Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Urinary tract infections (UTIs) are one of the most common infections that require antibiotic therapy. Providers working in three urgent care clinics located in Eastern West Virginia diagnosis and treat UTIs based on their clinical judgement. Variability in clinical judgement results in inappropriate antibiotic use which has implications on antibiotic resistance and the financial burden of the patients as well as the entire organization.

Evidence Review: A total of 10 articles were evaluated to support the implementation of antibiotic stewardship initiatives that provide guidance in caring for this population. Interventions include electronic health record enhancements, provider education, and tracking …

Empowered Choices: A Quality Improvement Women’S Health Initiative In Faith-Based Nursing For Women Recovering From Substance Use Disorder, Jennifer Mewshaw

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Women with substance use disorder (SUD) face higher rates of unplanned pregnancy, reproductive infections, and delayed prenatal care. Faith community nurses (FCNs) often already serve within this community and have a long history of promoting public health interventions. However, they lack the knowledge and confidence in sexual and reproductive health (SRH) education.

Evidence Review: A literature review identified barriers to SRH care for women with SUD and the role of FCNs in community and public health interventions. Evidence supports providing FCNs with the knowledge and skills to deliver SRH education and support for women with SUD using trauma-informed and …

Improving Access To Care And Utilization Of Telehealth In Pediatric Inflammatory Bowel Disease Patients Through Scheduling Interventions: A Quality Improvement Project, Sarah R. Bergstrom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Improving Access to Care and Utilization of Telehealth in Pediatric Inflammatory Bowel Disease Patients Through Scheduling Interventions: A Quality Improvement Project

Sarah Bergstrom

Introduction/Background. Inflammatory bowel disease (IBD) tends to affect pediatric patients with a more severe, aggressive phenotype as compared to adults. Following closely with a pediatric gastroenterologist (GI) is best practice to manage pediatric IBD. However, pediatric subspecialty clinics are generally located within academic institutions in urban areas. Patients in rural areas often have limited access to pediatric GI care, and poor access to care is associated with increased risk of poor disease control. Telehealth subspecialty …

An Evidence-Based Practice Initiative To Improve Blood Pressure Control, Teresa D. Hines

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: High blood pressure (HBP) is a significant public health concern. It affects millions of adults in the United States (US) and half of the adult population in the Appalachia regions. High blood pressure is a known risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality Appalachia. Complications associated with high blood pressure result in substantial economic burdens for patients and their families, healthcare systems, and national economies. High blood pressure is a significant health issue in West Virginia (WV), with an estimated 602,000 people suffering from HBP.

Purpose: The purpose of this …

Descriptions Of Breast Self-Care From Inner-City African American And Hispanic Women Seeking Care In A Comprehensive Breast Care Center, Salamata Yoda

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: A plethora of inquiries has irrefutably revealed a decline in the death rates of breast cancer in some ethnic populations due to timely diagnoses, and enhancement in treatment measures. However, not all women have gained equal access to these innovations in healthcare. Certainly, as a repercussion of the noted disparity, the overall breast cancer prevalence among African American and Hispanic women has steadily escalated. Although no single test can detect all breast cancers early, practicing breast self-care consisting of breast self-awareness (BSA) in combination with other screening methods such as clinical breast exam (CBE), mammogram screening, and a suitable …

Experience Of Parents Caring For A Child With An Acquired Disability, Brad E. Phillips

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Parents caring for a child with an acquired disability often report a negative impact on physical, psychological, emotional, and spiritual health associated with caregiver burden related to their child’s complex health needs. This is further complicated by additional challenges related to the loss of a previously healthy child. Traditional patterns of loss follow linear, time-bound stages that have been observed to be unrelated to the experiences of these specific parents and their families. Therefore, the concept transforming loss has been developed to better understand how these parents navigate loss and find meaning in spite of their suffering.

