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Articles 931 - 960 of 6102
Full-Text Articles in Medicine and Health Sciences
Staff Education Project Staff Education To Encourage The Accurate Use The Dynamic Appraisal Of Situational Aggression In A U.S. State Psychiatric Facility, Tracy Ann Reid-Saunders
Staff Education Project Staff Education To Encourage The Accurate Use The Dynamic Appraisal Of Situational Aggression In A U.S. State Psychiatric Facility, Tracy Ann Reid-Saunders
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project involved the development and implementation of a staff education program to enhance the use of the Dynamic Appraisal of Situational Aggression (DASA) tool. The aim of the project was to address the inconsistent and inaccurate applications of the DASA tool by health staff, leading to missed opportunities for early intervention to address patient aggression and increased risk of violence to both staff and patients. The importance of addressing this issue within the context of nursing practice rests on the DASA tool’s importance as a means for nurses to assess patients with aggressive behavior, …
More Than Numbers: Black Adolescents’ Journey With Type 1 Diabetes Management, Vanessa Di Felice
More Than Numbers: Black Adolescents’ Journey With Type 1 Diabetes Management, Vanessa Di Felice
Walden Dissertations and Doctoral Studies
Black adolescents with Type 1 diabetes mellitus (T1DM) face significant health disparities, yet their unique treatment journeys remain largely underreported. This phenomenological qualitative study explored the lived experiences of Black adolescents with T1DM. The study addressed two research questions examining how these individuals experience and navigate T1DM self-management, self-efficacy beliefs, and perceived barriers and facilitators to optimal self-care. Virtual semi-structured interviews were conducted with 15 Black adolescents with T1DM recruited from a pediatric hospital in Washington, DC. The study utilized Bandura's social cognitive theory as the theoretical framework. Thematic data analysis identified four key themes: (1) character development through knowledge …
Jc Polyomavirus Pooled Seropositivity Prevalence In Healthy Subjects, Lenka J. Kimla
Jc Polyomavirus Pooled Seropositivity Prevalence In Healthy Subjects, Lenka J. Kimla
Walden Dissertations and Doctoral Studies
JC polyomavirus (JCV) causes progressive multifocal leukoencephalopathy in immunocompromised individuals and has been linked to cancer development. To-date, no information is available about the JCV seroprevalence in the healthy (nondiseased) population or whether this virus is ecologically connected to humans. The aim of this systematic literature review and meta-analysis was to the estimate the overall seroprevalence of JCV in the healthy human population by age, region, and testing method. A meta-analysis conducted on 24 studies revealed a pooled JCV seroprevalence of 60% (95% CI, 55% - 65%) with statistically significant effect size (z = 32.93, p < 0.001). Meta-regression and subgroup analyses with STATA18 showed that age and region had a strong positive predictive value on prevalence (R = .578, R2 = 0.334, F(2,52) = 12.543, p < 0.001) whereas the testing method had no significant effect on prevalence. The theories that grounded this study were the ecological model and the systems theory, which support the study result that JCV appears to be ubiquitous in the human population with JCV being acquired very early in life. The results of the systematic literature review indicated that JCV is transmitted via fecal-oral and respiratory routes within and outside of families. Most infants are infected with JCV by the age of 6 months and JCV seronegativity may not be indicative of a lack of an underlying JCV infection. JCV seropositivity increases with age, which is most probably by viral reactivation due to immune senescence. These findings have positive social change implications with JCV treatment, screening, and vaccine development.
