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Articles 1 - 30 of 123
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 …
A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings
A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings
Evidence-Based Practice Project Reports
Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …
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 …
Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain
Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain
Evidence-Based Practice Project Reports
Chemotherapy-related cognitive impairment (CRCI), or “chemobrain”, is one of the most troublesome side effects of chemotherapy (Dijkshoorn et al., 2020). Ongoing CRCI may negatively affect relationships, confidence, sleep, fatigue, anxiety, and the ability to return to work activities leading to a decreased quality of life (Johns et al., 2016; Gokal et al., 2018). The purpose of this evidence-based practice (EBP) project was to assess the efficiency of a meditation-type exercise intervention, chair yoga, on decreasing perceived cognitive impairment (PCI) in breast cancer patients. The PICOT question for this project was: In breast cancer patients with chemotherapy related cognitive impairment (P), …
Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska
Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska
Evidence-Based Practice Project Reports
The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …
Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder
Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder
Evidence-Based Practice Project Reports
It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …
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 …
Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia
Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia
Evidence-Based Practice Project Reports
Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …
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 …
The Efficacy Of Tailored Text Messages To Improve Medication Adherence And Lifestyle Changes For Patients With Type 2 Diabetes Mellitus, Vanessa B. Silverio
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 …
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 …
Back To The Basics With Smart Goals: A Multimodal Intervention For Adults Who Have Type 2 Diabetes, Alyssa L. Snyder
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 …
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 …
Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli
Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli
Evidence-Based Practice Project Reports
Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best …
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 …
The Effect Of Implementing A Generalized Anxiety Disorder Protocol For Anxiety And Depression Symptoms In The Primary Care Setting, Bailey J. Hinman
The Effect Of Implementing A Generalized Anxiety Disorder Protocol For Anxiety And Depression Symptoms In The Primary Care Setting, Bailey J. Hinman
Evidence-Based Practice Project Reports
Generalized anxiety disorder (GAD) is very prevalent in the United States with 5.7% of citizens affected (National Institute of Mental Health [NIMH], 2017). This number is expected to be even higher because individuals avoid care due to stigma of mental illness (Andrews et al., 2018). GAD can have significant implications such as decreased ability to function, decreased quality of life and increased risk of suicide (Fong, 2018; Lizarondo, 2018). The purpose of this project was to improve outcomes for adult patients with GAD in the primary care setting by improving treatment to follow best practice recommendations. The Johns Hopkins Evidence …
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® …
Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk
Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk
Evidence-Based Practice Project Reports
The standard of care in the treatment for women diagnosed with breast cancer includes identification and biopsy of the sentinel lymph nodes (SLN) of the breast (Chaterjee et al., 2017; Kneece, 2017). The process of identifying the SLNs involves radioisotope injections into or near the areola. Because this area is highly sensitive, women report this procedure to be considerably painful. The purpose of this evidence-based practice (EBP) project was to determine if the provision of a 5-minute session of guided imagery (GI), as a complementary alternative medicine, prior to SLN injections was effective in mitigating reports of procedural pain. A …