Purpose: The …

Evaluation Of A Comprehensive Diabetes Mellitus Protocol At A Rural, Federally Qualified Health Center In Southern West Virginia, Hannah D. Davis

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Diabetes mellitus is a chronic disease that affects nearly 34 million Americans. In rural Appalachia, the population is affected disproportionately at a rate of 14% compared to the national average of 10%. Diabetes is a lifelong, chronic condition managed best by a multidisciplinary team-based approach to achieve optimal disease control. Best practices in the care of diabetes support the use of evidenced based care protocols and leveraging technology to decrease the burden of disease. Type 2 diabetes mellitus (T2DM) is the most common type, making it the focal population for evaluation.

Purpose: The purpose of this project was to …

The Effect Of A Standardized Handoff Tool On Communication, Interunit Transitions, And Wait Time: A Quality Improvement Project, Silvia N. Myndresku

Graduate Theses, Dissertations, and Problem Reports (ETD)

This project sought not only to improve the communication and interunit transitions of care between emergency department providers (EDPs) and inpatient providers (IPs) using a standardized handoff tool, but also to reduce the Emergency Room (ED) wait time for patients admitted to the community hospital. The project employed a quantitative quasi-experimental pre-test/post-test design to explore provider satisfaction with an evidence-based standardized handoff tools and wait time. Forty-eight providers completed the survey before the I-PASS implementation, and 43 providers completed the survey post I-PASS implementation. Though not statistically significant, data indicates that wait time increased for the post-implementation months of December, …

Reframing: A Grounded Theory Study Of Postmenopausal Women Following Osteoporotic Fracture, Ashley D. Barber

Graduate Theses, Dissertations, and Problem Reports (ETD)

BACKGROUND: Osteoporosis is a chronic disease resulting in low bone mass and increased bone fragility. Most often seen in women age 65 and older, osteoporosis is usually diagnosed following osteoporotic fracture. Despite numerous treatment options many women continue to remain untreated for osteoporosis and are at increased risk for subsequent fractures and complications. PURPOSE: The initial purpose of this classic grounded theory study was to explore the decision-making process women aged 65 and older experience when considering osteoporosis treatment following osteoporotic fracture. Following the tenth participant interview the researcher discovered a new main concern that emerged from participant interviews. Participants …

Examining Relationships Among Person Factors, Psychosocial Factors, And Coping Patterns In People Living With Type 2 Diabetes Mellitus In North Central Appalachia, Melissa A. Mccoy

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Diabetes is a complex, debilitating illness that imposes disease burden on the individual and society. T2DM is more prevalent in the Appalachian region than in any other Region of the United States. If diabetes is poorly controlled, patients are at risk for negative health outcomes. A gap exists in the literature related to understanding of the relationships among person factors, psychosocial factors, and coping patterns. Another gap in the literature is sex differences among these variables.

Purpose: The purpose of this study is to examining relationships among person factors, psychosocial factors, and coping patterns in people living with T2DM …

Women Veterans’ Descriptions Of The Patient-Provider Interaction With Civilian Providers, Billie S. Vance

Graduate Theses, Dissertations, and Problem Reports (ETD)

BACKGROUND: Women veterans require care for unique gender, and war-related health issues. Concerns exist regarding non-Veterans Health Administration (VHA), civilian healthcare providers’ preparedness to deliver care to the veteran population. Health outcomes are influenced by the quality of care provided to patients. There is a significant gap in the literature with regard to woman veterans’ perspectives about the quality of the patient-provider interaction between women veterans and non-VHA, civilian providers.

PURPOSE: The purpose of this study was to describe women veterans’ perspectives about interactions between themselves and civilian providers and to critically analyze the veterans’ data to further inform the …

A Video Decision Aid To Influence Advance Care Planning, Angela Petry

Graduate Theses, Dissertations, and Problem Reports (ETD)

The best mechanism to achieve successful advance care planning has yet to be identified. A randomized, controlled, experimental study was performed with a sample of 54 men and women who met inclusion criteria and were randomized into the intervention versus the control group in an outpatient clinical setting in rural West Virginia (WV) from December 2018 to March 2019. Participant mean age was 72.4 years. For those who chose to participate (n=42), the intervention group received the usual standard of care, which was a face to face advance care planning (ACP) discussion with the new intervention of a video decision …