804 research outputs found
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Diabetes Education and Management
Get PDFPurpose: Implementation of a diabetic self-management and education program based on the 2017 national standards of care.
Background: Empowering patients with the knowledge to manage their diabetes in conjunction with health care provider’s recommendations is essential. The American Association of Diabetes (2012) and American Association of Diabetic Educators (2017) have deemed the use of diabetic self-management education and support as the highest level of evidence based practice to prevent and effectively manage the long-term complications of diabetes (Burke, Sherr & Lipman, 2014).
Methods: The project was implemented at a family practice clinic in south San Antonio. A diabetic self-management and education team was identified and worked to improve the current diabetic education curriculum provided in established classes in order to match the 2017 national standards. Previously, only select patients enrolled in an external healthcare funding grant were referred to attend these classes. This project also improved the provider referral process and patient scheduling system to allow all patients the opportunity to attend. Project evaluation included weekly review of provider diabetic education referral rates and patient attendance in scheduled classes.
Results: The project improved the number of patient referrals for diabetic education from 0% to 11%. A sustainable diabetic education and self-management program was created to adhere to evidence based practice guidelines.
Implications for Practice: The implications for practice identify how collaboration to implement evidence based practice guidelines for diabetic education can be incorporated into a primary care setting and in a cost-effective and sustainable fashion
Screening, Brief Intervention, and Referral to Treatment for Alcohol Misuse in Primary Care
Get PDFAn annual average of 88,000 deaths in the United States from 2006 to 2010 has been attributed to alcohol misuse, defined as risky or heavy alcohol consumption. Heavy or risky alcohol use for all adults aged 65 and older and for women aged 18 and older is defined as consuming more than 7 drinks per week and/or 3 drinks per day. For men aged 18 to 65 years of age, heavy or risky alcohol use is defined as consuming more than 14 drinks a week and/or 4 drinks a day. Chronic alcohol misuse increases the incidence of heart problems, cognitive decline, hypertension, liver problems, and cancer. It is recommended to screen and treat patients for alcohol misuse in the primary care setting. The purpose of this project was to increase alcohol misuse screening and intervention for adults aged 18 years and older in an internal medicine practice. A screening and treatment protocol was established to align with the United States Preventive Services Task Force clinical recommendation guidelines. This protocol consisted of screening using the Alcohol Use Disorders Identification Test, brief intervention, and referral to treatment. During project implementation, 420 patients were screened and of those screened, 18 patients (4.3%) were positive for alcohol misuse. Of those that screened positive, 9 patients (50%) received brief intervention and verbal education in which 3 patients (33.3%) received educational handouts. Two patients were considered severe risk and both received brief intervention, refused the recommended referrals for psychiatric care, and considered follow-up treatments with the primary care physician. This project demonstrates that screening for alcohol misuse and providing brief intervention is feasible to implement in the primary care setting. Alcohol misuse awareness allows primary care providers to empower patients with the right tools to make informed decisions to their health
Implementing the Hyperlipidemia Statin Use Guideline in Patients With Diabetes Mellitus
Get PDFPurpose. To implement an evidence-based hyperlipidemia guideline for statin therapy use with diabetic patients. Background. In the United States, cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity for women and men with diabetes. Dyslipidemia is a modifiable risk factor for CVD and one of the leading drivers behind the development of coronary artery disease. In 2014, the American Diabetes Association issued a new recommendation guideline for using statins as a primary intervention for CVD in patients aged 40–75 with diabetes. Despite advances in prevention and treatment guidelines, the American College of Cardiology and ADA have identified a substantial gap in hyperlipidemia guideline implementation across clinical settings. Methods. Patients with diabetes were identified and assigned a statin dose based on their risk factors for atherosclerotic CVD. Patients with a history of clinical atherosclerotic CVD were initiated on a high-dose statin therapy, whereas those with no history of CVD were initiated on a moderate-dose statin therapy. Follow-up was conducted at 6 weeks. Outcomes. Out of 122 diabetic patients, 61 (46.5%) were newly started on a statin, 33 (27%) had their statin corrected to the proper dose, 28 (23%) were on the proper statin dose already, and 8 (3.5%) were ineligible for a statin. All patients (100%) taking a statin tolerated their dose and experienced no adverse effects. Implications for Practice. Bridging the gap between research and practice can be successful with careful implementation of a system that can be followed to improve outcomes
HIV Screening in Non-Pregnant Patients Age 13 – 64 Years Old in Primary Care Through the Implementation of the CDC Guidelines for HIV Screening
Get PDFAs many as 216,000 people living with HIV are unaware they have the disease. In order to combat the inadvertent spreading of HIV, the CDC recommends screening everyone 13 – 64 years of age. The purpose of this Quality Improvement project was to implement the 2015 Sexually Transmitted Diseases Treatment Guidelines as it pertains to HIV screening within a Southeast Texas rural health clinic. The objectives were 1) educating all staff and patients regarding the CDC recommendations for HIV screening, and 2) increase the number of eligible patients who were offered and received HIV screening. A colored checklist served as a data collection tool and reminder for HIV screening. Education was presented to providers and patients via handouts with each provider completing a pre and post-tests after completion. Of the 518 eligible patients, 284 had a checklist completed. Of those, 54.8% of patients were offered HIV testing and 13 patients had HIV labs completed. There was a 42.2% increase in documented HIV screenings during the 6-week implementation period. Some limitations for the project were staffing changes, provider vacations, lack of understanding on the need for testing, funding, and facility stressors. HIV awareness and the recommendations for screening assists in removing the stigma surrounding this disease. More patients who are aware of their status will aid in decreasing the inadvertent spreading of HIV and allow for early treatment
Employee Influenza Immunization: Education and a Directive to Increase Immunization Rates
Get PDFPurpose: The aim of this quality improvement project was to improve the influenza vaccination rate of health care workers at an ambulatory care center to meet the national benchmark of 90%.
