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Articles 31 - 60 of 86
Full-Text Articles in Medicine and Health Sciences
Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman
Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman
Dissertations
Problem: Traumatic Brain Injuries (TBI) are known as the signature wound of veterans serving in Operation Enduring Freedom (OEF) and the Operation Iraqi Freedom (OIF). After the initial TBI diagnosis, outpatient TBI follow-up rates are reported to be approximately 9% less in the Veteran Healthcare Administration (VA) system when compared to the private sector. The purpose of this quality initiative was to decrease the rate of missed appointments among OEF/OIF veterans using a telehealth alternative.
Methods: The Plan-Do-Study-Act (PDSA) method was used to implement a consistent process for the telehealth visit option. A retrospective medical record review over the same …
Aligning With Patient-Centered Medical Home Standards: Depression Screening In Primary Care, Elizabeth Segura
Aligning With Patient-Centered Medical Home Standards: Depression Screening In Primary Care, Elizabeth Segura
Dissertations
Abstract
Problem: The Patient Centered Medical Home (PCMH) is a model of care that improves the quality and experience of care and decreases cost. Use of a validated depression screening tool for adult patients is a PCMH certification requirement. The purpose of this quality initiative was to obtain baseline data when a depression screening tool was utilized among adult patients in an internal medicine clinic within a Midwestern public health department.
Methods: This was a quality improvement project utilizing a descriptive and observational design. A retrospective medical record review was used to assess the rate of depression screening utilizing the …
Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart
Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart
DNP Scholarly Projects
Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …
Congential Heart Disease (Chd) Adult Survivors And Type 2 Diabetes Mellitus, Olivia Sutter
Congential Heart Disease (Chd) Adult Survivors And Type 2 Diabetes Mellitus, Olivia Sutter
Nursing Student Class Projects (Formerly MSN)
Congenital heart disease (CHD) includes a wide array of disorders and varying degrees of severity and is the most common birth defect, comprising of 1% of all birth defects (CDC, 2018). Heart defects can be acyanotic (non-critical) or cyanotic (critical) (Deen & Krieger, 2016). Birth defects are determined to be cyanotic or acyanotic based on pulse oximetry and anatomy through echocardiogram technology (Mayo clinic, 2018). Due to the advances of interventions in this field, children with heart defects are living to adulthood and therefore are acquiring diseases of aging, such as atherosclerosis and type 2 diabetes, in addition to the …
Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning
Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning
Doctor of Nursing Practice Final Manuscripts
Title: Practicum to Practice: Family Nurse Practitioner Student Competencies in Integrated Psychiatric Mental Healthcare.
Background: Major Depressive Disorder (MDD) is a widespread and costly diagnosis that affects nearly 16 million people annually and costs the United States nearly $83 Billion. Primary care providers such as Family Nurse Practitioners (FNP) play a crucial role in screening for health problems, preventing, and managing illness. Opportunities exist to integrate psychiatric mental healthcare into FNP curriculum and clinical practicums to better prepare providers to identify and screen for depression.
Purpose: The purpose of this evidenced-based practice project is to evaluate FNP student competencies …
What’S Keeping America’S Heroes Awake? Screening For Obstructive Sleep Apnea In Male Veterans With Hypertension And Diabetes, Aaron James Stirling
What’S Keeping America’S Heroes Awake? Screening For Obstructive Sleep Apnea In Male Veterans With Hypertension And Diabetes, Aaron James Stirling
Doctor of Nursing Practice Final Manuscripts
Purpose: To reduce cardiovascular risk through optimal obstructive sleep apnea (OSA) management with proactive screening utilizing the Epworth Sleepiness Scale (ESS) in male Veterans with hypertension (HTN) and diabetes mellitus (DM).
