Medicine and Health Sciences Commons^™

Using Multi-Modal Education In A Public Health System To Increase Rates Of Cervical Cancer Screening, Christina Nardi

Doctor of Nursing Practice (DNP) Projects

While Papanicolaou (Pap) screening has been implemented since the 1950’s, and is linked to decreased rates of cervical cancer, national screening rates are still below the national target screening rate. In Contra Costa County (CCC), the current cervical cancer screening rate is 50.92% (Contra Costa Health Services [CCHS], 2016a). This is far below the national goal of 93% and the first benchmark of 54.33% needed in order to receive state funding under the California Department of Health Care Services (DHCS) Medi-Cal 2020 waiver. The Medi-Cal 2020 waiver has a 5-year Public Health Incentives and Redesign in Medi-Cal (PRIME) program requiring …

A Randomized Controlled Trial To Establish Realistic Patient Expectations Following Total Knee Replacement Surgery, Sharon E. Culliton

Electronic Thesis and Dissertation Repository

Objectives: To evaluate whether e-learning videos can affect whether patients felt their expectations were met and were satisfied with surgery 1 year following primary total knee replacement (TKR) (Chapter 3). In Chapter 4, we described characteristics of users and utilization patterns of the e-learning tool. In Chapter 5, we evaluated the internal consistency and construct validity of the new Knee Society Knee Scoring System (KSS) in a sample of TKR patients.

Methods: We recruited consecutive patients with osteoarthritis from the London Health Sciences Centre, Ontario, Canada (Chapter 3). We randomized patients with osteoarthritis to either control (n=207) they received our …

Health Literacy Assessment And The Meaningful Use Incentive Of Providing Clinical Summaries In An Underserved, Hypertensive Population, Tami Pettenger

Doctoral Projects

Hypertension is a common diagnosis in the United States and can lead to health complications if not well managed. However, this condition often has few to no symptoms which may lead patients to modify, disregard, or otherwise be non-adherent to treatment plans. Also a patient’s health literacy level may directly affect his or her ability to understand and act on health information. This may be especially true in vulnerable populations such as older adults and underserved communities. In addition, the education material provided to patients, such as clinical summaries following a health visit, may not be consistent or understandable or …

A Trial Examining An Advanced Practice Nurse Intervention To Promote Medication Adherence And Symptom Management In Adult Cancer Patients Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Peggy S. Burhenn, Tracy Dekoekkoek, Monica Schueller

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Aim: To report a study protocol that refines then examines feasibility, preliminary efficacy, and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behavioral therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents. Background: Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centers to patients and their caregivers. Thus, a need exists to standardize start-of-care for support patient self-management of care at home. Design: A two-phase quasi-experimental sequential design with repeated measures. Methods: Sixty five adult patients …

The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden

Evidence-Based Practice Project Reports

Heart Failure (HF) is a chronic progressive disease affecting over 5 million individuals with an expected increase in incidence as the population ages (Yehle & Plake, 2010). The costs associated with managing HF continue to increase and the Centers for Medicare and Medicaid Services (CMS) have attempted to identify ways to improve patient management of HF to reduce the revolving door of hospital readmissions and decrease expenditures. According to 2006 data, as many as one fourth of the Medicare beneficiaries discharged from acute care to skilled nursing facilities (SNF) were readmitted to the hospital within 30 days and the majority …

Affecting Tdap Vaccination Rates Among Women: A Multifaceted Intervention, Soneka Wynter

Evidence-Based Practice Project Reports

Despite the availability of a preventive vaccine, the incidence of pertussis in the United States has continued to increase over the past two decades and it is now considered the most common preventable infectious illness. Highly contagious in nature, it is estimated that about 50 million people are infected each year, and approximately 300,000 deaths occur worldwide (Centers for Disease Control and Prevention [CDC], 2012). In 2013, Indiana reported 616 cases (Indiana State Department of Health [ISDH], 2014). In spite of CDC recommendations on strategies that can improve vaccine delivery, rates of immunization remain low nationwide (CDC, 2014). The purpose …

The Impact Of Free Health Screenings At Community Pharmacies On Diabetes, Anna Smith, Jacques Allou, Jeniffer George, Jessica Amtower, Nicholas Daniels, Jeb Ballentine, Emily M. Laswell

The Research and Scholarship Symposium (2013-2019)

Diabetes is a prevalent issue in the United States, with an estimated 8.1 million people un-diagnosed as of 2012. Health screenings have been proven to identify diseases earlier, thereby resulting in earlier and more satisfactory treatment. Community pharmacies can offer many of the same screenings as those in doctor offices. The objective of this study was to assess the impact of free health screenings in community pharmacies on patient follow-up, perceptions, and knowledge of diabetes through blood glucose screenings and patient education. The study design was a pre-post observational study using surveys, blood sugar screenings, and patient education on diabetes. …

Enhancing Compliance With Allergic Rhinitis Therapy, Beth Wofford, Deborah S. Zeitlin

Deborah Zeitlin

Allergic rhinitis is one of the most common chronic conditions in the US, surpassing even heart disease. Over $1 billion is spent annually for over-the-counter (OTC) and prescription medications. In addition, allergic rhinitis causes an estimated annual loss of $639 million related to lost work days and diminished work performance.

