Family Practice Nursing Commons^™

Effectiveness And Feasibility Of In-Office Versus Smartphone Text-Delivered Nutrition Education In The College Setting: A Mixed-Methods Pilot Study, Jordan Rose, Deepika Goyal, Mary Ellen Wilkosz, Anita Catlin

Doctoral Projects

Often, being away from home for the first time, coupled with limited knowledge regarding healthy eating behaviors, leads to poor food choices and an increased risk of obesity among college-aged young adults. These college students are prone to high-calorie diets and limited physical activity, putting them at risk for obesity, a physiologically, psychologically, and financially costly epidemic in the United States. College students use their cellular phones over eight and a half hours a day and cell phones are their primary means of information consumption outside of the classroom, suggesting that the phones would be a useful tool to provide …

How To Start A Nurse Practitioner Faculty Managed Clinic: Missing Components?, Johnna Edmunds

Doctoral Projects

A serious need exists for improved access to primary care for vulnerable populations. Nurse Practitioner Faculty Managed Clinics (NPFMC) can help to alleviate this problem. The purpose of this qualitative, descriptive study was to identify and examine the beginning components necessary for implementing this inter-professional collaboration. A comprehensive literature review identified the absence of these components, which were then revealed through the interviews with founders of NPFMCs. Prior to the interviews two manuals were reviewed about the process of starting a free clinic. Questions were explored relating to the participants’ experiences in starting a NPFMC. Review of the manuals was …

The Influence Of Birth Weight On Body Mass Index In Young Children In Northwest Arkansas, Margaret Frame

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a screening tool to measure body fat that is calculated based on the height, weight, age, and gender of a child. Being overweight as a child is defined as having a BMI between the 85^th and 95^th percentiles. Obesity is defined as having a BMI at or above the 95^th percentile (“Basics About Childhood Obesity,” 2012). Having a high BMI comes with an increased risk of multiple co-morbidities, both physical and psychosocial (Pulgarón, 2013). Birth weight has been presumed to play a role in the prevalence of obesity in children. The purpose …

Using Focus Groups To Identify Ways To Reduce Infant Mortality In Kalamazoo, Leah Dries

Honors Theses

Study goals were to explore maternal perceptions of possible ways to reduce infant mortality in Kalamazoo County, with specific regards to the infant mortality rates of non-Hispanic African American babies versus non-Hispanic Caucasian babies. Two focus groups were conducted of voluntary, anonymous, participants from the YWCA domestic violence shelter and clients of home visiting services provided by the Kalamazoo County Department of Health and Community Services. The focus groups were guided allowing women to voice their opinions about ways to prevent infant mortality in Kalamazoo. Women were also asked to respond to the goals created by a community planning committee …

Effect Of Dietary Self-Monitoring In Caucasian And African-American Women, Julianne Tondreau

DNP Scholarly Projects

Purpose: The purpose of the study is 1) to assess the effect of dietary self-monitoring on weight loss in a population of Caucasian and African-American women and men; and 2) to determine if there is a difference in African Americans’ and Caucasians’ use of self-monitoring in weight loss.

Review of the Literature: Previous studies demonstrated increased weight loss with dietary self-monitoring; however, these studies’ samples are 70-80% Caucasian women and cannot be generalized to African-Americans or men. Studies confirming the effectiveness of dietary intake self-monitoring in non-Caucasian women and men are needed.

Methodology: Using a cohort design with prospective and …

The Effect Of Reduced Carbohydrate Diet Education On Hemoglobin A1c In Patients With Type 2 Diabetes, Lauren Parker

Evidence-Based Practice Project Reports

Type 2 diabetes (T2D) is characteristically the result of modifiable risk factors, impacting the health and well being of all ethnic backgrounds across the lifespan. Research has indicated that despite the many risk factors associated with T2D, alterations in dietary macronutrient composition can lead to improvements in disease management and resultant complications. Therefore, the purpose of this evidence-based practice (EBP) project was to provide individuals with reduced carbohydrate (carb) diet education to promote greater glycemic control and reduce associated risk factors through macronutrient modification, specifically carb intake. An integration of the most current evidence obtained from the critically appraised literature …

Exploring The Needs And Preferences For A Diabetes Self-Management Program In Hispanics Living In The Central Valley Of California, Emily Lane Kimble

Doctoral Projects

Diabetes mellitus type 2 is an ever increasing threat to the health of people living in the United States, especially those of Hispanic ethnicity. This ethnic group is disproportionately afflicted with the chronic condition and is also more likely than non-Hispanic whites to suffer from serious complications of diabetes. This project examines this growing problem among Hispanics living in the Central Valley of California by exploring how best to structure diabetes self-management education in a network of community health centers.

The Social Cognitive Theory provides a theoretical basis for investigation into motivation for diabetes self-management. This needs assessment specifically explored …

A Phenomenological Assessment Of Factors That Affect Medication Adherence Among Hypertensive Nigerian Immigrants, Beulah Iroegbu

Doctoral Projects

This qualitative study explored the perceptions that affect medication adherence among hypertensive Nigerian immigrants in Sacramento, California. The research questions focused on factors that influenced the adherence to hypertension medication; specifically, how the sample population explained the cause of hypertension and whether culture and religion impacted the cause and management of hypertension. A phenomenological approach was used to understand perceptions about medication adherence. A predefined group of 9 acted as a purposive sample and was given semi-structured individual interviews. Qualitative data analysis of the interviews was performed using Colaizzi's 7-step method. Results from the study found the cause of hypertension …

Nursing Spirit, Volume 1 (Spring 2016), Neal Chambler, Dean, Mary Bennett, Director, Susan Megahee, Editor, Creative

School of Nursing Publications

No abstract provided.

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …

Embryo Adoption As An Ethical Option For Couples Faced With Infertility, Rachel M. Walters

Senior Honors Theses

Embryo adoption takes embryos that are still forming and introduces them into the uterus of a woman with whom they do not share any genetic material. If pregnancy does ensue and continues without complications, the child that will be born will not share any genes with the woman who carried him or her. In addition, if the child is born to parents who already have other children, the children in the adoptive family will share no biological link to the newborn. Essentially, the child will have two families—a biological family and an adoptive family. This thesis will explore and discuss …

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

Co-Occurring Health Risks Among Middle Aged Hispanic Men Who Have Sex With Men (Hmsm) In South Florida, Beatriz Valdes

FIU Electronic Theses and Dissertations

In 2010, men who have sex with men (MSM) represented 4% of the population in the United States (US) and accounted for 78% of all new Human Immunodeficiency Virus (HIV) infections among Hispanic men. Hispanic men who have sex with men (HMSM) accounted for the third largest number of new HIV infections (6,700 cases). This dissertation explored the effects of age, loneliness, substance use, depression, and social support on high risk sexual behaviors that predispose middle aged HMSM to sexually transmitted infections (STIs) and HIV infection risk. A sample of 150 urban HMSM aged 40 to 65 were surveyed in …

The Role Of Primary Care Providers In Patient Activation And Engagement In Self-Management: A Cross-Sectional Analysis, Carmen Alvarez, Jessica L. Greene, Judith H. Hibbard, Valerie Overton

Nursing Faculty Publications

Background

The increasing burden of chronic illness highlights the importance of self-care and shifts from hierarchical and patriarchal models to partnerships. Primary care providers (PCPs) play an important role in supporting patients in self-management, enabling activation and supporting chronic care. We explored the extent to which PCPs’ beliefs about the importance of the patients’ role relate to the frequency in which they report engaging in collaborative and partnership-building behaviors with patients.

Methods

PCPs’ beliefs were measured using the Clinician Support for Patient Activation Measure (CS-PAM). We also assessed whether PCPs’ CS-PAM scores were positively associated with changes in their patients’ …

Maternal Perceptions To Open-Ended Questions About Life With Down Syndrome In Korea, Hyunkyung Choi, Marcia Van Riper

The Qualitative Report

In this study the authors explored maternal perceptions of life with Down Syndrome (DS) in Korea. Written responses to open-ended questions were collected as a part of a larger study and examined using content analysis. Most mothers commonly reported responses toward children with DS at both the societal and community level were negative. Many mothers acknowledged that even though there are ongoing challenges associated with being the mother of a child with DS, they have experienced unexpected joys as well. Increased awareness of cultural differences in beliefs and attitudes about children with DS and their care will help health care …

Waiting Room Health Promotion For Older Adults In Rural Primary Care, Emma G. Kopecky

College of Nursing and Health Sciences Nursing Master Project Publications

Background: Advances in health care technology have lead to adults living longer than in previous decades. Longer life expectancy in combination with the aging of the Baby Boomer generation is predicted to result in rapid and exponential growth among the older adult population. Adults in the U.S. over the age of 65 have on average five or more chronic illnesses, many of which are often poorly managed. Older adults who experience chronic diseases often report decreased quality of life, limitations in functional ability, loss of independence, and periods of decline and increasing disability. Health promotion efforts can help in delaying …

The Role Of The Community Health Worker: An Educational Offering, Kameron Escajeda

College of Nursing and Health Sciences Nursing Master Project Publications

Reducing health disparities among underserved and minority populations are an ongoing challenge for the United States’ health care system. The Affordable Care Act proposes the addition of a Community Health Worker (CHW) to the health care workforce to serve as a liaison between community and health services as a possible solution to improve quality and health outcomes in underserved populations. The newly formed health care team created in collaboration with the Visiting Nurse Association of Chittenden and Grand Isle Counties will welcome the CHW as a new team member to help improve the care and coordination of services for New …

Evaluating An Online Family Assessment Activity: A Focus On Diversity And Health Promotion, Paul Smith, Melissa Jones

Faculty Publications

This article describes the development, implementation and evaluation of a family assessment activity that was designed for a transition course in an RN-BSN program. The family assessment activity emphasized diversity and health promotion as key curricular concepts highlighted through the use of constructivist teaching strategies in the online classroom. The activity was developed and implemented by utilizing the Family Health Systems (FHS) approach to family assessment and Healthy People 2020 as a framework for family health promotion. The activity was evaluated through faculty observation and student feedback which is discussed in the article.

Rural India Women's Perception Of Health, Kaye Wilson-Anderson

Faculty Publications - College of Nursing

This qualitative, descriptive, phenomenological study explored how southern, rural women in India ( N = 14) view health, how they learned about health, and what health education they desired. Health education classes were offered, based on participants’ responses. Recommendations are offered for a best practice model that could potentially enhance the efforts of non-Indian nurses desiring to assist impoverished women and families in India.

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective …

Therapy Options For Winged Scapula Patients: A Literature Review, Samantha L. Normand

Honors Undergraduate Theses

Winged scapula is a condition characterized by lateral or medial protrusion of the scapula caused by nerve damage leading to muscular paralysis. The purpose of this systematic review of literature is to evaluate the current research literature related to the effectiveness of therapy options for winged scapula. Eleven peer reviewed English language research articles published from 1998 to present were included for evaluation. Study results revealed positive therapeutic outcomes for physical therapy and scapular bracing. Results also showed positive outcomes for the use of transcutaneous electrical nerve stimulation and acupuncture for the treatment of nerve related conditions similar to winged …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

Educational Intervention For Identification Of Metabolic Syndrome (Icd-10 E88.81): Presentation Of A Toolkit For Providers And Staff In Two Primary Care Settings, Sadie Russell

Doctor of Nursing Practice (DNP) Projects

Metabolic syndrome plays a vital role in present-day primary care. The ICD-10 diagnostic coding for this set of symptoms more comprehensively identifies patients with increased risk of cardiovascular events and comorbidities. Metabolic syndrome affects one-third of adults in the US and is defined as the presence of three of the following characteristics: abdominal obesity, hypertension, elevated triglycerides, low high-density lipoprotein, and elevated fasting plasma glucose. Proper screening for metabolic syndrome can identify complex patients before conditions like hypertension or type II diabetes develop. Management of metabolic syndrome emphasizes prevention and prioritizes lifestyle modifications as first-line treatment. Despite strong evidence supporting …

Improving Hpv Vaccination Initiation And Completion Rates: A Qi Project, Princy M. Varughese

Doctor of Nursing Practice (DNP) Projects

Human papillomavirus (HPV) is a common sexually transmitted infection in the United States and is the cause of most cervical cancers in women, as well as anogenital cancers, oropharyngeal cancer, and genital warts in both men and women (Centers for Disease Control [CDC], 2014b). The HPV vaccine is recommended for preteen girls and boys to protect against HPV infections (CDC, 2011). In line with the goal of Healthy People 2020, the purpose of this evidence-based quality improvement (QI) project was to implement a text message reminder system, and calculate the completion rate of the 3-dose HPV vaccination series among adolescents …

Management Of Adolescent Depression In The Primary Care Setting: An Educational Program For Providers, Kelly Clow

Doctor of Nursing Practice (DNP) Projects

Background: The prevalence of adolescent depression is estimated at 15-20% in the general population and often under-treated. The primary care provider is in a prime position to identify and treat depression in this age group. However, many providers feel uncomfortable with treating and managing depression in adolescents, due to a lack of education or experience. Purpose: The focus of this quality improvement project was to educate primary care providers on the current recommendations for the management of adolescent depression and provide an education sheet for both the medical and non-medical treatment of adolescent depression. An educational intervention was presented to …

Obesity Group Medical Visits, Brenda L. Jaeger

Doctor of Nursing Practice (DNP) Projects

Background: Obesity is a major risk factor associated with multiple chronic diseases, presenting a significant global health challenge. Current evidence supports that group medical visits, an alternative format for the provision of primary care, are effective in disease management.

Purpose: The goal of this project was to examine the effectiveness of group medical visits for the management of obesity in primary care.

Methods: Individuals with a BMI greater than 30 participated in a series of six multidisciplinary group medical visits over a 12-week period. Each session included a brief individual medical visit followed by group education and discussion. Topics …

Assessment Of Blood Pressure Control In Patients Diagnosed With Hypertension In A Primary Care Setting, Lauren Prince

DNP Projects

Purpose: To evaluate provider adherence to the current hypertension management guideline, JNC 8, by assessing blood pressure control in individuals diagnosed with hypertension in an internal medicine clinic.

Methods: A retrospective chart review was conducted to assess the percentage of patients diagnosed with essential hypertension meeting the blood pressure goals set forth in JNC 8. In the absence of blood pressure control, provider intervention was assessed. Data collected included blood pressure, use of home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three office visits. In addition, current …

Compliance With The 2015 American Diabetes Association Screening Guidelines For Diabetes Mellitus Type 2 In Primary Care, Krista L. Johnson

DNP Projects

Purpose: The purpose of this project was to evaluate provider use of hemoglobin (HgA1c) measurement as a method of screening for Type Two Diabetes Mellitus (T2DM) per the 2015 American Diabetes Association screening guidelines in a multidisciplinary primary care clinic in Kentucky.

Methods: A retrospective electronic medical record review was conducted in a large ambulatory care clinic. A master list was compiled of all patients aged 45-89 years who were seen for any reason the first week of November 2015. A total of 127 records that met inclusion criteria were randomly selected. The proportion of patients who were appropriately screened …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …