Public Health and Community Nursing Commons^™

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

A Practical Understanding Of Preeclampsia For A Nurse In A Third World Setting, Anna Lovin

Senior Honors Theses

Preeclampsia is a disease of pregnancy that affects approximately 3-5% of women with child. It is one of the primary causes of mortality in mothers and babies across the globe. The exact cause, pathogenesis, or disease progression is unknown. Therefore, there is no definition of which patients are at risk for developing preeclampsia and what can work as a preventative measure. In high socioeconomic settings where there is good healthcare, standard treatment is established to manage the symptoms and decrease the progression of preeclampsia to eclampsia. However, in more rural, third-world settings of developing countries, caring for patients with preeclampsia …

A Multi-Component Education, Skill, And Resource Evidence-Based Practice Intervention For The Alzheimer’S Caregiver, Cheryl Garmon

DNP Final Reports

Abstract

Dementia caregiving is expensive, stressful, and consumes all facets of the caregiver’s (CGs) life. The purpose of this project is to introduce the evidence-based practice (EBP) interventions most helpful in decreasing stress and burden in those who are in-home caregivers for Alzheimer’s disease and related dementias (ADRD) individuals.

The three primary intervention domains of the EBP studies that results in a positive impact are; providing education about the terminal course of the disease, introducing communication and caregiving skills, and furnishing resource and social network information.

The methodology included a convenient and voluntary population of CGs who sought service at …

Early Identification Of Frailty Predictors In A Vowed Religious Community Of Catholic Men: A Strategy For Successful Aging In Place, Julia Senn-Reeves

Graduate Theses, Dissertations, and Capstones

Background: The population in the United States is aging and experiencing age- and disease-related changes, leading to increased frailty, as well as increased disability, morbidity, and mortality. Timely recognition of these vulnerabilities, and intervention implementation, are crucial to prevent adverse outcomes and to support successful aging in place. Purpose: The purpose of this project is to develop and implement a multifaceted assessment process to identify early predictors of frailty among members of a vowed religious community of Catholic men to ultimately support successful aging in place. Participants: A single vowed religious community of Catholic men in the United States, living …

Implementation Of A Nurse-Led Transitional Care Model For Older Adults With Copd Admitted To Home Health, Michelle Ryan Hunt

Doctor of Nursing Practice Projects

Problem Description: The importance of management of chronic disease and preventing rehospitalization has been identified at national and local levels. Chronic obstructive pulmonary disease (COPD) is one of the chronic diseases with notable rates of emergency department use and recurrence of hospitalizations.

Rationale: Implementation of transitional care models have been successful for health care organizations in chronic disease management.

Interventions: The health-social partnership transitional care management program (HSTCMP) was used to design a transitional care model process pilot for a home health agency (HHA) within a health system. This process used a multidisciplinary team led by a registered nurse for …

Increasing Physical Activity In Hispanic Adults To Reduce Complications Of Type 2 Diabetes, Linda C. Valenzuela

Doctor of Nursing Practice Projects

Problem Description: Adults in the United States do not exercise sufficiently to meet the specifications outlined in the 2018 Physical Activity Guidelines (U.S. Department of Health and Human Services, 2018). The Office of Disease Prevention and Health Promotion’s (2018) Healthy People 2020 aims to eliminate health disparities and achieve health equity among all population groups in the United States. However, statistics from the U.S. Office of Minority Health (2014) indicate that Hispanics are twice as likely to be diagnosed with type 2 diabetes as non-Hispanic whites. According to a Centers for Disease Control and Prevention (CDC) report in 2015, …

The Role Of Resilience And Preparedness In Nurses Working During Hurricane Disasters, Julie George

Nursing Theses and Dissertations

Problem: Resilience is the ability to “bounce back” from adversity and can serve as an avenue for nurses to recover from the disaster and subsequent potential issues related to coping with the event. To date, very little is found in the literature specific to nurses and how they adapt to and recover from disasters in their personal or professional lives.

Theory: Taormina’s (2015) theory of adult personal resilience and Veenema’s disaster management model (World Health Organization [WHO] and International Council of Nurses [ICN], 2009) provided the foundation of this study.

Hypothesis: It is hypothesized that levels of personal and professional …

Advance Directives In Primary Care, Andrew T. Vincent

Scholars Week

Advanced Directives are one of the most important documents in the health care system. An advanced directive is a “living will” that describes medical ambitions for the patient’s end-of-life care. The idea of end of life can be stressful for patients, families and health care professionals, and advance directives guide these participants into making end-of-life decisions organized. A dilemma occurring in health care includes patients arriving to emergency departments and critical care areas without an advance directives. A policy was introduced to initiate AD conversation prophylactic to extreme injury or impending death.

Osteoporosis Education: Success In A Community Setting, Cathy H. Abell, Maria E. Main, Maire M. Blankenship, S. Renea Watkins

International Journal of Faith Community Nursing

The purpose of the quasi-experimental study was to examine the effect of a community educational offering on attendees’ knowledge of osteoporosis as measured by the Osteoporosis Knowledge Test. A statistical significant difference was noted between the pretest and post-test means (p = .000). The findings demonstrate that a brief educational session can increase knowledge regarding osteoporosis. Development of partnerships with community populations to provide opportunities for health education can be valuable in promoting healthy behaviors.

Describing Transitional Care Using The Nursing Intervention Classification: Faith Community Nursing, Deborah J. Ziebarth, Katora Campbell

International Journal of Faith Community Nursing

Abstract

Objective(s)

Faith community nurses (FCNs) provide transitional care to community patients following discharge from acute care facilities. Study objectives: describe transitional care using a standardized nursing language, Nursing Intervention Classification (NIC) and compare transitional care interventions to those considered to be evidenced-based.

Sample

Two years of de-identified intervention data captured from the FCN’s documentation of transitional care.

Design

A mixed method descriptive design was used to facilitate a thorough exploration of the interventions. A qualitative descriptive method operationalized the concepts regarding transitional care interventions performed. A quantitative descriptive design was used to count nominal categories of documented nursing interventions. …

A Pre And Post Survey To Evaluate Patient Perception Of Group Diabetes Self-Management Education In Rural Health Clinics, Stormy Carter, Ashleigh Heter

Posters

Diabetes is a significant clinical issue in the primary care setting. Providers struggle to overcome barriers to facilitate therapeutic interventions for populations served. The specific aim of this study was to assess group diabetes self-management education from a patient perspective. Evaluation of diabetes knowledge and self-efficacy confidence was conducted in rural primary care clinics using pre and post surveys. This study utilized a one-group pretest-posttest design to patients receiving group diabetes self-management education in Southeast Kansas rural primary care clinics by a certified diabetes educator. The surveyed population included individuals ages 18-65 with prediabetes, type I, or type II diabetes …

Bringing Truth To The Table: An Evidence Review To Dispell Common Dietary Myths, Madison Pierce

Senior Theses

Background/Significance

Nurses are most directly involved with patient care and are in an excellent position to be patient educators. Patients are more likely to actively listen after establishing rapport, especially for loaded topics such as lifestyle choices. While nurses have general nutrition knowledge, they may lack current, scientifically-based information to help patients implement a healthy diet. Nurses can both educate and be an example of health habits that patients should emulate, and therefore need to be adequately informed about topics like dietary misconceptions.

