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Articles 181 - 210 of 815
Full-Text Articles in Nursing
Improving Education On Preeclampsia With Non-Severe Features And Frequency Of Assessment Among Nurses In The Maternal-Child Postpartum Unit, Alyssa J. Willsher
Improving Education On Preeclampsia With Non-Severe Features And Frequency Of Assessment Among Nurses In The Maternal-Child Postpartum Unit, Alyssa J. Willsher
Master's Projects and Capstones
Problem: This Quality Improvement (QI) project aims to improve preeclampsia education among nurses and reduce the frequency of preeclampsia assessments among patients(without severe features) (SF) in the Mother-Baby postpartum unit at Hospital A. Nurses often stated that patients are unable to have uninterrupted rest periods with frequent assessments, which research shows is necessary for reducing patient blood pressure.
Context: The QI project is implemented in a 25-bed postpartum unit that cares for women and their newborns in the postpartum period. The unit’s nurse educator and nurse manager requested that the visiting University of San Francisco research group focus on simplifying …
Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy
Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy
Master's Projects and Capstones
Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.
Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.
Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …
Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso
Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso
Master's Projects and Capstones
Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.
Context: The endocrinology clinic serves a patient population, …
The Effects Of Education On Influenza Vaccination Uptake, Jazzlyn Lawson
The Effects Of Education On Influenza Vaccination Uptake, Jazzlyn Lawson
MSN Capstone Projects
Influenza is a viral illness that occurs internationally and peaks in prevalence during the months of October to May. There are several types of influenza viruses: Influenza A, B, C, and D (CDC, 2023). Vaccines are available in the United States as early as the start of the flu season to those who wish to receive it. The influenza virus types covered by the annual flu vaccine include Influenzas A and B types (CDC, 2023). The influenza vaccine is recommended by the CDC with the intent to limit the occurrence and spread of influenza each year. Symptoms of influenza consist …
Enhancing Athletic Participation: Continuous Glucose Monitoring For Pediatric Type 1 Diabetes Athletes, Danielle Santiago
Enhancing Athletic Participation: Continuous Glucose Monitoring For Pediatric Type 1 Diabetes Athletes, Danielle Santiago
Nursing | Student Research Posters
Background: Type 1 diabetes mellitus (T1DM) is a lifelong autoimmune condition requiring exogenous insulin, daily insulin management, and blood glucose monitoring (Kahanovitz et al., 2018). Diagnosis, often in childhood, brings overwhelming challenges for children and parents. While no cure exists, advances in monitoring and insulin delivery enhance blood sugar control and quality of life (Mayo Clinic, 2023)
Problem Statement: It is suspected that children with T1DM develop a fear of hypoglycemia (FOH) that deters exercise. Cockroft et al. (2023) found that 70% of youth with T1DM do not meet the recommended amount of exercise (Cockcroft et al., 2023). Physical education …
Youth Shelter Bed Bugs & Lice Education, Madeline Mary Rettenmier, Elvina S. Kuzubov, Quoc H. Phan, Megan Myra Joseph, Allie Mechtel
Youth Shelter Bed Bugs & Lice Education, Madeline Mary Rettenmier, Elvina S. Kuzubov, Quoc H. Phan, Megan Myra Joseph, Allie Mechtel
Nursing Leadership in Community Engagement Projects
Youth Shelter Bed Bugs & Lice Education
Allie Mechtel, Maddy Rettenmier, Elvina Kuzubov, Megan Joseph, Kevin Phan
School of Health Sciences, Seattle Pacific University
NUR 4153: Nursing Leadership in Community Engagement
Leah Ngoche DNP, MPH, ARNP-BC
8 November 2023
Youth Shelter Bed Bugs & Lice Education
Introduction
Seattle Pacific University Nursing students were assigned a fifth quarter leadership project in the greater Seattle area. Our group was assigned to a youth shelter located in Belltown, Seattle Washington. It is a thirty-bed, animal friendly shelter for young individuals looking for a safe place to stay. They offer long-term housing for those …
Skin Safety Bootcamp: Empowering Nurses To Own Hapi Prevention: A Quality Improvement Initiative, Brooke Randol Msn, Rn, Agcns-Bc, Cmsrn, Cws, Michelle Wood Msn, Rn-Bc
Skin Safety Bootcamp: Empowering Nurses To Own Hapi Prevention: A Quality Improvement Initiative, Brooke Randol Msn, Rn, Agcns-Bc, Cmsrn, Cws, Michelle Wood Msn, Rn-Bc
Posters & Presentations
Poster presented at Parkview Nursing Research Symposium, 2023
Question: For inpatient cardiovascular nurses, does implementing a skin safety bootcamp improve the use of pressure injury prevention interventions compared to preintervention, resulting in a decrease in hospital-acquired pressure injuries?
