LAIR: Lenoir-Rhyne Academic Institutional Repository
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Relationship Centered Care for Caregivers: Long-Term Care Integration
Get PDFThe purpose of this project was to determine if a relationship centered care quality improvement (QI) program based on practicing relationship centered care (RCC) could improve workplace satisfaction and caregiver burden scores for all healthcare providers in a long-term care facility. A sample of all healthcare workers were recruited from a long-term care (LTC) facility in a rural community to participate in this prospective study with a 3-month follow-up. The primary outcome measures were workplace satisfaction and caregiver burden
Undergraduate Nursing Education: Culturally Competent Care Coordination for a Vulnerable Population
Get PDFBackground: Educating undergraduate nursing students to perform care coordination and practice with cultural competence are important considerations for nursing programs. Method: This project, designed to enhance undergraduate nursing education, introduced cultural competence learning modules into the curriculum and a clinical experience developing care plans for vulnerable patients in a community clinic. Students completed pre- and post-intervention surveys related to cultural awareness and responded to guided reflection questions following their clinical experience. Results: Survey analysis indicated statistically significant improvement in student’s perception of their cultural awareness overall. Guided reflection content analysis revealed themes related to understanding the role of nursing in care coordination, working with interprofessional teams, and increased mindfulness related to vulnerable patients. Conclusion: Enhanced education for undergraduate nursing students related to cultural competence and a clinical experience providing care coordination for vulnerable patients enhanced students’ cultural awareness and understanding of care coordination as a professional nursing role
Intervention Strategies Aimed at Mealtime Difficulties for Children Diagnosed with Autism Spectrum Disorder
No full textChildren diagnosed with ASD oftentimes struggle with sensory overloads, leading to difficulties with mealtime behaviors. These difficult mealtime behaviors come in many form and have varying impacts on parents and how to address management of mealtime difficulties. By utilizing a survey design, data was collected through social media and analyzed for both quantitative and qualitative results about a child's eating preferences. Through the data collected in the survey, it was shown that children with ASD had picky food preferences and often exhibited unwanted behavior during mealtimes. The finding of this study revealed some similarities and differences between previously published research
Identification of Opioid Overdose Risk in Primary Care
Get PDFBackground: The Centers for Disease Control and Prevention (CDC) estimates an average of 41 deaths per day resulting from opioid use. Identification of patients at risk of overdose or opioid induced respiratory depression (OIRD) is the primary modality of preventing opioid related deaths. Measures: This study is a quality improvement project of mixed design. Responses were gathered from participating providers and a chart review of qualifying patients. Intervention: To determine patient OIRD risk, physical assessors were identified in order to assess patients who met the inclusion criteria of the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD). Outcomes: The primary outcome measures were the level of satisfaction of providers who applied the RIOSORD tool. Secondary outcome measures were the identities of at-risk patients who were identified using the RIOSORD tool. Conclusions/Lessons Learned: Assessors were unanimous in their approval of the RIOSORD and several patients were identified as being at high risk of OIRD
Increasing Screening for the Use of Long-Acting Reversible Contraception
Get PDFThe purpose of this project is to determine if a contraceptive screening tool utilized by care providers in a primary care practice would increase patient selection of long-acting reversible contraceptives (LARC) as a contraceptive choice. Methods: The family nurse practitioner at a rural women's health practice in North Carolina was given an educational presentation on the safety and efficacy of LARC methods and appropriate utilization of the screening tool. Ancillary office staff who had direct contact with patients were also educated on the administration of the screening tool to eligible participants. A chart review was then performed to determine screening tool adherence and LARC uptake during project implementation. Results: Overall adherence to the screening tool was approximately 20%, with 30% of women screened choosing a LARC method. Analysis demonstrated a weak correlation between screening tool use and LARC uptake. The small sample size and low rates of adherence may limit the generalizability of this project. Conclusions: Outcomes for this project demonstrated a poor relationship between LARC screening and the selection of LARC as a contraceptive choice. Numerous limitations may have affected project outcomes. This project highlights the need for further research to bridge the gap between LARC education and LARC choice in the primary care setting
Telemedicine and COVID-19: An Investigation of the Perceived Impact on Medical Professionals in Rural and Urban Areas
