma And Allergy Clinlic, Erika Lynn Bullert, Laura Johnson, Ariel M. Schibilla

All Electronic Theses and Dissertations

In response to demands on healthcare, systems have looked to refine current processes to use time, materials, and finances more efficiently. Lean/Six Sigma (L/SS) is a model that has been used to improve procedural efficiency in various settings. The purpose of this study was to implement L/SS into an outpatient private practice setting and to evaluate the effect on efficiency as measured in the length of individual patient visits who presented to that clinic for routine re-evaluation. In this study, the amount of time between a patient’s entrance and exit from the clinic was documented for 878 patients before implementation …

Oncology Providers’ Opinions On Preventative Recommendations For Patients With Brca1 Or Brca2 Breast Cancer Mutations, Rebecca L. Crissman, Kathleen Dunsmore

All Electronic Theses and Dissertations

BRCA1 and BRCA2 gene mutations have been identified as increasing an individual’s risk for developing breast cancer. Genetic testing for these genes has become increasingly more common. However, once genetic testing has established that an individual has either a BRCA1 or BRCA2 mutation, there is no set guideline for preventative measures. The purpose of this study is to gain the opinions of oncology healthcare providers on their recommendation for preventative treatment in women who have been diagnosed with the mutation at varying ages. A web-based survey was emailed to oncology healthcare providers from Minnesota Oncology in Minnesota and Allegheny Health …

Assessing Deaf Culture Awareness Of Physician Assistant Students In The Midwest, Sheryl E. Delude, Morgan, Kay Foizie

All Electronic Theses and Dissertations

Currently, there has been insufficient research to support the need for implementation of deaf awareness training into physician assistant (PA) program curriculums. To address this gap in research, PA students in the Midwest United States were surveyed in order to assess student knowledge of Deaf culture and knowledge regarding appropriate management of patients who are deaf. Survey knowledge scores were compared to previously documented knowledge scores of medical students enrolled in the Medical Students, Cancer Control, and the Deaf Community Training (DCT) program at the University of California, San Diego (UCSD). PA student scores were also compared to scores of …

Current Usage Of Animal Assisted Therapy In Nursing Homes In Ramsey County, Minnesota, Lauren K. Duerst, Natalie E. Nikonovich, Ashley M. Young

All Electronic Theses and Dissertations

The main purpose of this study was to determine the use of animal assisted therapy (AAT) for residents living in nursing home facilities in Ramsey County, Minnesota. Furthermore we compiled the thoughts and opinions of each facility director regarding the usage and perceived barriers that accompany the implementation of AAT programs.

Attitudes And Utilization Of Tissue Plasminogen Activator Involving Telemedicine, Karin K. Filip, Brittany R. Kelly, Stacy M. Underhill

All Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is used to treat acute ischemic stroke and is widely accepted as standard practice in the medical community. Literature shows that providers are hesitant to use this therapy due to the associated risks. Supporting literature shows that tPA is highly effective if administered within a three hour window, when adhering to strict protocols and guidelines for patient qualification. Telestroke programs have been shown to improve the time from stroke onset to administration of tPA by allowing a neurologist to be present during the decision making process. The aim of the study was to examine attitudes of …

Comparison Of Oral And Printed Health Literacy Tools In Hypertension Education For Low-Income Patients, Andrew D. Forsgren, Annie Heggestad, Charles Ruegemer

All Electronic Theses and Dissertations

Hypertension is a prevalent health concern in today’s society, especially among individuals of low-income economic status. An increased risk for heart disease has long been correlated to hypertension, and this risk increases further as the population ages. Patient education is crucial for prevention and management of diseases such as hypertension; therefore it is necessary to develop effective education tools. This is particularly true among high-risk groups such as low-income populations. This study compared the efficacy of printed educational materials versus orally presented educational materials in terms of improving patient knowledge regarding hypertension. Subjects were randomly assigned to either the printed …

Chemically Self-Assembled Antibody Nanorings: A Novel Approach To Bispecific Design For Cancer Therapeutics, Kari A. Gabrielse

All Electronic Theses and Dissertations

Targeted antibody therapeutics are currently being developed for treatment of a wide variety of cancers. By extending the scope of targeted antibody therapeutics into a bispecific design, it has been shown that simultaneous targeting of the CD3 T cell receptor and cancer cell receptors is possible. While great success has been achieved with the use of bispecific agents, many of these agents are genetically fused antibody fragments that can only target one type of cancerous receptor. Here we describe a simple and straightforward method of spontaneously assembling bispecific antibody therapeutics. Using fusion proteins consisting of two dihydrofolate reductase proteins and …

Health Disparities On American Indian Reservations: Can Mid-Level Practitioners Make A Difference?, David Evard Johnston

All Electronic Theses and Dissertations

Introduction: American Indians/Alaskan Natives (AI/AN) suffer from a number of health issues and at higher rates than other United States populations. Efforts have been made through the Indian Health Service (IHS) to improve the AI/AN state of health, but healthcare disparities remain. Purpose: The purpose of this study was to assist in identifying options in reducing healthcare disparities on American Indian reservations in South Dakota. The need for recruitment of additional physicians and mid-level practitioners (also known as mid-level providers or advanced practice providers) was assessed, as well as the potential for mid-level practitioners to meet that need. Methods: A …

Prevalence Of Non-Conventional And Folk Medicine Usage Among Hmong In St. Paul, Minnesota, Matthew T. Vang

All Electronic Theses and Dissertations

Hmong Americans have been identified to utilize various modes of medicine including: folk/herbal remedies, spiritual/shamanistic rituals, and adapted treatments from countries like Thailand or Laos. However, there is a lack of studies that measured the prevalence of these medications among the Hmong community in Saint Paul, Minnesota. A questionnaire was distributed at a Saint Paul, Minnesota Hmong market to explore the prevalence of Hmong medicine usage. Demographical information was also collected to help determine any relationships that might exist between certain socio-cultural factors and Hmong medicine usage. The study had a total of 54 participants. Of the 54 participants, twenty-eight …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

The Experiences Of Occupational Therapists Working On Interprofessional Primary Health Care Teams: A Case Study., Emma Blake Mcclellan

Online Theses and Dissertations

The aim of this research was to provide evidence on the integration of occupational therapy (OT) intervention in primary care from the perspective of OTs. Typical services provided, experience with team members, and the identified value of OT in primary health care was explored. OT possesses the expertise and skill set to address the most common chronic conditions that primary care providers treat by entry level educational preparation. OT services are based upon a holistic view of individuals creating an affective skill set to participate in and coordinate health care delivery for the client. Currently limited evidence is available to …

Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel

DNP Projects

The purpose of this capstone is to investigate the potential for hemolytic uremic syndrome (HUS) risk reduction in children through the evaluation of current evidence as well as pediatric primary care providers' knowledge and experience with children at risk for HUS. The goals of this capstone are to 1) evaluate the current literature to determine best practice for prevention of HUS, 2) assess primary care provider knowledge of HUS and experience with children with acute watery, and 3) develop a guideline for the initial management and referral of these children at risk for HUS.

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …