Health and Medical Administration Commons^™

Evaluation Of An Education Program Implementation For Adults With Stage 4 And 5 Chronic Kidney Disease, Dana Marie Carter

Dissertations

Abstract

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.

Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Aligning The American Health Information Management Association Entry-Level Curricula Competencies And Career Map With Industry Job Postings: Cross-Sectional Study, Susan H Fenton, David T Marc, Angela Kennedy, Debra Hamada, Robert Hoyt, Karima Lalani, Connie Renda, Rebecca B Reynolds

Faculty, Staff and Student Publications

BACKGROUND: The field of health information management (HIM) focuses on the protection and management of health information from a variety of sources. The American Health Information Management Association (AHIMA) Council for Excellence in Education (CEE) determines the needed skills and competencies for this field. AHIMA's HIM curricula competencies are divided into several domains among the associate, undergraduate, and graduate levels. Moreover, AHIMA's career map displays career paths for HIM professionals. What is not known is whether these competencies and the career map align with industry demands.

OBJECTIVE: The primary aim of this study is to analyze HIM job postings on …

The Mission System: An Electronic Health Record For Medical Treatment In Guatemala, Tawniece M. Curry

Dissertations

Abstract

Problem: The introduction of an electronic health record (EHR) system has become an essential component in monitoring and tracking patient information in most developed countries but are difficult to implement in underdeveloped countries. Guatemala is a country with poor health care and limited resources for patient tracking and monitoring. An organization in Guatemala, Nursing Heart Inc. (NHI), provides care to over 40 underserved rural communities but lacks the ability to monitor and track patient information. In order for NHI to properly monitor and evaluate their programs and track patients’ continuity of care, the introduction of an EHR system is …

Using Community-Based Participatory Research To Assess The Needs Of Hiv-Related Services For Infected Individuals In Rural Communities, Elizabeth Brown, Charles Brown, Owen Johnson, Wendelyn Inman, Revlon Briggs, Wanda Burrell, Rosemary Theriot, Elizabeth Williams, Alexis Heaston

Public Health, Health Administration, and Health Sciences Faculty Research

HIV/AIDS remains a significant health concern in rural communities, which may also experience many disparate issues including reduced access to health services (Department of Health and Human Services, 2015). Community efforts should be increased to improve services to people living with HIV/AIDS (PLWHA), especially in rural communities. In the state of Tennessee, using a community-based participatory research (CBPR) approach, a needs assessment was conducted to identify gaps, barriers, and strategies for improving HIV-related comprehensive care services for people diagnosed with HIV/AIDS in 26 rural counties. The paper describes the CBPR partnership and the needs assessment project that was conducted and …

Exploring Ohiohealth Employer Solutions Fitness And Wellness Team, Sammer Hamed

Masters Theses/Capstone Projects

Goal 1 I will apply the lessons learned from my coursework by becoming an advocate of corporate fitness and wellness through my research and program creation. Goal 2 I will improve my advocacy for health and wellness in the workplace by increasing my knowledge of workplace health and wellness with research. Goal 3 I will improve my understanding of the changes the pandemic had on corporate health and wellness by learning about the effects of COVID-19 on fitness in the workplace. Goal 4 I will learn about the workplace from a team perspective by integrating myself into the fitness and …

Comparison Of Unmet Health Care Needs In Children With Intellectual Disability, Autism Spectrum Disorder And Both Disorders Combined, K. Haller, Adrienne Stolfi, John Duby

Medical Education Faculty Publications

Background: The purpose of this study was to assess the unmet health care needs of children with intellectual disability (ID) compared with children with autism spectrum disorder (ASD) and whether access to health insurance coverage is a contributing factor. Children with ID may be masked in the health care system due to increased diagnosis and awareness of ASD. The needs, unmet needs and insurance coverage of children with ID alone, ASD alone, and co-occurring ID and ASD were assessed in this study.

