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Shared Medical Appointments for Type 2 Diabetes Management in Hispanic Adults
No full textHispanic adults living in the United States carry a disproportionate burden of type 2 diabetes (T2DM) and face many socio-economic and cultural barriers to effective disease management. The purpose of this quality improvement study was to evaluate the effectiveness of a shared medical appointment (SMA) model at improving diabetes outcomes in Hispanic adults with T2DM. This study was conducted at a single site, and utilized a one-group, pretest-posttest design. Participants were limited English proficient, Hispanic adults with hemoglobin A1c > 8%, who were patients at a free clinic in southwestern Wisconsin. Six SMAs were conducted over a 5-month period. Six participants completed the study. Steps per day, A1c levels, self-care behaviors, and qualitative interview data were collected. Participants responded favorably to the SMA model, reporting satisfaction with the peer support and learning opportunities. Participants did not demonstrate statistically significant improvements in A1c, steps per day, or self-care behaviors. Challenges and barriers to effective implementation of an SMA model for Hispanic patients with T2DM in a free clinic setting were identified. Given the high levels of patient satisfaction with the SMA, future work should identify strategies that empower Hispanic patients to improve diabetes self-care behaviors within the SMA model
The La Crosse Girlchoir: How Local Clubs Build Civic Engagements
No full textThis project explores how the La Crosse Girlchoir builds a sense of community among those involved. Focusing on the Apple Pie Bake, we will look at how the choir involves the outside community
Elder Abuse and Neglect: What We Can Do To Make A Difference
No full textThe problem of elder abuse and neglect is prevalent in Wisconsin, and even in La Crosse County. There are an increasing number of older adults in our society, and this is not going to change anytime soon. This issue has been occurring for many years, but it was not thoroughly discussed or brought to the public’s attention until the 1970s. The issue of elder abuse and neglect had been a hidden issue before this time. Recognition and knowledge of the issue has grown, but the problem of elder abuse continues and goes underreported. Only 1 in 24 cases are reported to the appropriate authorities (Weingarden, 2023)
OB Nest Optimization: Addressing Documentation Burden
No full textThe electronic health record (EHR) and the use of patient portals have become commonplace. Documentation burden has been reported as a consequence of the EHR. OB Nest is a model of prenatal care that reduced the number of in-office visits by implementing virtual visits completed with a registered nurse (RN). The model increased the time RNs spent with OB Nest patients versus usual care patients. Required documentation for OB Nest patients was attributed to the additional time. A quality improvement project was implemented to decrease perceived documentation burden among RNs and decrease manual care coordination by 25%. A care registry was developed to improve documentation efficiency for OB Nest visits. A single group pre- and post- intervention survey (BurDoNsaM survey) was administered to measure perceived documentation burden among RNs conducting OB Nest visits. Time in minutes spent on OB Nest visits was recorded by the participants pre- and post- intervention. Four out of 5 RNs participated. Pre-intervention, 2 RNs slightly disagreed that the volume of documentation impeded patient care while 2 agreed. Reduction in perceived documentation burden could not be determined as no post-intervention surveys were returned. Manual care coordination in minutes per patient visit increased by 19.4% pre- to post- intervention. The RNs cited automatic entry of vital signs as a theme for reducing documentation. Development of a platform to allow patient entry of vital signs to flow into the EHR would be an excellent next step. Keywords: electronic health record, documentation burden, registered nurse, OB Nes
The Effectiveness of Workplace Nutrition Counseling on Improving Employee Nutritional Knowledge and Biometric Measures
No full textNutrition has been identified as a key component in preventing chronic disease however, there remains little research that has examined the effect of dietary interventions specifically, and there is little to no research examining what type of nutrition interventions are most effective at changing dietary habits in the context of a workplace wellness program. This study aimed to determine if nutrition counseling provided in a workplace setting will increase employee nutritional knowledge and improve biometric measures. Participants were asked to complete a modified general nutritional knowledge survey and have baseline biometric measures recorded. The intervention consisted of nine one-on-one nutrition counseling sessions over 12 weeks. At the close of the study, participants