Purpose

The purpose of this project is to provide current evidence-based information regarding dietary misconceptions to nurses …

Follow-Up Among Homeless Patients At San Francisco General Hospital: Examining The Social Determinants Of Health, Robert Gnat

Doctoral Projects

The San Francisco General Hospital emergency department has a high occurrence of homeless patients that are lost to follow-up after discharge. This Doctor of Nursing Practice project conducted a survey to evaluate the social determinants of health among this population and how they influence the participant’s ability to follow-up. This is the first phase of a three-phase project involving assessment and evaluation. The second and third phases of this project will center on intervention and re-evaluation after intervention. The survey was administered to eligible participants who presented to the emergency department at San Francisco General Hospital. Fifty participants were surveyed …

Pathways To A Sustainable Community Health Worker Program In A Rural Native American Community, Hannah R. Duby

Doctoral Projects

Introduction: American Indian/Alaska Native (AI/AN) people have some of the greatest health disparities of any other citizen group in the U.S. (National Indian Health Board [NIHB], 2018). As liaisons between community members and health services, community health workers (CHWs) play an important role in reducing disparities in AI/AN communities (Indian Health Service [IHS], 2018). CHWs in the organization of interest are not being used to their full potential as the documentation of their care is not accessible to the primary care providers (PCPs) for care coordination and the program is threatened by issues related to sustainability.

Objectives: The purpose of …

Screening For Social Determinants Of Health In Diabetic Patients Served In Primary Healthcare Centers, Hewan K. Chekol

Doctoral Projects

Background: Social Determinants of Health (SDOH), such as food, transportation, housing, and financial status, plays a significant role in a diabetic patient’s health care outcome. However, primary healthcare centers lack a systematic method of identifying patients with unmet social needs in order to provide appropriate referrals to community resources.

Objective: This project seeks to improve the screening methods of SDOH in a midwestern federally qualified primary healthcare center by incorporating an evidence based SDOH screening tool. This SDOH screening tool is tailored towards diabetic patients.

Method: Kotter’s Eight Step Change model guided the implementation process of this quality improvement project. …

Improving A Midwestern Community Mental Health Organization's Smoking Treatment Services For Individuals With Serious Mental Illness, Leah J. Magnuson

Doctoral Projects

Tobacco smoking is the leading cause of preventable death in the United States. Billions of dollars are lost yearly in direct and indirect healthcare costs as well as lost work productivity due to smoking. While smoking rates have declined among those of the general population, they remain high among those with serious mental illness (SMI). Many of those with SMI desire to quit and are able to quit smoking when they are provided with appropriate interventions and resources. It is recommended for those with SMI to receive combined interventions in the form of pharmacotherapy and cognitive behavioral therapy to help …

Implementation Of The Vaccines For Children Program In A Midwest, Urban Clinic Dedicated To The Underserved Population, Akmal Saydazamov

Doctoral Projects

Background: Low immunization rates weaken herd immunity and endanger children. The Safety Net Health Clinic (SNHC) study site serves an underprivileged and refugee population with significantly lower than ideal coverage. Series completion disparities persisted after control for demographic, access-to-care, poverty and language effects (Varan et al, 2016).

Objectives: SNHC implemented the Vaccines for Children (VFC) program in order to increase the vaccination rates among the underserved population.

Methods: As an efficacy study, the project focused on three major areas in the VFC implementation – cost, staff preparedness and patient need. Cost was determined by utilizing electronic medical records (EMR) and …

Development Of A Process For Adoption And Attainment Of Pcmh Recognition Requirements For An Urban Primary Care Clinic, Jamie L. Hendricks

Doctoral Projects

The Centers for Disease Control and Prevention (2017) reported that in 2016, healthcare expenditures in the United States totaled 17.9% of the gross domestic product. Unfortunately, care quality is not reflective of the high costs of care. Models of care delivery like the patient centered medical home (PCMH) have shown promise in addressing these concerns.

This project focused on program development for PCMH adoption at an urban clinic in an effort to improve financial stability and remain competitive. The purpose was to propose a plan for adoption and attainment of PCMH recognition requirements for an urban primary care office.

