Primary Care Commons^™

Introduction Of Hiv Point-Of-Care Testing In Adolescent Primary Care: A Quality Improvement Project, Jennifer Quinn Belfry

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: HIV, first identified in 1981, remains a persistent public health problem affecting 1.1 million Americans today. Detection is a critical first step to ending the HIV epidemic and the CDC recommends universal HIV screening for all patients 13-64 years of age regardless of risk factors. HIV screening rates are suboptimal especially in adolescent and young adult populations who face unique barriers to screening. The aim of this project was to improve HIV screening rates in adolescent and young adult patients at a large, urban FQHC.

LOCAL PROBLEM: In the state of Rhode Island, 1 in 10 persons living with …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Implementation Of The Stop-Bang Screening Tool In The Primary Care Setting: A Quality Improvement Project, Thriciana Powell

DNP Projects

Significance and Background. There are approximately 25 million adults in the United States with obstructive sleep apnea (OSA). OSA is a sleeping disorder that is caused by periodic airflow blockage during sleep. It has been linked to numerous health problems and within the primary care setting OSA is not routinely screened for at visits. This leads to delayed diagnosis of a serious health issue and the potential for poor health outcomes. The STOP-BANG questionnaire (SBQ) is a simple eight-question tool that is used to screen patients for OSA. The STOP section focuses on snoring, tiredness, observed apnea, and high blood …

Mental Health Disorders And Psychotropic Medication: Prevalence And Related Characteristics Among Individuals In Foster Care, Jill Mcleigh, Lauren Malthaner, Madeline Tovar, Mohsin Khan

Behavioral Health/Developmental Delay

This study sought to provide prevalence data for mental health (MH) diagnoses and psychotropic medication prescriptions among individuals in foster care and to examine their relationships with physical health status, maltreatment type, placement type, and demographic variables.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Evaluating The Impact Of A No-Show Policy: A Quality Improvement Project, Adrianne S. Harding

DNP Projects

Significance and Background: No- shows are a global problem that creates a significant challenge for the healthcare system. When a patient misses an appointment, it decreases health care staff productivity, creates a waste of resources and it negatively impacts revenue (Lance et. al, 2021). Current evidence supports interventions that incorporate voluminous data and artificial intelligence with strategies such as overbooking, appointment notification systems and financial incentives to reduce outpatient no-shows (Oikonomidi et al., 2022). This project will evaluate the impact of a no-show policy and provide insights to improve primary care attendance and inform decisions.

Purpose: To evaluate an outpatient …

A Survey Of Medical Student Experiences During The Covid-19 Pandemic, Stephanie Gappy, Girish Nair, Dwayne Baxa

Posters

During the COVID-19 pandemic, medical students switched from an in-person to virtual curriculum. This shift placed stress on medical schools to find alternatives to train students. Students relied on recorded lectures, emails, and video-conferencing to stay up-to-date with schoolwork. Understanding student experiences during the pandemic will help prepare students and administrators for repeat lockdown events. The goal of this study is to understand the experiences of medical students during the pandemic.

Covid-19 And Depression And Anxiety Screening In Primary Care, Elizabeth Bernier, Abrey Feliccia, Leah Wood, Kate Herlihy, Kristen A. Woodberry

Costas T. Lambrew Research Retreat 2023

Introduction:

• The COVID-19 pandemic had a severe effect on mental health, heightening the prevalence and severity of anxiety and depression amongst the general population in rural and non-rural areas, particularly youth.

• Most reports draw from available data from mental health referrals, hospitalizations, suicides, and other incident data

• There is limited longitudinal information from general population samples using standardized mental health assessments.

Optimizing Collaboration Among Clinical Pharmacy Specialists And Behavioral Health Providers In The Primary Care Setting To Increase Mental Health Access, Ryan Ferris, Christine Doran, Bonnie Jiron, Dara L. Johnson

Providence Pharmacy PGY2 Program at Providence Medical Group 2023

No abstract provided.

The Impact Of Pharmacy Led Education On The Management Of Heart Failure With Preserved Ejection Fraction In The Primary Care Setting, Laura Kays, Ben Rosati, Trevor Laursen, Maurice N. Tran

Providence Pharmacy PGY2 Program at Providence Medical Group 2023

No abstract provided.

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Chronic Wound Management; Surgical Therapy And Complementary Nursing With Manuka Honey, Georgeta Paunică-Panea, Sergiu Teodorescu, Aurelia Preda, Laura Elena Gligor, Adrian Silaghi, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Objectives. This study aims to analyze the evolution of chronic wounds treated both surgically and by complementary nursing using Manuka honey. The parameters monitored were: presence/persistence of bacterial infection, the duration of healing, the recovery period and the patients' quality of life. Materials and Methods. The study group and the control group each consisted of 10 patients, aged between 50-60 years, with chronic wounds of various etiologies but without other significant systemic pathologies. Data collection was carried out through anamnesis, physical examination and analysis of medical documents. Results. In the study group, the depth of the wound was reduced rapidly …

Matrix Gla Protein – A New Marker For Colorectal Cancer Detection? A Systematic Review, Mirela-Georgiana Perné, Lorena Ciumărnean, Olga-Hilda Orășan, Vasile Negrean, Teodora-Gabriela Alexescu, Mircea Vasile Milaciu, Ioana Roșca, Răzvan Dan Togănel, Gabriel Emil Petre, Lucia Procopcoiuc, Cristina Drugan, Alexandra Crăciun

Journal of Mind and Medical Sciences

Background. Colorectal cancer is a real public health issue, with high morbidity and severe impact on quality of life. Although mortality from this type of cancer is decreasing due to modern diagnostic and treatment methods, the understanding of its genetic and molecular mechanisms is important to develop a broader range of diagnostic and therapeutic approaches. Genetic therapy is an important strategy in cancer treatment, and the matrix Gla protein (MGP) gene expression has been described in numerous studies as increased in tumour pathology. In this article, we have summarized the currently available evidence on the connection between MGP and colorectal …

Anxio-Depressive Disorders In A Pandemic Context: A Comparative Analysis: Year 2019 Versus 2020, Andreea Roxana Droahnă, Lavinia-Alexandra Moroianu, Valeria-Anca Pietroșel, Cristina Ioana Bica, Teodor Salmen, Cecilia Curis, Emanuele Maria Merlo, Roxana Adriana Stoica, Marius Moroianu

Journal of Mind and Medical Sciences

The outbreak of SARS-CoV-2 pandemic has resulted in increased rates of anxiety and depression worldwide. Objective. To comparatively evaluate factors associated with the psychological impact of Coronavirus disease between 2019 and the pandemic year 2020. Materials and Methods. The study was performed on a group of 3224 patients, of which 197 were hospitalized, selected from Jan 1st 2019 until 30th Dec 2020 in a tertiary care center for psychiatric disorders. Data were collected from the observation charts. Results. The incidence of anxiety disorders is higher in the age range 40-70 years with an average value of 53 years old. In …

Management Of Pelvic Pain Caused By Endometriosis, Denisa Oana Balalau, Ioana Andreea Ciupitu, Delia-Maria Bogheanu, Alexia-Ioana Ghiocel-Zariosu, Cristian Balalau, Liana Ples, Daniela Gabriela Bălan, Ioana Paunica, Marina-Romina Sima

Journal of Mind and Medical Sciences

Endometriosis is a disorder of the epithelium and/or endometrial-like stroma outside the endometrium and myometrium, usually with an associated inflammatory process. It mainly affects young women of reproductive age, the prevalence being estimated at approximately 10%. Due to the varied clinical symptoms marked by chronic pelvic pain, dysmenorrhea, infertility, dyspareunia, dysuria, endometriosis requires a complex treatment. Endometriosis is a major health problem with socioeconomic impact, which is why many gynecological societies have published different guidelines to assist clinicians in the diagnosis and treatment of endometriosis. The variety of available treatments combined with the complexity of this disease leads to significant …

The Role Of Primary Care In Improving Population Health, Kurt C. Stange

Faculty Scholarship

In widely quoted ecological analyses, primary care is associated with population health. Not only with population health, but with health equity, health care quality, and lower health care expenditure - a pretty good definition of value. Yet, there is a paradox about primary care. Despite these desirable population‐level attributes, at the disease level at which we typically measure, incentivize, and organize the work of health care, when assessed with one‐disease‐at‐a‐time quality measures, primary care does not perform as well as care focused on a single disease. What is going on here? In caring for patients’ individual diseases, primary care appears …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey

Evidence-Based Practice Project Reports

Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

“Healing Can Be A Very Jagged Line”: Reflections On Life As A Covid-19 Long Hauler, Leah M. Hecht, Rhonda Adams, Danielle Dutkiewicz, Debbie Radloff, Mallory N. Wales, Jeffory Whitmer, Dana Murphy, Sara Santarossa

Journal of Patient-Centered Research and Reviews

“Long COVID” — a term referring to COVID-19-associated symptoms and conditions (ie, sequelae) that remain or emerge after resolution of a SARS-CoV-2 infection — is a multifaceted condition about which little is known. As part of formalized patient-engaged research at a large Midwestern health system, patient stakeholders with long COVID (N = 5) wrote stories based on their lived experience, as this was their preferred format for detailing their experience with the condition. These patient stakeholders reviewed one another’s stories, identified relevant quotes, and provided opportunities for elaboration. Independently, a trained researcher extracted quotes from the stories, identified themes, and …

Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens

Doctoral Projects

Diabetes mellitus continues to grow in global prevalence and consumes an increasing amount of healthcare resources. Persons that live in disadvantaged groups have a higher prevalence due to a lack of understanding and access to care. Diabetes is one of the leading causes of chronic disease and limb loss worldwide. Diabetes foot care is essential, as diabetes can be dangerous to patients’ feet.

The purpose of this doctoral project was to increase diabetic foot care education and foot exams for staff and providers in a federally qualified health center (FQHC). Many people in this rural community do not understand the …