Medicine and Health Sciences Commons^™

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

Improving Home Health Nurses' Knowledge Of Heart Failure Self-Care Management, Nenette Hoffman

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure results in life-altering and devastating illnesses, predominantly among older adults. Heart failure management is complex, and requires patients and their caregivers to actively monitor symptoms and sufficiently understand care management to maintain health-promoting behaviors. While home health nurses have the primary role as patient educators of their patients with heart failure, evidence from the literature indicates that nurses lack sufficient knowledge to fulfill this role.

Local Problem: Nurses’ inadequate knowledge of heart failure self-care management has been associated with insufficient patient education, the inability of patients to perform heart failure self-care management, worse clinical outcomes, and …

Pharmacist-Provided Educational Intervention And Its Impact On Medical Resident Knowledge And Comfort Level With Continuous Glucose Monitors (Cgms), Chelsea Dezfuli, Sarah Muench, Colleen Lauster

Posters

Continuous glucose monitors (CGMs) have become an integral component of diabetes care

American Diabetes Association now recommends that CGMs be offered to all patients on insulin who can use the device safely

Integrating CGMs into clinical practice can be challenging for several reasons: – Data overload – Cost – Need for education on data interpretation

Evaluating Literacy Sensitive Client Education Materials For The Smmart Clinic, Mckenzie Brink, Kelsey L. Colvin, Kelsey Holmer, Rachel G. Kullas, Paige M. Loy, Alexander W. Manos, Gretta N. Obeid, Kelly O'Connor, Allison Park

Graduate Projects & Research

This master’s project was completed in collaboration with the St. Mary’s Medical and Rehabilitative Therapies (SMMART) Clinic, located on the campus of St. Catherine University in St. Paul, Minnesota. Through the completion of literature reviews, a needs assessment, and project activities, nine graduate occupational therapy students analyzed the needs of this clinic and aimed to improve client care. The SMMART clinic serves primarily Spanish-speaking clients who are low-income, uninsured, or underinsured. This population often faces obstacles in accessing primary health care and rehabilitation, including language and literacy-related barriers. Occupational therapy can play an important role in addressing these barriers and …

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …

Our Early Years Of Life's Effects On Our Future Health And Well-Being, Claudia Gagliano

Nursing | Senior Theses

Many poor health outcomes later into adulthood have been triggered by adverse life events that have occurred during childhood. Most of the general population has experienced some sort of adverse childhood event that has negatively impacted their future health. Adverse childhood events include any traumatic event that has occurred during childhood including maltreatment (sexual abuse, mental abuse, and physical abuse), neglect, parental loss, and peer victimization.

Raising awareness regarding the opportunities to intervene in a child’s life as a means to prevent behavioral, psychological, and substance abuse disorders before they would typically manifest on their own is the ultimate goal. …

The Components Of Vaccine Hesitancy And The Role Of Patient Education In Promotion Of Vaccinations In Newborns, Camille Joy Rayo

Nursing | Senior Theses

Background

Due to an array of reasons relating to vaccine hesitancy, many newborns are without their standardized and recommended vaccinations as a result of their parent’s beliefs. Parents hold the power to vaccinate their children. Nurses must provide reliable information, debunk myths, and pursue pro-vaccination ideas when educating a parent about newborn vaccinations. By doing so, vaccine hesitancy should decrease and vaccination rates should increase. Unvaccinated newborns are put at a greater risk of contracting serious illnesses that may spread to others or even lead to one’s own death.

Objective

To identify common factors regarding vaccine-hesitant parents of the newborn …

Emergency Medicine Clinician Experiences Addressing Uncertainty In First-Trimester Bleeding., Garrison Nord, Amanda Doty, Andrew J Monick, Danielle M Mccarthy, Robin J Casten, Amer Z Aldeen, Philip S Nawrocki, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

The purpose of this work is to understand Emergency Department (ED) clinicians' experiences in communicating uncertainty about first-trimester bleeding (FTB) and their need for training on this topic. This cross-sectional study surveyed a national sample of attending physicians and advanced practice providers (APPs). The survey included quantitative and qualitative questions about communicating with patients presenting with FTB. These questions assessed clinicians' frequency encountering challenges, comfort, training, prior experience, and interest in training on the topic. Of 402 respondents, 54% reported that they encountered challenges at least sometimes when discussing FTB with patients where the pregnancy outcome is uncertain. While the …

Improving Medication Education On An Infectious Disease Unit For Hospitalized Patients At Discharge: A Quality Improvement Project, Kristin L. Pilong

DNP Scholarly Projects

Medication education by nurses during patients’ hospital stay is an important component of patient care. Nurses’ knowledge of specific medications and the resources that support teaching patients about medications may play a key role in increasing their satisfaction with the hospitalization experience. This quality improvement doctoral project created and validated evidenced-based cognitive aids for nurses to support this process. The project is part of a quality improvement initiative at a hospital in South Jersey to create and validate cognitive aids for 5 high frequency medications prescribed for patients prior to discharge from the hospital The cognitive aids focused on three …

Implementing The 4ds (Diet, Drinks, Drugs, And Dialysis) To Lower Hyperphosphatemia Among Outpatient Hemodialysis Patients, Morgan Atchison

Doctor of Nursing Practice Projects

Background: Hyperphosphatemia, also known as excess phosphate in the blood, is a problem that continually causes health issues for the outpatient hemodialysis population. Hyperphosphatemia yields multiple health comorbidities and can increase mortality (Rastogi et al., 2021).

Purpose: Hyperphosphatemia is directly correlated with end-stage renal disease (ESRD) (Goyal & Jialal, 2020). This project aimed to decrease the incidence of hyperphosphatemia in the chronic outpatient hemodialysis setting. The primary objective of this project was to increase adherence levels to diet, drinks, drugs, and dialysis (4Ds) in those receiving chronic outpatient hemodialysis in the pursuance of achieving and maintaining blood serum phosphorus levels …

Postural Orthostatic Tachycardia Syndrome (Pots): A Frequently Missed Diagnosis, Aubrey R. George, Blaine A. Winters

Student Works

Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating chronic illness that involves a sustained tachycardia upon standing and affects millions of patients in the United States alone. POTS is most commonly seen in adolescent females and substantially reduces overall quality of life. In 2019, less than a third of all providers had heard of POTS and patients may wait over a decade for a proper diagnosis and treatment. With the intermittent and variable nature of symptoms, 83% of patients reported being misdiagnosed with a psychological condition before receiving a diagnosis of POTS. Understanding the relationship between autonomic compensation and hemodynamic …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

A Multimodal Approach To Decreasing Hesitancy And Increasing Uptake Of The Covid-19 Vaccine In The Family Care Setting, Meghan Zwierzynski

Evidence-Based Practice Project Reports

Since December 2019, the coronavirus disease 2019 (COVID-19) has swept across the world, infecting and killing millions of people, making it one of the worst pandemics in history (WHO, 2021). However, the rates of confirmed cases and deaths have slowed since the discovery of the COVID-19 vaccine. The purpose of this evidence-based practice (EBP) project was to decrease vaccine hesitancy and increase uptake of the COVID-19 vaccine in the family care setting. The Iowa Model-Revised (Iowa Model Collaborative, 2017) is a practical, effective multi-step change process that acted as a guide for the EBP project. A review of literature showed …

The Efficacy Of Tailored Text Messages To Improve Medication Adherence And Lifestyle Changes For Patients With Type 2 Diabetes Mellitus, Vanessa B. Silverio

Evidence-Based Practice Project Reports

Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by increased amounts of glucose in the blood, and is the seventh leading cause of death in the United States (United Health Foundation [UHF]), 2021). T2DM can be effectively treated with medication and behavioral lifestyle modifications. Even small improvements in glycemic control can reduce the risk for debilitating complications such as heart disease, stroke, kidney disease, sepsis, and retinopathy (Wang et al., 2021, Haider et al., 2019). The purpose of this evidence-based practice (EBP) project was to identify the most effective intervention for improving medication adherence, lifestyle changes, and hemoglobin …

Improving Osteoporosis Screening Rates Of Women In A Primary Care Setting, Kristine E. Davis

Evidence-Based Practice Project Reports

Osteoporosis is caused by caused by low bone mass, microarchitecture disruption and increase in skeletal fragility (Rosen & Drezner, 2021). This disease presents as a silent disease without any clinical manifestations and increases risk for bone fracture. The purpose of this Evidence-Based Practice (EBP) project was to increase screening rates for osteoporosis in the female population by mailing a patient reminder letter to the home of qualifying patients in the primary care setting and to determine if mailing a patient reminder letter would increase screening rates. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare professionals (JHEBP) model was used …

Empower You: An Adult Type 2 Diabetes Mellitus Management Program With Utilization Of A Mobile Phone Application, Kelsey Jahn

Evidence-Based Practice Project Reports

In 2018, 34.2 million Americans had diabetes and there continues to be 1.5 million Americans diagnosed with diabetes every year (ADA, 2018). Due to this increasing prevalence, self-management of type 2 diabetes mellitus (T2DM) is essential to disease management. The PICOT question for this project was: In adults with T2DM with a hemoglobin A1C (HbA1C) greater than 8% in a diabetes specialty clinic (P), what is the effect of a multimodal smartphone application (I) compared to prior nonuse of the application (C) on average blood glucose readings (O) over an 8-week period (T)? The project was completed in a large, …

Back To The Basics With Smart Goals: A Multimodal Intervention For Adults Who Have Type 2 Diabetes, Alyssa L. Snyder

Evidence-Based Practice Project Reports

Diabetes, the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2020a) and the ninth leading cause of death worldwide (World Health Organization [WHO], 2020), has increased by 70% over the last two decades (WHO, 2020). Type 2 diabetes (T2D), the most prevalent type accounting for 90% to 95% of diagnosed cases (CDC, 2020a), affects individuals of all ages and often results in major health problems including stroke, heart attack, and kidney disease. The purpose of this patient-centered, evidence-based practice (EBP) project was to evaluate the effectiveness of a multimodal intervention on hemoglobin …

Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson

Evidence-Based Practice Project Reports

Elevated blood pressure (BP), or hypertension (HTN), can cause a cascade of detrimental effects to the body. It is associated with increased risk of stroke, angina, myocardial infarction, heart failure, peripheral artery disease, end-stage renal disease, and abdominal aortic aneurysms (Whelton et al., 2018). HTN is also a major risk factor for the development of cardiovascular disease (CVD), which is the United States’ (U.S.) leading cause of death in men and women (U.S. Preventive Services Task Force [USPSTF], 2020). The PICOT question for this project was: does an eight-week (T) structured walking program utilizing a smartwatch for step counts and …

Expanding The Role Of Occupational Therapy For Oncology Patients: A Focus On Tumor- And Blood-Based Cancers, Erika N. Clark

Occupational Therapy Capstone Presentations

Tumor and blood-based cancer diagnosis rates are increasing rapidly in the United States. To improve survivorship, treatment practices are constantly evolving, however, patients are often left to face the consequences of survival. With decreased range of motion, strength, and ability to participate in desired activities, patients may experience a decrease in overall quality of life. Through a holistic lens, occupational therapists are well suited to address the diverse needs of cancer patients through the duration of their cancer treatments. Unfortunately, occupational therapy remains a widely underutilized service for this population. This capstone experience worked to address this gap by expanding …

Nurse Practitioner-Led Heart Failure Education Program, Ruairi Fox

The Eleanor Mann School of Nursing Student Works

Heart failure is a chronic, progressive disease that has a global burden on the healthcare system and on patient’s lives. HF patients who experience a hospital admission are at a greater risk of being readmitted to the hospital within 30 days, impacting healthcare spending costs and patient quality of life. Self-care activities by patients, such as monitoring weight and making lifestyle changes, are the hallmark of outpatient care, and is shown throughout the literature to reduce readmissions and impact patient quality of life. Unfortunately, many patients are either unaware of proper self-care management techniques or find them hard to follow. …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Cpr-Directive Conversations In The Emergency Department: The Opinion Of Elderly Patients, Kelvin H. Kramp Dr., Rutger De Hond, Mirwais Mehrab, Martijn Van Hooft, Roger A.P.A. Hessels

Journal of Geriatric Emergency Medicine

Background: The average age of patients admitted to the emergency department (ED) continues to rise. Many face difficult discussions about cardiopulmonary resuscitation (CPR) and end-of-life decisions.

Objectives: This study aimed to determine which healthcare professionals elderly patients admitted via the ED preferred to discuss their CPR-directive with and their opinion about the ED as a setting for discussing their CPR-directive.

Methods: A mixed-methods study with an explanatory sequential design was conducted. A questionnaire was administered to 100 patients >65 years of age admitted to nursing wards via the ED that had a CPR-directive conversation during admission 24-48 hours earlier. Patients …

Responding To Sexual Abuse In Health Care: Development Of A Guide For Patients, Tristan Mcintosh, Heidi Walsh, Meredith Parsons, Erin D. Solomon, Jessica Mozersky, James M. Dubois

Journal of Patient-Centered Research and Reviews

This report details the development of a stakeholder- and evidence-informed online resource guide for patients that provides information to raise awareness about sexual abuse in health care, the value of chaperones, and options for responding to sexual abuse. The guide was developed to reflect lessons learned from 10 years of researching physician wrongdoing (ie, sexual violations, improper prescribing, and unnecessary invasive procedures), a 5-year National Institutes of Health-funded mixed-methods study of 280 cases of egregious wrongdoing in medicine, and an expert working group. Focus groups were conducted with 22 patients from diverse backgrounds to obtain feedback on the acceptability of …

Inaccuracies In Patient Self-Report Of Genetic Testing Results For Hereditary Cancer Risks Could Impact Risk-Management Practices, Brittany Faye Sears

USF Tampa Graduate Theses and Dissertations

Pathogenic variants (PV) or likely pathogenic variants (LPV) in a cancer risk gene increase lifetime risks of developing cancer. National guidelines provide evidence-based recommendations on cancer risk management (CRM) strategies tailored to the cancer risks associated with PV/LPV in different genes. Emotional responses after learning of a PV/LPV have been studied as predictors of patient adherence to CRM, but less attention has been given to whether patients remember their actual genetic test results and the impact this may have on subsequent adherence to CRM. We surveyed a group of 114 participants registered with the Inherited Cancer Registry (ICARE), all of …

Guidelines For Medication Education For Occupational Therapists, Jaclyn K. Schwartz

The Open Journal of Occupational Therapy

Taking medications is a vital health management activity for people with chronic health conditions. These individuals must take their medications as prescribed to receive the intended benefits and minimize negative effects. Many people with chronic health conditions do not know essential information about their medications, which limits their ability to take their medications as prescribed. Occupational therapists regularly engage in client education to enhance performance of health management. When addressing medications, however, additional considerations are needed because of the highly regulated, interdisciplinary, and complex nature of this occupation. The purpose of this practice guideline is to describe the integration of …

Improving Knowledge And Competency Of Self-Monitored Blood Pressure In Older Adults, Edna Koh Hwa Tang, Melanie Keiffer Dnp, Aprn, Anp-Bc, Cne

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background. The risk for developing uncontrolled hypertension increases with age. Hypertension remains under-controlled and underdiagnosed in rural areas. This trend is exacerbated by the COVID-19 pandemic due to decreases in primary care visits, increases in telehealth visits, and a significant decline in assessment of blood pressure. Evidence reveals that telemedicine in conjunction with self-monitored blood pressure (SMBP) are proven tools to support patients and providers in the remote management of hypertension.

Purpose. This project aimed to improve utilization of self-monitored blood pressure (SMBP) for management of hypertension in older adults (65 years and older) and accuracy of self-reported …

Improving Medical-Surgical Nursing Knowledge Of Congestive Heart Failure, Sylvia Rene Cunningham

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing practice project was to address the nursing gap in knowledge about congestive heart failure (CHF) management. Lack of staff knowledge on this topic inhibits their ability to educate patients. Poor patient understanding can lead to frequent readmissions and poor patient outcomes. The project aim was to determine if educating medical-surgical nurses about CHF management increased their knowledge of topic. The ADDIE model was used to design staff education. Lewin’s change theory guided the project. Nine registered nurses attended a power point presentation. A pre-education questionnaire was distributed, and participants created unique identifiers. The …

Increasing Medicare Wellness Visit Participation In A Primary Care Clinic, Katherine Rodriguez-Guerrant

DNP Projects

Background: Medicare Wellness Visits (MWV) came into use in 2011 to provide Medicare patients and their providers a chance to create a 5 to 10 year plan to prevent illness, disease, and disability. These visits are often underutilized due to various barriers on both the provider and patient side.

Purpose: The purpose of this study is to assess provider barriers to conducting MWVs and provide an educational tool that will assist providers in increasing the number of MWVs conducted within this system.

Design: This is a descriptive, quasi-experimental study to assess provider barriers combined with a Quality improvement project that …

Activating The Patient: A Nurse Led Coaching Intervention To Engage Health Information Seeking Behaviors Using The Ideal Discharge Framework And Get Well Network, Korinne Callihan

DNP Projects

Background: Cardiovascular (CV) patients are often overwhelmed by the unexpected emergence of the health condition, volume of knowledge for self-care mastery and acceptance of the responsibility for self-care upon care transition to the home setting. Low health literacy levels have been linked to poor outcomes in CV patients, requiring investigation into appropriate methods for patient education. The Get Well Network (GWN), an interactive digital patient education care plan at UK HealthCare (UKHC), is underutilized in this patient population.

Purpose: the purpose of this study is to assess the effect of a nurse-to-patient coaching intervention using the IDEAL discharge framework from …