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Description
Brundtland’s definition of sustainability is the ability to “meet the needs of the present<br/>without compromising the ability of future generations to meet their needs” (IISD, 2021). But<br/>what if there are no future generations? Social sustainability, the sector of sustainability that<br/>foregrounds the well-being and livelihoods of people (and thereby continuation of humanity), is<br/>included in definitions within the sustainability field, but less developed in sustainability<br/>practice. In an effort to bridge this gap of knowledge, 14 U.S. cities and over 100 sustainability<br/>policies were analyzed for their social sustainability performance. An eight-item analytical<br/>framework that deals with differing areas of social equity guided the analysis. Results found that<br/>most cities’ sustainability departments fell short of truly addressing social sustainability<br/>concerns. Out of the eight items, the most frequently addressed were housing security and racial<br/>and gender equality whereas few, if any, cities addressed the more specific social concerns of<br/>immigration, technology and media, or arts/cultural preservation. Future research is<br/>recommended to gain a better understanding of the ways existing cities can improve in this area.
ContributorsWeekes, Daniel Buckner (Co-author) / Tam, Joey (Co-author) / Brian, Jennifer (Thesis director) / Keeler, Lauren Withycombe (Thesis director) / N/A, N/A (Committee member) / Dean, W.P. Carey School of Business (Contributor) / Department of Economics (Contributor) / Department of Supply Chain Management (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
This thesis concerns the adoption of health information technology in the medical sector, specifically electronic health records (EHRs). EHRs have been seen as a great benefit to the healthcare system and will improve the quality of patient care. The federal government, has seen the benefit EHRs can offer, has been advocating the use and adoption of EHR for nearly a decade now. They have created policies that guide medical providers on how to implement EHRs. However, this thesis concerns the attitudes medical providers in Phoenix have towards government implementation. By interviewing these individuals and cross-referencing their answers with the literature this thesis wants to discover the pitfalls of federal government policy toward EHR implementation and EHR implementation in general. What this thesis found was that there are pitfalls that the federal government has failed to address including loss of provider productivity, lack of interoperability, and workflow improvement. However, the providers do say there is still a place for government to be involved in the implementation of EHR.
ContributorsKaldawi, Nicholas Emad (Author) / Lewis, Paul (Thesis director) / Cortese, Denis (Committee member) / Jones, Ruth (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2013-05
Description
Electronic Health Records: Suggestions for Future Use explores how EHRs are currently being used in the clinical setting and in the research setting. This paper provides suggestions for how EHRs should be used in the future, so that patient centered health care is optimized while maintaining efficiency. Additionally, the thesis discusses why privacy is viewed as an innate human right in society as well as why it is specifically valued in the healthcare setting. The value of privacy significantly impacts how EHRs are currently used, and the more automated EHR systems become, the more likely it is that the privacy of patients is threatened. It was concluded that the healthcare industry can improve EHR use in future clinical and research settings, while upholding privacy laws.
ContributorsPhillips, Emily (Co-author) / Waldman, Lauren (Co-author) / Brian, Jennifer (Thesis director) / Mason, Hugh (Committee member) / Department of English (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Introduction: The objective of this study is to emphasize the significance of exclusive breastfeeding (EB) and investigate methods to encourage and sustain it within a hospital environment. Using the self-efficacy theory, the study seeks to improve the current support system for breastfeeding mothers and their families. Methods: The project was approved by the university IRB and facility IRB; guidelines were maintained. The project takes place in a non-profit organization in the southwestern United States. Education was conducted at a required staff meeting for Women and Infant Services (WIS) floor about supporting breastfeeding mothers. A pre- and post-education Breastfeeding Knowledge Scale (BKS) survey was performed, effectiveness was measured using a two-tailed t-test. The reliability of the BKS scale is 0.83 and the validity of the scale is reported to be strong. The hospital measures the EB rates of patients that are greater than 37 weeks gestation without need for neonatal intensive unit care and the mom requests to breastfeed. Results: The goal was 42% rate of EB in the first 48 hours after birth. After education the average rate of EB was 39.6%, lower than the goal but higher than the 33.7% rate before education. A two-tailed paired sample t-test (n=27) was used for BKS and the results were significant based on an alpha value; thus, showing significant knowledge gain. Conclusion: Consistent staff education improves breastfeeding support for moms in the hospital, leading to successful exclusive breastfeeding. This project benefits various settings, such as pediatric, postpartum, labor and delivery, and pediatric offices.
