Family Practice Nursing Commons^™

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear

DNP Projects

PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19^th through October 10^th, 2017.

RESULTS: There were 37 patients eligible to participate …

Use Of The Afix Model To Improve Adolescent Hpv Vaccination: A Pilot Research Study, Emily Messerli

DNP Projects

Problem: The CDC estimates one person every 20 minutes every day acquires an HPV-related cancer. Kentucky’s HPV associated cancer burden is among the highest in the nation. Adolescent HPV vaccination rates in Kentucky are far below HealthyPeople 2020 goals. Barriers are multifaceted and include provider, patient and system barriers. The AFIX model is an evidenced based quality improvement program that addresses key provider barriers. The USPSTF findings identify a gap in the literature related to AFIX methods to improve rates of adolescent vaccines.

Objectives: The purpose of this study was to evaluate the effects of an intervention using the AFIX …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects and Capstones

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones. …

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

Perceptions Of Renal Disease Risk Among African Americans: A Review Of The Literature, Casey L. Migliore, Julie Barroso, Allison Vorderstrasse

Journal of Health Disparities Research and Practice

African Americans are disproportionately at risk for renal disease, especially those with type 2 diabetes (McDonough et al., 2011). Despite this disease disparity, the literature lacks research on renal disease awareness and risk perceptions among African Americans with type 2 diabetes. Therefore, a literature review guided by the Common Sense Model was conducted to review and synthesize the literature on African Americans’ awareness of renal disease and existing risk perceptions, capturing sociocultural factors in the African American community that could influence the development of those risk perceptions. The literature identified an overall lack of knowledge about renal disease risk factors, …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

The Secret Ingredient For Improving Infant/Child Mental Health: Teaching Parents To Play, Geraldine Healy Marini

Occupational Therapy Doctorate Capstone Projects

Disorders in mental health are the highest of all disorders and results in the most common form of disability. Since 2011, mental health disorders have increased at alarming rates. It is estimated that 9.5 to 14.2% of children between the ages of 0 to 5 years have and emotional or behavioral problem. The mental health of parents or caregivers can affect and impact the development of young children (Nelson & Mann, 2011, Zero to Three, 2004).

The over arching goal of this research is to explore issues of mental health within parent-child interactions. Coaching parents during the co-occupation of play …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Documentation Of Smoking History And Adherence To The Uspstf Recommendation For Lung Cancer Screening: A Retrospective Chart Review, Laura A. Golden

DNP Projects

Purpose: The purpose of this project was to evaluate provider compliance with documentation of smoking history and, if criteria met, referral for lung cancer screening as recommended by the United States Preventive Services Task Force in 2013.

Methods: A retrospective chart review was conducted using an electronic medical record (EMR) at a large, rural community family practice clinic. Patients meeting inclusion criteria of having a smoking history (current or past) of 30 pack years, aged 55 to 80 years, and no history of lung cancer diagnosis were included for randomization. One hundred patients were selected from 300 randomized charts; five …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

The Role Of The Faith Community Nurse In Fostering Spirituality In Those With Alzheimer's Disease, Verna Carson Phd, Pmh/Cns-Bc

International Journal of Faith Community Nursing

Alzheimer ’s disease (AD) strips individuals of memories and abilities that have defined them as productive adults throughout their life. While the decline in memory is real and results in a ‘loss of self’ this does not equate to a ‘loss of soul.’ AD patients continue to have spiritual needs throughout their life as do the family, and/or caregivers. This article explores the spiritual needs and care of AD patients and families and the unique opportunity faith community nurses have to help the AD patient and their support system. The Reisberg Functional Assessment Staging System is used to explain the …

Wecan Implementation For Parents Of At-Risk Hispanic Adolescents In Middle School, Shannon Leigh Devita

Doctor of Nursing Practice Final Manuscripts

Abstract

CDC-reported childhood obesity rates have tripled in the past three years. Among children in grades five, seven and nine, 30% are overweight or obese, with Hispanic students more likely to be overweight than White students. This evidence-based project examined the effectiveness of NHLBI’s WeCan! for at-risk middle-school-age Hispanic children and parents. The program was implemented at school in two weekly sessions, and its effectiveness was evaluated using the WeCan! survey. The program resulted in improved knowledge, behaviors, and attitudes related energy balance, portion size, healthy foods, physical activity, and screen time and may be useful in other school settings.

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Effects Of Multimodal Fever Education On Parents Of Febrile Children, Teresa S. Parkhouse

Evidence-Based Practice Project Reports

Insufficient knowledge regarding the physiology and appropriate management of fever in children often contributes to an increased parental anxiety, inappropriate antipyretic use, and overutilization of medical resources (Chang, Liu, & Huang, 2013; Crocetti, Moghbeli, & Serwint, 2001; Schmitt, 1980). Parental concerns regarding childhood fever can lead to an overuse of health care resources as febrile illness in children accounts for approximately 20% of emergency department visits, 30% of office visits, and over 50% of after-hour phone calls to private physicians (Zomorrodi & Attia, 2008). Research shows that multidimensional educational interventions are most effective in improving parental management of fever (Young …

Promoting Oral Health Knowledge In African American College Students, Terri Huff-Simmons

Doctor of Nursing Practice Scholarly Projects

Objective. The primary aim was to assess African American college student's knowledge of oral health and healthcare access.