Methods: The 2016 to 2019 United States' Census Bureau National Survey of Children's Health was used to determine …

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this July 2022 issue, the reader will find the following original content:

• A cover feature on negotiating reimbursement rates with PPO contracts.
• A cover feature on guarding against employee embezzlement.
• A 10-Minute EBD on rampant caries management and prevention with ADHD patients taking stimulant medications.
• A Back Page look at the 2022 MDA award winners.
• News you need: an Editorial, guidance on dental practice cybersecurity, and regular department …

Staff Matters: Independent Contractor Or Temporary Employee?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

Determining whether temporary hygienists should be classified as independent contractors or employees requires careful consideration. While treating them as independent contractors offers advantages, such as avoiding payroll taxes and paperwork, it must align with specific IRS criteria. The classification hinges on the degree of control the practice exerts over their work, encompassing behavioral and financial control. If the practice significantly controls aspects like duties, hours, and business aspects, it may be wiser to classify them as employees. The IRS provides a form (SS-8) to assess the relationship in-depth. Additionally, if hygienists request employee status and you cannot definitively prove otherwise, …

Evaluating The Extent Of Fall Prevention Knowledge Of Direct Care Clinicians In A Post-Acute Hospital Setting: A Quality Improvement Initiative, Joseph Henry Mitchell Jr

Doctor of Nursing Practice Projects

Background: Events, such as falls, continue to maintain permanence in countless public health settings and organizations, attributing to unnecessary resource utilization. Proven methods for mitigating fall occurrences transpire through reliable fall education and by creating programs that directly impact these incidents. These agendas are essential and can lessen undue stress, obligations, and associated fiscal liability.

Purpose: This DNP project aimed to ascertain and expand unit nurses' fall prevention strategy knowledge in a long-term acute care hospital, bringing awareness of evidence-based practices through a learning addendum.

Methods: This program, based on a descriptive, quasi-experimental, pre-, and post-analysis, strategically …

Implementing Antimicrobial Stewardship For Healthcare Providers In An Urgent Care Setting To Reduce Antibiotic Misuse For Respiratory Infections, Ashley Pauldin

Doctor of Nursing Practice Projects

Background: Antimicrobial resistance has been identified as a major threat by the World Health Organization (WHO), and antimicrobial stewardship is a key strategy to overcome resistance. A major contributing factor to this crisis is the inappropriate use of antibiotic prescriptions in outpatient settings. Although evidence-based guidelines on appropriate treatment for acute upper respiratory infections (URIs) have been developed, the need for improving provider and patient awareness and knowledge in the urgent care setting is critical.

Purpose: The purpose of the DNP project was to implement antimicrobial stewardship guidelines in the urgent care facility to decrease the misuse of antibiotic prescribing …

Utilizing Multimodal Communication Strategies To Improve Average Risk Women Veteran Patient Participation In Returning Colorectal Fecal Immunochemical Test Kits, Shuntae Hooten

Doctor of Nursing Practice Projects

Background: Cancer is one of the most dreadful diseases present in today’s world. It is responsible for millions of deaths worldwide. The disease is debilitating to one’s physical and emotional well-being. Cancer impacts not only the affected individual but also those close to them. When colorectal cancer is identified early via preventive screenings, it has a greater chance of responding to treatment, therefore, increasing the chances of survival. The fecal immunochemical test (FIT) kit plays a pivotal role in the early detection of colon cancer. Schreuders et al. (2016) revealed that FIT kits have better adherence, usability, and accuracy, citing …

Assessment Of Electronic Health Record For Cancer Research And Patient Care Through A Scoping Review Of Cancer Natural Language Processing, Liwei Wang, Sunyang Fu, Andrew Wen, Xiaoyang Ruan, Huan He, Sijia Liu, Sungrim Moon, Michelle Mai, Irbaz B Riaz, Nan Wang, Ping Yang, Hua Xu, Jeremy L Warner, Hongfang Liu

Faculty, Staff and Student Publications

Purpose: The advancement of natural language processing (NLP) has promoted the use of detailed textual data in electronic health records (EHRs) to support cancer research and to facilitate patient care. In this review, we aim to assess EHR for cancer research and patient care by using the Minimal Common Oncology Data Elements (mCODE), which is a community-driven effort to define a minimal set of data elements for cancer research and practice. Specifically, we aim to assess the alignment of NLP-extracted data elements with mCODE and review existing NLP methodologies for extracting said data elements.