Education Module To Improve Staff Medication Administration Practice, Linda Ikegwuoha
Education Module To Improve Staff Medication Administration Practice, Linda Ikegwuoha
Walden Dissertations and Doctoral Studies
Executive Summary: Staff Education Project Education Module to Improve Staff Medication Administration Practice by Linda C. Ikegwuoha BSN, Austin Community College, 2021 ADN, Austin Community College, 2019 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2025
Improving Financial Sustainability Through A 990n-Sized Charity’S Fundraising-Activity Audit, Eileen Callejas
Improving Financial Sustainability Through A 990n-Sized Charity’S Fundraising-Activity Audit, Eileen Callejas
Walden Dissertations and Doctoral Studies
Current scholarly literature has asserted that large non-profit organizations benefit from conducting fundraising-activity audit portfolio analyses. However, suitable techniques and tools that ultra-small nonprofits (990N-sized charities) can use to improve their fundraising-activity analyses have not been clearly established. The research problem was in modifying tools that work efficiently for hyper-localized charities to compare the effectiveness of their fundraising-activities. Preferred tools were needed to reinforce ideation and align improvements within the charities’ known constraints. The purpose of this study was to explore three suitably modified instruments that could be used for fundraising-activity auditing. Based on Ostrom’s institutional analysis and development framework, …
Staff Education Project Enhancing Provider Knowledge And Integration Of Freestyle Libre Continuous Glucose Monitoring In A Family/Occupational Health Clinic, Kesha Lebron
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project focused on enhancing provider knowledge and supporting the integration of FreeStyle Libre continuous glucose monitoring (CGM) technology in a family medicine and occupational health clinic. A gap in provider understanding of CGM technology and its role in diabetes management was identified. The intervention targeted a diverse group, including medical assistants, management, clerical staff, occupational health specialists, and medical providers. A pre- and post-education knowledge assessment was conducted, and results showed an increase in provider understanding. The pre-intervention average score was 76.52 (SD = 2.64), which increased to 98 (SD = 3.34) post-intervention. While …
The Nurseonetap Project: Staff Education To Rio Vista Behavioral Health, Justin Benedict
The Nurseonetap Project: Staff Education To Rio Vista Behavioral Health, Justin Benedict
Walden Dissertations and Doctoral Studies
The NurseOneTap Project is a staff education initiative designed to improve nursing documentation accuracy and efficiency through the implementation of a culturally sensitive electronic health record (EHR) system. This project addressed a critical gap in nursing practice—transitioning from paper-based documentation to EHR systems—by providing structured educational interventions to enhance staff proficiency, confidence, and documentation accuracy. A pre- and post-evaluation methodology was employed to assess improvements in system navigation, real-time data access, workflow optimization, and documentation accuracy. Results demonstrated a 54.5% increase in staff proficiency, a 50% improvement in documentation accuracy, and a 76% rise in staff confidence in using the …
Staff Education On Phq-9 Screening Tool Implementation, Sweetie Hope Doychinov
Staff Education On Phq-9 Screening Tool Implementation, Sweetie Hope Doychinov
Walden Dissertations and Doctoral Studies
The purpose of this DNP project was to evaluate whether a staff education program could measurably improve healthcare professionals' knowledge of the Patient Health Questionnaire-9 (PHQ-9) for depression screening at the practicum site. Depression remains underdiagnosed in primary care, largely due to inconsistent use of standardized tools like the PHQ-9, which is essential for timely diagnosis and treatment. This project addressed this gap by educating healthcare staff on the administration, scoring, and integration of the PHQ-9 into patient care, thereby enhancing their confidence and competence in its consistent application. The practice-focused question was the following: For healthcare staff at an …
A Standardized Approach To Patient Teaching Regarding Medication Adherence For Schizophrenic Patients, Ifeanyi Christian Onye
A Standardized Approach To Patient Teaching Regarding Medication Adherence For Schizophrenic Patients, Ifeanyi Christian Onye
Walden Dissertations and Doctoral Studies
Medication nonadherence in schizophrenic patients is one of the most challenging facets of mental healthcare management. This chronic problem affects leads to worsening symptoms and a higher hospitalization frequency. This project was a staff education project designed to address the practice problem of knowledge deficit of staff regarding medication adherence for schizophrenic patients. The practice-focused question was “Does staff education on a standardized approach to medication adherence provide increased knowledge and ability of the staff in the support of schizophrenic patients?” The practice question addresses identified gaps in nursing knowledge and lack of defined teaching standards for the improvement of …
Staff Education For Intake Clinicians On A Behavioral Health Unit At A 137-Bed Safety Net Hospital In An Underserved Community, Latisha Stennis
Staff Education For Intake Clinicians On A Behavioral Health Unit At A 137-Bed Safety Net Hospital In An Underserved Community, Latisha Stennis
Walden Dissertations and Doctoral Studies
Mental health conditions among adolescents are rising across the nation. This project consisted of an educational intervention implemented at a 137-bed safety net hospital that is expanding psychiatric services for adolescents, and numerous personnel at the organization reported having limited knowledge and experience working with this population. The project aimed to reduce the knowledge gap by accentuating the signs and symptoms of adolescents with anxiety, depression, suicidal, and self-injurious behaviors. The practice question that was developed to address this problem was as follows: Does implementing an educational intervention focused on adolescent anxiety, depression and recognizing suicidal and self-injurious behaviors enhance …
Workplace Violence Prevention, Solomon Soroibe Okwueze
Workplace Violence Prevention, Solomon Soroibe Okwueze
Walden Dissertations and Doctoral Studies
This staff education and quality improvement project was created to reduce workplace violence incidents within a psychiatry and primary care health group. Research has shown that the frequency of workplace violence events can create a critical practice problem that severely impacts the safety, morale, and, ultimately, retention of nursing staff. Addressing workplace violence in the healthcare field not only can ensure a safer working environment but also can increase the well-being of staff and assure high-quality care for patients. The project highlights a proactive approach to mitigating violence, promoting safety culture, and improving workplace ambiance. The central practice-based question guiding …
Relationship Between Years Of Experience, Age, Teamwork, And Medical-Surgical Nurses’ Intentions To Stay, Kimberly Dawn Reddish
Relationship Between Years Of Experience, Age, Teamwork, And Medical-Surgical Nurses’ Intentions To Stay, Kimberly Dawn Reddish
Walden Dissertations and Doctoral Studies
The United States is currently experiencing a nurse staffing crisis that is significantly impacting the medical-surgical (MS) nursing workforce. With MS nurses providing the most care for inpatient beds, hospital administrators must identify strategies that support MS nurse retention to preserve access to care for patients and support patient safety. The purpose of this study, guided by the complex adaptive systems theory, was to understand the relationship between teamwork, age, years of experience, and MS nurses’ intentions to stay in their roles in acute care hospitals. MS nurses were recruited via invitations from the chief nursing officer of a system …
Hurricane Irma's Impact On Mortality Among The Chronically Ill Populations In Florida, Cody Ray Thornton
Hurricane Irma's Impact On Mortality Among The Chronically Ill Populations In Florida, Cody Ray Thornton
Walden Dissertations and Doctoral Studies
Natural disasters pose significant risks to individuals with chronic diseases, exacerbating health disparities through disruptions in healthcare access and systemic vulnerabilities. This study investigated the association between chronic disease-related mortality occurring within 2 months of Hurricane Irma, and whether demographic variables, including age, sex, race, Hispanic ethnicity, poverty, urbanicity, and educational attainment, modified this relationship. This cross-sectional study used the social-ecological model to analyze secondary mortality data from the National Vital Statistics System. Bivariate and multivariate logistic regression revealed that deaths from chronic illnesses, occurring between September 2017 and October 2017, were 2.694 times higher, compared to the same period …
Association Between The Lack Of Health Insurance, Income, And The Severity Of Negative Perinatal Outcomes Among Native Spanish- And English-Speaking Women Living In Florida, Khadijeh Ashktorab
Association Between The Lack Of Health Insurance, Income, And The Severity Of Negative Perinatal Outcomes Among Native Spanish- And English-Speaking Women Living In Florida, Khadijeh Ashktorab
Walden Dissertations and Doctoral Studies
Evidence indicates that non-English-speaking mothers, particularly Spanish-only speakers, experience worse maternal health outcomes compared to their mainstream counterparts. Language barriers often hinder communication and negatively affect perinatal care. This study used data from the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System from Florida (2019–2020) to examine associations between health insurance, income, and perinatal outcomes among Spanish and English-speaking women. Krieger’s eco-social theory guided this cross-sectional, quantitative analysis. Chi-square tests were used for bivariable analysis, and multivariable models were used to adjust for confounders. Results showed that native language alone significantly predicted specific outcomes such as large-for-gestational-age …
Standarized Educational Nursing Intervention In The Prevention Of Implanted Port Infection, Maribel Melendez Ocasio
Standarized Educational Nursing Intervention In The Prevention Of Implanted Port Infection, Maribel Melendez Ocasio
Walden Dissertations and Doctoral Studies
