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Full-Text Articles in Primary Care

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos May 2024

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos

Evidence-Based Practice Project Reports

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent, chronic condition with symptoms that include inattention, hyperactivity, and impulsivity. ADHD affects six million children in the United States (Tran et al., 2021). The purpose of this evidence-based practice project was to implement a holistic office protocol that addressed the chronicity and future health outcomes of children and adolescents, ages 2-17 years with ADHD through stimulant or non-stimulant medication prescriptions, behavioral therapy referrals, and education surrounding diet, and exercise. A comprehensive, systematic literature search yielded 16 articles to determine best practice when treating children and adolescents with ADHD in primary or …


The Effect Of Using A Meal Tracking Smartphone Application In Overweight And Obese Adolescents With Prediabetes Or Type 2 Diabetes To Improve Bmi And Hba1c, Lauren Torhorst May 2024

The Effect Of Using A Meal Tracking Smartphone Application In Overweight And Obese Adolescents With Prediabetes Or Type 2 Diabetes To Improve Bmi And Hba1c, Lauren Torhorst

Evidence-Based Practice Project Reports

Obesity has become one of the most common chronic pediatric illnesses worldwide and is closely linked to the onset of prediabetes and subsequent Type 2 Diabetes (T2D); therefore, preventing and treating childhood obesity has become a high priority (Hampl et al., 2023). The purpose of this Evidence-Based Practice (EBP) project is to lower Glycosylated Hemoglobin A1c (HbA1C) and Body Mass Index (BMI) in overweight and obese youth with prediabetes and T2D using a meal tracking smartphone application. The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was utilized to pilot this project between two pediatric endocrinology offices located in Southeast Wisconsin. …


A Multimodal Approach To Decreasing Hesitancy Of The Influenza Vaccine In The Family Care Setting, Carley J. Ellenberger May 2024

A Multimodal Approach To Decreasing Hesitancy Of The Influenza Vaccine In The Family Care Setting, Carley J. Ellenberger

Evidence-Based Practice Project Reports

The uptake of the influenza vaccine is the most effective and proactive action an individual can take to defend themselves against the influenza outbreak each season; therefore, it is recommended that everyone at least six months of age and older should receive the annual flu vaccine (CDC, 2022; WHO, 2023). Unfortunately, influenza vaccine hesitancy is demonstrated on a global level affecting the uptake compliance annually each influenza season despite the millions of people that experience influenza symptoms annually (CDC, 2022, WHO, n.d.; Healthy People 2030, n.d.). The PICOT question for this project was in adults, over the age of 18, …


Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios May 2023

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 …


Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee May 2021

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 May 2021

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 May 2021

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 …


A Tailored Multicomponent Intervention In Primary Care For Survivors Of Adverse Childhood Experiences (Aces), Rebecca L. Peterson May 2021

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 …


Efficacy Of Diabetes Self-Management Education Administered Via Telehealth For Adults With Uncontrolled Diabetes, Tanner Free Apr 2021

Efficacy Of Diabetes Self-Management Education Administered Via Telehealth For Adults With Uncontrolled Diabetes, Tanner Free

Evidence-Based Practice Project Reports

Patient’s with a diagnosis of diabetes require significant lifestyle modification and education. The need for patient education has led to the development of diabetes self-management education (DSME) classes. Unfortunately, utilization of DSME classes is only 5% among Medicare beneficiaries and 6.8% among privately insured patients (Centers for Disease Control [CDC], 2018). The purpose of this evidence-based practice (EBP) project was to implement DSME via telehealth and assist with goal formation to help patients with uncontrolled diabetes achieve glycemic control by increasing access to crucial education. The intervention consisted of bi-weekly calls for a period of 3 months. Participant data were …


Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula Apr 2021

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 …


The Effects Of Motivational Interviewing For Those Afflicted With Opioid Addiction, Kathy Roberts May 2020

The Effects Of Motivational Interviewing For Those Afflicted With Opioid Addiction, Kathy Roberts

Evidence-Based Practice Project Reports

Substance use disorders are a worldwide problem, according to the Center for Disease Control (CDC) there were 70,237 drug overdose deaths that occurred in the United States in 2017, of which 47,600 were opioid related. Illinois had a 14.3% increase of opioid deaths from 2016-2017 (CDC, 2017). Numerous interventions exist to address this health concern, yet evidence shows that Motivational Interviewing (MI) was the most efficient and effective way to promote behavioral change. The purpose of this EBP project was to provide evidence that MI increased referrals and promoted compliance with appointments to treatment programs. The sample for this project …


Identification And Management Of Adolescent Alcohol Use: Screening And Motivational Interviewing, Kelsie L. Berger May 2020

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 …


Efficacy Of A Mobile Application In A Chronic Kidney Disease Population, Jennifer R. Zamora May 2020

Efficacy Of A Mobile Application In A Chronic Kidney Disease Population, Jennifer R. Zamora

Evidence-Based Practice Project Reports

Chronic kidney disease (CKD) is associated with high healthcare costs, poor health outcomes and low quality of life (Donald et al., 2018). The US CKD prevalence is 15%, costing Medicare $79 billion in 2016 (United States Renal Data System, 2018). Self-management could reduce CKD burden (Jeddi, Nabovati, and Amirazodi, 2017). Mobile technology offers a low-cost, ease-of-access platform for chronic disease self-management (Whitehead & Seaton, 2016), potentially slowing disease progression and improving health outcomes (Jeddi, 2017). The purpose of this project was to utilize a CKD-specific mobile application, CARELogiQ, to facilitate symptom management; increasing patient satisfaction and decreasing hospitalizations and ER …


Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey May 2020

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …


The Implementation Of Diabetic Foot Care Into Primary Care, Shelby D. Strong May 2020

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 …


Effectiveness Of A Multi-Component Intervention Program For Treating Childhood Obesity, Suzy Free May 2020

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 …


Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn May 2020

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 …