Background: OSA is a common finding in primary care, with 1 in 5 adults feeling its effects: excessive sleepiness, impaired cognition, reduced quality of life and increased mortality. Unmanaged OSA has been highly correlated with increased cardiac risk in populations with chronic diseases such as HTN and DM. Fortunately, identification and treatment of OSA has been shown to improve cardiovascular outcomes and reduce mortality. Evidence supports outpatient screening to …
Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph
Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph
Doctor of Nursing Practice Final Manuscripts
Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …
An Evaluation Of The Treatment Modality And Management Of Acute And Chronic Low Back Pain Individuals In Rural Southeast Kansas, Michele R. Carey
An Evaluation Of The Treatment Modality And Management Of Acute And Chronic Low Back Pain Individuals In Rural Southeast Kansas, Michele R. Carey
Doctor of Nursing Practice Scholarly Project
Roughly 25 million American adults experience pain, and 23 million others withstand severe assiduous pain that is disabling and results in decrease work productivity, loss of quality of life and diminished health (Meldrum, 2016). Treatment of pain, including chronic and acute low back pain includes a multidisciplinary approach merging cognitive-behavioral, psychological and physical therapies, respite, pain coping management and self-hypnosis (Meldrum, 2016). In 1999, pharmaceutical companies reassured physicians that opioid pain relievers were not addictive, and the prescribing rate began to increase (NIH, 2017). The quantity of opioids being prescribed has quadrupled since 1999 which has led to an increase …
The Effect Of Algorithm Implementation In The Family Practice Setting On The Pain And Recovery Of Acute Low Back Pain Patients, Joan Caito
Evidence-Based Practice Project Reports
Nearly $86 billion is spent annually in healthcare costs for Americans with low back pain (Lee, McAuley, Hübscher, Allen, Kamper, Moseley, 2016). Additionally, the burden on the economy due to loss in productivity incurs approximately $114 billion dollars of lost revenue annually (Lee et. al., 2016). Patients with an acute low back injury inadequately treated may become a chronic issue. Only 50% of patients who experience back pain symptoms for 12 months will return to work (Petit, Fouquet, & Roquelaure, 2015). The purpose of this project will be to implement an evidence-based algorithm to standardize acute low back pain care …
Impact Of Motivational Interviewing On Body Mass Index, Tajsier L. Thompson
Impact Of Motivational Interviewing On Body Mass Index, Tajsier L. Thompson
Doctor of Nursing Practice Projects
Introduction
Being overweight and obese has become a common lifestyle. More than half of American adults are overweight and more than a quarter of overweight adults are obese. Despite this overwhelming statistic, weight-loss coaching by primary care providers is usually disregarded due to time constraints and lack of skills to motivate patients to reach weight-loss goals. Motivational interviewing (MI) focuses on helping people investigate and overcome ambivalence toward healthy lifestyle modifications by helping them to explore their weaknesses, strengths, and preferences in an effort to facilitate behavioral changes.
Objective
The primary objective of this project is to assess the effectiveness …
Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott
Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott
DNP Scholarly Projects
The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …
The Effectiveness Of Insulin Pump Therapy After Transition From Multiple Daily Insulin Injections In Type 1 Diabetes, Sima Sapkota
The Effectiveness Of Insulin Pump Therapy After Transition From Multiple Daily Insulin Injections In Type 1 Diabetes, Sima Sapkota
Doctoral Projects
The population of patients who have been diagnosed with diabetes mellitus (Type 1 or Type 2) has been increasing in the United States. Patients with type 1 diabetes may receive insulin through delivery via insulin pump therapy (IPT) or multiple daily insulin injections (MDII). In addition to requiring insulin, other management regimens have included frequent blood glucose monitoring, checking laboratory values hemoglobin A1c (A1C), maintaining normal body mass index (BMI), keeping a balanced diet, carbohydrate counting, and exercise. The purpose of the study was to compare the retrospective data of A1C and BMI of patients with type 1 diabetes after …
Development And Validation Of A Silhouette Scale To Measure African-American Mothers’ Perception Of The Body Size Of Their Two To Four Year Old Children, Joan Buckley
