Matching Items (12)
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- All Subjects: Adolescent
- All Subjects: Screening
- Creators: Arizona State University. College of Nursing & Healthcare Innovation
- Creators: Bucci, Aimee
- Member of: Doctor of Nursing Practice (DNP) Final Projects
- Resource Type: Text
- Status: Published
Description
Introduction: Electronic cigarettes (e-cigarettes) among youth has increased drastically in recent years. E-cigarettes are being used with nicotine which can lead to dependency. Healthcare providers (HPs) are in a unique position to advise against the use of e-cigarettes. Recent studies report a lack of formal education among HPs about e-cigarettes. The purpose of this quality improvement project is to examine how increasing e-cigarette awareness among HPs can change their behavior on patient counseling against e-cigarette use. Methods: A modified E-cigarette Knowledge, Beliefs and Attitude Questionnaire was proctored before and after a virtual educational training about e-cigarettes. All advanced HPs employed, in a Southwestern state, at the organization were invited to participate by email. Results: 29 participants completed the pre-survey, and 4 participants completed the post-survey. While 90% of the participants reported that they first learned about e-cigarettes through informal sources, 72% of the participants reported interest in learning more about e-cigarettes to enhance their practice. Further, a two-tailed Mann-Whitney U test was significant on the “e-cigarettes are helpful aid for smoking cessation” statement based on an alpha value of 0.05, U = 12, z = -2.69, p = .007. Conclusions: Increasing the knowledge about e-cigarettes among HPs is critical in decreasing nicotine use among the public. This project will help in the fight against the use of tobacco products, and adds to the literature on how formal education about e-cigarettes among HPs can increase their intention to screen and counsel patients.
ContributorsWelch, Analuisa (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
Purpose & Background: This project evaluates the impact of education on a provider’s intent to screen for vitamin D deficiency in adults with depression. An internal Quality Improvement (QI) study at a local mental health primary care clinic revealed that only 1 in 3 patients with depression were routinely screened for vitamin D deficiency. Vitamin D is a crucial component of numerous systemic functions, including mental health, specifically depression.
Methods: This QI project used the Rosswurm and Larrabee Model implementation framework. Institution Review Board (IRB) expedited review approval was received. This project was conducted at 10 Veteran’s Affairs (VA) primary care clinics in Arizona. An initial email with a recruitment flyer was sent to providers to launch the project. A second email was
sent to participants who volunteered to participate in the project, with instructions and links to the asynchronous pre-survey, recorded education PowerPoint, and post-survey. Responses were analyzed using Intellectus Statistics software.
Results: Provider knowledge of impact and intent to screen for vitamin D deficiency increased after viewing a brief education video (n=30). Frequency distribution analyses revealed a 23% average increase in agreement to screen for vitamin D deficiency at annual visits, “at-risk” individuals, knowledge of the association, and intent to screen regularly in depression.
Conclusion: The education intervention was found to positively impact the provider’s intent and demonstrate the importance of screening for vitamin D deficiency in adults with depression.
ContributorsMiller, Evangelina (Author) / Medland, Jacqueline (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
The number of adolescents who are overweight are suffering from diseases once thought to only occur in adults, such as diabetes mellitus type 2, coronary heart disease, and liver disease with cases increasing exponentially. This may be correlated with adolescents making unhealthy choices in life resulting in depression in obese adolescents. Healthcare providers must continuously explore novel ways to empower teens to make healthy lifestyle changes. The Creating Opportunities for Personal Empowerment (COPE) Thinking, Emotions, Exercise, and Nutrition (TEEN) program was delivered to three adolescent participants in a primary care pediatric clinic in Southwest Arizona. The 15 sessions were provided weekly in the pediatrician’s office using the COPE TEEN manual. The participants completed the HABITS questionnaire and the Patient Health Questionnaire-9 (PHQ-9) before starting the program and after program cessation and kept confidential. The survey results were compared using descriptive analysis and paired t-tests to analyze the data collected. Due to a small sample size (n=3), statistical significance could not be calculated. However, clinical significance was found as evidenced by lower depression scores and improvement in healthy habits. A cognitive behavior skills-building program such as the COPE TEEN program has the potential to empower adolescents to make healthy decisions in life. These healthy choices lead to a long, happy life free from diseases caused by unhealthy choices. This program positively impacts the clinical care of adolescents who are overweight or obese by offering providers an alternative manner of educating adolescents.