The …

Using Technology-Driven Patient Communication Appointment Reminders To Improve Uniform Data System Measures In A Federally Qualified Health Center, Ana Torres

Doctoral Projects

Background: Process of meeting Uniform Data System (UDS) measures in a west Michigan Federally Qualified Health Center (FQHC) has several components with different team members sharing responsibility in the process and workflow to document preventative screenings. An evidence-based technology-enhanced patient communication intervention was developed to meet benchmarks for the FQHCs UDS reporting metrics. The purpose of this quality improvement project was to answer the clinical question: Will technology-enhanced communication appointment reminders using automated telephone communication increase rates of screening follow-up visits to improve data reported to UDS at a west Michigan FQHC organization?

Objectives: Increase percentage of screening visits after …

Implementing Use Of The Moss (Michigan Opioid Safety Score) Tool And Interventions To Reduce Opioid-Related Overdose Events In High Risk Patients, Michelle J. Kloss

Doctoral Projects

Opioids are among the most common pharmacological class of therapeutic medications prescribed to alleviate pain across all healthcare settings. However, opioid-related adverse events are a growing problem contributing to an increase in morbidity and mortality. Current hospital practice does not utilize a pre-opioid administration screening tool to assess patient risk of adverse events related to opioid administration. The implementation of the Michigan Opioid Safety Score (MOSS), an evidence-based risk assessment tool which utilizes patient characteristics as well as respiratory assessment for the prediction and early detection of opioid-induced adverse events. This quality improvement project evaluated the effectiveness of the MOSS …

A Need For A Culturally Congruent Obesity Intervention At A Community Safety-Net Clinic, Claudia D. Rivera-Salas

Doctoral Projects

Background: Obesity is an epidemic in the United States which causes numerous chronic conditions and disproportionally impacts underserved populations. The removal of barriers that prevent active lifestyles such as unaffordable facilities and inaccessibility are of primary importance in promoting a healthy lifestyle.

Objectives: Collaboration with community organizations to increase access to culturally congruent nutrition and exercise classes for underserved Latino/Hispanic patients of a Midwestern safety-net clinic to reduce obesity, increase physical activity, and improve dietary habits.

Methods: Assessment of current practices revealed the need for project development. Six-week nutrition education class and exercise classes were held for eligible patients which …

Evaluating The Effectiveness Of Diabetes Class: A Project To Improve Quality Metric Measures, Miriam O. Russell

Doctoral Projects

Background: Diabetes is a significant health issue worldwide. Its increasing prevalence globally and regionally has been documented. Consequently, complications have resulted in higher morbidity and mortality in patients with diabetes (Martin & Lipman, 2013). The lack of education on self-managing diabetes can lead to serious complications. An effective approach, including evaluating and enhancing diabetes education, is necessary to improve diabetes self-management (Johnson & Raterink, 2009).

Objectives: To provide evaluation of a diabetes education class through quality measures and create a toolkit that will enhance the impact on the current diabetes education class.

Methods: A retrospective chart review that analyzes five …

Is There A Relationship Between Limited English Proficiency (Lep), Medication Adherence Behaviors, And Adverse Asthma Outcomes In Hispanic Adults With Moderate To Severe Persistent Asthma?, Archana Kartik Chandra

Doctoral Projects

The effects of LEP are well documented in the literature. LEP decreases medication adherence, causes ineffective communication between patients and providers, and reduces health outcomes. Asthma is known to be misdiagnosed and under-treated in Hispanic adults. There are discrepancies in the literature about the effects of LEP in Hispanic adults with persistent asthma.

The purpose of this study was to determine if the presence of LEP is associated with medication adherence behaviors and adverse asthma outcomes in Hispanic adults with moderate to severe persistent asthma. Hispanic adults with LEP were assessed for asthma outcomes and medication adherence behaviors.

The results …

Effects Of Sexual Health Interventions On The Sexual Health Behaviors Of Young Adults, Zoe Lang

Grace Peterson Nursing Research Colloquium

No abstract provided.