This project addressed the high infection rate of implanted ports at a cancer treatment hospital in Puerto Rico due to the lack of a standardized training program for nurses. The project occurred in the hospital’s oncology unit with 24 beds. The infection rate for newly implanted ports was an alarming 100% in 1 month. Addressing this issue was crucial because port infections can significantly impact patient outcomes, especially for oncology patients. The goal of this project was to develop and implement an educational program based on the analyze, design, develop, implement, and evaluate model to enhance nurses’ knowledge and adherence …
A Disparities Analysis Of Cancer Patients’ Access To Depression Treatment By Health Insurance Status And Type, Stephanie Minbiole-Snider
A Disparities Analysis Of Cancer Patients’ Access To Depression Treatment By Health Insurance Status And Type, Stephanie Minbiole-Snider
Walden Dissertations and Doctoral Studies
Research has demonstrated that comorbid conditions like depression in cancer patients reduce quality of life, prolong recovery, and reduce survival time of the cancer patient. Although other studies have investigated the issue of depression among cancer patients, there is a dearth of studies looking at differences in taking depression medication with health insurance as a source of disparity. Using survey data from the National Health Interview Survey (NHIS), and the health belief model as the theoretical framework, this study had two purposes. The first was to determine if there were differences in the likelihood of taking medication for depression based …
Training Staff To Improve Medication Adherence Among Outpatient Mental Health Patients, Josephine Nada Bondje
Training Staff To Improve Medication Adherence Among Outpatient Mental Health Patients, Josephine Nada Bondje
Walden Dissertations and Doctoral Studies
Medication adherence is a practice issue in the treatment of patients suffering severe mental illness. A suburban outpatient clinic in the Eastern United States did not have standardized staff education regarding medication adherence strategies for treating psychiatric patients diagnosed with major depression, anxiety, bipolar disorder, or schizophrenia. The purpose of this project was to enhance the staff’s knowledge regarding methods for helping patients achieve medication adherence. The clinical question that guided the project was: Will staff education regarding medication adherence strategies related to mental health conditions in an outpatient clinic increase the knowledge of the staff? Data were collected from …
Staff Education On Advantages Of Administering Phq-9 Screening To Adolescents And Young Adults Receiving Transcranial Magnetic Stimulation (Tms) Therapy In An Outpatient Mental Health Clinic, Florence O. Gbadehan
Staff Education On Advantages Of Administering Phq-9 Screening To Adolescents And Young Adults Receiving Transcranial Magnetic Stimulation (Tms) Therapy In An Outpatient Mental Health Clinic, Florence O. Gbadehan
Walden Dissertations and Doctoral Studies
page This Doctor of Nursing Practice (DNP) study filled a practice gap in an outpatient mental health clinic by increasing staff understanding of the PHQ-9 screening tool for teenagers and young adults undergoing Transcranial Magnetic Stimulation (TMS) therapy. The project sought to answer the following practice-focused question: will teaching staff about the PHQ-9 increase knowledge? A staff education program was developed and implemented to address this gap, with professional persons examining and approving the content before it was distributed. Twelve voluntary clinical staff members attended a sixty-minute in-person educational session, which was followed by a ten-question multiple-choice pre/post-test to assess …
Reducing Patient No-Show Rates In A Mental Health Outpatient Clinic, John K. Kamau
Reducing Patient No-Show Rates In A Mental Health Outpatient Clinic, John K. Kamau
Walden Dissertations and Doctoral Studies
This doctoral project is a quality improvement initiative to enhance staff knowledge and confidence through expert feedback validating educational interventions at a mental health outpatient clinic. The practice problem highlighted staff preparedness gaps to effectively address patient-specific barriers, impacting patient engagement and care delivery, resulting in high appointment no-shows. Addressing this issue within nursing practice was essential, as consistent care was critical for managing psychiatric conditions effectively. The question guiding the project was as follows: How does implementing a specialized staff training program impact staff knowledge and confidence in reducing no-shows? This project aimed to equip staff with evidence-based tools …
Cauti Bundle Education In A Long-Term Care Facility, Pius Awandem Tanyifor
Cauti Bundle Education In A Long-Term Care Facility, Pius Awandem Tanyifor
Walden Dissertations and Doctoral Studies
Catheter-associated urinary tract infections (CAUTIs) are the most frequent but preventable infections that patients may acquire in healthcare, also known as HAI or nosocomial. A CAUTI bundle is a set of evidence-based practices (EBPs) that, when implemented together, can significantly reduce the occurrence of CAUTIs in any healthcare setting. The practice problem in a long-term care facility was the staff knowledge deficit on the CAUTI bundle. This is a staff education project. The pre- and post-survey results showed an increase in knowledge of the CAUTI bundle, from 56% in the pretest to 97 % in the posttest.