Methods. The project was a quantitative descriptive study using a pre and posttest design. A pre questionnaire containing items regarding oral hygiene and oral health based on the recommendations of the American Dental Association (ADA) as well as questions about access to oral healthcare was distributed to African American college students to measure their knowledge. A demographic questionnaire was distributed. Students participated in a 20-30 minute oral health educational program. A post-test was given 4-6 weeks after the initial pre-test.

Results. …

Maine's Breastfeeding Gap: How Initiation And Duration Differ By Socioeconomic Status, Zoe Miller

Thinking Matters Symposium Archive

The preventive health benefits of breastfeeding for both mothers and children are widely recognized. Leading health authorities recommend exclusive breastfeeding for the first six months of life.

Though breastfeeding rates in the United States have been increasing for the past decade, significant disparities continue across race and socioeconomic status.

The Benefits Of Breastfeeding, Helen L. Byers

Senior Honors Theses

It is important to educate women of childbearing age, their families, and society of the benefits that breastfeeding has over bottle-feeding and formula-feeding. The benefits of breastfeeding are in three main categories. First, the developmental, physical, emotional, and spiritual benefits of the baby will be discussed. Then the physical, emotional, and spiritual benefits for the mother will be talked about along with possible contraindications or difficulties. Finally, the financial benefits of breastfeeding over feeding an infant from the bottle will be discussed as it relates to the family and government. The goal is to persuade that breastfeeding is a superior …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

Overcoming Barriers To Screening For Anal Intraepithelial Neoplasia For Persons Living With Hiv, Brandon Hastings

Doctor of Nursing Practice (DNP) Projects

Screening has proven an effective strategy in the management of diseases that plague the population. This technique has proven to be most effective when screening is conducted with those who are most at risk for developing the targeted illness and when the frequency of screening follows set guidelines. Currently there are no nationally recognized screening guidelines for anal intraepithelial neoplasia (AIN). Screening for AIN stands to reduce overall incidence of anal squamous cell carcinoma through destruction of the dysplastic cells before they become cancerous. The goals of this project were to identify the patient population that stands to benefit the …

The Prevalence Of Smoking In Nursing Students, Jennifer Trotter

Undergraduate Honors Theses

Tobacco use is one of the most preventable sources of death and disease, and yet remains a worldwide problem. With the rising costs of healthcare, the focus of efforts to control them has honed in on lifestyle behaviors that contribute to the escalating costs. Within the scope of this scrutiny, the prevention or cessation of smoking and tobacco usage has become a global priority and a major focal point of worldwide anti-tobacco initiatives. The World Health Organization (WHO) has identified cessation interventions by health care professionals as a crucial factor in successful patient smoking cessation, and studies have shown that …

The Baby Friendly Hospital Initiative, Kathryn E. Brackett

Senior Honors Theses

Abstract

The Baby-Friendly Hospital Initiative (BFHI) is a worldwide movement started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that is aimed at providing hospitals with a certification that guarantees the best possible patient-centered care for mothers and infants. It focuses on breastfeeding as optimal infant nutrition, and implements strategies to encourage and support mothers to breastfeed their infants exclusively for six months after birth. The Ten Steps to Successful Breastfeeding are a set of 10 simple, easy to understand guidelines developed by WHO and UNICEF for implementing this initiative in the hospital setting and …

Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis

DNP Projects

Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.

Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …

Patient Engagement: Patients As Partners In Their Own Health Care, Nancy L. Falk, Mary Jean Schumann

Nursing Faculty Posters and Presentations

No abstract provided.

Childhood Home Injuries: A Nursing Student Approach To Preventing Childhood Home Injuries, Jinging Sparrow, Katherine Carman, Katelyn Kerr, Renee Farmer

OUR Journal: ODU Undergraduate Research Journal

Unintentional injuries are the leading cause of death for children under 14 years of age. Of the unintentional injuries, a significant portion occurs within the home setting. Creating a safe home environment for children has become a focus in current efforts for health promotion and injury prevention. Our objective is to enhance caregivers’ knowledge of home safety thus decreasing the incidence of childhood unintentional injuries. To this end, a series of educational workshops were conducted on poisoning, choking, furniture tip-over, scalds and burns. The material was presented via PowerPoint, videos, posters, handouts, demonstrations and return demonstrations. Verbal pre-and post tests …

Advance Practice Nurses Readiness To Change Assessment Methods In Parents Of Obese Children, Carolyn Leach

UNLV Theses, Dissertations, Professional Papers, and Capstones

The worldwide epidemic of child and adolescent overweight and obesity continues to increase at disturbing rates. Unhealthy dietary practice is one of multiple causative behaviors leading to child and adolescent overweight and obesity. This behavior can contribute to short and long-term health consequences. Parents are modulators in the development of children's dietary behavior practices. It is recommended clinical practice that pediatric nurse practitioners (PNPs) assess readiness to change behavior in parents of overweight or obese children. The components of the Prochaska and DiClemente's Transtheoretical Model (TTM) in correlation with the counseling style of Rollnick, Miller and Butler's methods of Motivational …

'Science Of Trivalency', Kwaku L. Carlisle Woods Rn Md Metd1, Dr. Kwaku L Carlisle Woods Rn Md Metd1

Walden Faculty and Staff Publications

Due to mine cross cultural living, (I was born in the U.S. but grew in Southeast Asia), I became very interested in the Anthological, Social and Scientific difference between cultures. This led to a historical meta evaluation of humanity in general. Using the principals of Noetic Science, this evaluation reviled the ignorance and down right absence of any educational opportunities to learn the true functional abilities of mankind.