ContributorsCortes, Holly (Author) / Esperas, Amanda (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Problem Statement & Purpose: Cervical cancer screening rates for a Federally Qualified Health Center (FQHC) in rural Northern Arizona is 78%, which is below the Healthy People 2030 goal of 84.3%. Identification of socioeconomic barriers unique to rural women through the use of an intake survey can improve cervical cancer screening rates. This project was guided by the Social Cognitive Theory (SCT). SCT proposes that behavioral change is determined by environmental, social, personal, and behavioral elements.
Methods: At a one-day well-woman event called, “See, Test, and Treat” hosted by the FQHC, an anonymous intake survey was implemented that identified participant demographics, basic cervical cancer knowledge, and perceived socioeconomic barriers to routine cervical cancer screening. Participants were recruited through the FQHC. Participant inclusion criteria: Arizona resident, uninsured, underinsured, 21-65 years old, English or Spanish speaking.
Results: Descriptive statistics were utilized to evaluate the survey responses, reliability, and validity of responses unknown due to self-reported responses. A total of 18 surveys were completed with a final yield of (n = 10). Surveys didn’t identify barriers to routine cervical cancer screening; however, an unawareness of cervical cancer risk factors including multiple sexual partners (n = 5, 50.00%), sex at an early age (n = 4, 40.00%), and misperception that cervical cancer is genetic (n = 7, 70.00%) was identified.
Implications for Practice: A need for cervical cancer education exists within the surveyed community. Providing rural women with knowledge regarding cervical cancer can improve screening rates.
ContributorsParkman, T. Lacey (Author) / Janicek, Patricia (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Substance use among adolescents is incessantly problematic, but its recent collision with a rising opioid epidemic has exponentiated deaths in this age group. Despite opioids being a major contributor, indications remain that adolescent prevention efforts should focus on total substance abstinence. Evidence consistently highlights adverse childhood experiences and mental dysfunction as the strongest predictors of youth substance use initiation, and parent-focused interventions as the most significant prevention model. Participants in this project included five parents, with a teen between 11 and 16 years of age, who had recently experienced homelessness or where currently living in a transitional shelter. Guided by the Transtheoretical Model, this project assessed the impact of an evidence-based parenting program among high-risk families. Participants completed the Teen Triple P Online program from home while receiving weekly text message support. Each parent completed a pre-and post- Conflict Behavior Questionnaire (r=.86) and Depression, Anxiety, and Stress Scale (r =.71–.81), and a Client Satisfaction Questionnaire. A two-tailed Wilcoxon signed rank test was performed on the matched pairs of pre- and post- measures with the mean scores compared. Though statistically insignificant results were yielded, this quality improvement project found a clinically significant decrease in conflict behavior and parental anxiety, depression, and stress after completing the Teen Triple P Online program. Participant satisfaction with the program and subsequent family improvements was also found. These results suggest that interventions that decrease family conflict and improve a parent’s mental health, directly impact major family factors that contribute to adolescent substance use and adverse childhood experiences. This project contributes to the evidence that positive parenting programs have an impact at the individual, family, and societal levels.
ContributorsAllen, L. Amber (Author) / Helman, Jonathan (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-01
Description
Purpose/Background: Children exposed to adverse childhood experiences (ACEs) and toxic stress have an increased risk of developing chronic illness and early death in the absence of protective factors. Many providers feel inadequately prepared to screen for and treat ACEs. This quality improvement project, based on the Health Belief Model, investigated if providing ACEs education before a screening program is effective in improving attitudes, knowledge, and the number of completed screenings. Method: The project was conducted at a pediatric primary care practice in the southwestern United States. All providers voluntarily consented to attend four education sessions: 1) Trauma overview, 2) Trauma physiology, 3) Trauma-informed care, 4) Screening tool/referral process. An anonymous pre/post-education Likert-Scale survey was completed to assess knowledge and attitudes about ACEs and screening. The number of completed ACEs screening tools and referrals made were collected four- and eight-weeks post-implementation. Results: Data were analyzed using Intellectus Statistics SoftwareTM. There was a significant increase in ACEs knowledge from the pre-test (p= .011, ?=.05). There was not a significant change in attitudes from the pre-test (p=.066, ?=.05). However, the mean pre- to post-survey scores increased for both categories, indicating improved attitudes. Over the first four weeks, 75% of eligible children were screened and 6% were referred to an ACEs resource program. In the second four weeks, 56% of children were screened and 8.6% were referred. Discussion: A comprehensive education program for providers can improve knowledge about ACEs screening, leading to improved screening practices, early identification, and the introduction of protective resources.
ContributorsChaisson, Charlotte (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Seclusion and restraint (SR) continue to be used in psychiatric settings when a patient is a harm to self or others despite growing concern and calls to eliminate the practice due to its harmful, potentially life-threatening effects on patients. The purpose of this evidence-based project was to assist a hospital in the southwestern United States decrease their seclusion and restraint rates among their adolescent patients. Trauma-informed care approaches have been shown to significantly reduce the incidence of SR in inpatient settings.
The nurses and behavioral health technicians (BHTs) received a two-hour trauma-informed care training in November of 2019. SR rates three months pre-training and post-training were compared. In the three months prior to the training, SR rates averaged 23.4 events per 1000 patient days. Comparatively, the three months after the training SR rates averaged 19.5 events per 1000 patient days. This shows a clinically significant decrease in SR rates after the TIC training. This evidence-based project (EBP) highlights the need to address this problem and gives an intervention option that can reduce harm for patients and address the needs of healthcare organizations seeking to improve patient care.
ContributorsNava, Lidice L. (Author) / Bucci, Aimee (Thesis advisor)
Created2020-05-03
Description
Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in ADHD and if a brief education on sex differences in ADHD affects the primary care setting's screening rate.
Design/Methods: With the Arizona institutional review Boards' approval, primary care providers (PCP) in a Southwest family practice in Arizona (n=35) are provided with virtual education on sex differences in ADHD. Pre- post-intervention surveys were electronically administered to five PCPS. Data were deidentified. A two-tailed paired t-test was conducted to examine the mean difference of responses.
Results: Analysis of responses demonstrate that primary care providers are well aware of sex differences in ADHD but screened less for ADHD before the education intervention. Major themes emerged from provider comments on ADHD symptom recognition, time constraints, and increased screening to identify girls in the primary setting. A significant increase in ADHD screening is seen four weeks post-intervention t(4) = -6.32, p = .003.
Conclusion: Future research is needed to identify other factors that could strengthen ADHD screening during well-child visits overall. Also, the use of a pediatric screener which can highlight inattentive symptoms would assist in the process of identifying girls with ADHD.
ContributorsO'Connell, Roseann (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
The physiologic changes that occur during pregnancy can increase risk of maternal periodontal disease. This is more often observed in women seeking prenatal care in community health centers. Poor oral health in pregnancy can negatively impact birth outcomes and the oral health of children born to mothers with a history of perinatal periodontal disease. Despite the evidence of importance and safety, oral health continues to be overlooked during prenatal care visits. There is a lack of interprofessional collaboration between prenatal and dental providers leading to missed opportunities and preventable adverse maternal and fetal health outcomes. Several professional organizations have affirmed that dental care and treatment during pregnancy is safe and recommended to prevent complications during and after pregnancy. In previous studies, barriers preventing pregnant women from receiving oral health exams, oral health education, and referrals include lack of provider awareness regarding the importance of oral health, lack of dental coverage for pregnant women, and reluctance among dental providers to treat women during pregnancy. The Maternal Oral Health Screening (MOS) tool has been used successfully to increase oral health screening in early pregnancy. The MOS was installed in a prenatal care intake form in an electronic health record at a federally qualified health center (FQHC). An education program about oral health care recommendations and safety of oral health care in pregnancy was presented to prenatal care staff. The intervention resulted in increased oral health screening and referral for dental care for pregnant people enrolled at the FQHC.
ContributorsWood, Elizabeth D. (Author) / Link, Denise (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Preventing deaths from uncontrolled bleeding remains a national priority, as mass causality events in communities and schools continue to rise. National initiatives have been set in motion by the Department of Homeland Security, to teach laypersons hemorrhage control techniques while waiting for emergency personnel to arrive. A full and growing body of evidence supports the use of hemorrhage control training classes among adult laypeople and is growing steadily in the adolescent population. With the majority of shooting events occurring at high schools, the implementation of a hemorrhage control training curriculum can increase survival rates among high school students in the event of an active shooter. The purpose of this paper is to investigate current knowledge and hemorrhage control practices among high school students and the implication of implementing a hemorrhage control educational intervention by evaluating current knowledge of hemorrhage control as well as their willingness, confidence, and perceived value in hemorrhage control education. This evidenced-based assessment is proposed utilizing the Social Learning Theory and Rosswurm and Larrabee’s implementation framework.
ContributorsMaddaluna, Christina (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-03