If not effectively treated, allergic rhinitis may lead to potential complications such as otitis media, sinusitis, facial and dental abnormalities, hearing loss, poor speech development, and recurrent upper respiratory tract infections. Ineffective treatment often the result of intentional or unintentional noncompliance and inadequate patient education. Therefore, it is imperative that …

Enhancing Compliance With Allergic Rhinitis Therapy, Beth Wofford, Deborah S. Zeitlin

Deborah Zeitlin

Allergic rhinitis is one of the most common chronic conditions in the US, surpassing even heart disease. Over $1 billion is spent annually for over-the-counter (OTC) and prescription medications. In addition, allergic rhinitis causes an estimated annual loss of $639 million related to lost work days and diminished work performance. If not effectively treated, allergic rhinitis may lead to potential complications such as otitis media, sinusitis, facial and dental abnormalities, hearing loss, poor speech development, and recurrent upper respiratory tract infections. Ineffective treatment often the result of intentional or unintentional noncompliance and inadequate patient education. Therefore, it is imperative that …

A Trial Examining An Advanced Practice Nurse Intervention To Promote Medication Adherence And Symptom Management In Adult Cancer Patients Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Peggy S. Burhenn, Tracy Dekoekkoek, Monica Schueller

Peer Reviewed Articles

Aim: To report a study protocol that refines then examines feasibility, preliminary efficacy, and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behavioral therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents.

Background: Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centers to patients and their caregivers. Thus, a need exists to standardize start-of-care for support patient self-management of care at home.

Design: A two-phase quasi-experimental sequential design with repeated measures.

Methods: Sixty five adult patients …

Awareness Of Antibiotic Resistance In The General Population As Related To Education Level, Rachel M. Cantlon, Emma Wilson

All Electronic Theses and Dissertations

An antibiotic is a drug, also known as an antimicrobial, which is used to treat infectious diseases caused by bacteria (National Institute of Allergy and Infectious Diseases (NIAID), 2012). The effect of antibiotic overuse and mistreatment with these drugs has led to infectious bacteria developing antibiotic resistance (Centers for Disease Control and Prevention (CDC), 2014). Antibiotic resistance results in at least 23,000 deaths each year in the United States alone (CDC, 2014). The purpose of this study was to evaluate the general population’s awareness of antibiotic resistance in regard to education level, and proper use of antibiotics as measured by …

Pneumococcal Pneumonia In The Older Adult: Increasing Patient Education And Vaccination, Jessica E. Valletta

Doctor of Nursing Practice (DNP) Projects

Background:Pneumococcal disease is a transmitted infectious illness that results in serious complications and death every year in the United States. Given their increased susceptibility to the potential complications of this disease, patients aged 65 and older are considered to be high-risk, but vaccination compliance for this population remain well below state and national goals.

Purpose: The purpose of this project was to increase pneumococcal vaccination rates among adults aged 65 and older in a primary care clinic by increasing patient education.

Methods: An educational intervention was implemented within a large primary care practice located in Central Massachusetts. Educational …

A Practice Improvement Project To Improve Knowledge And Perceptions Of Palliative Care Among Patients With Heart Failure And Cancer In The Acute Setting Using Video Enhanced Education, Crystal F. Spellman

DNP Projects

Background: Clear communication of the purpose and benefits of palliative care can reduce barriers to acceptance of such services for patients and families. The purpose of this practice improvement project was to assess and improve knowledge and perceptions of palliative care among patients with a diagnosis of heart failure and cancer in the acute setting using a video enhanced education intervention. Methods: This practice improvement project took place at a 555 bed teaching hospital. 18 patients referred to an inpatient palliative care consult service in the acute care setting with a diagnosis of either heart failure or cancer participated. …

Lyme Disease In Brattleboro, Vt: Office Triage And Community Education, Peter Evans

Family Medicine Clerkship Student Projects

The rates of Lyme disease are rising Vermont, with 710 reported cases in 2015. While preventable, the disease has significant sequelae and primary care offices in Brattleboro, VT are reporting high volume of calls from patients asking for more information about Lyme disease. Formal surveys of Brattleboro Family Physicians and their clinical support staff identify the need for a uniform triage protocol to answer patient calls, as well as further patient education materials, particularly regarding prophylactic antibiotic use following tick exposure.

Hpv Vaccination: Educating And Empowering The Next Generation, Sruthi Sakamuri

Family Medicine Clerkship Student Projects

Vaccination against Human Papillomavirus (HPV) is able to protect against 70% of strains causing cervical cancer and and 90% of strains causing genital warts, yet vaccination rates for boys and girls are still well below average vaccination against many other preventable diseases. Experts agree that patient education and strong physician recommendation of HPV vaccination of pre-teens and teenagers is essential in improving vaccination rates in CT. The objective of this project was to assess and improve understanding of HPV, its implications, and vaccination in a high school population in Danbury, CT. The education session significantly improved students' understanding of HPV …

Improving Patient Understanding Of Low Back Pain In The Primary Care Setting, Xiaoyu Lu

Family Medicine Clerkship Student Projects

Low back pain (LBP) is the most common type of pain reported by U.S. adults across all age groups and is the leading cause of disability worldwide. Up to 80% of individuals will experience LBP at some point in their lives. 411 patients ages 20-98 were seen over a one-year period for LBP at Castleton Family Health Center in Rutland County, Vermont. Patients and providers both saw a benefit to having educational materials on LBP in the office.

An Educational Intervention To Increase Advance Directive Completion, Kimberly Harlow

Regis University Student Publications (comprehensive collection)

In the United States, it is common for patients to receive prolonged, aggressive medical care at the end of life (Levi & Green, 2010). This level of medical care may or may not be in alignment with patients’ wishes. Advance directives developed as a response to this situation. Despite the widespread availability of advance directives and the impetus for health care facilities to discuss advance directives with patients, most Americans do not have a completed advance directive. The average completion rate for advance directives in all populations in the United States is about 25% (Silveira, Witala, & Piette, 2014). This …