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Full-Text Articles in Medicine and Health Sciences
A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller
A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller
Evidence-Based Practice Project Reports
U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …
Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios
Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios
Evidence-Based Practice Project Reports
Diabetes mellitus type 2 (T2DM) is a growing epidemic that affects millions of people throughout the world. The recent COVID-19 pandemic has created many new challenges, including access to health care for treatment of chronic diseases, such as diabetes (Robson & Hosseinzadeh, 2021). Telehealth has offered a promising approach to improve the management of diabetes(Bellman, 2021). People with diabetes are less likely to manage their diabetes through the usual care because of risk of contracting COVID-19 (CDC, 2022). The purpose of this EBP project was to evaluate the effectiveness of T2DM management through a telehealth approach. This project has addressed …
A Prescription For Diabetes Self-Management Education: Best Practice For Persons With Type Ii Diabetes Mellitus, Ashley J. Milcarek
A Prescription For Diabetes Self-Management Education: Best Practice For Persons With Type Ii Diabetes Mellitus, Ashley J. Milcarek
Evidence-Based Practice Project Reports
Diabetes self-management education and support (DSMES) programs have been shown to improve patient outcomes and lower hemoglobin A1c (Hgb A1c) levels in those who are diagnosed with type two diabetes mellitus (T2DM). However, these programs are often underutilized and have low referral rates, despite the known benefits (Powers et al., 2020). The purpose of this patient-centered EBP project was to evaluate the effectiveness of a patient-driven questionnaire, completed by patients with T2DM during routine office visits, in increasing the percentage of patients referred to DSMES by their provider. Specifically, this project addressed the following PICOT question: In adults who have …
Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey
Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey
Evidence-Based Practice Project Reports
Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …
A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski
A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski
Evidence-Based Practice Project Reports
Breastfeeding provides multiple benefits for mothers and infants. An overwhelming amount of evidence indicates that breastmilk optimizes infant growth and develops the immune system (Yu et al., 2018). Apart from the health benefits for infants, the immediate effects of breastfeeding for mothers include a decreased risk for hemorrhage, stress, and postpartum depression (Flemming, 2021). A mother’s psychological state impacts lactation success, mainly by affecting milk ejection (Dabas et al., 2019). Despite evidence suggesting that relaxation techniques are beneficial for all human beings, it is one of the least commonly used approaches for postpartum mothers (Joseph et al., 2019). The PICOT …
The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson
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
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
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 …
Behavioral Intervention To Increase Condom Use Among Men Who Take Pre-Exposure Prophylaxis And Have Sex With Men, Marek J. Piszczatowski
Behavioral Intervention To Increase Condom Use Among Men Who Take Pre-Exposure Prophylaxis And Have Sex With Men, Marek J. Piszczatowski
Evidence-Based Practice Project Reports
In the absence of an effective vaccine, the introduction of pre-exposure prophylaxis (PrEP) in 2012 offered a promising new approach to human immunodeficiency virus (HIV) prevention. However, the introduction of a single-pill regimen which helps to prevent HIV transmission created, in men who have sex with men (MSM) population, a phenomenon referred to as risk compensation resulting in PrEP replacing consistent condom use as a preventive measure (Freeborn & Portillo, 2018; Kumar et al., 2020; Montaño et al., 2018; Ramchandani & Golden, 2019; Traeger et al., 2018). The purpose of the evidence-based practice project was to implement a single, one-on-one …
Improving Osteoporosis Screening Rates Of Women In A Primary Care Setting, Kristine E. Davis
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
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, …
Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson
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 …
Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik
Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik
Evidence-Based Practice Project Reports
Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …
A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith
A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith
Evidence-Based Practice Project Reports
Obesity is a worsening pandemic that requires immediate action. It is recommended that primary care providers screen patients for obesity and provide multimodal behavioral interventions to their patients to treat and prevent obesity (USPSTF, 2018). The purpose of this evidenced-base practice (EBP) project is to implement a multimodal intervention for weight loss in adults within primary care. Five search engines were utilized, and 16 articles were ultimately selected as evidence. The evidence supported self-monitoring and close follow-up while in active weight loss. The Iowa Model for EBP to promote quality care was used as the framework to guide the project …
Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler
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 …
Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee
Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee
Evidence-Based Practice Project Reports
Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …
Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson
Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson
Evidence-Based Practice Project Reports
The United States (U.S.) is amidst an obesity epidemic, with Indiana ranking as the 15th worst state (Institute of Medicine, 2012; United Health Foundations, 2020). Despite current management strategies, the obesity rate in both the U.S. and Indiana continues to rise (WHO, 2020). Therefore, obesity management must change. The purpose of this evidence-based practice (EBP) project was to determine if the addition of shared medical appointments (SMAs) consisting of informational group sessions by specialists and brief individualized meetings with the provider will result in greater reduction of weight and body mass index (BMI) compared to standard care alone in those …
Education Combined With Reminder Strategies To Improve Cervical Cancer Screening Rates, Christina E. Mclean
Education Combined With Reminder Strategies To Improve Cervical Cancer Screening Rates, Christina E. Mclean
Evidence-Based Practice Project Reports
Cervical cancer is the second most common cancer among women worldwide and a leading cause of death in some countries (Jayasekara, 2020). Approximately 13,800 cases of cervical cancer were diagnosed in the U.S. last year, and about 4,290 women died (American Cancer Society [ACS], 2020). Regular cervical cancer screening (CCS) reduces morbidity and mortality, but screening rates are low in the U.S. and at the project site (ACS. 2020). The purpose of this evidence-based practice (EBP) project was to increase CCS at a Federally Qualified Health Center (FQHC) with six clinic locations in Northwest Indiana; the primary project site was …
Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic
Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic
Evidence-Based Practice Project Reports
The prevalence of stress is increasing in colleges, where students are experiencing anxiety at an alarming rate, with anxiety being the topic most discussed in university counseling centers. The purpose of this evidence-based practice project was to determine the effect of mindfulness exercises on college students’ perceived stress. The Stetler Model guided the project development and implementation. The literature search revealed that best practice included mindfulness exercises through a combination of face-to-face instruction and remote online audio meditation for a duration of eight weeks. For this project, 56 undergraduate students (health care-leadership, health-science, and nursing majors) enrolled in a health …
Don't Be Such A Buzzy®Kill: Reducing Pain During Vaccinations In College-Age Students, Katherine Long
Don't Be Such A Buzzy®Kill: Reducing Pain During Vaccinations In College-Age Students, Katherine Long
Evidence-Based Practice Project Reports
Immunizations play a fundamental role in reducing the occurrence of preventable diseases in the population. Injections related to immunization are the most frequent pain-producing medical procedure implemented worldwide and account for nearly 12 billion injections annually (CDC, 2019; Taddio et al., 2015). These procedures are often perceived as simple but can have a variety of complications including pain. This evidence-based practice project addressed the following PICOT question: In college-aged students receiving immunizations (P), does the Buzzy® device (I) when compared to non-intervention standard of care (C) effectively reduce injection site pain (O) over a 12-week time period (T)? The Buzzy® …
A Tailored Multicomponent Intervention In Primary Care For Survivors Of Adverse Childhood Experiences (Aces), Rebecca L. Peterson
A Tailored Multicomponent Intervention In Primary Care For Survivors Of Adverse Childhood Experiences (Aces), Rebecca L. Peterson
Evidence-Based Practice Project Reports
Adverse childhood experiences (ACEs) include 10 traumatic events of abuse, neglect, and household dysfunction that occur before 18 years of age. Adverse childhood experiences affect greater than 60% of the population, and approximately one in six individuals affirm that they have experienced four or more types of ACEs. They are associated with negative, long-term health outcomes in adults, including 9 out of the 10 leading causes of death in the United States (Centers for Disease Control and Prevention, n.d.; Felitti et al., 1998). The purpose of this evidence-based practice project was to implement a tailored, multicomponent intervention to mitigate the …
Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren
Overcoming Obesity: Provider Reminders And Education In Pediatrics, Michelle Warren
Evidence-Based Practice Project Reports
The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and …
Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula
Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula
Evidence-Based Practice Project Reports
Hypertension (HTN) is the leading cause of hospitalization and is responsible for approximately 50% of cardiovascular and cerebrovascular events (Al-Noumani, et al., 2018). Uncontrolled HTN can lead to comorbidities including ischemic heart disease, renal disease, or life-threatening arrythmias (World Health Organization [WHO], 2019). The leading cause of HTN is medication non-compliance (Varleta, et al., 2017). The purpose of this evidence-based practice project was to determine the effectiveness of daily text messages on antihypertensive medication adherence. A comprehensive review of literature generated ten high-level evidence studies demonstrating that daily text messages near each medication dosing time is best practice for improving …
Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax
Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax
Evidence-Based Practice Project Reports
The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …
You're Not Forgotten: Effects Of Screening For Postpartum Depression Within A Pediatric Setting, Marrisa S. Culver
You're Not Forgotten: Effects Of Screening For Postpartum Depression Within A Pediatric Setting, Marrisa S. Culver
Evidence-Based Practice Project Reports
Postpartum depression (PPD) is depression that occurs in women following childbirth occurring during the postpartum period and affects 1 in 7 women (The United States Preventive Services Task Force, 2019). The American Academy of Pediatrics [AAP] (2019), recommends that pediatric healthcare providers utilize their position to screen for PPD. The purpose of this evidence-based practice (EBP) project was to implement a PPD screening intervention within a pediatric healthcare setting using the Edinburgh Postnatal Depression Scale (EPDS). The Academic Center for Evidence-Based (ACE) Practice Star Model guided this EBP project with evidence-based interventions developed after a comprehensive literature search. Implementation of …
A Multicomponent Tailored Intervention Program Protocol For Weight Loss In An Underserved Adult Patient Population With Obesity, Rita R. Arnold
A Multicomponent Tailored Intervention Program Protocol For Weight Loss In An Underserved Adult Patient Population With Obesity, Rita R. Arnold
Evidence-Based Practice Project Reports
Obesity is a multifactorial, individualized, chronic disease that increases known risk factors for significant comorbidities and mortality. The primary purpose of this Evidence-Based practice project was to improve indicators of obesity (weight, BMI) among patients served by a free medical clinic, using a tailored multicomponent intervention. The secondary purpose was to determine if the weight loss intervention was associated with a decrease in blood pressure and depression symptoms. The intervention was guided by the Health Promotion Model by Nola Pender. The Johns Hopkins Nursing Evidence Based Practice Model (JHNEBP) guided implementation of the project. A comprehensive literature review was completed …
Mass Matters: Increasing Mammography Rates To Underserved Women, Ingrid N. Cooper
Mass Matters: Increasing Mammography Rates To Underserved Women, Ingrid N. Cooper
Evidence-Based Practice Project Reports
Breast cancer is the most frequently diagnosed cancer among women in Indiana and the United States (Indiana Cancer Organization, 2019). An estimated 268,000 new cases of invasive breast cancer were diagnosed and 41,760 women died due to breast cancer in 2019 (ACS, 2019). Substantial breast cancer-related morbidity and mortality disparities persist among the underserved. Disparities in breast cancer outcomes are due to lower mammography screening rates, lack of timely follow-up of abnormal results, and lack of timely treatment initiation among women with breast cancer (Highfield et al., 2015). The purpose of this evidence-based practice project was to address low mammography …
The Implementation Of Diabetic Foot Care Into Primary Care, Shelby D. Strong
The Implementation Of Diabetic Foot Care Into Primary Care, Shelby D. Strong
Evidence-Based Practice Project Reports
Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide. It can lead to complications in many parts of the body and can increase overall risk of dying prematurely (World Health Organization (WHO), 2016). Diabetic peripheral neuropathy (DPN) in the feet is one of the most frequent complications of DM (Wang et al., 2017). Other lower extremity complications which can occur as a result of diabetic foot complication (DFC) includes peripheral artery disease (PAD), infection, ulcer and amputation. One of the obstacles for preventing (DFC) is the lack of examinations of the feet in clinical practice (Feitosa et …
Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger
Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger
Evidence-Based Practice Project Reports
Adolescent alcohol consumption is a serious health problem in the United States. Alcohol is the most widely used substance, and it continues to be the drug of choice for adolescents (CDC, 2018). Over 7 million adolescents and approximately 30 percent of high school students in the U.S. that admit to drinking more than a few sips of alcohol in the past 30 days (NIAAA, n.d.). Underage alcohol use can lead to many complications such as social, school, and legal problems, and when initiated early in life is associated with the development of alcohol use disorder (NIAAA, n.d.). The purpose of …
Does Access To Telephone Counseling Improve Smoking Cessation In Disadvantaged Populations?, Karin Warden-Thomas
Does Access To Telephone Counseling Improve Smoking Cessation In Disadvantaged Populations?, Karin Warden-Thomas
Evidence-Based Practice Project Reports
Tobacco usage leads to the development of a multitude of diseases. Years of research have shown that evidence-based interventions such as counseling and pharmacotherapy increase smoking quit rates. Studies have demonstrated that either proactive or reactive telephone counseling has been beneficial in providing long term smoking abstinence particularly in disadvantaged populations (Haas et al., 2015). The purpose of the project was to improve smoking cessation by facilitating access to telephone counseling using an electronic medical order. The Stevens Star Model of Knowledge Transformation (Stevens, 2004), was the framework employed to support the process for change. This evidenced-based project occurred at …