Background: Influenza is a communicable disease that affects over 130,000 people causing 7,000 deaths (CDC, 2017b). Over the last 3 years the influenza immunization rates at the facility of interest have been on a downward trend despite multiple interventions, resulting in 43% last season. A directive was published at the beginning of the 2017-2018 influenza season mandating each employee to either get a vaccine or decline in writing. This directive resulted in a formal grievance filed by the union causing a delay in enforcement.
Methods: An intense effort to improve the immunization rate was undertaken in collaboration with the Occupational Health employees. Staff were educated with a script that would be utilized for employees who declined the influenza immunization. Employees who were not immunized by week 1 of the project were tracked by the Occupational Health team for directive adherence and provide face-to-face communication to encourage immunization.
Results: At the end of the influenza season the health care immunization rate increased to 86% (n = 883)
Conclusion: Having a one-on-one interaction with individuals who had not made an immunization decision provided the opportunity for education and administration of the immunization if desired. With increased compliance, documentation, and education the project obtained overall success despite unexpected challenges
The Effects of Fashion Trends on the Perceptions of School Uniforms
Get PDFWhile the effects of school uniforms have been studied, a gap exists within the literature, which includes the effects of fashion trends inspired by schoolgirl uniforms. The purpose of this ethnographic pilot study was to fill the gap within the literature on the practice and transgressive use of female school uniforms and to determine the need for a larger study, while researching if schoolgirl-inspired fashion trends influence the perspectives of women who wore school uniforms as children. Eight participants were interviewed one on one about their experiences and their perceptions of school uniforms and the fashion trends they inspire. All of the participants were women between the ages of 18 and 39 and wore school uniforms in elementary, middle, and/or high school. The data shows that half of the participants acknowledged the existence of sexual connotations associated with schoolgirl-inspired trends. However, the majority of the women stated that the trends and their connotations do not impact their perception of either the uniform’s meaning or purpose. In conclusion schoolgirl-inspired trends appear to have minimal impact on the perceptions of women who wore the uniform, however other effects may exist. Further research in the form of a larger study is needed to further explore these implications
Organizational Leadership Preparation: An Exploration of Recently Ordained Roman Catholic Priests
Get PDFResearch Focus. This qualitative study explored the expectations and the experiences of recently ordained Roman Catholic priests as leaders in their parish communities. Leadership preparation of Roman Catholic priests is an important issue. Roman Catholic priests, by following the example of Jesus Christ, and as described in Apostolic Letters, Decrees and Apostolic Exhortations from the Vatican, would appear to be expected to be the personification of a good leader. Thus, the question is posed as to what newly ordained priests thought the leadership expectations would be, and what their experience has been.
Research Methods. This basic interpretive qualitative study explored perceptions of leadership, both expected and experienced by 10 newly ordained Roman Catholic priests within a Catholic Archdiocese in the Southwestern United States. Semi-structured open-ended questions were used. The data was collected from interviews, transcribed, themes identified, documents analyzed and a domain analysis conducted. Spradley’s Developmental Research sequence was implemented to conduct a domain analysis that was in-depth, allowing an opportunity to reveal the complexity of a given culture.
Research Results/Findings. Leadership by example, presence, servant-leader, and pastoral leadership were the most frequent terms mentioned in the interviews to describe leadership approaches. In each parish community and in each diocese, as in the post-Vatican II Catholic Church, more participative management is encouraged. As a result, for a new pastor, leadership has become more challenging. The evidence indicates that leadership preparation in the traditional secular sense is not a deliberate aim of the seminary. However, pastoral leadership is an essential part of priestly formation. In every interview, participants suggested or implied that additional leadership preparation would have been very useful. Even priests with past business experience suggested that so many of the leadership requirements are unique to the position of parish pastor that additional preparation is essential.
Conclusions from Research. The best place to develop needed leadership skills is during internship. Carefully selecting pastors who are willing and able to provide training in those skills is essential. Not every pastor is so inclined or able to provide training. Providing each intern with a superior experience in a parish community and with a pastor who is excited about teaching the intern is an investment in the quality of future priestly ministry, not a luxury
Motivations of NCAA Student Athletes in Community Service
Get PDFResearch Focus. Research is ongoing around the United States on volunteer motivations; however, NCAA student athletes remain an understudied population. This quantitative study investigated the motivations of NCAA student athletes in community service to determine if the importance of motivational functions differ demographically. The specific purpose of this study was to examine and determine the order of the motivational function of importance for NCAA student athletes in connection to their participation in mandatory community service. Determining if the importance of motivational functions differ demographically by gender (male, female), academic classification (freshman, sophomore, junior, senior, graduate students), and by sport type (team, individual) was an additional focus of this study. The research aimed to contribute beneficial insight and establish base knowledge regarding the importance of the motivational functions of NCAA student athletes in community service.
Research Methods. The instrument used in this study is the Volunteer Functions Inventory (Clay et al., 1998), developed to understand the motivations of volunteers; demographic questions were also asked. The VFI categorizes individuals’ motivations for volunteering into six different functions; values, understanding, enhancement, career, social and protective. The authors of the inventory have established reliability and validity of the VFI (reported later). SurveyMonkey was used to collect demographics and VFI responses from NCAA student athletes who were listed on a current roster at the University of The Incarnate Word. The 150 student athletes participating in the study included 90 female and 60 male; this total population included 40 freshman, 33 sophomore, 36 junior, 28 senior, and 13 graduate level students. Data were analyzed using IBM SPSS (IBM, 2016) predictive analytic software and Microsoft Excel. Descriptive statistics (frequencies, percentages, means, and standard deviations), independent t-test, and ANOVAs were used to explore significant differences between function by gender, academic classification, and sport type. An independent sample t-test was used to compare the means of different demographic variables to determine whether there was statistical evidence that the associated population means were significantly different. ANOVA tests were used to identify if any demographics differ from each other. Data analysis equality of variance in all cases was checked and homogeneity of the variances was confirmed through a Levene’s test. Since data met the assumptions of homogeneity of variances, a post Tukey’s HSD was used when the ANOVA analysis identified a difference between groups.
Research Results/Findings. Findings conclude participants (N = 150) scored the motivational functions in the following order of importance: Values, Understanding, Career, Enhancement Social and Protective. Females scored all but one motivational function higher than males, indicating that females may be more inclined to volunteer. The Social function showed statistical differences in the academic classification with freshman compared to both junior and seniors. The Social function additionally identified a statistical significance in female freshman and female juniors. Male seniors reported the lowest mean score on all functions. Male seniors showed statistical differences for Value and Enhancement compared to male freshman and juniors.
Conclusions from Research. This study may provide insight into what motivates current student athletes to participate in community service and identifies demographic differences within functions. Student athletes in this study did not directly benefit from the results of this study but may be indirectly affected when it is used for future community service events. This study align with literature in females reporting higher mean scores on most of motivational functions (Chesbrough, 2011; Metz, McLellan, & Youniss, 2003), suggesting females are more inclined to volunteer than males (Sullivan et al., 2013). The high level of importance for the social function in males suggests that they are more motivated by team events and working with others rather than independently. Male seniors were identified as a population with the lowest level of motivation to complete community service
The Development and Integration of Community Engagement in Graduate Education
Get PDFThis study, framed by Kolb’s experiential learning theory, explored the intentions, perceptions, and understanding of graduate faculty and staff on community engagement. Questions have arisen as to whether students with advanced degrees are entering the job market with sought-after skills. In response, universities have continued to seek program improvements to enhance quality learning experiences to better prepare them for what follows after graduation. Within higher education, community engagement programs have been identified as an approach to respond to challenges as they have been shown to add substance, meaning, and value to students’ learning.
An epistemological case study was conducted to better understand how graduate faculty and staff viewed the roles of graduate education and community engagement within their environments and how community engagement could be developed and integrated into graduate programs at a private faith-based University in south Texas. This approach also provided the opportunity to understand the “how” and “why” of a particular phenomenon that is both complex and contemporary in nature rather than historical.
Domain and taxonomic analyses of interviews revealed five main topics: the purpose of graduate education; how practicums provide engagement opportunities; serving others; the role of reflection; and, barriers limiting further engagement practice. Findings indicated that engagement makes a difference in what students learn; however, topics that emerged from the data expressed complex perspectives as to how engagement should function within graduate education. Continued exploration on these topics is likely to yield benefits to students with corresponding and reciprocal benefits to the University and the communities it serves.
The data revealed a willingness to support the inclusion of community engagement practices in graduate programs at a private faith-based University in south Texas. However, there was no clear indication to suggest how to overcome identified barriers that presently limit engagement practice to existing programs. Moving forward, it is likely that multiple approaches to engagement will need to be more fully examined. Advocates of greater engagement practice to achieve a fully engaged campus will likely need to address differences in how practices are structured but they may also find it helpful to assess those areas where there is common ground
