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Articles 1 - 16 of 16
Full-Text Articles in Medicine and Health Sciences
Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor
Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor
Doctor of Nursing Practice Projects
Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …
Telehealth Integration In Primary Care, Ashley Simons
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 …
Use Of Anticipatory Guidelines In Late Infants And Toddlers 12 To 24 Months In Primary Care, Claire E. Eller
Use Of Anticipatory Guidelines In Late Infants And Toddlers 12 To 24 Months In Primary Care, Claire E. Eller
Doctor of Nursing Practice Projects
Anticipatory guidance is a well-known and utilized method that has been implemented in a majority of pediatric primary care offices. As the need for efficiency grows and increasing patient volumes climb, there is a growing need for strategies to provide this information effectively and efficiently. Prior evidence can be utilized to identify the most critical knowledge caregivers and parents will require. Our findings indicate safety, communication, nutrition, social development, and behavior as cornerstone topics for anticipatory guidance. To increase the volume of education provided to parents and caregivers, alternate methods beyond verbal discussion could be used. After gathering scientific literature …
Weight Loss Communication And Treatment In Primary Care, Courtney Russell, Sarah Puckett, Jessica Mcrill
Weight Loss Communication And Treatment In Primary Care, Courtney Russell, Sarah Puckett, Jessica Mcrill
Doctor of Nursing Practice Projects
Obesity is undertreated in the primary care setting as a single medical condition. Obese patients are higher risk for comorbid conditions including heart disease, hypertension, diabetes mellitus and stroke. There is no universal screening tool implemented in the primary care setting for obesity management. An extensive literature review was completed to identify barriers in the primary care settings for providers to treat obesity as a disease state, assess current practices for weight management in these settings, and to identify health behaviors of adult patients with obesity. This project implemented the Five A’s Communication Tool to identify patients willing to discuss …
Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman
Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman
Doctor of Nursing Practice Projects
In Illinois, the do-not-resuscitate (DNR) form that is legally binding in all healthcare facilities is known as the Practitioner Orders for Life-Sustaining Treatment (POLST) form. The Patient Self-Determination Act (PSDA) of 1991 mandates only certain facilities to discuss advanced care planning (ACP). Primary care offices are not included in this mandate. Therefore, no structured process exists for primary care providers to identify patients who may benefit from ACP discussions. The purpose of this Doctor of Nursing Practice (DNP) project was to initiate conversations about ACP with patients 55 years and older in a primary care office and complete POLST forms …
Recognizing Barriers In The Elderly Population And Increasing Access To Case Management Services, Loveleena Alex
Recognizing Barriers In The Elderly Population And Increasing Access To Case Management Services, Loveleena Alex
Doctor of Nursing Practice Projects
Abstract
Implementing case management can lead to fewer hospitalizations in the elderly population. Barriers influencing the number of hospitalizations include low socioeconomic status, transportation needs, health literacy, financial strain, multiple comorbidities, underserved populations, medication availability, availability of community resources, and access to primary care. A review of the available literature revealed that by addressing these barriers in a primary care setting and implementing case management, the number of hospitalizations can be decreased and the quality of life in the elderly population can be improved. This quality improvement project implemented a screening and referral process for chronic care management in the …
Implementation Of Routine Screening To Detect Early Cases Of Depression And Anxiety In Hispanic Adolescents In The Primary Care Setting, Latoya Hayward
Implementation Of Routine Screening To Detect Early Cases Of Depression And Anxiety In Hispanic Adolescents In The Primary Care Setting, Latoya Hayward
Doctor of Nursing Practice Projects
Depression and anxiety are among the leading causes of illness and disability in adolescents and are two of the most prevalent mental health conditions in Latino youth. If left unrecognized and untreated, these conditions can lead to decreased quality of life and increased rates of suicide. Researchers recommend early mental health screening to occur in the primary care setting. Through routine screening using evidence-based screening tools (PHQ-9 and GAD-7), the primary goal of this quality improvement project was to increase early detection of depression and anxiety in primary care and initiate early treatment. Project methods included implementation of new workflow, …
Utilizing A Personal Health Coach In The Management Of T2dm, Emily Killebrew, Matthew Huelsman, Verah Bonareri, Terri Furfaro
Utilizing A Personal Health Coach In The Management Of T2dm, Emily Killebrew, Matthew Huelsman, Verah Bonareri, Terri Furfaro
Doctor of Nursing Practice Projects
Management of type 2 diabetes mellitus (T2DM) can reduce hemoglobin a1c values and ultimately reduce the risk of morbidity and mortality. Many adults live with uncontrolled T2DM due to a lack of knowledge of disease management. The purpose of this project was to evaluate the implementation of a personal health coach for the management of T2DM in adult patients. An extensive literature review was conducted, and the use of the Diabetes Management Self-Efficacy Scale (DMSES) was chosen to evaluate participants’ self-efficacy regarding their T2DM. Adult patients aged 21-75 with a diagnosis of T2DM and a hemoglobin a1c >7 in a …
Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney
Improving Depression Surveillance At The We Care Clinic, Kaitlin Springer, Emma Hanney
Doctor of Nursing Practice Projects
Depression is one of the most underdiagnosed and untreated disorders affecting more than 16 million people in the United States each year (Henry et al., 2020). Unmanaged depression can lead to emotional suffering, decreased productivity, reduced income, impaired relationships, and an increased risk for comorbidities (Sinisalchi et al., 2020). It can affect anyone, however, individuals who are non-white, female, undereducated, disabled, pregnant or postpartum, have low socioeconomic status, or lack social support are at an increased risk (United States Preventative Services Task Force, 2019). The Southern Illinois University Edwardsville We Care Clinic provides primary care to minority patient populations who …
Community Health Worker Intervention To Improve Hba1c In Adult Diabetic Patients, Megan Wojtko
Community Health Worker Intervention To Improve Hba1c In Adult Diabetic Patients, Megan Wojtko
Doctor of Nursing Practice Projects
Type 2 Diabetes Mellitus (T2DM) is a disease that disproportionally impacts patients with multiple socioeconomic barriers that are often difficult to address during a primary care visit. Several provider and practice-level barriers also exist including time limitations within the visit and lack of trained staff to help with patient education and case management. Uncontrolled T2DM leads to poor health outcomes and increased healthcare costs. Community Health Workers (CHW) are trained lay persons that can successfully address the patient’s unmet needs and assist with the provider’s recommendations. The purpose of this project was to explore if a CHW led intervention focused …
The Misuse Of Convenient Care And Importance Of Establishing A Primary Care Provider, Bailey M. Johnston, Amanda Lt Hawkins
The Misuse Of Convenient Care And Importance Of Establishing A Primary Care Provider, Bailey M. Johnston, Amanda Lt Hawkins
Doctor of Nursing Practice Projects
Over the last decade, there has been substantial increase in the use of urgent care (UC) and convenient care (CC) clinics nationwide. While these clinics are valued and serve a purpose in our communities, more patients are utilizing their services exclusively in place of primary care (PC), resulting in millions of Americans not receiving essential preventative care and chronic disease management. An extensive literature review evaluated current and effective interventions used to decrease inappropriate use of CC clinics, while simultaneously exploring strategies in increasing patient compliance with routine comprehensive health management. Based on literature review findings, an education-based project was …
Implementing A Validated Developmental Screening Tool In A Rural Pediatric Primary Care Clinic To Enhance Early Diagnosis Of Developmental Delays From Birth To 36 Months, Melissa A. Armstead
Implementing A Validated Developmental Screening Tool In A Rural Pediatric Primary Care Clinic To Enhance Early Diagnosis Of Developmental Delays From Birth To 36 Months, Melissa A. Armstead
Doctor of Nursing Practice Projects
Abstract
Evaluation of childhood development with a validated screening tool has been the gold standard for best practice recommended by the American Academy of Pediatrics (AAP) since 2006. A rural pediatric clinic was the setting for this quality improvement project. The goals of the project were to 1) increase the number of children identified with developmental delays, 2) identify children with delays earlier, and 3) maximize the number of children receiving early intervention (EI) services between the ages of birth to 36 months. The Ages and Stages Questionnaire (ASQ-3) was the selected screening tool adopted by the clinic in June …
Implementation Of The Edinburgh Postnatal Depression Scale In A Midwest Primary Care Clinic, Amanda Lee
Implementation Of The Edinburgh Postnatal Depression Scale In A Midwest Primary Care Clinic, Amanda Lee
Doctor of Nursing Practice Projects
Recent data from the World Health Organization reveals that the prevalence of postpartum depression is about 13%. Research portrays that untreated postpartum depression can have a detrimental impact on maternal and child outcomes. The American Academy of Pediatrics recommends integrating postpartum depression screening at the 1-, 2-, 4-, and 6-month well-child visits. The purpose of this project was to increase early identification of women with postpartum depression (PPD) by increasing the frequency of the Edinburgh Postpartum Depression Scale (EPDS) and evaluating the adherence of the recommended protocol at a Midwestern Primary Care clinic. The healthcare staff received training that included …
Depression Screening In The Primary Care Setting, Colleen Dostal, Stephanie Boerding
Depression Screening In The Primary Care Setting, Colleen Dostal, Stephanie Boerding
Doctor of Nursing Practice Projects
Recent data reveals that approximately 17.3 million adults in the US population experience an episode of depression each year. Unidentified and untreated depression has many consequences leading to a poor quality of life, direct and indirect healthcare cost-related increases, and an increase in medical comorbidities. The U.S. Preventative Services Task Force recommends that all adults be screened for depression. The PHQ-2 and PHQ-9 are the most widely accepted screening tools in the preliminary detection of depression. The purpose of this project was to educate health care professionals regarding depression and the implementation of a new depression screening protocol: A positive …
Clinical Guideline Based Interventions To Increase Smoking Cessation Success In Primary Care, Chloe Marth
Clinical Guideline Based Interventions To Increase Smoking Cessation Success In Primary Care, Chloe Marth
Doctor of Nursing Practice Projects
Current evidence indicates that providers play an integral role and are most successful in improving cigarette smoking cessation rates through a combination of counseling, patient follow up, and pharmacotherapy. In order to address high smoking rates among patients at a primary care clinic in an urban community, the Five A’s model for smoking cessation (Ask, Advise, Assess, Assist, and Arrange) was initiated. During clinic visits, patients were asked about their smoking status. For those who stated they smoked cigarettes, further evaluation was conducted using the Fagerstrom Test for Nicotine Dependence and the patient’s willingness to quit was assessed. Five of …
Implementation Of High Blood Pressure Guidelines In Clinical Practice, Jessica Walker
Implementation Of High Blood Pressure Guidelines In Clinical Practice, Jessica Walker
Doctor of Nursing Practice Projects
Abstract
This quality improvement project implemented 2017 Guidelines for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. An in-service education session on the 2017 High Blood Pressure Guidelines was provided to clinical staff. In addition, the AHA/ACC pooled cohort 10-year risk calculator was installed to computer desktops or smart phones, for providers. “Seven simple tips to get an accurate blood pressure reading” (American Medical Association, 2016) was posted in exam rooms and proper measurement and documentation techniques were reviewed with clinical staff. Review of recommended non-pharmacological treatment methods with proper patient education documentation was also conducted. …