Methods: Published literature studies were searched …

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

Red Flags And Risks: Unpleasant Surprises When An Office Manager Suddenly Leaves, David Harris Cpa

The Journal of the Michigan Dental Association

Losing an office manager can pose significant challenges for dental practices. This article delves into the red flags and potential risks that may accompany an office manager's sudden departure, shedding light on the importance of understanding the circumstances surrounding their exit. The article highlights how embezzlement can be a reason behind unexplained departures and emphasizes the need to assess the situation more deeply. It explores account ownership issues that can hinder practice owners from accessing crucial business information, particularly in embezzlement investigations. The article recommends proactive measures for practice owners to secure access to vital accounts to prevent potential issues …

Negotiating Reimbursement Rates With A Ppo Plan, Dana Moss

The Journal of the Michigan Dental Association

Dentists often struggle to negotiate reimbursement rates with dental insurance companies. This article discusses the importance of managing reimbursement from benefit plans and highlights the advantages and disadvantages of participating in insurance networks. It provides a step-by-step guide to negotiating insurance allowances effectively, emphasizing the need for preparation, data analysis, and communication skills. The article suggests ways to maintain profitability in practices with a significant PPO patient base. It includes recommendations for keeping fees balanced, choosing negotiation plans, and building relationships with insurance representatives. The emotional aspects of negotiation are also addressed, promoting a respectful and collaborative approach.

Quality And Transparency, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

In a recent JDR Clinical & Translational Research report, the American Dental Association's clinical practice guidelines (CPGs) were determined to offer high-quality guidance for the dental profession. The study employed the AGREE II tool to validate the ADA's guidelines’ methodological rigor and transparency, ensuring their quality. This external review is promising for the profession, as it indicates that the ADA has developed reliable CPGs that support advocacy and implementation. However, the article raises questions about consumer-targeted quality scores for dentist providers, such as DentaQual by P&R Dental Strategies LLC. It suggests that for such scoring systems to be credible, they …

Dentistry And The Law: Risk Of Employment Discrimination In Job Advertisements, Dan Schulte Jd

The Journal of the Michigan Dental Association

Employment discrimination in job advertisements that include religious references, such as statements like "faith-based practice" or symbols like crosses, is a legal concern. Federal and Michigan state laws, particularly the Elliot Larson Civil Rights Act (ELCRA), prohibit discrimination in employment, encompassing various protected classes. ELCRA applies to all employers in Michigan, regardless of their size. Violating ELCRA can lead to legal consequences, including injunctive relief and compensatory damages. Including such references or symbols in job ads can be used as evidence against employers in discrimination claims, even if rejected candidates have lesser qualifications. Publishers of these ads are also at …

Analysis Of An Antibiotic Stewardship Program For Asymptomatic Bacteriuria In The Veterans Affairs Health Care System, Larissa Grigoryan, Aanand D Naik, Paola Lichtenberger, Christopher J Graber, Payal K Patel, Dimitri M Drekonja, Timothy P Gauthier, Bhavarth Shukla, Anne E Sales, Sarah L Krein, John N Van, Laura M Dillon, Sylvia J Hysong, Jennifer R Kramer, Annette Walder, David Ramsey, Barbara W Trautner

Faculty, Staff and Students Publications

IMPORTANCE: Antibiotic stewardship for asymptomatic bacteriuria (ASB) is an important quality improvement target. Understanding how to implement successful antibiotic stewardship interventions is limited.

OBJECTIVE: To evaluate the effectiveness of a quality improvement stewardship intervention on reducing unnecessary urine cultures and antibiotic use in patients with ASB.

DESIGN, SETTING, AND PARTICIPANTS: This interrupted time series quality improvement study was performed at the acute inpatient medical and long-term care units of 4 intervention sites and 4 comparison sites in the Veterans Affairs (VA) health care system from October 1, 2017, through April 30, 2020. Participants included the clinicians who order or collect …