Medical Specialties Commons^™

A Protocol To Increase Referral Rates To Diabetic Education, David M. Rokser

Evidence-Based Practice Project Reports

In 2015, approximately 30.3 million Americans, including 10.5% of the population of Minnesota, had been diagnosed with diabetes mellitus (American Diabetes Association, 2019). Increased risk of diabetic complications including neuropathy, retinopathy, nephropathy, cardiovascular disease, and chronic wounds has been associated with an elevated hemoglobin A1C (HgA1C). Formal diabetic education has been shown to be a cost-effective intervention to reduce HgA1C. The Office of Disease Prevention and Health Promotion published an objective within HealthyPeople 2020 that seeks to increase the percentage of diabetics receiving formal diabetic education in the United States from 46.9% of adults to 58.4%. The purpose of this …

Effectiveness Of A Multi-Component Intervention Program For Treating Childhood Obesity, Suzy Free

Evidence-Based Practice Project Reports

Childhood obesity is one of the most chronic childhood illness worldwide (Centers for Disease Control and Prevention [CDC], 2019; World Health Organization [WHO], 2019). The prevalence of childhood obesity has been described as one of the most common chronic childhood conditions (CDC). The purpose of this evidence-based practice (EBP) project was to reduce the BMI scores of obese children using a multi-component intervention program that incorporates healthy eating, physical activity, and family involvement. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was used to facilitate the implementation of this EBP project. The synthesis of the appraised literature established that utilizing …

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 …

Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn

Evidence-Based Practice Project Reports

Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic …

A Protocol Driven Stroke Code's Impact On Door-To-Needle Times, Jesse Osborne

Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is most effective the faster it is able to be administered to a patient that has been affected by stroke. A Stroke Code is a strategy that acute care facilities implement to reduce the time from diagnosing a stroke to administering tPA. The purpose of this study was to determine if the initiation of a Stroke Code in an acute care hospital reduces the door-to-needle time for patients affected by a stroke. In particular, does a Stroke Code reduce door-to-needle times. The research was conducted using data from April 1, 2014 to December 31, 2014 (pre-Stroke …

Understanding The Importance Of Psychological Screenings For Patients Undergoing Elective, Invasive Cosmetic Surgery: A Literature Review, Jazmin N. Rush

Theses and Dissertations

All over the United States (U.S.), men and women alike are undergoing elective, invasive cosmetic surgery. Research has found there is an increasing number of patients choosing cosmetic surgery in hopes of alleviating psychological disorders such as body dysmorphic disorder and low self-esteem. The objective of this review is to analyze the literature available regarding cosmetic surgery and the psychological issues leading to the decision to undergo elective, invasive cosmetic surgery in order to understand and identify the possible benefits of psychological screenings. Information for this study was obtained from three electronic databases - Galileo, PubMed, and CINAHL. U.S. based …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

Living Sweet: A Multi-Functional Mobile-Phone Application Strategy For Adults With Uncontrolled Type 2 Diabetes Mellitus, Chantel K. Anderson

Evidence-Based Practice Project Reports

Type 2 Diabetes Mellitus (T2DM), one of the most common chronic diseases, is increasing worldwide, and once diagnosed, lifetime self-management is critical to maintain glycemic control (Vermeire et al., 2005; American Diabetes Association (ADA), 2018). Management of T2DM has been acknowledged as challenging due to the need for strict lifestyle adaptations. From a public health perspective, uncontrolled diabetes leads to increased healthcare costs, secondary complications, and ultimately severe disabilities (ADA, 2018). The purpose of this evidencebased practice (EBP) project was to evaluate the effectiveness of a diabetes-specific mobile health application (MHA) on glycated-hemoglobin (HbA1C), self-care perception (SCP), and self-care behaviors …

Dancing During Labor: Social Media Trend Or Future Practice?, Caroline P. Toberna, Drew Horter, Kayla Heslin, Marie M. Forgie, Emily Malloy, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Over the past 30 years, medical interventions in pregnancy and childbirth have increased. Some pregnant women seek less invasive and nonpharmacological options to manage discomforts during labor. While exercise during pregnancy is recommended, less is known about exercise, specifically dancing, during labor. While anecdotal evidence is supportive, little is known about the implications of exercise and dance during the first stage of labor for pain reduction and labor progression. Some movements common in dance, such as expanding hip circles that loosen and relax muscles of the pelvic floor, may be beneficial to women during labor. Available evidence suggests that dancing …

Increasing Patient Adherence To Gestational Weight Gain Goals In Pregnancy, Annie Vining

Dissertations

Abstract

Problem: The inability to maintain healthy weight gain during pregnancy may contribute to multiple pregnancy-related complications. Nutritional education and support may improve nutrition and vitamin consumption, and recommendations for healthy gestational weight gains have been published. However, pregnant women have reported minimal advice regarding healthy weight gain during pregnancy. A personalized, nutritional counseling program was initiated in a Midwestern, suburban OB-GYN private practice.

Methods: A quality improvement descriptive, correlational design was used. A cohort of pregnant women first trimester through six-weeks postpartum received individual counseling and face-to-face interaction at an office visit each trimester.

Results: Twenty ( …

Nurses Improving Nutrition Group Attendance Through Rn Invitations, Shelly Johnson, Susanna Mitchell

Articles, Abstracts, and Reports

Background: Gestational diabetes (GDM), a common pregnancy complication, increases the risk of dangerous birth outcomes, fetal anomalies, and sustained disease and comorbidity for mothers and infants throughout the lifespan. Insulin use is an independent predictor of anomalies. Our prenatal care did not include detailed nutrition assessments and modifications such as Mediterranean diet, a lifestyle associated with reduction in non-pregnant adult diabetes incidence, even reversal. Adding hands-on cooking to nutrition counseling has improved A1c outcomes. We hypothesized a comprehensive package of diet review, nutrition guidelines, and participation in an onsite cooking class initiated at the beginning of prenatal care (Green …

High-Risk Pregnant Patients In The Third Trimester: Comparing Mental And Physical Health, Megan Maxwell

MSN Capstone Projects

The purpose of the paper is to compare physical and mental health in high-risk pregnant patients in their third trimester who are managed in an inpatient setting compared to an outpatient setting. This paper looks at specific high-risk pregnancy diagnoses.

Effect Of Lifestyle Modifications On Blood Pressure And Bmi In Overweight Or Obese Adults With Primary Hypertension, Mariska Vandenbergh

Evidence-Based Practice Project Reports

Hypertension (HTN) and obesity contribute to poor cardiovascular outcomes which can be managed with diet and exercise lifestyle changes. In addition, self-awareness (SA) of eating patterns can be a useful tool to promote adherence to lifestyle changes. The purpose of this project was to determine the effect of lifestyle education, the DASH diet, and tools to increase SA for adult clinic patients who were overweight with hypertension. The REAP and PIH tools were utilized to increase patients’ SA of their diagnosis and current dietary habits. A literature search over five databases was conducted and analyzed thoroughly. National guidelines strongly recommend …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Hpv Vaccination Knowledge, Attitudes, And Uptake In College Nursing Students, Joanna Marie Plumb, Jeannie Giese, Martha Buckner, David Phillippi, Robin Cobb

DNP Projects

Background: The human papillomavirus (HPV) is a preventable, sexually transmitted infection. The vaccines for HPV are safe and effective, but previous research demonstrated that nursing students have low knowledge levels and vaccine uptake. Low knowledge and attitude levels in nurses and nurse practitioners can influence parental and patient decision making for HPV vaccination. Purpose: The purpose of this scholarly project was to evaluate HPV knowledge and attitudes and their association with vaccination uptake in college nursing students. There is limited research in the United States on HPV knowledge, attitudes, and uptake of the vaccine among nursing students. Methods: This project …

School-Based Interventions To Promote Personal And Environmental Hygiene Practices Among Children In Pakistan: Protocol For A Mixed Methods Study, Nousheen Pradhan, Waliyah Mughis, Tazeen S. Ali, Maleeha Naseem, Rozina Karmaliani Professor

Community Health Sciences

Background: Poor personal hygiene and inadequate sanitation practices among young children leads to communicable diseases. There remains a gap in the holistic assessment of school children's hygiene literacy, practices and effectiveness of school-based hygiene interventions in Pakistan. Therefore, a school-based intervention protocol has been designed to promote personal and environmental hygiene practices for primary school children. Towards improving children's hygiene behaviors, the study will also focus on enhancing mothers' hygiene knowledge and practices.
Methods: Using quasi-experimental design with mixed methods data collection approaches, this study will be conducted in schools located in an urban squatter settlements in Pakistan. To assess …

Abstracts From The 26th Annual Health Care Systems Research Network Conference, April 8–10, 2020

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of community-based care delivery systems with a shared mission to improve health and health care through research. The network’s annual conference serves as a forum for attendees to disseminate study findings, stimulate collaborations, and share insights about conducting research in real-world care settings. Although this year’s live conference was cancelled to help slow the spread of COVID-19, the oral and poster abstracts accepted for presentation at HCSRN 2020 are published in this open access supplement to Volume 7, Issue 1 of the Journal of Patient-Centered Research and Reviews, the …

Evaluation Of An Advanced Quality Improvement Program, Arjun M. Dangre Bds Mph, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Texas Children’s Hospital implemented the Advanced Quality Improvement and Patient Safety Program (AQI) in 2009, designed to train clinicians and staff to develop leaders in quality improvement to improve patient care, lower costs, change culture, and lead improvement initiatives at the organization. Evaluations of the AQI programs measured the program’s effectiveness in achieving its goals and objectives. This paper describes the Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety program (AQI,) the program’s evaluation processes, and show the results of the evaluation of the AQI programs using evaluation surveys completed by QI participants over the span of 13 successful …

Therapeutic Approach For Amyand’S Hernia; A Case Report, Sorin Berbece, Valeriu Ardeleanu, Vlad Denis Constantin, Ioana Paunica, Alexandra Toma

Journal of Mind and Medical Sciences

In very few cases stated in the literature, the vermiform appendix might be contained in a hernial sac. This distinctive pathology is described as Amyand's hernia and has the very small occurrence of about 1%. We report the case of a 62-year-old man that presented for a reducible tumoral mass located in the right inguinal region. Amyand’s hernia was the intraoperative diagnostic. We performed hernioplasty (using the Lichtenstein tension-free mesh repair with a composite polypropylene mesh) without appendectomy. This case matches the type 1 Lossanoff and Basson’s classification and has no facile management. Due to the clinical specificities of each …

Implementation Of A Chemotherapy Guideline: A Quality Improvement Project To Standardize The Chemotherapy Delivery Process, Sara Maciej

Nursing Posters

Adjusting chemotherapy rates is one gap in chemotherapy practice that evokes inconsistency. The purpose of this project was to implement a standardized guideline for staff to utilize in adjusting rates of chemotherapy medications.

A Quality Improvement Project To Improve Financial Sustainability Of Home-Based Palliative Care Program, Andrea L. Giffel

Doctoral Projects

Background and Objectives: Home palliative care services are challenging to bill due to the complexity of services and competing time demands. Objectives and protocol were developed to guide coding and billing to increase Relative Value Unit generation and improve financial sustainability.

Design: A quality improvement project.

Setting: A home-based palliative care program in one health system in the Midwest.

Participants: Participants included 7 nurse practitioners.

Intervention: Coding protocol were developed, providers were educated, electronic health record audits were conducted to collect data on improvement, and feedback provided to prompt improvement.

Measurement and Analysis: Documentation of advanced care planning and billing, …

(Des)Cuidando A Quienes Nos Crían: Una Exploración Cualitativa Del Abordaje Para El Diagnóstico, La Prevención Y El Tratamiento De La Depresión Posparto En La Ciudad Autónoma De Buenos Aires (2020) / (In)Adequate Care For Those Who Raise Us: A Qualitative Exploration Of The Approach To Diagnosis, Prevention And Treatment Of Postpartum Depression In The City Of Buenos Aires (2020), April Hopcroft

Independent Study Project (ISP) Collection

Aunque el embarazo y la maternidad están representadas como periodos de alegría, la llegada de un bebé es una transición significativa en la vida que también puede provocar sentimientos de ansiedad y depresión. La depresión posparto (DPP) es un trastorno de estado de ánimo que plantea consecuencias graves para ambas madre y bebé. Dada la vacancia de investigación en la Argentina, este trabajo pretende analizar el abordaje actual de intervención de la DPP en la Ciudad Autónoma de Buenos Aires. Los objetivos específicos son: 1) identificar y describir el proceso de diagnóstico, prevención y tratamiento, y 2) indagar las percepciones …