ContributorsHudson, Jennifer (Author) / Esperas, Amanda (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
Description
Introduction: Depression screening in the pediatric setting is a crucial part of the adolescent's examination. A standardized screening tool and protocol streamlines the process of assessing adolescents and minimizes the chances of serious mental health disorders going undetected and untreated. Evaluation of current evidence demonstrates the use of a standardized tool improves detection, diagnosis, and management of depression and other mental health illnesses.
Method: The Patient Health Questionnaire—modified for adolescents (PHQ9-A) was administered to all eligible adolescents, ages 12-18, during an annual well visit for a period of 6 weeks. Lewin's Change Theory guided a system change in the electronic health record, and the questionnaire results were documented and provided to the pediatric provider at the time of the appointment. A chart review was conducted to determine whether all eligible patients were administered the questionnaire and if a depression diagnosis or mental health referral had been made.
Results: Out of 76 eligible well visits, 65 (86%) patients completed the PHQ9-A. The average score was 5.29 (SD = 6.49) with a maximum score of 25. Out of those that completed screening, 11 (17%) had a positive PHQ9-A score resulting in 8 referrals to mental health services and 2 mental health diagnoses in the clinic.
ContributorsCoomer, Meagan (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
Description
Background: There is growing evidence that persistent exposure to the adverse effects of stressful work conditions, abuse, and re-traumatization without proper intervention leads to compassion fatigue (CF) and reduced compassion satisfaction (CS). Without appropriate intervention, the outcome of CF affects the patient, staff, and the organization. Despite proposed self-care measures, mental health (MH) workers continue to struggle with CF and lack the resources to combat the issue.
Objectives: Ongoing awareness on the implications of trauma and its impact on one's behavior, supports the use of Trauma-informed care (TIC) skills in creating a conducive work environment. This quality improvement project examines the efficacy of TIC education as an intervention for CF pre/post-one-hour education session among MH workers.
Methods: MH nurses (n=8) from diverse backgrounds in a Phoenix inpatient psychiatric hospital gave consent for the study. Participation was sought via flyers and entailed attending the one-hour education session, filling out a demographic, and pre/post-professional quality of life (ProQol) surveys. The ProQol standardized tool measures CF, CS, and burnout with reliability >0.70. Expected outcomes include a reduction in CF and an improvement in CS. Data analysis using intellectus software involved descriptive analysis and paired t-tests to compare outcomes.
Results: Pre/post data analysis was statistically significant, P = 0.003, which shows a reduction in CF and an improvement in CS.
Conclusion: TIC as an intervention for CF looks promising. MH nurses can manage their stress symptoms and that of their patients using TIC skills.
ContributorsOnyia, Nneka (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29
Description
An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth.
Methods:
This project was implemented among students attending an alternative high school in Arizona. Nine students participated in four different mindfulness, hands-on activities during two classes- 1 hour each. Participants completed a pre and a post-test with the 10-item questionnaire Perceived Stress Scale (PSS), and a 3-question survey to evaluate the program at the end of the second week.
Results: Among the 9 participants (mean age = 16 SD=2.06), the stress levels were considered low to moderate in the pretest (mean=16.56) and the post-test (mean=15.89). Stress level scores were reduced after the education although the difference was not statistically significant. Furthermore, all participants agreed that the content and activities were appropriate, 88.9% agreed they had a "better understanding of how to reduce stress," and 77.8% stated their "knowledge of stress has improved."
Discussion/Conclusion:
This project aimed to help reduce vulnerable adolescents' stress level through mindfulness activities. Mental health education like this may help adolescents better manage stress and consequently promote their overall well-being. Future projects should recruit a larger sample and implement a longer time for larger and longer effects.
ContributorsQualman, Stephanie (Author) / Chen, Angela (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-10
Description
Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental health literacy (MHL) in adolescents would improve while decreasing stigma and improving help-seeking behaviors after a program of enhanced mental health education. Partnering with a large Arizona suburban school district social work department, a teen Mental Health First Aid (tMHFA) pilot program was implemented for a class of nine (n = 9) adolescent students (aged 17-18 years) old during the school day. tMHFA was delivered in three 90-minute class days. Using the Mental Health Literacy questionnaire (MHLq), a pre and post-test design revealed a significant (p value=less than 0.05) increase in the students' MHL, help-seeking behaviors, and decreased stigma after delivery. This quality improvement project was IRB approved, and all human subjects' rights were protected. In conclusion, there is strong evidence that enhanced mental health programming, such as tMHFA, effectively educates adolescents about mental health challenges and, perhaps, could promote behavioral changes in future generations.
