Medicine and Health Sciences Commons^™

Management And Support Of Uninsured Patients With Diabetes Type Ii Within A Nurse Managed Clinic, Emma Spencer

Dissertations

The purpose of the project was to improve the quality of care for the uninsured, Type II Diabetics residing in a Midwestern urban underserved community. Community Health in Partnership Services (CHIPS) was a nurse-managed clinic, located in that area, that sought to lessen the burden of being uninsured. An annual fee of $35.00 allowed an uninsured community member access to a variety of different health care providers including specialists. In order to utilize this health care team efficiently, it was necessary to implement nurse-led care coordination for patients diagnosed with Type II Diabetes. This quality improvement project followed the Plan …

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

Increasing Nursing Competence And Confidence During Obstetric Emergencies Through Simulation: A Quality Improvement Project, Tram Wallen

Dissertations

Problem: This quality improvement project aimed to improve the knowledge and confidence of the mother/baby nursing staff during postpartum hemorrhages through in situ simulation. PPH is a leading cause of maternal death. Hospitals across the U.S. lack a standard approach to managing obstetric emergencies; the complications of childbirth are often identified too late. Multidisciplinary simulation-based team training has been associated with improved outcomes in obstetrics.

Methods: A convenience sample of 26 registered nurses (RNs) that care for postpartum patients attended a one-hour instructor-led presentation followed by in situ simulations of postpartum hemorrhage. A knowledge assessment and confidence survey were administered …

Evaluating The Delivery Of Diabetes-Related Care Among The Asian Population, Lyly Bui

Dissertations

Purpose: This project evaluated current practices for Type 2 diabetes mellitus (T2DM) screening and management among Asian Americans (AAs) presenting to a primary care clinic and determined whether these practices adhered to the American Diabetes Association (ADA)’s 2018 guidelines.

Methods: A retrospective chart review was performed to extract data from clinical case records of AAs who visited the Vietnamese Health Center (VHC) between November 1, 2017 and November 1, 2018. Descriptive statistics were utilized to analyze the data.

Results: Of 173 charts reviewed, 76.3% of AAs had no previous T2DM diagnosis and 23.7% had a previous diagnosis. Among those without …

A Rural Telehealth Objective Structured Clinical Examination, Devon Schlottach

Dissertations

Problem Rural healthcare consumers experience increased health disparities, especially when accessing health care. The use of telehealth to improve access has become an essential competency for nurse practitioner (NP) students. This study evaluated NP students’ confidence and competence of rural social determinants of health (rSDOH) before and after a telehealth simulation.

Methods A descriptive, cohort design was used to review NP students’ pre- and post-surveys, written case studies, and a video-recorded telehealth OSCE for a patient living in a rural area.

Results Student self-rated knowledge of rural health care did not improve despite didactic learning and simulation (z = …

A Community-Wide Collaboration To Reduce Cardiovascular Disease Risk: The Hearts Of Sonoma County Initiative., Allen Cheadle, Michelle Rosaschi, Dolores Burden, Monica Ferguson, Bo Greaves, Lori Houston, Jennifer Mcclendon, Jerome Minkoff, Maggie Jones, Pam Schwartz, Jean Nudelman, Mary Maddux-Gonzalez

Articles, Abstracts, and Reports

PURPOSE AND OBJECTIVES: Collaboration across multiple sectors is needed to bring about health system transformation, but creating effective and sustainable collaboratives is challenging. We describe outcomes and lessons learned from the Hearts of Sonoma County (HSC) initiative, a successful multi-sector collaborative effort to reduce cardiovascular disease (CVD) risk in Sonoma County, California.

INTERVENTION APPROACH: HSC works in both clinical systems and communities to reduce CVD risk. The initiative grew out of a longer-term county-wide collaborative effort known as Health Action. The clinical component involves activating primary care providers around management of CVD risk factors; community activities include community health workers …

Skeletal Muscle Fiber Adaptations Following Resistance Training Using Repetition Maximums Or Relative Intensity, Kevin M. Carroll, Caleb D. Bazyler, Jake R. Bernards, Christopher B. Taber, Charles A. Stuart, Brad H. Deweese, Kimitake Sato, Michael H. Stone

ETSU Faculty Works

The purpose of the study was to compare the physiological responses of skeletal muscle to a resistance training (RT) program using repetition maximum (RM) or relative intensity (RISR). Fifteen well-trained males underwent RT 3 d·wk−1 for 10 weeks in either an RM group (n = 8) or RISR group (n = 7). The RM group achieved a relative maximum each day, while the RISR group trained based on percentages. The RM group exercised until muscular failure on each exercise, while the RISR group did not reach muscular failure throughout the intervention. Percutaneous needle biopsies of the vastus lateralis were obtained …

A Provider-Driven Approach To Preventative Oral Care In Nursing Home Facilities, Molly Anderson, Brandon Mccrossin, Kary Franchetti, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

Oral care is an essential part of preventative medicine as it minimizes risk for pneumonias and other infections. In nursing home settings, often oral health care is not routinely provided due to a number of issues. A health care system that either owns or contracts nursing home facilities initiated a performance improvement plan to address this patient care concern.