Exploration Of The Effectiveness Of Naprotechnology In Women’S Healthcare, Cecilia Cerven

Honors Projects

Many women today struggle with abnormal menstrual cycles and the painful symptoms of reproductive disorders. The standard approach to treatment of infertility, irregular menses, polycystic ovarian syndrome (PCOS), endometriosis, hormonal abnormalities, premenstrual syndrome (PMS), and other pathophysiologic reproductive conditions is the prescription of a pill for symptom management or implementation of assisted reproductive technologies. However, many women may not feel comfortable with this treatment strategy due to ethical concerns or apprehension about potential side effects. The purpose of this paper is to assist in bridging the gaps in education to increase overall awareness of a new approach to women’s healthcare, …

Increasing Chlamydia Trachomatis And Neisseria Gonorrhea Screening Among Women 15 To 24 Years Old Using A Multifaceted Approach, Mackenzie Shireman

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC) (2017a) estimates that one-quarter of sexually active people are between 15 and 24 years old, but account for half of 20 million sexually transmitted diseases (STD) reported annually in the United States. Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) are the most common reportable STDs (CDC, 2018). The purpose of this project was to increase CT/NG screening rates among sexually active, nonpregnant women 15 to 24 years old within the primary care setting through colleague education, routine sexual history taking, and indicated testing. A 30-minute colleague in-service was provided to educate clinical …

Process Improvement To Improve Quality Measures In A Rural Primary Care Clinic, Lucille Yurko Vanderwoude

Doctoral Projects

Health disparities are differences in health that increase the amount of sickness in certain parts of the population, these inequalities in health are directly influenced by social, economic and environmental status (Healthy People 2020, 2008). Individuals living in poverty, violence, or disability have less opportunity for good healthcare and often have higher rates of chronic disease. Rural geographic locations additionally fall under this category (Healthy People 2020, 2008). These disparities can result from decreased exercise, violence in living situations, and unhealthy diet choices or options (CDC, 2018). Research has shown that health disparities increase with a reduction of individual’s income …

The Effect Of The Screening, Brief Intervention, Referral To Treatment (Sbirt) Model On Adult Depression In An Outpatient Setting, Genevieve E. Sweeney

Doctoral Projects

Depression is one of the most common chronic conditions in the world. Despite this, depression continues to be under-screened, inaccurately assessed and diagnosed, and poorly treated in outpatient settings. Many providers solely rely on clinical judgement instead of a screening tool or evidence-based toolkit when a patient presents with depression symptoms, resulting in underdiagnosis and inappropriate treatment. Utilization of resources can help a provider appropriately screen, diagnose and treat an individual with depression. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based model intended to improve these measures. Studies from the literature support the efficacy of the SBIRT model …

Improving Blood Pressure Control Among Patients Diagnosed With Hypertension In A Primary Care Setting, Eriko Apriliando

Doctoral Projects

Hypertension affects over 38% of adults or approximately 103 million Americans, costing around $131 billion annually in treatment and loss of productivity. It is also an independent risk factor for coronary events, heart failure, stroke, and end-stage renal disease contributing to 410,624 United States (U.S.) deaths in 2014. The American Heart Association (2016) has released the Measure Accurately, Act Rapidly, and Partner with Patient (MAP) protocol in order to address this issue. This project focused on implementing parts of the MAP protocol. The purpose was to improve blood pressure (BP) control of patients diagnosed with hypertension in a primary care …

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

The Social Dimensions Of Reproductive Health: Analyzing Disparities In Morocco Through Health Indicators And Social Determinants, Mila Sicorsky

Independent Study Project (ISP) Collection

This paper explores the social dimensions of reproductive health in Morocco through a look at its health indicators and social determinants. Existing literature discusses reproductive health differences that run on economic, social, and cultural lines. In this paper, I shed light on how best to measure and understand these disparities. The research shows that reproductive health in Morocco is most accurately indicated by maternal mortality rates (MMR), access to prenatal and postnatal visits, and access to adequate family planning. It also finds that location of residence, economic status, and women’s status are key social determinants of reproductive health in Morocco. …