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Articles 1 - 30 of 61
Full-Text Articles in Medicine and Health Sciences
A Multiple Comparison Study That Test The Validity Of Varian’S Rapidplan For Prostate Cancer Cases Based On Models Built From Outside Institution., La'rone Reid
Culminating Experience Projects
In radiation oncology treatment planning techniques and outcomes can differ from one institution to the next. With knowledge-based planning (KBP) the experience of larger institutions could help smaller institutions who may not have the opportunity to encounter certain types of cancer cases. However, this scenario is only true if the KBP software is consistent with its algorithmic output. Varian's KBP software called Rapid Plan (RP) will be analyzed for algorithmic consistency. This study investigates the validity and consistency of RP models from two different radiation oncology institutions, and compare data to determine RP quality, and consistency when planning prostate cancer …
Comparison Of A Self-Audit Tool To Accrediting Health Care Agencies’ Standards Of Care In A Corrections Setting, Matthew C. Widerman
Comparison Of A Self-Audit Tool To Accrediting Health Care Agencies’ Standards Of Care In A Corrections Setting, Matthew C. Widerman
Doctoral Projects
Millions of individuals enter correctional facilities each year and require health services. Inmates are bound to a set of rules, wherein they are thought of as objects of surveillance, punishment, or rehabilitation, rather than as patients. In addition to standards of care defined by national accrediting bodies and state boards of practice, correctional facilities also have state laws that define expected health services for incarcerated persons. All health care providers have a responsibility to provide the highest quality care, but in prisons, patients are still inmates bound to correctional rules. Policies and procedures guide health care practices in correctional facilities, …
Exploring Neighborhood Level Variation In Incidence And Secondary Transmission Of Seasonal Influenza, Melissa Freeland
Exploring Neighborhood Level Variation In Incidence And Secondary Transmission Of Seasonal Influenza, Melissa Freeland
Masters Theses
Influenza epidemics in the United States, are major causes of morbidity and mortality, and cause serious economic disruption on an annual basis. Evidence has begun to accumulate linking neighborhood-level socioeconomic disadvantage to higher rates of hospitalization and mortality related to influenza (Cordoba & Aiello, 2016; Jung, Lin, & Viswanath, 2013). Some studies suggest that this may be due to lower rates of vaccination, higher rates of comorbidities in socioeconomically disadvantaged communities (Cordoba & Aiello, 2016; Jung, Lin, & Viswanath, 2013; Ross & Mirowsky, 2001). However, few studies have evaluated the effects of neighborhood level socioeconomic disadvantage and structural features on …
Introduction Of Auricular Acupuncture, Monica Lyons
Introduction Of Auricular Acupuncture, Monica Lyons
Doctoral Projects
The overall purpose of this quality improvement project was to assess if there was an interest to add auricular acupuncture to a substance abuse program. The two guiding questions of the Doctor of Nursing Project were (a) how can auricular acupuncture be helpful when treating patients with substance abuse in a selected organization? (b) what information is needed for both staff and patients to make an informed decision regarding auricular acupuncture? The Promoting Action on Research Implementation in Health Services (PARiHS) framework was used as the theory framework for implementation of evidence-based research into an organization. The facilitator in the …
Developing An Evidence-Based Discharge Process For Patients On A Cardiac/Renal Acuity-Adaptable Inpatient Unit, Tami Gallagher
Developing An Evidence-Based Discharge Process For Patients On A Cardiac/Renal Acuity-Adaptable Inpatient Unit, Tami Gallagher
Master's Projects
Introduction: Readmissions continue to negatively impact patient outcomes and create a significant financial burden. Regardless of efforts to reduce readmission rates, the cost of readmission continues to increase.
Clinical Problem: All-cause, 30-day readmission rates on a cardiac/renal acuity-adaptable inpatient nursing unit ranged from 11% to 33% from July to December 2018 for patients diagnosed with COPD, AMI, HF, and sepsis. The readmission rate for the organization was 16.2% in September 2018 with a target goal of 14.8%.