Executive Summary: Staff Education Project Reducing Burnout Through Mindfulness Education, Shateria Michelle Boone
Executive Summary: Staff Education Project Reducing Burnout Through Mindfulness Education, Shateria Michelle Boone
Walden Dissertations and Doctoral Studies
Summary This Doctor of Nursing Practice (DNP) project focused on addressing burnout for staff nurses working in a psychiatric hospital. Evidence indicated that burnout among nurses, caused by emotional stress and heightened responsibilities, may result in increased medical errors, diminished patient satisfaction, and significant dangers to patient safety and care. The practice-focused question for this project addressed whether a mindfulness-based educational intervention program would increase staff knowledge and decrease burnout among nurses working in a psychiatric hospital. The program incorporated a pretest/posttest format, educational content delivered via a PowerPoint presentation that included an interactive mindfulness meditation training session, and a …
Implementation Of An Educational Program To Improve Nurses’ Knowledge Of Basic Ostomy Care, Angela Trajcevski
Implementation Of An Educational Program To Improve Nurses’ Knowledge Of Basic Ostomy Care, Angela Trajcevski
Walden Dissertations and Doctoral Studies
This staff education project aimed to determine if an educational program would improve nurses’ knowledge of basic ostomy care in a surgical unit. Nurses in the surgical unit lack the knowledge and skills to perform proper ostomy care. Regardless of the years of experience, nurses may lose skills over time if they do not refresh their knowledge on basic ostomy care. The PICO (population, intervention, comparison, and outcome) question for this project was as follows: Does participation in an educational program focused on basic ostomy care improve the ostomy knowledge of staff nurses working on a surgical unit? This project …
Educating The Crisis Unit Staff On Implementing The Brief Trauma Questionnaire, Ambrose Oyemhen Ukpebor
Educating The Crisis Unit Staff On Implementing The Brief Trauma Questionnaire, Ambrose Oyemhen Ukpebor
Walden Dissertations and Doctoral Studies
The Facility-Based Crisis Unit (FBCS) nursing staff demonstrated an inadequate understanding of how to apply evidence-based trauma screening tools, such as the Brief Trauma Questionnaire (BTQ), to patients with substance use disorders. Studies indicate that over 60% of individuals recovering from or actively using illicit drugs report experiencing childhood and lifetime trauma. Integrating trauma screening into nursing practice can significantly improve patient care outcomes. This educational project aimed to enhance providers’ knowledge of BTQ administration using the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) model to ensure effective learning. The project utilized expertise from content specialists, the Walden University manual, …
Perceptions Of Nurse Preceptor Program Structure, Process, And Outcomes, Shinto Thomas
Perceptions Of Nurse Preceptor Program Structure, Process, And Outcomes, Shinto Thomas
Walden Dissertations and Doctoral Studies
Precepting is crucial in successfully onboarding nurses in healthcare organizations, yet challenges remain in ensuring effective preceptor development. Well-structured preceptor programs contribute to consistent and safe nursing practices, enhance job satisfaction and competency among new nurses, and improve preceptor effectiveness while minimizing turnover. This quality improvement Doctor of Nursing Practice (DNP) project evaluated a structured nurse preceptor program's structure, process, and outcomes, focusing on its impact on clinical and critical thinking skills development through enhanced training and support. A key gap in understanding the program’s effectiveness was the lack of outcome data. This study explored participants’ perceptions of the preceptor …
Staff Education On Medication Nonadherence For Patients With Bipolar Disorder, Julius Chick Abam
Staff Education On Medication Nonadherence For Patients With Bipolar Disorder, Julius Chick Abam
Walden Dissertations and Doctoral Studies
Summary From both the literature and the staff observation in this private practice, bipolar disorder (BD) patients who do not comply with medication are at a higher risk of hospitalization and poor quality of life. The purpose of the project was to implement staff training focused on adherence strategies, including motivational interviewing and psychoeducation to improve medication adherence rates among BD patients. The project question was: Does providing an interactive education program using case studies improve staff knowledge and self-confidence? Different studies support the effectiveness of both psychoeducation and motivational interviewing in improving adherence and functionality in BD. An interprofessional …
The Generalized Anxiety Disorder 7-Item (Gad-7) Tool For Anxiety Screening, Nicholas Tindong
The Generalized Anxiety Disorder 7-Item (Gad-7) Tool For Anxiety Screening, Nicholas Tindong
Walden Dissertations and Doctoral Studies
The staff education project aimed to address the gap in practice regarding the use of the Generalized Anxiety Disorder 7-item (GAD-7) screening tool at a psychiatric clinic. Approximately 40% of the clinic’s patients exhibited symptoms of generalized anxiety disorder (GAD), yet the nurses did not consistently use validated tools to assess anxiety severity, relying instead on unstructured clinical interviews. This inconsistency has resulted in delayed diagnoses and suboptimal patient care. The project sought to improve nursing staff's knowledge and confidence in using the GAD-7 tool through a structured education program guided by the following practice-focused question: Among nurses at a …
Reducing Disparities In Breastfeeding Among African American Women Through Professional Support, Latonia Feagin
Reducing Disparities In Breastfeeding Among African American Women Through Professional Support, Latonia Feagin
Walden Dissertations and Doctoral Studies
This project involved developing a toolkit and implementing a staff education program to increase provider self-efficacy and knowledge concerning breastfeeding, increase provider understanding of the importance of a toolkit for addressing the gap in breastfeeding among African American women, and increase the intention of providers to use the toolkit by a minimum of 20%. The clinic reported breastfeeding in only 21% of African American patients, attributing this mainly to provider lack of breastfeeding self-efficacy and knowledge. It is essential for providers to deliver evidence-based, culturally sensitive breastfeeding information. This project involved evaluating provider self-efficacy, knowledge, understanding the importance of a …
Allostatic Load And Incident Dementia Among Older Adults In The United States, Mohammed Usman Kabeto
Allostatic Load And Incident Dementia Among Older Adults In The United States, Mohammed Usman Kabeto
Walden Dissertations and Doctoral Studies
Allostatic load (AL), the cumulative physiological burden of chronic stress, is a significant health problem, and it has been associated with adverse health outcomes, including cognitive functioning. There is a paucity of literature examining associations between AL and incident dementia in the United States. This quantitative study used data from the United States Health and Retirement Study cohort (2016-2020) to examine the association between AL quartile and incident dementia among participants who were aged 56 and older at baseline. Dementia status was determined measuring immediate and delayed recall, serial seven subtraction, and backward count, as well as self-report conditions for …
Residence, Education, Wealth, And Hiv/Aids Prevention Knowledge Among Nigerian Adults, Chinedu Nwaobia Nwaru
Residence, Education, Wealth, And Hiv/Aids Prevention Knowledge Among Nigerian Adults, Chinedu Nwaobia Nwaru
Walden Dissertations and Doctoral Studies
HIV has remained the most prevalent and deadliest epidemic affecting humanity. It is pertinent to note that, despite the number of years since the first case was reported in the early 1980s in the United States, and concerted efforts by local, national, and international governmental and nongovernmental agencies at curbing it, the level of knowledge of HIV transmission and the disease prevention, especially among Nigerians, is still not encouraging. Nigeria, the most populous country in Sub-Saharan Africa ranks second globally as the country with the highest number of people living with HIV/AIDS, which is currently estimated at 3 million. In …
Heart Failure Education For Medical Assistants In A Transitions Clinic, Kelly S. Kirk
Heart Failure Education For Medical Assistants In A Transitions Clinic, Kelly S. Kirk
Walden Dissertations and Doctoral Studies
This capstone project is an educational improvement intervention for medical assistants (MAs), in the transitions clinic for heart failure patients. This capstone was designed to assess baseline heart failure (HF) knowledge of the MA and provide education on HF sign symptoms and urgency of provider notification as well as a postintervention assessment of knowledge. The terminal outcome was to improve the recognition of urgent symptoms that should be reported to providers so that providers can intervene early to prevent a possible exacerbation of heart failure. In order to assess the improvement in education of the MAs before and after the …