Enhancing Diabetes Care With Peer Mentorship And Support Groups, Barry Mccann Bsn, Rn
Enhancing Diabetes Care With Peer Mentorship And Support Groups, Barry Mccann Bsn, Rn
Posters & Presentations
Poster presented at the Parkview Nursing Research Symposium, 2023.
Continued increase in prevalence of type 2 diabetes indicates need for more effective interventions to support lifestyle and behavior changes (ADA 2018).
• Evidence indicates attending diabetes self management education programs can improve diabetes outcomes, unfortunately they are often under referred and underutilized (Powers et al. 2015, Boakye et al. 2018).
• Limited class times, locations, and capacities can make attendance for all patients difficult and vulnerable populations are less likely to participate (Boakye et al. 2018).
• Diabetes education programs often lack culturally and individually relevant guidance, provide no long-term …
Impact Of Discharge Teaching On 30-Day Readmission Rates In The Incarcerated Patient Population, Natasha P. Walker
Impact Of Discharge Teaching On 30-Day Readmission Rates In The Incarcerated Patient Population, Natasha P. Walker
Doctor of Nursing Practice Scholarly Projects
Problems Statement: Current incarcerated patient policy prohibits communicating discharge information to the patient on day of discharge to mitigate elopement risk. Purpose: The purpose of this DNP project is to improve hospital quality metric 30-day readmission rates in the incarcerated patient population by implementing a trial period of discharge teaching the day of discharge. Method: Implementation of discharge teaching utilizing the Krames patient education standardized discharge teaching tool integrated within the health system’s electronic health record. Analysis: The project’s initial plan to use the Pearson correlation coefficient to evaluate relationship between 30-day readmission rates and standardized discharge teaching on the …
Affective Domain Development In Virtual Education: Visual Thinking Strategies And Art Pedagogy, Jayne Josephsen
Affective Domain Development In Virtual Education: Visual Thinking Strategies And Art Pedagogy, Jayne Josephsen
Nursing Faculty Publications and Presentations
Development of the affective domain is linked to increasing self-awareness of internal dialogue, such as biases and assumptions, which can affect the ability of nurses to engage in person-centered care and meet the identified patient outcomes. Through visual thinking strategies (VTS) paired with art-based pedagogy to examine grief, loss, and bereavement concepts in a hospice and palliative care nursing virtual education course, affective domain development was advanced. Foundational to this virtual educational intervention was using the VTS framework of questions and pairing them with art-based pedagogy promoting open-ended interpretation and response to the art presented. This assisted the students in …
Tefra 7 Requirements: Assessment Of Education On Crna Knowledge, Erin Tienhaara
Tefra 7 Requirements: Assessment Of Education On Crna Knowledge, Erin Tienhaara
College of Science and Health Theses and Dissertations
Failure to follow the seven requirements of the Tax Equality and Fiscal Responsibility Act (TEFRA) when working in a medical direction model can place a CRNA at increased liability related to Medicare fraud. CRNAs and SRNAs often lack basic knowledge about the TEFRA 7 requirements which puts them at risk of committing inadvertent medical billing fraud. The purpose of this study was to determine if the investigator-developed educational flyer improved CRNA and SRNA knowledge regarding the TEFRA 7 requirements. A convenience sample of CRNAs and SRNAs (n=61) completed an online knowledge pre-test about TEFRA, reviewed the investigator-developed educational flyer about …
Podcasting As An Education Modality On The Environmental Effect Of Desflurane, Jacob Bonnema
Podcasting As An Education Modality On The Environmental Effect Of Desflurane, Jacob Bonnema
College of Science and Health Theses and Dissertations
Background: Climate crisis is well-documented as posing a major threat to the population. The provision of anesthesia utilizes gases that contribute to this problem. Podcasts may serve as a useful modality to educate anesthesia providers on best practices.
Purpose: The purpose of this study was to evaluate the effectiveness of an evidence-based educational intervention in the form of a podcast which focuses on the evaluation of knowledge, attitudes, and practice habits related to the use of desflurane among anesthesia providers.
Methods: An observational cross-section study using survey methodology was utilized in this pre-test post-test design. Knowledge, attitudes, and practice habits …
Gender Affirming Anesthesia: It’S More Than Pronouns, Matthew Klimesh, Angela Kurth
Gender Affirming Anesthesia: It’S More Than Pronouns, Matthew Klimesh, Angela Kurth
College of Science and Health Theses and Dissertations
Transgender individuals experience healthcare-related discrimination, resulting in significant disparities and negative health outcomes in comparison to the general population. Many CRNAs do not receive formal or adequate education before being expected to care for transgender patients that contributes to these negative health outcomes. To correct this problem, an educational intervention was created to improve anesthesia providers' knowledge of genderaffirming therapies and to survey anesthesia provider attitudes towards transgender patients and knowledge, beliefs, and preferences towards treating transgender patients. A sample of anesthesia providers was collected (n=27) that included SRNAs and CRNAs at varying levels of professional experience from diverse sociodemographic …
Opioid Use Disorder (Oud) And Neonatal Abstinence Syndrome (Nas) Education In An Undergraduate Nursing Program, Tara Flood, Dnp, Rn, Cbc
Opioid Use Disorder (Oud) And Neonatal Abstinence Syndrome (Nas) Education In An Undergraduate Nursing Program, Tara Flood, Dnp, Rn, Cbc
College of Nursing Posters
Background
In 2018 the American Academy of Nursing urged all nursing schools to adopt curriculum to address the opioid epidemic, although few programs have begun this work.
Minimal background training in nursing school is focused on caring for patients with Opiate use disorder ( OUD) and Neonatal Abstinence Syndrome (NAS) leaving nurses to develop the necessary skills for optimal patient engagement to be formulated in practice. An undergraduate nursing program in an urban setting developed OUD and NAS education into their curriculum.
Undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Previous research indicates …
Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado
Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado
Doctor of Nursing Practice (DNP) Projects
Background: Globally, adverse health effects, including deaths and disabilities, occur from living or working in unhealthy domains where exposure to environmental and occupational hazards exists. A multitude of these hazards are present in clinical settings in the healthcare environment where nurses care for patients and risk ongoing exposures to toxic substances.
Problem: Environmental and occupational health education is rarely included in the standard undergraduate nursing curriculum, contributing to a deficit among nurses in environmental health awareness and knowledge.
Methods: The study design was a pre/post evaluation of a single cohort (n=32) of undergraduate nursing students to assess environmental and occupational …
Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo
Expanding The Volunteer Role To Include Advance Care Planning Knowledge, Andrea C. Leomo
Master's Projects and Capstones
Problem: Transition patients at the end-of-life are those patients who are not mentally ready or physically eligible for hospice thus not enrolled in a Palliative or Hospice Program. Only one-third of the Transition patient census had completed and filed advance care plans. Healthcare providers are obligated to perform life-saving measures unless documented otherwise. A lack of advance care planning can create complicated scenarios and cause discordant care incidents.
Context: End-of-life care is a delicate subject to navigate conversations with patients. With holistic care being a large component of hospice and palliative care, it is important to have updated and accurate …
Robot Revolution: Impacting Adoption Of The Technology, Cece Noland
Robot Revolution: Impacting Adoption Of The Technology, Cece Noland
MSN Capstone Projects
The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.
Standardizing Congestive Heart Failure Education To Decrease Readmissions, Cyntia Boter
Standardizing Congestive Heart Failure Education To Decrease Readmissions, Cyntia Boter
Master's Projects and Capstones
Background: The setting of this project took place in a small 100-bed community hospital that is a part of a larger healthcare organization in Northern California. The focus of the project was the implementation of standardized education for patients with congestive heart failure (CHF) to lead to an outcome of decreased readmissions. Readmissions to hospitals are costly and effective discharge planning can impact and decrease readmissions.
Problem: The facility in which this project took place has 35 readmissions a year for CHF. It is the third highest DRG and reason for readmissions in 2022. Although there is work in place …
Improving Prediabetes Screening, Diagnosis, And Referral To A Diabetes Prevention Program In The Primary Care Setting., Brittany Morguelan
Improving Prediabetes Screening, Diagnosis, And Referral To A Diabetes Prevention Program In The Primary Care Setting., Brittany Morguelan
Doctor of Nursing Practice Papers
Improving Prediabetes Screening, Diagnosis, and Referral to a Diabetes Prevention Program in the Primary Care Setting
Table of Contents
Abstract……………………………………………………………………………………………4
Background………………………………………………………………………………………..5
Purpose…………………………………………………………………………………………...10
Literature Review……………………………………………………………………………...…10
Conceptual Framework…………………………………………………………………………..15
Setting………………………………………………………………………………………...….17
Context…………………………………………………………………………………………..18
Procedures/Intervention…….……………………………………………………………………19
Ethical Considerations…..……………………………………………………………………….20
Measures…………………………………………………………………………………………20
Data Analysis……………………………………………...……………………………………..22
Results……………………………………………………………………………………………23
Discussion……………………………………………………………………………...………...26
References……………………………………………………………………………………….33
Appendix A: Implementation Timeline…………………………………………………………40
Appendix B: IROC Quality Improvement Leadership Approval Letter………………………...41
Appendix C: PCP Referral Process and Diabetes Prevention Program Referral Order………...42
Figure 1: Monthly Number of N-DPP EHR Referrals by PCPs…………………………………….43
Figure 2: Monthly Total PCP Screening HbA1c/FBG Orders vs. Monthly Results HbA1cs……44
Figure 3: Demographic Analysis: Patients with a Documented Prediabetes ICD-10 (R73.03/R73.0)………………………………………………………………………………………….45
Abstract
Background: Prediabetes is a …
Alarm Fatigue Prevention Benchmark Project, Lauren James
Alarm Fatigue Prevention Benchmark Project, Lauren James
MSN Capstone Projects
Healthcare technology is constantly evolving to find ways to help provide better outcomes for patients. Clinical monitoring is technology that helps healthcare staff recognize deterioration of the patient which allows them to intervene earlier, which increases the patient’s chance for survival. The monitors are connected to the patients to monitor vital signs such as heart rate, oxygen saturation, respirations, and blood pressures. They allow staff to get real time feedback of the patient’s condition and determine if the patient is getting better or any interventions need to be done due to clinical deterioration.
However, all technology has setbacks and downfalls. …
Application Of Teaching Regarding Injury Appearance In Darker Pigmented Skin Patients: A Quality Improvement Project, Tiffany Akiba
Application Of Teaching Regarding Injury Appearance In Darker Pigmented Skin Patients: A Quality Improvement Project, Tiffany Akiba
DNP Projects
Significance and Background: The skin is the largest organ of our body, and skin injury prevention begins with accurately inspecting skin. Current practices stress on looking for any signs of redness which often signify that the skin is possibly injured or compromised. However, darker skin tones do not appear red when injured. Assessing for redness is a practice that is suited better for lighter skin tones.
Purpose: Provide education to providers on current skin assessment practices of darker skin tones.
Methods: The IHI Model of Improvement was used for this project, and the Plan-Do-Study-Act cycle was used to test for …
Use Of Evidence-Based Telehealth To Reduce Complications In Adults With Type 2 Diabetes In A Rural Health Facility, Joni Kelley
Use Of Evidence-Based Telehealth To Reduce Complications In Adults With Type 2 Diabetes In A Rural Health Facility, Joni Kelley
Doctor of Nursing Practice Projects
Background: Formal education for type 2 diabetes mellitus (T2DM) patients is essential, especially in rural areas where diabetes is approximately 17% higher than in urban areas (Bolin & Ferdinand, 2018). In 2019, diabetes was listed as the direct cause of 1.5 million deaths, and 48% of all deaths due to diabetes occurred before 70 years (American Diabetes Association, 2021). According to the American Diabetes Association (2021), approximately 550,149 people in Alabama, or 14.1% of adults, have been diagnosed with diabetes. An additional 119,000 people in Alabama have diabetes but are unaware, significantly increasing their risk of complications (American Diabetes Association, …
The Lived Experiences Of Faculty Conducting Post-Simulation Debriefing In Nurse Practitioner Programs, Jodi Borden Duncan
The Lived Experiences Of Faculty Conducting Post-Simulation Debriefing In Nurse Practitioner Programs, Jodi Borden Duncan
Doctoral Dissertations and Projects
Simulation-based education is a teaching–learning pedagogy widely used in nursing programs today. While much research has been done on student perceptions of simulation and the fact most learning occurs in the post-simulation debriefing session, little research has been done on how learning takes place in debriefing. Nurse practitioner faculty also use simulation as a teaching methodology, but the implementation of debriefing methods and faculty experiences with debriefing sessions are not known. As simulation may not be counted as direct clinical hours in nurse practitioner programs, more research must be done before the substitution of hours can be considered. The substitution …
Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio
Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio
Nursing Leadership in Community Engagement Projects
Introduction
The National Library of Medicine notes an emerging area of research interest is the relationship between substance abuse and sleep (Mahfoud et al., 2009). According to the same 2007 National Survey on Drug Use and Health, “7.6 percent of Americans older than 12 years met the criteria for alcohol abuse or dependence” and goes on to highlight the mundanity of sleep disorder. Additionally, the 2008 National Sleep Foundation’s “Sleep in American” poll demonstrated “addicts in recovery are 5 to 10 times more likely to experience sleep disorders.” (Moufoud et al., 2009). Clinical Site 1 is an agency in Downtown …
Wound Care For Unhoused Youth, Diana Altman, Monse Villasenor, Grace Fry, Maddy Johnson, Matthew Messenger
Wound Care For Unhoused Youth, Diana Altman, Monse Villasenor, Grace Fry, Maddy Johnson, Matthew Messenger
Nursing Leadership in Community Engagement Projects
Wound Care For Unhoused Youth
Introduction
We partnered with a non-profit organization designed to serve the unhoused youth, ages 18-25, who have a day program as well as an overnight shelter. They have 30 beds and reserve 20 of those beds for individuals who are “residents,” who commit to staying for several nights and work towards finding more permanent options. The other 10 beds are for individuals to use for a single night, but these are not always guaranteed, you must sign up to save a spot. The day program has various activities ranging from painting to resume workshops and …
A Pilot Project For Tuberculosis Education In College Students, Sarah Williams
A Pilot Project For Tuberculosis Education In College Students, Sarah Williams
Doctor of Nursing Practice Final Manuscripts
Background: San Diego’s Tuberculosis (TB) incidence is more than double the national rate. The majority of cases of active TB are due to the progression of latent TB infection (LTBI).
Objectives: This evidence-based practice (EBP) project aimed to increase knowledge, awareness, and improve attitudes and practices regarding TB among college students.
Participants: Twenty Community College Students in San Diego participated in the project.
Methods: Students attended an in-person educational session. A pre-post knowledge, attitudes and practices (KAP) questionnaire measured the impact.
Results: The intervention improved knowledge and attitudes. The average post-intervention TB knowledge score was 95.8% compared to 57% …
Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante
Improving Care For Children And Adolescents With Down Syndrome In The Military Health System, Katherine B. Arrogante
Doctor of Nursing Practice Final Manuscripts
Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. In the United States, DS occurs in one out of every 700 births. Children with DS have an increased risk of developing serious health conditions. In the military health system, children with DS face many barriers such as frequent relocations and poor access to specialty care. Primary care providers (PCPs) do not consistently follow published guidelines for health supervision.
Purpose: This project aims to improve the care for pediatric patients with DS in the military health system by increasing the knowledge and confidence of PCPs.
Methodology: An educational program …
Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart
Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart
Doctor of Nursing Practice Final Manuscripts
Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .
Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …
Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich
Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich
Doctor of Nursing Practice Final Manuscripts
Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).
Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …
A Team-Based Approach To Increase Initiation Of Self-Management Goals In Adult Patients Diagnosed With Hypertension With The Use Of A Self-Management Goal Toolkit, Kristel Danette Ramsay
A Team-Based Approach To Increase Initiation Of Self-Management Goals In Adult Patients Diagnosed With Hypertension With The Use Of A Self-Management Goal Toolkit, Kristel Danette Ramsay
Doctoral Dissertations and Projects
Due to the high risk of cardiovascular disease and other negative complications, it is imperative that patients in the primary care clinic diagnosed with hypertension control blood pressure levels. The purpose of this scholarly project was to increase the initiation of self-management goals (SMGs) among adult males and females age 30 to 60 diagnosed with hypertension. These patients were active duty military, reservists, and dependent beneficiaries who receive care at the Navy Medicine Readiness Training Unit–Memphis. The practice change took the onus of introduction and education about SMGs off the provider and added key responsibilities to support staff, who provided …