Built Food Environment And Perinatal Depression: An Integrative Literature Review, Rachel N. Mileski

Grace Peterson Nursing Research Colloquium

Background: Built food environment contributes to food access and insecurity, which impactsmaternal health due to increased rates of perinatal depression.

Objectives: The purpose of this integrative literature review will be to (1) identify contributing factors of built food environments in communities that increase the rate of perinatal depression and (2) evaluate the current intervention programs and methods addressing these factors in order to provide recommendations for further research.

Method: An integrative literature review will be used, in accordance with the Ecological Model, to evaluate contributing factors and suggestions.

Results: Findings from this integrative literature review revealed a link that connects …

Improving Rural Pediatric Patient Management Through Streamlined High-Volume Patient Clinical Pathways Enhanced By Standardized Nursing Education For Care Confidence, Marie-Cassandre O. Macdonnell

Doctoral Projects

Rural America creates a challenging, poorly financed environment for pediatric health. More than 20 million Americans live in areas with physician shortages too great to meet basic health need (Petlz et al., 2013). In comparing rural versus urban data, rural population experience a 7% higher rate of chronic health conditions (44% versus 37%), increased inpatient costs ($8, 507 versus $7, 174) and higher odds ratios for pediatric 30-day readmission. Findings from Khan et al., (2015) note that hospital readmission rates have higher odds ratios in pediatric patients (95% CI); of Caucasian ethnicity 0.74 [0.65–0.84] to 0.88 [0.79–0.99]); when admitted to …

Nonalcoholic Fatty Liver Disease And The Pnpla3 Gene, Lori Houghton-Rahrig, Debra Schutte, Jenifer I. Fenton, Jennifer Awad

Peer Reviewed Articles

Nonalcoholic fatty liver disease (NAFLD) is a rapidly emerging worldwide public health concern strongly associated with obesity, insulin resistance/diabetes type 2, and the metabolic syndrome (Younossi et al., 2011). It is the most common cause of liver disease in the world (World Gastro - enterology Organisation [WGO], 2012). Defined as a total liver weight comprised of more than 5% fat, NAFLD can progress from simple fatty liver disease to nonalcoholic steatohepatitis with or without fibrosis, liver cirrhosis, liver cancer, or liver failure resulting in premature death (Levene & Goldin, 2012). The development and progression of NAFLD is influenced by genetic …

The Lived Experiences Of Parenting Children With Food Allergies: A Phenomenological Study, Anne Zavell

Dissertations

This phenomenological study focuses on five mothers' experiences of the phenomenon of living with a diagnosed food allergy in the family. Attention is given to the contexts or situations that have typically influenced or affected their experiences, including the impact of the diagnoses, travel and restaurants, friendships, sibling relationships, and anxiety. There is a major emphasis on these mothers' experiences advocating for the needs of their children in schools, including their strategies, concerns, and frustrations. Policies related to food allergies are reviewed from the contemporary and historical perspectives, with recommendations for policy change. The lived experiences of food allergy mothers …

Organizational Wellness Programs As Internal Social Marketing: A Literature Review Of Feasible Approaches, Faith Bontrager Rn, Bsn, Kimball P. Marshall Ph.D.

Atlantic Marketing Association Proceedings

No abstract provided.

The Lived Experience Of Spiritual Well-Being Amongst Informal Caregivers Of Persons With Dementia On Palliative Care Living At Home, Michael Baumgardner

Dissertations

Title. The Lived Experience of Spiritual Well-Being Amongst Informal Caregivers of Persons with Dementia on Palliative Care Living at Home.

Purpose.This study explored the lived experience of spiritual well-being amongst informal caregivers of a person with dementia who were living at home and enrolled in palliative care.

Background. Patients with dementia comprise the third leading diagnosis in palliative care patients and many receive informal care from family members. Palliative care improves quality of life in patients and their informal caregivers. However, little is known about spiritual well-being in the setting of caregiving of persons with dementia on palliative care. …