No full textTelemedicine use has increased substantially since the beginning of the COVID-19 pandemic. Though it has been widely implemented, its accessibility has been a barrier in rural healthcare communities in comparison to urban healthcare. Telemedicine can be defined as the electronic exchange of medical information through a variety of digital mediums. The sudden spike in telemedicine usage in the past year has clearly exposed the weaknesses of this mode of medicine in both rural and urban areas. The main focus of this study is to assess the attitudes and perspective of medical professionals in rural and urban communities as it relates to telemedicine and the COVID-19 pandemic. This will be done through a survey sent out to a variety of medical professionals in a quantitative format. From this study, it was found that the COVID-19 had a major impact on the use of telemedicine in the surveyed communities. Even more so, the majority of participants had a positive attitude toward telemedicine, after experiencing it throughout the pandemic
Improving Identification of Prediabetes and Undiagnosed Diabetes in Primary Care
Get PDF84.1 million Americans over 18 have prediabetes, with 88.4% of those individuals remaining undiagnosed. Early diagnosis and treatment of prediabetes can prevent or deter Type 2 Diabetes Mellitus (T2DM). The American Diabetes Association (ADA) screening guidelines for T2DM focus on symptomatic individuals 45 and older. No standard risk assessment tool is in place for screening prediabetes and T2DM for asymptomatic, non-pregnant patients 18-44 years of age. Methods: Non-pregnant patients aged 18-44, without a diagnosis of prediabetes or T2DM, completed the ADA Diabetes Risk Test (ADADRT) during intake. ADADRT scores of 5 or greater received behavioral modification education and provider referral for diagnostic testing using A1C or fasting plasma glucose (FPG). Providers documented referral for testing and education provided in EHR. Patients with lab values in the prediabetes or T2DM range were notified of results and scheduled for a two-week return appointment, at which time providers used the treatment algorithm to determine the proper treatment. Interventions: ADADRT was used to guide providers on appropriate referrals for diagnostic testing and patient education. Lab results and the treatment algorithm determined appropriate treatment. Results: Staff administered the ADADRT to a convenience sample of 53 patients meeting participant criteria the ADADRT. Provider use of the ADADRT was documented 100% from the date of implementation. Secondary outcomes show the use of ADADRT increased proper screening for prediabetes and undiagnosed T2DM in the 18 – 44-year-old patient population by 19%. Fourteen at-risk patients were identified and received appropriate education and referral for diagnostic testing. Six patients had laboratory findings in the prediabetic range, received 100% follow-up and a treatment plan. Conclusions: ADADRT is effective as an assessment tool and improved patient identification for risk for prediabetes and T2DM. The provider educated at-risk patients on the benefits of behavior modification, ADA diet, and exercise recommendations and referred patients for diagnostic testing. Provider and patient discussed treatment options using the treatment algorithm provided. Keywords: prediabetes, risk assessment, evidence-based practice, prevention, diabete
Telehealth at Community-Based Palliative Care
Get PDFThis DNP quality improvement (QI) project implemented telehealth at a Community-Based Palliative Care (CBPC) in response to the global COVID-19 pandemic. CBPC is an essential service and it was critical to continue providing services during the pandemic (Calton et al., 2020; Etkind et al., 2020; The Lancet, 2020). This project measured CBPC provider's perception of the utility of using telehealth to provide CBPC services in response to the global COVID-19 pandemic. Telehealth is the delivery of health services using information and communication technology (Monaghesh & Hajizadeh, 2020; Smith et al., 2020). The project used mixed methods of qualitative and quantitative research. Provider perception of telehealth was measured using anonymous open-ended survey questions and content analysis. Process and symptom measures were collected using the Palliative Care Qualitative Collaborative (PCQC) Data Registry and chart review. The goal was to use telehealth during the pandemic to maintain and improve the quality and integrity of palliative care services
Telemedicine and COVID-19 An Investigation of the Perceived Impact on Medical Professionals in Rural and Urban Areas
No full textTelemedicine use has increased substantially since the beginning of the COVID-19 pandemic. Though it has been widely implemented, its accessibility has been a barrier in rural healthcare communities in comparison to urban healthcare. Telemedicine can be defined as the electronic exchange of medical information through a variety of digital mediums. The sudden spike in telemedicine usage in the past year has clearly exposed the weaknesses of this mode of medicine in both rural and urban areas. The main focus of this study is to assess the attitudes and perspective of medical professionals in rural and urban communities as it relates to telemedicine and the COVID-19 pandemic. This will be done through a survey sent out to a variety of medical professionals in a quantitative format. From this study, it was found that the COVID-19 had a major impact on the use of telemedicine in the surveyed communities. Even more so, the majority of participants had a positive attitude toward telemedicine, after experiencing it throughout the pandemic
Dana Foundation
Get PDFA review is presented of website located at "https://www. dana.org/." of Dana Foundation which offers information on neuroscience, and brain research