LAIR: Lenoir-Rhyne Academic Institutional Repository
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Bridging the Gap in Knowledge Deficit in Type-2 Diabetes among Hmong Americans
Get PDFThe Hmong from Laos are among the most recent groups to seek refuge in the United States, with Catawba County of North Carolina becoming home to the fourth-largest Hmong resettlement. However, in adopting the western lifestyle, their traditional meals are being frequently replaced by fast food, and this has led to a higher percentage of persons with at-risk body mass index (BMI) and therefore an increased risk for diabetes among the Hmong Americans. Their current at-risk BMI prevalence is higher than Caucasian Americans and other Asian Americans. There is a lack of diabetes education and support programs for this English as a Second Language (ESL) population. To improve their quality of life and provide them with the necessary support and education required to prevent the complications associated with type 2 diabetes (T2DM), a culturally dynamic Hmong diabetes self-management and support program was designed. The results reveal that after participating in the program, the participants’ diabetic knowledge improved, and they had fewer unhealthy days than before program implementation
Improving the Screening for Substance Use Disorders in Emergency Department Patients: A Quality Improvement Project
Get PDFThis quality improvement project aimed to connect emergency department (ED) patients with substance use disorders (SUD) to community resources for assistance with treatment options. This was achieved by promoting the screening of patients as they presented to the ED by the nurses. This project was conducted through a system change that introduced an information card about the community resources to the ED for distribution to patients with positive SUD screenings. This system change also included modifications to the electronic health record (EHR) that allowed the nurses to document when the information card was offered to patients. An in-service session describing the system change was held for the nurses and included education on SUD screening and strategies to approaching this topic with patients. The outcomes for this project were measured through chart reviews and a qualitative analysis collected from the nurses on the system change
Nursing Stroke Education Pathway (NSEP): A Quality Improvement Project to Enhance Documentation Accuracy and Compliance
Get PDFQuality improvement project determining if the system change of implementation of the Nursing Stroke Education Pathway (NSEP) in the electronic health record improved nurse adherence with use of pathway and increased nurse confidence in education documentation
Sex & Sexuality Module II: Self-Expression, Community and Identity
Get PDFSex & Sexuality, Module II: Self-Expression, Community, and Identity published by Adam Matthew Digital is a collection of digitized primary sources obtained from archives in the United States, United Kingdom, and Australia with content from the nineteenth to twenty-first centuries “showing the shifting attitudes and varied experiences of sexuality”. While covering the full range of human sexuality, the collection primarily focuses on the LGBTQ+ experience. This module will be a beneficial resource for academic programs studying gender and human sexuality at the undergraduate and graduate levels. Users seeking more current, global primary and secondary resources on gender, women’s, and LBGTQ+ topics may find ProQuest’s GenderWatch a more suitable choice. Those seeking information on sexuality from the sixteen to mid-twentieth centuries or a more global perspective from the nineteenth to twenty-first centuries may prefer modules three and four respectively of Gale’s Archives of Sexuality & Gender
Program TESA - Human Trafficking: Education, Screening and Action
Get PDFHuman trafficking in the United States and worldwide is a growing problem. Millions of men, women and children are victims of human trafficking each year. Victims of human trafficking are often vulnerable due to a number of factors, to include emotional problems, social instability, and economic difficulties. Fear of traffickers and the trauma the victims are subjected to make them reluctant to seek help, even in settings oriented to care, such as hospitals and medical practices.1 Studies have found up to 88% of victims of human trafficking are seen in an emergency department during their captivity. Emergency department providers can play an essential role in identification and response to a victim. Improving the knowledge of emergency department providers on recognition and reporting victims of human trafficking is one of the most important ways to intercede with this vulnerable population.2 Objective: The goal of this project was to determine if a human trafficking quality improvement program named Trafficking, Education, Screening and Action (TESA) could create a system change that will improve the identification of human trafficking victims through education, screening tools, and algorithm implementation
TEMPLES: A Faith-based Intervention to Increase the Quality of Life of Women with Cardiovascular Disease
Get PDFHeart disease is the leading cause of death for Americans. Advanced health care providers located in rural North Carolina implemented a six-session faith-based intervention, called TEMPLES. Evidence-based health-improvement measures, combined with spiritual guidance, promoted both faith and health during six online classes. The four volunteer healthcare professionals who led the TEMPLES implementation were interviewed after the program, and a content analysis revealed their thoughts regarding personal spiritual growth and satisfaction with program implementation. Mean scores on the WHOQOL-BREF quality of life tool increased significantly (p < .001) after the program for the 31 participants
