Medicine and Health Sciences Commons^™

Implementation Of A Self-Care Management Program Utilizing Telehealth In Adults With Hypertension, Diann Schmitt

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) can lead to heart disease which is the leading cause of death in the United States for men, women, and most racial and ethnic groups. Evidence-based practice supports early recognition of available self-care management (SCM) modalities to impact hypertension improvement and medication adherence. Best practices for heart disease prevention and management include lifestyle modification, reducing out-of-pocket costs, self-management support and education, and self-measured blood pressure monitoring. Successful evidence-based approaches within literature have addressed the modalities and successful outcomes.

The Plan-Do-Study-Act (PDSA) is a quality standard of The Institute of Health Improvement (IHI) was used to conduct this project …

Improving Access To Care For Specialty Pediatric Orthopedic Patients: Maximizing Telehealth To Achieve Outcomes, Tammy Keesey

Student Scholarly Projects

Practice Problem: The lack of resources such as transportation, insurance, and finances can negatively impact a patient’s access to much-needed specialty care. Providing education, assessing telehealth literacy, and creating a specific process for identifying appropriate telehealth visits can improve pediatric specialty access to care.

PICOT: The PICOT question for this project was: In pediatric orthopedic clinic patients (P), what is the impact of the active introduction of telehealth as a clinic visit option (I) versus the current standard passive process of scheduling telehealth visits (C) on the rates of access to care (O) after nine total weeks of …

Recursive Functional Learning In Nonfluent Aphasia, Gerald C. Imaezue

Dissertations, Theses, and Capstone Projects

People with nonfluent aphasia (PWNA) require feedback from an external agent as well self-feedback to facilitate performance of language production tasks. The extent to which PWNA can use self-feedback alone to improve their task performance is unknown. In addition, it is argued that self-feedback may reinforce or minimize performance errors over time. To test whether either is the case, we introduce an original learning mechanism, recursive functional learning, which uses self-feedback loops to optimize recursively multiple subsystems (cognitive and linguistic subsystems) that PWNA engage during task performance. We used this mechanism to underpin a novel automated procedure we developed, recursive …

Improving Health Outcomes Among Patients With Chf Through Implementation Of Telehealth Depression Screening And Chf Symptom Management, Akudo Udodiri Unanwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Comorbid congestive heart failure (CHF) and depressive disorder is a leading cause of mortality globally. Despite effective detection and therapeutic options, 30-day hospital readmission rates for CHF patients remain high, with patients experiencing adverse clinical outcomes and poorer quality of life. Depression is identified as a common comorbidity among CHF patients that may negatively impact patient self-care and adherence to a CHF treatment plan.

Problem: Telehealth applications are an increasingly utilized approach to healthcare delivery that enhances timely access to healthcare services by reducing physical proximity and transportation barriers to care. Currently, telehealth screening for CHF in the …

Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini

MUSC Theses and Dissertations

Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …

Predictive Ability Of A 3d Body Scanning Mobile Application For Metabolic Health Risk, Caleb Brandner

Master's Theses

There is an increasing prevalence of obesity within the US and rising rates of metabolic syndrome among those aged 20-39 concurrent with a decrease in the reception of primary care. Limitations to healthcare including access, cost, and availability, highlighting the need for simple, efficient, and accessible cardiometabolic health risk screening. Given the surge in smartphone ownership over the last decade, this study sought to determine the predictive ability of a mobile 3D-optical (3DO) body composition assessment application in determining metabolic health risk. A total of 62 participants (female: 36) underwent traditional anthropometric measurements, 3DO body scanning using a smartphone application, …

Reducing 30-Day Heart Failure Hospital Readmissions Through The Implementation Of A Telehealth Education And Screening Program, Madison Geib, Jo Loomis, Maria (Dupi) Gomez Cogan

Doctor of Nursing Practice (DNP) Projects

Heart Failure (HF) is a difficult disease to manage. It requires knowledge on weight monitoring, diet, exercise, medications, and symptom management. With this difficulty, there is a high incidence of HF patient readmissions into the hospital, especially in the first 30-days after discharge, showing that patients are not well equipped to manage their HF on their own at home. A review of the available literature found that some of the most common reasons for readmission include poor discharge planning, a lack of continuation of care, as well as a lack of education and adherence to their medications (Mathew & Thukha, …

Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios

Evidence-Based Practice Project Reports

Diabetes mellitus type 2 (T2DM) is a growing epidemic that affects millions of people throughout the world. The recent COVID-19 pandemic has created many new challenges, including access to health care for treatment of chronic diseases, such as diabetes (Robson & Hosseinzadeh, 2021). Telehealth has offered a promising approach to improve the management of diabetes(Bellman, 2021). People with diabetes are less likely to manage their diabetes through the usual care because of risk of contracting COVID-19 (CDC, 2022). The purpose of this EBP project was to evaluate the effectiveness of T2DM management through a telehealth approach. This project has addressed …

Telehealth Integration In Primary Care, Ashley Simons

Doctor of Nursing Practice Projects

Telehealth has been proven to be a useful and integral tool in primary care settings. Carlinville Family Health Care Clinic, a rural health clinic, has the current ability to conduct Telehealth visits but is not currently doing so. They have several programs available that are equipped with Telehealth capabilities. The physicians cite lack of education on these programs and lack of a standard streamlined practice for which program to use or how to use it.