Project Aim: To use quality improvement tools and an interdisciplinary team to implement the teach-back method during discharge education and a discharge preparedness …
A Quality Improvement Project To Enact Evidence-Based Guidelines To Improve Documentation Of Hemoglobin A1c For Inpatient Diabetes Populations, Karyn C. Kinney
A Quality Improvement Project To Enact Evidence-Based Guidelines To Improve Documentation Of Hemoglobin A1c For Inpatient Diabetes Populations, Karyn C. Kinney
Master's Projects
The purpose of this paper is to describe a quality improvement project aimed to improve the documentation of hemoglobin A1c in the discharge instructions for patients with a diagnosis of diabetes prior to a transition from the acute care setting. Clinical practice guidelines from the American Diabetes Association and patient education recommendations from The Joint Commission are the impetus for this process improvement. The Plan-Do-Study-Act (PDSA) model was utilized to identify, design, and implement the process change in collaboration with an interprofessional team. The documentation rate of hemoglobin A1c was measured on two medical-surgical inpatient hospital units both pre- and …
Program Evaluation Of The Impact Of Sensory Room Activities On Student Readiness In Muskegon County, Mary C. Spyhalski
Program Evaluation Of The Impact Of Sensory Room Activities On Student Readiness In Muskegon County, Mary C. Spyhalski
Education
There is a lack of research regarding the effect of sensory room interventions and equipment on student’s school readiness, as well as a lack of research regarding documentation and monitoring the effectiveness of sensory rooms. This is a problem for occupational therapists and teachers implementing sensory interventions that are not backed by research (Stephenson & Carter, 2011). Occupational therapists in Muskegon County Northern Service Unit (NSU) have determined a need to collect data on the impact of sensory room interventions on student readiness for school-day activities within their district. Program evaluations are needed in order to gather data that discusses …
Evidence-Based Cardiac Monitoring: A Practice Change, Joseph Paul Urbanski
Evidence-Based Cardiac Monitoring: A Practice Change, Joseph Paul Urbanski
Doctoral Projects
Background: Overuse of cardiac monitoring (CM) in acute care settings contributes to increased healthcare spending and cost of services for patients. Additionally, inappropriate use of CM can contribute to wastefulness of healthcare resources, increases in hospital staff workloads, and can be improved with best evidence-based practice recommendations. A Midwest acute care hospital lacked an evidence-based, systematic method to define care for patients requiring CM.
Objective: The purpose of the project was to pilot an evidence-based CM change initiative, determine feasibility for sustainment, and propose next steps for adoption of the change initiative across non-emergency department, non-intensive care inpatient CM units …
Optimizing Clinical Processes Using The Electronic Health Record To Improve Patient Outcomes In Primary Care, Alex Jubril
Optimizing Clinical Processes Using The Electronic Health Record To Improve Patient Outcomes In Primary Care, Alex Jubril
Doctoral Projects
Background: The EHR has been used to leverage clinical processes for the improvement of patient outcomes. The average users of EHR limit its uses to the minimum level required to complete the daily tasks needed, regardless of the existence of features within the EHR that are readily available to optimize clinical processes for efficiency and effectiveness.
Objectives: The objective of this project was to improve the documentation in a nurse-managed health clinic related to the patient-centered medical home (PCMH) core criteria through enhancing the EHR to foster the quality improvement metrics and reporting.
Methods: This was a quality improvement project …
Occupational Therapy In Prisons, Amber Carmean, Amanda Boman, Katie Kowalski, Joselyn Walsworth
Occupational Therapy In Prisons, Amber Carmean, Amanda Boman, Katie Kowalski, Joselyn Walsworth
Community Based
This study investigates the needs of incarcerated individuals upon reintegration into the community. In this article, we use thematic analysis to dissect two prison documentaries in order to best assess the needs of these individuals to inform occupational therapy intervention. Occupational therapy seeks to empower individuals while analyzing needs and how the individuals can be best supported. Our analysis shows that there are many needs that go unaddressed prior to community reintegration leading to a higher chance of recidivism recurring. Through better understanding the needs of individuals, occupational therapy can become better informed on how intervention can benefit this specific …
Advocacy-Related Occupations Among People With Disabilities: Assessing Program Outcomes Of An Advocacy Workshop, Audrey Tarbutton, Stefanie Austin, Rachel Bendewald, Hayley Monforte
Advocacy-Related Occupations Among People With Disabilities: Assessing Program Outcomes Of An Advocacy Workshop, Audrey Tarbutton, Stefanie Austin, Rachel Bendewald, Hayley Monforte
Community Based
An emerging area of occupational therapy (OT) practice includes program development for persons with disabilities (PWD). These programs are designed to train PWD how to identify issues and advocate for inclusion and accessibility (Umeda et al., 2017). Among the available literature on community-based advocacy programs, results show positive social outcomes including increased self-advocacy knowledge and related behaviors (i.e. Kramer, 2015; Mishna et al., 2011). Regarding the present study, an advocacy training program titled “Community Organizing Advocacy Skills Training” (COAST) was developed using the Midwest Academy Training Manual for the Advocate. The purpose of this study was to pilot a tool …
A Family's Perception Of Occupation-Based Activity Sessions During Their Transition To Permanent Housing, Laura Opie, Lauren Goldstein, Ashton Roth, Ella Savalox
A Family's Perception Of Occupation-Based Activity Sessions During Their Transition To Permanent Housing, Laura Opie, Lauren Goldstein, Ashton Roth, Ella Savalox
Community Based
This study aimed to evaluate families' perceptions of occupation-based activity sessions during their transition from homelessness to permanent housing. A phenomenological design was selected to identify families' perceptions. Results identified potential benefits of providing occupation-based activity sessions to families in transition and indicated the importance of empowering families to enact their own sense of agency to successfully resolve their transition to permanent housing.