Motivational Interviewing to Improve Provider Outcomes in Treating Childhood Obesity
Get PDFBackground: Childhood obesity has become a public health crisis, straining the healthcare system. Top healthcare organizations have identified pediatric primary care providers as pivotal in treating and addressing childhood obesity. Objective: To determine if an interdisciplinary pediatric primary care-based motivational interviewing quality improvement program can improve provider outcomes in treating childhood obesity. Methods: Pediatric primary care providers in two rural clinics were trained in motivational interviewing directed at childhood obesity. All recruited providers received the intervention, and implementation took place over 12 weeks. A retrospective chart audit was conducted. Results: There was a post-implementation increase in providers’ confidence in using motivational interviewing, engaging in discussions, and obtaining patient and parent/caregiver buy-in. Most participants were satisfied with the program, likely to recommend it, and use motivational interviewing. Conclusions: The use of a motivational interviewing training program led to improvements in provider outcomes. The program was beneficial in addressing pediatric obesity and engaging in difficult conversations with patients and families. Implications for Nursing: Motivational interviewing can have tremendous positive health outcomes for pediatric patients. Offering training in motivational interviewing would prove beneficial to healthcare providers and patients
Screening and Intervention to Reduce Alcohol and Substance Use in the Adolescent Population
Get PDFThe National Youth Risk Behavior Survey (2018) reported that in North Carolina, approximately 25% of adolescents currently drink alcohol and 18% currently use marijuana. Adolescent alcohol and substance use influence academic performance, personal safety, and mental health. Many adolescents are not screened in the primary care setting (PCS) for alcohol and substance use. Methods: Standardized alcohol and substance use screening and interventions were implemented in a pediatric PCS. The interventions were motivational interviewing and referrals, based on the screening results and discretion of the providers. Descriptive statistics evaluated tool usage, adherence to interventions by the providers, population demographics, and categorized substances used. Secondary outcomes were measured by Spearman’s Correlation analysis that evaluated the association between the PHQ-9M score and CRAFFT risk. Findings: The CRAFFT screening tool version 2.1 and interventions were successfully implemented in a pediatric PCS. A very weak association was found between PHQ-9M score and CRAFFT risk. Conclusion: The quality intervention project provided a standardized process for alcohol and substance use screening. The project is sustainable due to its simplicity and EHR documentation. Keywords: substance use/abuse; adolescent; quality improvement, teen PHQ-9, CRAFFT version 2.1
Pioneers of German-Polish inclusive exchange: Jaczewski’s and Kluge’s Europeanization in education despite the Iron Curtain
Get PDFHistorical and autobiographical approaches are combined with interviews to analyze the case of the Europa-Kontakt in pre-1989 Poland and West Germany within the framework of Europeanization. The international education encounters exemplify the tendencies to Europeanize, which emerged in both countries despite the Iron Curtain. The painful relationship between Poland and Germany is contrasted with the personal trust and cooperation between Polish and German exchange pioneers since the 1970s. Their pioneering work focused on multinational inclusion, participation, intercultural learning, gifted education, creativity, and building leadership skills. It merged German adaptation of the United States’ HighScope model with philosophy of encounters typical of scouting tradition, Janusz Korczak’s pedagogy, and Carl Rogers’ humanistic psychology, preparing ground for the 1989–2004 European Union enlargement process
Implementation of the Seattle Heart Failure Model In a Specialty Cardiology Clinic
Get PDFBackground: Due to the increasing complexity of caring for heart failure patients and identifying those patients that are in need of palliative care referrals or advanced therapies, an order set was created to guide the decision-making process of those individuals. Methods: A mixed method design using qualitative pre- and post-surveys were used to measure the providers perception of using the model within their practice. Findings: The limited participation of providers in the project implementation site rendered the results of this project inconclusive. Reflections on two case-based patient encounters is provided to demonstrate the use of the Seattle Heart Failure Model with patients who have been diagnosed with heart failure. Conclusions: Integration of the Seattle Heart Failure Model order set within in the electronic health record of the entire cardiology practice was a strong first step for encouraging implementation of the tool throughout the system for all providers who see patients diagnosed with heart failure. Further projects that are disseminated system-wide to educate providers about this evidence-based tool are needed