According to the physicians in this practice, along with their patients, the use of Telehealth has multiple advantages. Because visits in this clinical are usually …

Telehealth Monitoring For Non-Hospitalized Covid-19 Positive Patients In A Rural Setting, Rebekah Leann French

Doctor of Nursing Practice Scholarly Projects

Purpose

This quality improvement project evaluates the efficacy of an outpatient COVID-19 telehealth monitoring program intended to increase access to care, decrease emergency room/urgent care visits, and hospital admissions among telehealth observed adult patients in a rural area while providing safe home monitoring during acute illness.

Rationale/Background

Prior to COVID-19 pandemic, healthcare systems within the United States encountered several challenges including healthcare inequality and decreased healthcare access, particularly in rural communities. These gaps became more apparent when a novel COVID-19 pandemic emerged straining healthcare systems in the United States and throughout the world. Challenges ranged from overwhelmed emergency room (ER) …

Tele-Sim For Nurse Practitioner Clinical Education: An Online, Real-Time, Educational Innovation Using Simulation And Telehealth For Learning Physical Assessment Skills, Kat Tremblay

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …

A Content Analysis Of Media Coverage Of Telehealth In Mississippi, Hailey Layne

Honors Theses

Telehealth’s utilization within healthcare has expanded and changed areas of healthcare delivery. In rural states like Mississippi barriers to accessing healthcare services exist due to demographic factors, socioeconomic factors, or geographic distance. This study was meant to look at the literature related to telehealth that was being disseminated to Mississippians through online news sources. It was noted whether these articles viewed telehealth utilization in a positive or negative way. Utilizing a cross-sectional media analysis, the news articles were screened using a coding form that acknowledged different themes in the literature. Frequency analyses were conducted to aid in interpreting the common …

Implementing A Self-Measured Blood Pressure Monitoring Process, Alecia Christensen

Student Scholarly Projects

Practice Problem: Because of the prevalence of hypertension worldwide, it is prudent for all patients to have the knowledge and ability to self-monitor their blood pressure. Patients monitoring their own blood pressure and communicating the readings with healthcare providers facilitates a more comprehensive plan of care.

PICOT: The PICOT question that guided this project was: In adults 18-90 years old with primary hypertension (P), will a self-measured blood pressure monitoring that includes a monthly telehealth visit with a provider (I), compared to blood pressure monitoring at routine office visits (C), decrease patients' systolic blood pressure readings by five mmHg …

Utilizing Telehealth To Decrease Hospital Readmissions For Heart Failure Patients, Madison Geib, Jo Loomis

DNP Qualifying Manuscripts

Abstract

Background: Without proper education, heart failure (HF) is very difficult to manage. A lack of education and proper management of HF can lead to frequent hospital readmissions, decreased quality of life, and early morbidity and mortality.

Objective: Through literature review, this paper aims to identify the benefits of implementing telehealth education for HF patients in order to decrease hospital readmissions.

Methods: A range of relevant articles were analyzed and summarized in this literature review. An extensive literature search was performed and systematic reviews, meta-analyses, critically appraised research studies, qualitative, and peer-reviewed research studies were included.

Results: Ten articles met …

Visiting Nurses' Knowledge, Attitudes And Beliefs Regarding Telehealth To Promote Medication Compliance In The Elderly Population, Diane Renee Logan

Seton Hall University Dissertations and Theses (ETDs)

Introduction: Medication noncompliance in the elderly home dwelling adult is a persistent problem resulting in decreased quality of life, hospital readmission within a 30-day period and increased morbidity. Visiting nurses are in a key position to assist the elderly population to employ medication compliance strategies that are tailor-made to fit their individual needs and abilities. The introduction of telehealth technology, while meant to aid elderly home dwelling individuals, may negatively impact the infusion of medication compliance strategies and thus increase medication noncompliance if visiting nurses are not effective in employing this technology.

Aim: The aim of this study is to …

The Course Of Covid: How Has The Pandemic Changed The Ways Therapists Use Art In Their Therapeutic Practice?, Deborah Sharpe

Art Therapy | Doctoral Dissertations

In 2020, the global pandemic fundamentally changed our everyday lives personally and professionally. The purpose of this study was to explore the impact of COVID-19 on the art therapy profession: the challenges of shifting to telehealth, managing work/life balance, confronting new realities around notions of privacy and confidentiality, and adapting the materials used in sessions. The necessary innovations and adjustments also revealed the unexpected benefits the pandemic and online therapy platforms provided. The researcher was interested in exploring the challenges and benefits of telehealth, the changes to the practical and essential qualities of the art therapy session, the therapeutic relationship, …

Implementing A Covid 19 Policy For Telehealth, Ashley M. Morello

Doctor of Nursing Practice Projects

The proposed DNP Project explored the implementation of a COVID-19 telehealth policy to clarify evidence-based practice, promote use of safe medications, and reduce hospitalizations. Providers were recruited from a telehealth organization, educated on current guidelines, and given a pocket card for reference and re-enforcement of training. Data was collected to examine guideline utilization, confidence in treating COVID-19, and efficacy of pocket card. COVID-19 patients also received follow up calls to determine if hospitalization was required post treatment. Chart audits were then completed to review compliance with guidelines. The results indicated both objective and clinical improvement in provider confidence treating COVID-19. …

The Impact Of Telemedicine On Patient-Provider Communication At A University Student Health Center, Venkata Naga Sreelalitapriya Duvuuri

Honors Undergraduate Theses

Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Impact Of Telehealth Versus Traditional Visits On Pain Management Patients Utilizing Medical Cannabis During The Covid-19 Pandemic, Todd Pankratz

Walden Dissertations and Doctoral Studies

AbstractAlternatives to traditional office visits have become a necessity with the recent COVID-19 outbreak, resulting in an unmatched surge in telehealth adoption. The present study was an investigation of the impact of telehealth versus traditional office visits in medical cannabis clinics treating patients for chronic pain. With 50,000,000 American adults experiencing pain and over 750,000 overdoses attributed to opioid usage, collecting research-driven evidence to increase the availability of safe, effective, and nonopioid treatment options will create positive social change. The Donabedian model was applied to measure the quality of care, focusing on structure (cannabis clinics), process (telehealth vs. traditional office …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

Behavioral Health Leadership Strategies To Increase Telehealth Engagement, Ramona Singletary-Robertson

Walden Dissertations and Doctoral Studies

One of the challenges brought on by the recent COVID-19 pandemic has been the promotion and use of telehealth services. While recent data from Medicare has depicted an increase in this new service delivery modality (over 4,000%), there has been a stark disparity in the use of telehealth services in lower socioeconomic demographics, such as rural and underrepresented communities, and among Medicare recipients. Equitable, consistent, and optimal service expansion of the telehealth modality requires therapists and leaders of behavioral health organizations to develop and deploy creative tactics to remedy this disparity. In this case study, leaders of Miss Emma's Behavioral …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Clinicians' Perceptions Of Telehealth Services During The Covid-19 Pandemic In Virginia, Johnetta Hill Guishard

Walden Dissertations and Doctoral Studies

The onset of COVID-19 introduced unprecedented changes to how U.S. public health services were delivered. Many public and private agencies faced mandatory closures, social distancing mandates, and rapid transitions to telehealth interventions and treatment. Mental health clinicians witnessed disruptions in continuity of care and an increase in mental health risks overall. Although some studies have been conducted to survey clinicians’ perceptions of the usefulness and ease of use of technology-based interventions, knowledge about mental health clinicians’ experiences and perceptions in Virginia was sparse. The purpose of this generic qualitative study was to explore how mental health clinicians in Virginia described …

Impact Of Telehealth Versus Traditional Visits On Pain Management Patients Utilizing Medical Cannabis During The Covid-19 Pandemic, Todd Pankratz

Walden Dissertations and Doctoral Studies

AbstractAlternatives to traditional office visits have become a necessity with the recent COVID-19 outbreak, resulting in an unmatched surge in telehealth adoption. The present study was an investigation of the impact of telehealth versus traditional office visits in medical cannabis clinics treating patients for chronic pain. With 50,000,000 American adults experiencing pain and over 750,000 overdoses attributed to opioid usage, collecting research-driven evidence to increase the availability of safe, effective, and nonopioid treatment options will create positive social change. The Donabedian model was applied to measure the quality of care, focusing on structure (cannabis clinics), process (telehealth vs. traditional office …

Analyzing Veterans Affairs Telehealth Services Between Rural And Urban Centers In West Virginia, Vicki J. Dix

Walden Dissertations and Doctoral Studies

Veterans often have difficulty accessing health care within the Veterans Affairs (VA) system, contributing to the growing need for health care services in rural communities. The increasing demand for health care services in rural communities is driven by the aging population, an increase in life expectancy, and an increase in chronic disease. This quantitative study aimed to explore the relationship between the type of appointment and patient location on initial primary care and telehealth primary care wait times for veterans in West Virginia. The two research questions addressed the independent variables, type of appointment (telehealth or face to face) and …