The first goal of this project was to reduce the variation in oral care between nursing home facilities within the system. The second goal was 100% of their patients will have one oral health care exam documented in EPIC once a …

Scsd Receives Grant From Parkinson Voice Project Scsd Committed To Offering Parkinson Voice Project's Speech Therapy Program In The Michiana Area, Parkinson Voice Project And Andrews University

Andrews Agenda: Campus News

No abstract provided.

Contribution Of Animal Models To Contemporary Understanding Of Attention Deficit Hyperactivity Disorder, Constança Carvalho, Mariana Vieira Crespo, Luísa Ferreira Bastos, Andrew Knight, Luís Vincente

Biomedicine and Animal Models in Research Collection

Attention Deficit Hyperactivity Disorder (ADHD) is a poorly understood neurodevelopmental disorder of multifactorial origin. Animal-based research has been used to investigate ADHD etiology, pathogenesis and treatment, but the efficacy of this research for patients has not yet been systematically evaluated. Such evaluation is important given the resource consumption and ethical concerns incurred by animal use.

We used the citation tracking facility within Web of Science to locate citations of original research papers on animal models related to ADHD published prior to 2010 identified in PubMed by relevant search terms. Human medical papers citing those animal studies were carefully analyzed by …

Decreasing Opioid Overprescription Following Outpatient Gynecology Surgery, Monica Kistler

Dissertations

Problem: Opioid abuse may be a result of overprescribing opioids. There are no opioid prescribing recommendations for minor gynecologic surgery. As a result, there is a wide variation in prescribing practices at a privately-owned surgery center where excessive opioid prescription occurs.

Methods: A quality improvement initiative with a descriptive, cohort design. A retrospective review of medical records and telephone surveys over three months resulted in the development of a series of posters describing prescription data for three procedures: hysteroscopy dilation and curettage (HDC), uterine ablation (UA), and laparoscopy (LAP). The trends and changes in opioid prescription practices were displayed throughout …

Depression Screening In Antepartum Females, Michelle Burk

Dissertations

Problem: Perinatal mood disorders, including depression, affects one in five pregnant or postpartum females. The American College of Obstetricians and Gynecologists (ACOG) and the US Preventative Task Force (USPTF) recommended screening for depression at least once during the antepartum and postpartum periods. The purpose of this quality improvement initiative was to introduce depression screening using the patient health questionnaire (PHQ) in antepartum women in a Midwestern private OB-GYN practice.

Methods: An observational, descriptive, cohort design utilizing a retrospective record review was used to evaluate for PHQ depression screening. A convenience sample of antepartum patients at/or around 36-weeks gestation was studied. …

Examining Opioid Ordering Rates Of Advanced Practice Providers In An Emergency Department, Bridgette Thompson

Dissertations

Problem Opioid abuse has become a major public health issue in America. Many Americans die daily from an opioid overdose. The Centers for Disease Control and Prevention (CDC) has identified prescription drug abuse and overdose as a major health threat.

Methods Descriptive cohort design with a retrospective record review of the number of opioids ordered by the advanced practice provider six weeks before and six weeks after a didactic and simulation educational experience.

Results The total sample was four (N=4). Using the paired samples t test there was no difference (t = 0.65, p = 0.56) between the number …

Primary Care Delays In Underserved Areas: A Strategic Plan To Improve Access To Care, Debra Connell-Dent

Dissertations

Hypertension (HTN) and Diabetes Mellitus Type 2 (DM2) are two chronic conditions contributing to morbidity and mortality. 23.1 million people have DM2 and 7.2 million people have it an are undiagnosed in the U.S. During 2015-2016, the prevalence of HTN was 29.0% and increases with age (CDC, 2018). This purpose of this article was to discuss the benefits of developing a Transition Clinic (TC) in a highly traveled metro transit area and the development of a strategic plan on implementing this project, as well as the barriers that may be encountered when implementing such a clinic similar to this. A …

Goats Distinguish Between Positive And Negative Emotion-Linked Vocalisations, Luigi Baciadonna, Elodie Briefer, Livio Favaro, A. G. Mcelligott