ContributorsJones, M. Christina (Author) / Schiller, Zita (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-15
Description
Background: Diabetes (DM) is a costly disease that negatively impacts patients and the healthcare system that requires complex and structured management. Literature has shown a gap in effective, structured diabetic education and management for providers and patients.
Objective: The purpose of this quality improvement project was to investigate the impact of how outreach, through a structured educational care plan, affects healthcare team experience, perception, and impact on their ability to communicate and comanage patients' chronic diabetes. Utilizing telemedicine as an alternative to the office visit healthcare model to address a gap in care by providing ongoing, structured diabetes education and management.
Methods: A small-scale study initially included ten participants, with five that completed the study. This included the Population Outreach Team (POT), one provider, and four auxiliary support staff. They were introduced to and utilized a care plan tool (CPT) to assist providers and auxiliary health team communication and education delivery to patients with DM. The theoretical and implementation framework that guided the study was based on the nudge theory, focused on altering habits and behavior, and the Model for Improvement supporting future alterations and improvement as identified. A CPT was designed based on HEDIS diabetes measures and the American Diabetic Association (ADA). Improvement was measured through nine question pre- and post-surveys with an additional four questions specific to the CPT use based on a modified RAND Likert scale patient satisfaction survey. A post-qualitative interview with the provider was conducted to gain further insight into CPT use and perception.
Results: A total of ten healthcare and auxiliary participants joined the study; of these, five completed it. The data, including the pre- and post-perception surveys, were collected over a 6-week study period with a post-implementation interview with one provider. Data analysis was captured through descriptive statistics. Pre-perception, M = 19.6 (SD. 4.04, 14 – 25). Post-perception, M = 7.60 (SD. 1.34, 6 – 9). CPT perception post, M = 14.4 (SD. 3.65, 10 – 18). A lower score indicated improvement. The interview identified the following barriers that impacted the CPT's success, including the patient-provider relationship, EHR "easability", patient readiness, and patient education barriers.
Conclusion: This small study indicated the positive impact structured, ongoing education provides to improve communication and comanage patients' with DM through the POT improved perception with CPT use. Barriers identified will assist with future implementations and other areas for improvement, which may increase success in the objective of this study and the delivery of healthcare for patients with DM. Future utilization of this intervention may be easily translated to other primary care environments. The intention is that successful DM management may lead to decreased medical management, complications, and financial strain.
ContributorsWilde, Daniella (Author) / Moffett, Carol (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-01
Description
Clinicians confront formidable challenges with information management and coordination activities. When not properly integrated into clinical workflow, technologies can further burden clinicians’ cognitive resources, which is associated with medical errors and risks to patient safety. An understanding of workflow is necessary to redesign information technologies (IT) that better support clinical processes. This is particularly important in surgical care, which is among the most clinical and resource intensive settings in healthcare, and is associated with a high rate of adverse events. There are a growing number of tools to study workflow; however, few produce the kinds of in-depth analyses needed to understand health IT-mediated workflow. The goals of this research are to: (1) investigate and model workflow and communication processes across technologies and care team members in post-operative hospital care; (2) introduce a mixed-method framework, and (3) demonstrate the framework by examining two health IT-mediated tasks. This research draws on distributed cognition and cognitive engineering theories to develop a micro-analytic strategy in which workflow is broken down into constituent people, artifacts, information, and the interactions between them. It models the interactions that enable information flow across people and artifacts, and identifies dependencies between them. This research found that clinicians manage information in particular ways to facilitate planned and emergent decision-making and coordination processes. Barriers to information flow include frequent information transfers, clinical reasoning absent in documents, conflicting and redundant data across documents and applications, and that clinicians are burdened as information managers. This research also shows there is enormous variation in how clinicians interact with electronic health records (EHRs) to complete routine tasks. Variation is best evidenced by patterns that occur for only one patient case and patterns that contain repeated events. Variation is associated with the users’ experience (EHR and clinical), patient case complexity, and a lack of cognitive support provided by the system to help the user find and synthesize information. The methodology is used to assess how health IT can be improved to better support clinicians’ information management and coordination processes (e.g., context-sensitive design), and to inform how resources can best be allocated for clinician observation and training.
ContributorsFurniss, Stephanie Kohli (Author) / Kaufman, David R. (Thesis advisor) / Grando, M. Adela (Committee member) / Johnson, William G. (Committee member) / Arizona State University (Publisher)
Created2017