Global Occupational Therapists’ Health And Wellness Interventions With Community-Dwelling Older Adults, Catherine Keegin, Lyndsey Lehman, Hannah Meier, Megan Weinberg
Global Occupational Therapists’ Health And Wellness Interventions With Community-Dwelling Older Adults, Catherine Keegin, Lyndsey Lehman, Hannah Meier, Megan Weinberg
Older Adult
Rationale: The profession of occupational therapy (OT) has an opportunity to positively impact health and wellness for community-dwelling older adults with the approaching global increase of the aging population (He, Goodkind, & Kowal, 2016). Objective: The purpose of this study was to explore occupational therapists’ use of health promotion and wellness approaches to facilitate healthy aging with community-dwelling older adults in a global context. Results: Four qualitative themes were uncovered: perceptions of older adults, safety, the role of OT, and preventive versus reactive care. Participants with 10 or more years of experience addressed spirituality in practice more often than those …
Exploring The Connections Between The Presence Of Developmental Trauma And Clinical Reasoning: The Lived Experience Of Pediatric Occupational Therapists, Gwendolyn R. Blake, Briar E. Plantinga, Julie Shafer
Exploring The Connections Between The Presence Of Developmental Trauma And Clinical Reasoning: The Lived Experience Of Pediatric Occupational Therapists, Gwendolyn R. Blake, Briar E. Plantinga, Julie Shafer
Pediatrics
Background: Developmental trauma is a current issue facing the nation. It adversely affects participation in occupations across the lifespan. This paper examines how the clinical reasoning of practicing pediatric occupational therapists changes when treating clients who have experienced developmental trauma.
Methods: A phenomenological approach was applied using multiple cases. Four individuals, who identified as working with clients with developmental trauma, were interviewed using a series of semi-structured and open-ended questions on their experience treating these clients.
Results: Narrative transcripts were reviewed by the authors and organized into themes of performance patterns of the therapist and the context of developmental trauma …
Program Evaluation Of The Impact Of Sensory Room Interventions On Student Readiness In Muskegon County, Emilie Brzak, Olivia Deweerd, Erica Roll
Program Evaluation Of The Impact Of Sensory Room Interventions On Student Readiness In Muskegon County, Emilie Brzak, Olivia Deweerd, Erica Roll
Pediatrics
Aim: This study is a program evaluation of four different sensory rooms in the schools within Muskegon County Northern Service Unit (NSU) to uncover the benefits of sensory interventions on students’ school readiness.
Methods: Grand Valley State University occupational therapy students analyzed data from the school occupational therapists to promote evidence based practice of this program.
Results: Within this program, sensory interventions increased students’ school readiness.
Conclusion: Outcomes indicate that the primary means of increasing students’ school readiness include transitioning to an active activity following sensory interventions and participating in multiple stations. Results are not generalizable to other programs.
Prior Authorizations And Continued Treatment In Addiction Medicine, Wendy Hunting
Prior Authorizations And Continued Treatment In Addiction Medicine, Wendy Hunting
Doctoral Projects
Introduction: Patients that require medication assisted treatment for opioid addiction can have their treatment delayed through the prior authorization process. A prior authorization is required by many insurance companies and can cause lengthy delays before the drug is approved. The two drugs that were considered for this project were Suboxone® (buprenorphine/naloxone) and Sublocade® (buprenorphine). These drugs are used for the treatment of opiate addiction. The proposed solution to the problem was to use quality improvement methods to implement a tracking and tickler system to improve the approval time from the insurance company.
Objectives: The project goal was to decrease the …
The Acute Effects Of Melatonin On Striatal Dopamine Release: Progressive Electrochemical Analysis In An Ex Vivo Mouse Model Utilizing Fast Scan Cyclic Voltammetry, Kevin D. Hughes
Masters Theses
The caudate putamen is a sub region of the basal ganglia, containing neural tracts important for cognition, reward learning, and voluntary motor function. Dopamine (DA) signaling received from the dopaminergic neurons of the substantia nigra pars compacta mediate locomotion, degradation of which is the characteristic neuropathology for Parkinson’s disease (PD). PD is an initially neurovegetative motor disorder but can progress to include cognitive impairments as well. Sundowner’s syndrome (SS) has been observed in patient populations with neurodegenerative diseases, characterized by the decline of cognition into evening hours. Due to the circadian influence which the hormone melatonin has on the sleep-wake …
Women & Adhd Functional Impairments: Beyond The Obvious, Noelle Marita Lynn
Women & Adhd Functional Impairments: Beyond The Obvious, Noelle Marita Lynn
Masters Theses
Women with Attention Deficit Hyperactivity Disorder are an understudied and underserved population. Research on women with ADHD has shown that they are significantly impaired by ADHD and its functional impairments. It also shows that women often internalize their symptoms and impairments. However, no research was found that explores what this internalization does to the women. The researcher chose to begin to address this gap in the literature through this qualitative phenomenological study. The purpose of this study is to explore the impact of functional impairments caused by ADHD on the internal lived experiences of women.
The researcher conducted fourteen interviews …
Implementation Of Evidence-Based Chronic Non-Malignant Pain Management Protocol For Primary Care, Jenny E. Kipp
Implementation Of Evidence-Based Chronic Non-Malignant Pain Management Protocol For Primary Care, Jenny E. Kipp
Doctoral Projects
Chronic pain is the most prevalent health condition in the United States and is the most common reason people seek healthcare (Chang, Daubresse, Kruszewski & Alexander, 2014). In 2012, health care providers wrote 259 million prescriptions for opioid pain medications despite little change in self-reported pain prevalence (Centers for Disease Control and Prevention (CDC) 2016; Chang et al., 2014). Initiatives to prevent the under treatment of pain have resulted in overreliance on opioids to treat pain. As a consequence of opioid centric prescribing, an opioid epidemic has evolved with devastating consequences such as dependence, addiction and overdose deaths related to …
Evidence-Based Toolkit For Reduction Of Overdose Risk In Primary Care Patients On Opioid Therapy, Katelin A. Aris
Evidence-Based Toolkit For Reduction Of Overdose Risk In Primary Care Patients On Opioid Therapy, Katelin A. Aris
Doctoral Projects
Introduction: Opioids are powerful pain killing medications that can be highly addictive and can cause risk for overdose and even death (Michigan Prescription Drug and Opioid Task Force, 2015). Many primary care providers treat patients with acute and chronic pain, although it is recognized that many receive inadequate training in pain management and feel unprepared in the complexities of caring for these patients (Becker, Bair, Picchioni, Starrels, and Frank, 2018). To treat these patients safely, provider education and adherence to guidelines put forward by these initiatives is essential.
Methods: An evidence-based prescribing toolkit was devised using guidance from the literature …
An Evidence-Based Toolkit For Early Identification Of Frail Inmates, Morgan A. Kochajda
An Evidence-Based Toolkit For Early Identification Of Frail Inmates, Morgan A. Kochajda
Doctoral Projects
There are significant numbers of people aging and nearing end of life while being incarcerated (Richter & Hostettler, 2017). Currently the Department of Corrections (DOC) does not have a standardized process for early identification of inmates who may need increased end of life care services. A potential solution to this problem would be the use of a frailty screening tool for early identification of those inmates who may need increased resources. At this time, there is not a formalized relationship between a Midwest hospice and palliative care department and the DOC. There is a desire from leadership of the hospice …
Interprofessional Collaboration To Improve Discharge Planning, Erica L. Spalding
Interprofessional Collaboration To Improve Discharge Planning, Erica L. Spalding
Doctoral Projects
Historically, health care professionals collaborated solely with other professionals within the same discipline. However, evidence shows collaboration between all disciplines involved in patient care leads to improved patient outcomes. Interprofessional collaboration can reduce costs and improve patient care, yet is used inconsistently in health care systems. Interprofessional collaboration was not fully used on two medical-surgical units in a large health system in the Midwest, particularly during the discharge planning process. This project aimed to standardize rounds on two units as part of a larger initiative to standardize rounds across all units within the system. The clinical question to be answered …
Improving Heart Failure Care Plan Coordination Across The Health Care Continuum, Amy Veltkamp
Improving Heart Failure Care Plan Coordination Across The Health Care Continuum, Amy Veltkamp
Doctoral Projects
Heart failure costs the United States 31 billion dollars each year, with much of those costs attributed to hospital admissions. Coordinating care across the health care continuum is a critical factor in improving heart failure care and reducing readmissions. An organizational assessment was conducted using the Burke and Litwin Causal Model of Organizational Performance and Change. The quality improvement project implemented a longitudinal plan of care (LPOC) across 10 hospitals and numerous ambulatory care sites at a large Midwestern health organization. Nurse care managers (NCMs) were the focus of this project due to their high-level of involvement in care coordination. …
Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney
Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney
Doctoral Projects
Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …
An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter
An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter
Doctoral Projects
Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.
Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …
Evaluating The Effectiveness Of Diabetes Class: A Project To Improve Quality Metric Measures, Miriam O. Russell
Evaluating The Effectiveness Of Diabetes Class: A Project To Improve Quality Metric Measures, Miriam O. Russell
Doctoral Projects
Background: Diabetes is a significant health issue worldwide. Its increasing prevalence globally and regionally has been documented. Consequently, complications have resulted in higher morbidity and mortality in patients with diabetes (Martin & Lipman, 2013). The lack of education on self-managing diabetes can lead to serious complications. An effective approach, including evaluating and enhancing diabetes education, is necessary to improve diabetes self-management (Johnson & Raterink, 2009).
Objectives: To provide evaluation of a diabetes education class through quality measures and create a toolkit that will enhance the impact on the current diabetes education class.
Methods: A retrospective chart review that analyzes five …
Improving Communication Of Asthma Related Care Between Pediatric Primary Care Providers And Schools, Jessica N. Heichel
Improving Communication Of Asthma Related Care Between Pediatric Primary Care Providers And Schools, Jessica N. Heichel
Doctoral Projects
Introduction: Asthma is a life-altering chronic disease that affects many children throughout the state of Michigan. Evidence-based guidelines recommend a written asthma action plan (AAP) be given to all caregivers of children with asthma. This would include schools, but the plans are not making it there. This project focused on collecting school asthma data and designing a process change at a local clinic to send the plans directly to the schools.
Objectives: The goal of this project was to improve communication between healthcare providers and schools for children with asthma. The objectives were to increase the percentage of children with …
Final Defense: Sepsis Screening Tool Assessment At A Freestanding Children’S Hospital In The Midwest, Cassandra Cummings
Final Defense: Sepsis Screening Tool Assessment At A Freestanding Children’S Hospital In The Midwest, Cassandra Cummings
Doctoral Projects
Pediatric sepsis is a major contributor to childhood morbidity and mortality. Tools for predicting sepsis in pediatric patients have had poor predictive ability nor been validated. Risk assessment screening tools are effective at earlier detection of sepsis. The implementation of an evidence-based pediatric sepsis screening tool could reduce time to detect and diagnose severe sepsis so that patient treatment could occur earlier. This was a quality improvement project that evaluated a sepsis screening tool predictive validity at a children’s hospital.
Implementing Use Of The Moss (Michigan Opioid Safety Score) Tool And Interventions To Reduce Opioid-Related Overdose Events In High Risk Patients, Michelle J. Kloss
Implementing Use Of The Moss (Michigan Opioid Safety Score) Tool And Interventions To Reduce Opioid-Related Overdose Events In High Risk Patients, Michelle J. Kloss
Doctoral Projects
Opioids are among the most common pharmacological class of therapeutic medications prescribed to alleviate pain across all healthcare settings. However, opioid-related adverse events are a growing problem contributing to an increase in morbidity and mortality. Current hospital practice does not utilize a pre-opioid administration screening tool to assess patient risk of adverse events related to opioid administration. The implementation of the Michigan Opioid Safety Score (MOSS), an evidence-based risk assessment tool which utilizes patient characteristics as well as respiratory assessment for the prediction and early detection of opioid-induced adverse events. This quality improvement project evaluated the effectiveness of the MOSS …
Using The Rapid Assessment For Adolescent Preventive Services (Raaps) To Screen For Risk Taking Behaviors Of 13 To 18 Year-Olds In A Regional Family Practice Office, Megan E. Carpenter
Using The Rapid Assessment For Adolescent Preventive Services (Raaps) To Screen For Risk Taking Behaviors Of 13 To 18 Year-Olds In A Regional Family Practice Office, Megan E. Carpenter
Doctoral Projects
Risk-taking behaviors are a significant problem in the adolescent population and the three leading causes of mortality for adolescents are suicide, homicide, and unintentional injury (Heron, 2017). National organizations support screening for adolescent risk-taking behaviors and research demonstrates effectiveness of screening. This quality improvement (QI) project implemented the Rapid Assessment for Adolescent Preventive Services (RAAPS) screening tool at a regional family practice office as a vehicle to accomplish the objectives of increased identification of, and intervention for, risk-taking behaviors in adolescent patients. Included in the methods were baseline and implementation chart reviews that were used to assess the change in …