Bioacoustics Collection

Background: Evidence from humans suggests that the expression of emotions can regulate social interactions and promote coordination within a group. Despite its evolutionary importance, social communication of emotions in non-human animals is still not well understood. Here, we combine behavioural and physiological measures, to determine if animals can distinguish between vocalisations linked to different emotional valences (positive and negative). Using a playback paradigm, goats were habituated to listen to a conspecific call associated with positive or negative valence (habituation phase) and were subsequently exposed to a variant of the same call type (contact call) associated with the opposite valence (dishabituation …

Depression In Hiv-Positive Individuals Living In A Residential Housing Community, Danielle Njeri

Dissertations

Problem: Depression is the most prevalent psychiatric disorder among individuals living with HIV. Depression rates are three times greater than those found in the general population . Undiagnosed and untreated depression can have a negative effect on the management of HIV infection, resulting in increased mortality and a poorer quality of life. The purpose of this quality improvement initiative was to assess the incidence of depression in HIV-positive individuals living in a residential community.

Methods: A prospective, descriptive, cohort design. Convenience sample of HIV-positive adult residents living in an HIV residential community. The nine-question patient health questionnaire (PHQ-9) …

Screening For Sexually Transmitted Infections In Adolescents, Millicent Palacios

Dissertations

Abstract

Problem Adolescents are contracting sexually transmitted infections (STIs) with half of all new STIs occurring in those aged 15-24 years old. The American Academy of Pediatrics, recommended all sexually active adolescents be screened for STIs. Incorporation of a sexual behavior assessment may assist providers with identifying STI risk.

Methods A descriptive design comparing three cohorts of adolescents presenting for a well-exam. The cohorts analyzed were: urine screening on all adolescents, urine screening for only those reporting sexual activity, and a self-administered sexual history questionnaire tool, based on the HEEADSSS psychosocial assessments.

Results The majority (97%), of all three cohorts …

Implementation Of The Integrated Palliative Outcome Scale (Ipos) Into Palliative Care Practice, Lisa A. Pezold

Dissertations

Abstract

Problem: The Visiting Nurse Association of Greater St. Louis (VNA) has a grant-funded, palliative care program called Advanced Illness Management (AIM). The Integrated Palliative Outcome Scale (IPOS) is a tool for providers to identify symptoms. The VNA implemented the IPOS in 2017. A previous quality improvement project revealed that IPOS symptoms were addressed less than 95% of the time leaving patients to suffer from burdensome symptoms, thereby reducing their quality of life.

Methods: Providers were educated on the importance of addressing all symptoms with pharmacologic or nonpharmacologic interventions and the impact the interventions have on the AIM program, grant …

Improving Maternal Outcomes Through Labetalol Algorithm Utilization For Hypertensive Disorders Of Pregnancy, Hailee B. Taylor

Dissertations

Hypertensive disorders of pregnancy can have negative effects on both mothers and neonates and are a major contributor to the increasing morbidity and mortality affecting women pregnant women in the United States. Treatment algorithms are available for treatment of hypertensive disorders of pregnancy when treatment criteria are met. With proper use of these algorithms, healthcare personnel can decrease the mortality and morbidity rates, which will increase patient safety and decrease healthcare spending. This research project focused on implementing The American College of Obstetricians and Gynecologists’ (ACOG) Labetalol treatment algorithm to treat patients diagnosed with severe preeclampsia. Prior to implementation, data …

Longitudinal Changes In Physical Caregiving For Parents Of Children With Cerebral Palsy., Mohammed S Alghamdi, Lisa A Chiarello, Robert J Palisano, Sarah W Mccoy, Margo Orlin, Ehab M Abd-Elkafy

Physical Therapy Publications

Aims: To determine changes in physical caregiving for parents of children with cerebral palsy (CP) over a two-year period based on children’s gross motor function level and age.

Methods: 153 parents of children with CP rated their physical caregiving using the Ease of Caregiving for Children three times over two years. Parents and assessors classified children’s gross motor function using the Gross Motor Function Classification System (GMFCS). Physical caregiving was compared at three test times among parents of children grouped by GMFCS level (I, II–III, and IV–V) and age (1.7–5.9 and 6–11 years) using a three-way mixed ANOVA.