Dissertations, Theses, and Capstone Projects
Background: In the United States (U.S.), the Center for Disease Control (2011 – 2014) reported that one-third of adults and 17% of children between the ages of two and nineteen are obese. Obesity in the U.S. is higher in the African-American groups comprising 13.2 % of the U.S. population. With the link between obesity and chronic diseases, such as, diabetes, heart disease, stroke, and some cancers there is a necessity to understand and reverse the consequences of obesity. There is a need to change the development of obesity/adiposity from childhood to adulthood in African-Americans. Exploring the parent’s awareness of …
Sexually Transmitted Infection Risk Reduction For College Students, Mary Kathryn Dowling
Sexually Transmitted Infection Risk Reduction For College Students, Mary Kathryn Dowling
Doctoral Projects
University students have been assessed through many sexual health lenses, but there is a paucity of research on the sexual health of community college students. This population may provide good access to at-risk youth, and opportunity to reverse steep climbs in sexually transmitted infection (STI) rates. This research project pilot tests a theory-based intervention employing social facilitation to reduce STI risk among college students. Fifty students were recruited from Human Sexuality courses to participate in a 60-minute workshop. Pre- and post-testing measured for change in STI knowledge, attitude towards safer sex, and self-efficacy for engaging in safer sex practices.
A …
An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup
An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup
Electronic Theses and Dissertations
ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …
Perceived Health: A Grounded Theory Study On How Young Black Men Process Their Health, Layla L. Qaabidh
Perceived Health: A Grounded Theory Study On How Young Black Men Process Their Health, Layla L. Qaabidh
Dissertations, Theses, and Capstone Projects
This dissertation explored the perceptions young, Black men have regarding their health. It also sought to understand behaviors young, Black men engage in to maintain their health.
Culturally Sensitive Diabetic Group Education, Kelly Marie Flores
Culturally Sensitive Diabetic Group Education, Kelly Marie Flores
Doctoral Projects
This study assessed the effectiveness of a culturally sensitive type 2 diabetes group education program delivered to Hispanic women in Merced County. Design: A pre-test post-test design. Purposeful sampling was used. Fifteen Hispanic women from a Merced County outpatient clinic were invited to participate in a culturally relevant group education workshop over a 6-week period. Four (N=4) women accepted the invitation, completed the educational workshop, and participated in the assessments. Topics discussed in the education sessions included: (1) diabetic diet, (2) exercise, (3) blood sugar monitoring, (4) medication, and (5) preventative health. A knowledge check was completed by …
Enhancing Elderly Advance Care Planning Experience At A Primary Care Clinic, Oi Shan Wong
Enhancing Elderly Advance Care Planning Experience At A Primary Care Clinic, Oi Shan Wong
Doctoral Projects
The purpose of the project was to examine if the identification of readiness for an advance care planning (ACP) discussion of elderly participants would enhance the outcomes of participants' satisfaction, improve the likelihood of having an ACP discussion and increase the completion rates of an advance directive (AD) document after an office visit.
Forty-four elderly participants, who met the selection criteria, were recruited from a primary clinic in Northern California from October 1, 2017 to December 31, 2017 (Female, n =28). All participants were randomly assigned to either an intervention group (n= 22) or a control group ( …
Orthopedic Nurse Practitioner As A Subspecialty: A Case Study, Debra M. Palmer
Orthopedic Nurse Practitioner As A Subspecialty: A Case Study, Debra M. Palmer
Dissertations
Purpose: The overall purpose of this study was to describe the ONP role by exploring how and why NPs are utilized in orthopedic health care settings. Two problems associated with the evolving ONP role were addressed: the concomitant decrease in the supply of and increased demand for orthopedic patient care services and the nursing profession’s unmet challenge to keep pace with that increased demand and protection of the public and nursing profession through credentialing of ONPs and programs providing certification and training for ONPs.