repeated the modified general nutritional knowledge survey and the biometric measurements. Among the 18 participants, there were 15 females and 3 males with a mean age of 46.47 [+/- 14.5] years. Of all participants, 33% completed all nutrition counseling sessions, 56% completed less than half nutrition counseling sessions, and 11% withdrew from the study. The intervention showed no significant effect on participant biometric measures or the number of correct responses to the nutritional knowledge survey. There was, however, a statistically significant effect on the number of ""I don't know"" responses (P = 0.01) recorded on the modified general nutritional knowledge survey. The results illustrate that nutritional counseling may improve employee perception of nutritional knowledge, however more research is needed to determine the efficacy and impact of nutritional counseling in the workplace
Promoting Counselor Wellness: A Mindful Response to Covid-19-Related Stressors
No full textThe purpose of this study was to explore whether the introduction of a four-week mindfulness-based intervention into a counseling program accredited by the Council for Accreditation of Counseling and Related Programs (CACREP) could increase wellness and reduce compassion fatigue, secondary traumatic stress, and burnout in clinical mental health counseling students enrolled in an internship. A single-subject-research design was used to collect pre-and post-test data, which indicated that while counseling education students who engaged in mindfulness-based practice did not experience a change in overall wellness, several second-order and third-order wellness factors that indicated significantly positive increases. Comparison scores pre- and post-test for Burnout and Secondary trauma remained consistent, with a noted decrease in the Compassion Satisfaction score. Independent of research results, was the low participant response rate (38%) and high attrition rate (60%). Students electing not to participate in the research study stated the thought of engaging in a structured wellness activity actually exacerbated their level of stress. Comparison wellness scores from prior research of counselor education students indicated the total wellness of participants in this study was significantly lower than that of counselor education students prior to the COVID-19 pandemic. These findings are important for professional counseling because the American Counseling Association (ACA, 2014) the Association for Counselor Education and Supervision (ACES, 2011) emphasize the ethical obligation of counseling supervisors, counselors, and counselors-in-training to prioritize self-care practices in order to prevent burnout. Integrating mindfulness education and mindfulness-based practices into counselor education programs can support students in prioritizing wellness. Keywords: wellness, counselor education, mindfulness-based stress reduction, mindfulness, COVID-19 mental health implications
Healthcare and Wellness Management Internship: Breidanbach Sports and Family Chiropractic
No full textIntroduction - Position: Administrative Intern; Site: Breidenbach Sports & Family Chiropractic; Site Supervisor: Nancy Nunemacher; Hours: 165.5. Learning Outcome - Collaboration and Teamwork: Learners demonstrate an understanding of how individuals influence organizational behavior and demonstrate the ability to work in teams
Assessment of Medical Provider's Knowledge of Dietitians and the Referral Process
No full textSeveral studies have reported the underutilization of dietitians despite the numerous benefits they and nutrition care have on healthcare. This disconnect in the healthcare system was examined through an online survey targeted at providers in a position to make these referrals. Providers were asked 12 multiple choice and free response questions to further understand their accessibility, knowledge of, and utilization of dietitians. Twenty-two participants (Doctor of Medicine, Doctor of Osteopathic Medicine, nurse practitioners, and physician's assistants) completed the survey. Most providers reported less than ten percent of their medical schooling was nutrition focused. With providers receiving little nutrition education it is important patients receive the proper care when necessary, however nearly 75 percent of respondents reported a low referral rate as less than a quarter of their patients were referred daily. To fix this issue providers were asked what would allow them to increase their referral rate, most respondents suggested an increase in education regarding the benefits and role of nutrition in healthcare. Improvements can be made to the referral process by making guidelines with nutrition screeners and educating providers on nutrition services. The Academy of Nutrition and Dietetics can continue to advocate for the profession and inform providers of the benefits and services provided by this field. More research is needed to find the optimal number of dietitians needed by a facility to allow for adequate accessibility