Results: Among …

An Assessment Of A Video On The Link Between Diabetes And Peridontal Disease To Educate Native American Populations., Valerie E. Long

Dental Hygiene ETDs

As the Native American population of the Navajo Nation, becomes affected with diabetes dental offices across the Navajo Reservation must ensure that evidence based research is being presented n the oral systemic link of diabetes and periodontal disease. The purpose of this study was to bring awareness to the important topic of the bi-directional link of diabetes and periodontal disease with Native American dental patients. This topic seems to not be valued during oral hygiene education time and so that addition of a culturally-specific educational video on the topic should add value to the message. This topic was investigated via …

Malignant Distal Femur Tumors Management In Children, Low Cost Innovations With Affordable Care In A Tertiary Care Hospital, A Cross Sectional Study, Masood Umer, Javeria Saeed, Obada Hussein Hasan

Section of Orthopaedic Surgery

Introduction: Malignant musculoskeletal tumors in children are mostly comprised of Osteosarcoma and Ewing's sarcoma and distal femur is the most common site for primary bone tumors. This study examined the surgical management outcomes of pediatric patients (<18 years) presented in our setup with malignant distal femur tumors.
Methodology: We retrospectively reviewed the medical records of patients diagnosed with malignant sarcomas of distal femur and younger than 18 years of age who underwent limb salvage surgery during June 2009-June2017.
Results: There were 31 pediatric patients who had distal femur malignant tumors and out of them 20 patients were selected who underwent limb salvage as a primary surgery. The mean age (range) …

Canada's Assisted Human Reproduction Act: Pragmatic Reforms In Support Of Research, Tania M. Bubela, Erika Kleiderman, Zubin Master, Ubaka Ogbogu, Vardit Ravitsky, Amy Zarzeczny, Bartha Maria Knoppers

Office of the Provost

Canada's Assisted Human Reproduction Act is long overdue for Parliamentary review. We argue that the current regulation of research using human reproductive materials is not proportionate, not responsive to the uncertain threats posed to human and environmental health and safety, and is not considerate of diverse values in a democratic society. We propose tailored regulatory carve-outs for in vitro research for currently prohibited activities, such as gene editing, and for the exercise of Ministerial Discretion for access by Canadians to experimental in vivo interventions that are currently prohibited, such as mitochondrial replacement therapy. Our recommendations are bounded by constitutional constraints …

Reducing Cautis In A Neurological Icu, Claire Mckee

Dissertations

Catheter-associated urinary tract infections (CAUTIs) are the primary source of infection in patients with urinary catheters and are the fourth leading cause of healthcare-associated infection. Because indwelling urinary catheters are not completely avoidable in hospitalized patients, it is crucial to utilize evidence-based research to prevent CAUTIs. A urinary catheter maintenance bundle is one way to reduce CAUTI rates in hospitalized patients. This quality improvement project utilizes a catheter maintenance bundle with seven elements with the aim of reducing CAUTI rates. The project takes place in a 20-bed neurological intensive care unit (ICU) in a larger tertiary care medical center. Prior …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

Intratypic Genetic Variability Of Human Adenovirus Type 4: Implication For Viral Pathogenesis, Camden Roy Bair

Biomedical Sciences ETDs

Human adenovirus type 4 (HAdV-E4) is a causative agent of acute respiratory disease and conjunctivitis worldwide. Two major lineages of HAdV-E4 genomic variants have been identified by their distinct BamHI restriction profiles: prototype-like (p-like) strains and the a-like genomic variants. Recent molecular epidemiology studies have shown a predominance of a-like genomic variants detected in association with disease which suggests a-like strains have a fitness advantage or they may be more pathogenic. The impact of HAdV-E4 intratypic genetic variability on in vitro and in vivo phenotypes relevant to pathogenesis is a major gap in knowledge. I hypothesize that HAdV-E4 comprises two …

Outcome Of Inadvertent High Dose Bcg Administration In Newborns At A Tertiary Care Hospital, Karachi- Case Series, Sonia Qureshi, Khalil Ahmad, Paras Fatima, Rabia M. Hassan, Farheen Sherali, Naureen Lalani, Fyezah Jehan, Syed Asad Ali, Farah Qamar

Department of Paediatrics and Child Health

Bacillus Calmette-Guérin (BCG) vaccine is given to newborns soon after birth. BCG vaccine overdose has been rarely reported. Here we report the outcome of newborns who accidently received high dose BCG at a tertiary care hospital, Karachi. We reviewed records of 26 newborns, who accidentally received intradermal high dose BCG, used for the treatment of urinary bladder cancers and 80 times higher dose than the BCG used for routine vaccination. The incident happened from 14-16th April, 2016 at Aga Khan University Hospital, Karachi. Analysis was carried out using SPSS. A total of 23/26(88.5%) newborns were followed for atleast 3 months …

School Of Nursing News, Georgia Southern University

Nursing: News & Publications (2013-2023)

• Gratitude Club Donates Baby Blankets to East Georgia Regional Medical Center

College Of Health Professions News, Georgia Southern University

College of Health Professions: News & Publications (2012-2023)

• Students Gain Experience in Costa Rica
• The Biodynamics & Human Performance Center Awarded $9,965 Grant