Approach: This study employed a single-embedded case study research approach to answer the research questions and …
The Implementation Of Telehealth In Disease Management At Patient-Centered Medical Home, Mirsada Nurkanovic
The Implementation Of Telehealth In Disease Management At Patient-Centered Medical Home, Mirsada Nurkanovic
College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications
Purpose: Telehealth (TH) and video conferencing in the patient-centered medical home (PCMH) can bridge geographical gaps between patients and providers, by eliminating the inconveniences of leaving the house and traveling to appointments. The evidence indicates that TH also: provides clinical benefits in high-risk patients1, improves glucose control2, improves quality of life and reduces ED visits and hospitalizations for patients with COPD3, enables self-care of patients with heart failure4, reduces risk of admission for patients with asthma5, improves medication adherence6, results in potential cost savings7, and provides …
Depression Screening And Care Management In Diabetes Patients At Rural Health Clinics In Primary Care: Quality Improvement, Marcy Doyle
DNP Scholarly Projects
Depression is one of the leading causes of disease and disability, often found in patients with long-term chronic physical conditions such as diabetes. Collaborative care, which includes care managers, has shown to improve depression outcomes in patients; usual care has been shown to be inadequate. This quality improvement project screened patients with diabetes for depression. Patients with an elevated depression screening score were provided care management support and rescreened every two weeks to evaluate depression symptoms. A small cohort of patients from two rural health clinics participated in the improvement project. The practices noted improvement in depression screening; patients who …
The Effects Of Hormone Replacement Therapy (Hrt) On Surgically Postmenopausal Women: A Review Of The Literature, Leslie M. Hertweck
The Effects Of Hormone Replacement Therapy (Hrt) On Surgically Postmenopausal Women: A Review Of The Literature, Leslie M. Hertweck
Honors Undergraduate Theses
The primary purpose of this research was to examine the effects of HRT in women with acute estrogen deficiency from surgically induced menopause. The secondary purpose was to evaluate how HRT improves symptoms of acute estrogen deficiency and quality of life (QOL) in women using hormone supplementation. Peer reviewed articles published from 2000 to 2017 that were written in the English language with a focus on the use of HRT in women with acute estrogen deficiency after surgical menopause were evaluated for relevance. Evidence suggests the primary reason for decreased use of HRT is the associated risks outweighing the benefits; …
Health Literacy In A Primary Care Setting, Ashley Newman
Health Literacy In A Primary Care Setting, Ashley Newman
DNP Projects
BACKGROUND: Low health literacy is prevalent in the United States. As a result, the Agency for Healthcare Research and Quality (AHRQ) developed universal health literacy precautions to improve patient understanding of health information. Using universal precautions and specific tools, such as teach-back, has been shown to decrease morbidity and improve patient outcomes.
PURPOSE: The purpose of this quality improvement project is to assess provider knowledge of health literacy in a primary care setting. A secondary purpose is to assess the use of patient education material for patients with diabetes, hypertension, and hyperlipidemia that meet universal precautions.
METHODS: This study was …
An Evaluation Of Provider Adherence To Acute Bronchitis Quality Measures In Adults, Rachel L. Lazar
An Evaluation Of Provider Adherence To Acute Bronchitis Quality Measures In Adults, Rachel L. Lazar
DNP Projects
Background: Acute bronchitis management continues to be mistreated. Evidence based practice guidelines do not support antibiotic therapy for the treatment of acute bronchitis. Providers are encouraged to prescribe antitussives, suppressants and inhaler medications for the treatment of acute bronchitis symptoms, including cough.
Objective: The overall objective of this project is to evaluate the management of adults diagnosed with acute bronchitis in a limited services clinic.
Methods: A retrospective chart review was conducted on patients in a limited services clinic. The chart review assessed patients aged 18-64 with a diagnosis of acute bronchitis from July 1, 2016- June 30, 2017.
Results: …
Improving Fall Risk Assessment And Documentation: A Qi Project, Ashley N. Kohari
Improving Fall Risk Assessment And Documentation: A Qi Project, Ashley N. Kohari
DNP Projects
BACKGROUND: Unintentional falls commonly arise and can cause significant harm including fractures, head injuries, and death. Assessing each patient for falls and performing a fall risk assessment is recommended by the American Geriatrics Society and the Center for Disease Control and Prevention, and is mandated for institutional reimbursement. Fall risk assessment has been shown to decrease the rate of falls and healthcare costs.
PURPOSE: The purpose of this quality improvement project was to improve compliance for fall risk screening and documentation to meet MACRA requirements in a family medicine clinic.
OBJECTIVES: The objectives for this project were: 1. Conduct PDSA …
Evaluating The Relationship Between Tobacco Use And Pain Perception Using The Global Pain Scale (Gps) In Opioid Dependent Adults: A Retrospective Analysis, Kristina Robinson
Evaluating The Relationship Between Tobacco Use And Pain Perception Using The Global Pain Scale (Gps) In Opioid Dependent Adults: A Retrospective Analysis, Kristina Robinson
DNP Projects
Background: Chronic pain, smoking, and opioid use, contribute to a significant economic burden in the United States. Chronic pain affects all aspects of life, and is influenced by the use of cigarettes and opioids alike. Researchers suggest that there is a higher use of cigarettes and opioids in individuals with chronic pain. Chronic pain can promote smoking and smokers are more likely to use opioids. With the evidence that patients who smoke a higher number of cigarettes per day report higher pain, it is possible that smoking may be a stress-reducing behavioral response related to pain. Moreover, higher frequency and …
Increasing Influenza Vaccination Rates In A Primary Care Clinic: A Quality Improvement Study, Cassandra R. Roshel
Increasing Influenza Vaccination Rates In A Primary Care Clinic: A Quality Improvement Study, Cassandra R. Roshel
DNP Projects
Background
According to the most recent CDC statistics, the influenza virus kills between 12,000 and 56,000 people per year in the United States. Although influenza vaccination is recommended each year, only about half of all Americans are actually receiving the vaccine annually. The goal of this quality improvement project was to increase influenza vaccination rates at a large academic medical center in Kentucky. At baseline, there was no standardized screening protocol in place prior to this study.
Methods
This study implemented a pre-test post-test design to evaluate the impact of a process change intervention on vaccination status from September 1, …
An Evaluation Of The Effects Of A Diabetes Self-Management Education Program On The Hba1c In Patients With Type 2 Diabetes, Katherine Schoo
An Evaluation Of The Effects Of A Diabetes Self-Management Education Program On The Hba1c In Patients With Type 2 Diabetes, Katherine Schoo
DNP Projects
Introduction
Diabetes has become an epidemic in the United States. More than 30.3 29 million Americans are living with the disease, while an additional 84.1 million Americans are living with prediabetes (Centers for Disease Control and Prevention [CDC], 2018). Standards set forth by the American Diabetes Association (ADA) describe comprehensive and individualized self-management education and treatment as part of their guidelines for the management of diabetes (ADA, 2018). The “Active Steps for Diabetes” program is an example of a diabetes self-management education (DSME) program that supports national recommendations made by the ADA.
Methods
This study was a retrospective descriptive pre- …
A Retrospective Comparative Analysis On The Effectiveness Of Pharmacologic Weight Loss, Emily Dunn
A Retrospective Comparative Analysis On The Effectiveness Of Pharmacologic Weight Loss, Emily Dunn
DNP Projects
PURPOSE:Obesity costs the U.S. roughly $147 billion in health care spending annually. There has been a call for healthcare providers to initiate all possible weight loss interventions. One treatment strategy not used to its fullest potential is that of prescribing antiobesity medications. The purpose of this project was to examine and evaluate the effectiveness of three common weight loss medications used in the treatment of obesity, including discussion and recommendations.
METHODS: This project was a single-center retrospective study comparing three different groups of patients seen at a rural weight loss clinic. The sample consisted of 84 patients seen between September …
The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell
The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell
DNP Projects
BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.
PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.
METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …