Matching Items (9)
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- All Subjects: Children
- Creators: Arizona State University. College of Nursing & Healthcare Innovation
Description
The purpose of this project is to create an educational activity book for Spanish-speaking children that face a language barrier when seeking care in the Emergency Room. In order to effectively develop relationships and provide exceptional healthcare for clients, nurses must understand how to effectively communicate (Escarce & Kapur, 2006). Current research reports that clients with Spanish as their primary language were more likely to have a poor experience when seeking health care assistance (Hispanic Health Disparities and Communication Barriers, 2016). Additionally, they were more likely not to seek care at all due to little or no communication capabilities with healthcare staff (Hispanic Health Disparities and Communication Barriers, 2016). The language barrier present and the lack of resources available to address the issue have created a disparity in the quality of healthcare for Spanish-speaking clients (Juckett, 2013). The book was made with the intention of being distributed to Spanish-speaking children and/or children with Spanish-speaking guardians, upon arrival to the Emergency Department. This educational activity book is to be used by the child, their guardians, and their involved health care staff to more comfortably navigate their way through the Emergency Room process.
ContributorsBurkey, Lindsey (Co-author) / Streecter, Angela (Co-author) / Stevens, Carol (Thesis director) / Murphy, Ana Orrantia (Committee member) / Sutter, Kimberlee (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This creative project examines the effectiveness of several school based nutritional education and parent based programs along with multi-component interventions. Six published articles were reviewed and summarized to identify the most successful interventions to prevent childhood obesity. In addition to these studies other resources were examined to understand the developmental levels of school-aged and adolescent students. As part of this project a narrated power point covering the key aspects of the nutritional needs of the school-aged child was developed. This power point will be utilized by future nursing students whom are working with parents in the schools or in the community on nutrition strategies. The power point will provide a context for individual or group discussions with parents to offer helpful ideas on how to work effectively with their children. The topic of nutrition and obesity in school-aged children is a current topic in health care especially in environments where nutritional resources are limited. The overall outcome of this project will be to assist in decreasing the incidence of overweight and obese youth and the prevention of the development of premature chronic diseases especially in early adolescence and young adulthood.
ContributorsLopez, Leticia Marie (Author) / Hosley, Brenda (Thesis director) / Speer, Therese (Committee member) / Storto, Pamela (Committee member) / Barrett, The Honors College (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2014-12
Description
Post-traumatic stress disorder is prevalent in refugees. The population of refugees in the United States is continuing to increase, of which the majority of the incoming refugees are children. A more comprehensive approach is needed to assess children for PTSD. This creative project involved reviewing existing literature on refugees in the United States, child refugees, Erik Erikson's stages of psychosocial development, and available and applicable PTSD assessment tools. I developed a reference chart that compared the available assessment tools. I recognized that a PTSD assessment tool for refugee children does not exist. In response, I created an approach to assessing PTSD in refugee children ages 5-12. In creating this toolkit, I determined who is appropriate for administering the assessment, discovered how to create trust between the clinician and the child, created the assessment tool, including implementation instructions, and then provided directions on scoring and referrals. The tool itself is called the Child Refugee PTSD Assessment Tool (CRPAT-12). The creation of the CRPAT-12 will hopefully be disseminated and will encourage refugee resettlement organizations to assess children for PTSD upon intake. Early identification of symptoms of distress will help the child receive the appropriate treatment and will help prevent more extreme mental health complications.
ContributorsBuizer, Danyela Sutthida (Author) / Walker, Beth (Thesis director) / Stevens, Carol (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
The purpose of this study was to explore the effects of a four-week martial arts program implemented once a week on children diagnosed with attention-deficit hyperactivity disorder (ADHD) between the ages of four and seven. This was a single group, pre- and post-intervention assessment pilot study. The total sample of the study was four children (n=4) and the martial arts classes were based on the Duke Kenpo Little Tiger Program by Jonathan Duke of Mesa, Arizona. Change was measured using the Behavior Rating Inventory of Executive Function, 2nd edition (BRIEF-2) parental form and participants were encouraged to record at-home practice. Data were collected pre-intervention and four weeks afterwards. Limitations included small sample size, measurement limitation (e.g., ceiling effect), data based on parental report, a short intervention period, potential instructor bias, and uneven gender distribution. Given the small sample size (n=4), this study did not complete statistical analysis and alternatively described the changing patterns of the participant's ADHD symptoms from BRIEF-2 measures pre and post intervention. The results of this study could not generate the power to detect significance to state significant implications. However, the trends suggested that some participants declined in executive function in certain areas (e.g., task-monitoring and planning) and improved in other areas (e.g., working memory and organization of materials). All participants demonstrated improvement within the cognitive (CRI) scale of the BRIEF-2 and future studies may explore the potential for martial arts interventions in children under seven as a means to improve the cognitive aspect of executive function development. In addition, future studies may consider exploring the role of frequency versus time for at-home martial arts practice for children with ADHD under the age of seven.
ContributorsNaylor, Takara (Author) / Larkey, Linda (Thesis director) / Noah, Aggie (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
The purpose of the study was to determine the impact of social interaction with children on the symptoms of depression in elderly participants at the John C. Lincoln Adult Day Healthcare center when compared to depressive symptoms in the elderly who do not regularly interact with children. This organization provides care to elderly members of the community in a dignified and stimulating manner. It allows caregivers of participants to take a break from day to day responsibilities while providing the participants with a safe and active environment. It shares premises with the Lincoln Learning Center, which is a care/educational facility for children ages 6 weeks to 12 years of age. The children and the elderly interact one day a week for half an hour in a planned activity in the Adult Day Healthcare Center. The Geriatric Depression Scale- Short Form was used to assess for presence of depressive symptoms in both the control group (those who did not regularly interact with children) and the experimental group (those who did regularly interact with the children). The scale consisted of 15 yes-or-no questions regarding the average emotions the participants experienced in a week. A total of 15 people participated in the study, eight in the control group and seven in the experimental group. Eight of the participants were male, seven were female and they ranged in age from 58 to 96 years old. An independent sample t-test was performed to assess the data for statistical significance.
ContributorsHorneman, Kaitlyn Noelle (Author) / Speer, Therese (Thesis director) / O'Brien, Janet (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Declaration of Conflicts: This project has no conflicts of interest to declare.
Context: This project was completed at a federally qualified primary healthcare clinic in Phoenix, Arizona that served patients of all age groups, but primarily cared for the Hispanic population providing primary care, preventative services, family planning, two lab technicians, one promoter, two medical assistant supervisors, five front desk staff, one chief administrative officer, one chief financial officer, two medical directoers who were also providers at the clinic.
Problem and Analysis Assessment: During my clinical rotations, I saw the burden a missed patient appointment had not only on the patients themselves, but also on the clinic, providers, and the staff. It caused delay in treatment for patients, and it did not allow other patients that wanted to be seen to be seen. It also increased unnecessary costs and wasted provider time. Thereafter, I met with some of the leadership team and one of the medical directors to determine a solution to reduce the number of missed appointments that were occurring. An educational session was kept to discuss the findings of this problem to the providers and the staff and when surveys were handed out to the patients, providers, and staff to assess their satisfaction with the old scheduling system versus the new scheduling system, they were also provided with a cover letter discussing the project.
Intervention: In order for improvements in care to occur, a system process change including the way patients are scheduled must occur. In this case, an open-access scheduling system (OAS) was implemented. OAS allows a patient to schedule an appointment on the 'same-day' or the 'next-day' to be seen. One provider at each of the clinics, each day of the week was available for 'same-day' appointments from 1300-1600. The providers were still available for scheduled appointments using the previous scheduling method. Walk-ins were still accepted, and were scheduled based on patient provider preference; however, if an appointment was not available for their preferred provider, they were typically seen with the provider that was the 'same-day' provider for that day.
Strategy for change: Since patients were only allowed to schedule appointments one month in advance, only one month was needed to implement this process change. A recommendation for the future would be to clearly identify the patient encounter type, and label it as a same-day appointment, as this would be helpful when gathering and extracting data for this type of patient group specifically.
Measurement of Improvement: Over a three-month period, a data collection plan was used to determine the number of Mas over a three-month period before and after implementation of this change. Satisfaction scores were measured using likert scales for patients, provider, and staff, and a dichotomous scale was used to determine the likelihood of emergency room or urgent care use. A comparison was done to measure revenue during the same time frame. During the three months, a clinically significant decrease in MAs was seen (<0.52%), with an increase in revenue by 41%. Additionally, a statistically significant increase in patient, provider and staff satisfaction was also noted when compared to the old scheduling system, as >68% of all patients, providers and staff reported feeling either very satisfied or extremely satisfied with the new scheduling system. Additionally, patients also reported that they were less likely to visit an emergency room(88%) or urgent care (90%) since they were able to be seen the same-day or the next-day by a provider.
Effects of changes: An incidental finding occurred during this study - where 877 more patients were seen in the three months during the implementation of this project, compared to the three months prior; which likely resulted in a 41% increase in revenue. Additionally this project, allowed patients that wanted to be seen on the same day, to be seen, and it decreased unnecessary costs associated with emergency room or urgent care visits. Some of the limitations involved included the current political environment, appointment slots that were previously 15 minutes in length (in 2016), increased to 20 minutes in length (in 2017), a language barrier was noted for the patient surveys since English was not the first language for many of the patients who completed the survey (although documents were translated), and the surveys used were not reliable instrument given that a reliable instrument in previous studies could not be found.
Lessons learnt: In order to have accuracy of the survey results, it is best for the author of the study to hand out and provide scripture for the survey so that complete data is received from the surveyors.
Messages for others: Begin by making a small process change where only one provider allows for the open-access scheduling so that the entire office is not affected by it, and if results begin to look promising then it can be expanded. Additionally, correct labeling of patients as 'same-day' is also important so that additional data can be gathered when needed regarding the 'same-day' patients.
Patient/Family/Guardian Involvement: Patients who benefited from the new scheduling system (open-access scheduling) were asked to fill out a survey that asked them to disclose some demographic data and asked them to determine their satisfaction with the new vs old scheduling system and their likelihood of visiting an emergency room or urgent care.
Ethics Approval: Arizona State University Institutional Review Board (IRB) Received: September 2017
Context: This project was completed at a federally qualified primary healthcare clinic in Phoenix, Arizona that served patients of all age groups, but primarily cared for the Hispanic population providing primary care, preventative services, family planning, two lab technicians, one promoter, two medical assistant supervisors, five front desk staff, one chief administrative officer, one chief financial officer, two medical directoers who were also providers at the clinic.
Problem and Analysis Assessment: During my clinical rotations, I saw the burden a missed patient appointment had not only on the patients themselves, but also on the clinic, providers, and the staff. It caused delay in treatment for patients, and it did not allow other patients that wanted to be seen to be seen. It also increased unnecessary costs and wasted provider time. Thereafter, I met with some of the leadership team and one of the medical directors to determine a solution to reduce the number of missed appointments that were occurring. An educational session was kept to discuss the findings of this problem to the providers and the staff and when surveys were handed out to the patients, providers, and staff to assess their satisfaction with the old scheduling system versus the new scheduling system, they were also provided with a cover letter discussing the project.
Intervention: In order for improvements in care to occur, a system process change including the way patients are scheduled must occur. In this case, an open-access scheduling system (OAS) was implemented. OAS allows a patient to schedule an appointment on the 'same-day' or the 'next-day' to be seen. One provider at each of the clinics, each day of the week was available for 'same-day' appointments from 1300-1600. The providers were still available for scheduled appointments using the previous scheduling method. Walk-ins were still accepted, and were scheduled based on patient provider preference; however, if an appointment was not available for their preferred provider, they were typically seen with the provider that was the 'same-day' provider for that day.
Strategy for change: Since patients were only allowed to schedule appointments one month in advance, only one month was needed to implement this process change. A recommendation for the future would be to clearly identify the patient encounter type, and label it as a same-day appointment, as this would be helpful when gathering and extracting data for this type of patient group specifically.
Measurement of Improvement: Over a three-month period, a data collection plan was used to determine the number of Mas over a three-month period before and after implementation of this change. Satisfaction scores were measured using likert scales for patients, provider, and staff, and a dichotomous scale was used to determine the likelihood of emergency room or urgent care use. A comparison was done to measure revenue during the same time frame. During the three months, a clinically significant decrease in MAs was seen (<0.52%), with an increase in revenue by 41%. Additionally, a statistically significant increase in patient, provider and staff satisfaction was also noted when compared to the old scheduling system, as >68% of all patients, providers and staff reported feeling either very satisfied or extremely satisfied with the new scheduling system. Additionally, patients also reported that they were less likely to visit an emergency room(88%) or urgent care (90%) since they were able to be seen the same-day or the next-day by a provider.
Effects of changes: An incidental finding occurred during this study - where 877 more patients were seen in the three months during the implementation of this project, compared to the three months prior; which likely resulted in a 41% increase in revenue. Additionally this project, allowed patients that wanted to be seen on the same day, to be seen, and it decreased unnecessary costs associated with emergency room or urgent care visits. Some of the limitations involved included the current political environment, appointment slots that were previously 15 minutes in length (in 2016), increased to 20 minutes in length (in 2017), a language barrier was noted for the patient surveys since English was not the first language for many of the patients who completed the survey (although documents were translated), and the surveys used were not reliable instrument given that a reliable instrument in previous studies could not be found.
Lessons learnt: In order to have accuracy of the survey results, it is best for the author of the study to hand out and provide scripture for the survey so that complete data is received from the surveyors.
Messages for others: Begin by making a small process change where only one provider allows for the open-access scheduling so that the entire office is not affected by it, and if results begin to look promising then it can be expanded. Additionally, correct labeling of patients as 'same-day' is also important so that additional data can be gathered when needed regarding the 'same-day' patients.
Patient/Family/Guardian Involvement: Patients who benefited from the new scheduling system (open-access scheduling) were asked to fill out a survey that asked them to disclose some demographic data and asked them to determine their satisfaction with the new vs old scheduling system and their likelihood of visiting an emergency room or urgent care.
Ethics Approval: Arizona State University Institutional Review Board (IRB) Received: September 2017
ContributorsPatel, Dimple (Author) / Thrall, Charlotte (Thesis advisor) / Glover, Johannah-Uriri (Thesis advisor)
Created2018-05-02
Description
Background/Purpose: The prevalence of overweight and obesity in the pediatric population is a global epidemic. Rapid weight gain in early childhood exacerbates risk factors for obesity, chronic disease in adulthood, and disqualifies 31% of American youth from serving in the Armed Forces. Although the pediatric dependents weight crisis reflects the national dilemma, there are inconsistencies in provider knowledge, limited access to evidence-based, weight management intervention, and treatment options. This paper will assess provider needs, identify opportunity to improve practice, and process used in weight management in the clinic.
Method: Eight military and four civilian pediatric and family practice providers completed a 16-item needs assessment survey. The survey was distributed via email using an online survey tool, and a printed version was provided to those who had not completed it online. Data was collected over 8 weeks and a descriptive analysis of content was done using the Intellectus software.
Results: Although the response rate was 88.9%, it was lower than anticipated due to COVID-19 related military deployments. Descriptive data were obtained on a variety of provider needs and practices. Results provided valuable information on current attitudes of providers. Providers demonstrated a significant need for a multidisciplinary support team including a dietician and more time dedicated to weight management at office visits. At least 50% of providers have had motivational interviewing training and report that they apply these techniques as part of an intervention in patient’s weight management care.
Implication: Data supports overweight and obesity care practice changes in the clinic. Areas identified by providers included the need for further training and clinic management support including the availability of a pediatric dietician added to the healthcare team.
ContributorsGolding, Sonya S. (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Sickle cell disease is a genetic hemoglobinopathy resulting in chronic and daily pain, risk of serious sequelae, and altered activities of daily living. Resources dedicated to helping individuals with sickle cell disease are lacking, especially compared to other chronic diseases. Children with sickle cell disease experience school absence, fractured peer relationships, frequent healthcare visits, stigma, and feelings of isolation. Additionally, chronic pain decreases developmentally important play and physical activity in these children. The purpose of this Doctor of Nursing Practice (DNP) project is to conduct a needs assessment to inform sickle cell disease family camp programming in southern Arizona. Once a camp experience can be safely implemented, the effects of a camp experience on knowledge, empowerment, and disease management in children with sickle cell disease will be investigated. Research specific to camps for children suffering from sickle cell disease is lacking, however ample evidence suggests the benefit of disease specific camps. Medical specialty camps provide an opportunity for children and families to normalize their condition, participate in activities, and form peer relationships in an environment that safely accommodates their unique needs. This has led to the initiation of an evidence-based project to develop a needs assessment for families affected by sickle cell disease and community partners to inform camp activity development guided by Bandura’s theory of self-efficacy and the Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation.
ContributorsCessna-Vargas, Carolyn (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-23
Description
Adverse childhood experiences (ACEs) are traumatic events experienced during childhood that have negative effects starting as a child and extending into adulthood. The presence of multiple ACEs increases negative mental, physical, and behavioral health outcomes. Children of parents who have experienced ACEs are at a higher risk of experiencing ACEs themselves, creating an intergenerational cycle of trauma between parents and their children. Evidence suggests that parenting education can reduce the impact of ACEs and potentially eliminate poor health outcomes. The literature revealed that parenting education was found to increase parenting competency, which will in turn reduce the impact of ACEs on children.
The purpose of this evidence-based project is to evaluate parenting competency and parenting self-efficacy after implementing six parenting workshops. The workshop topics consist of: (a) stress management, (b) understanding trauma, (c) positive parenting, (d) positive discipline, (e) play, and (f) learning development and support. The workshops were delivered at a community residential facility for women seeking recovery from abuse, incarceration, chemical dependency and other life-controlling problems. Participants included 10 female residents.
Demographics, ACE scores, pre and post Parenting Sense of Competency Scale, and a post intervention satisfaction questionnaire and discussion were used to collect data from the participants. Mothers’ ACE scores ranged from 2-9. The parenting self-efficacy score increased in the subgroup that attended all six workshops. All of the mothers agreed that the workshops would help with parenting their children. The findings suggest that parenting education increases parenting knowledge and self-efficacy, and may reduce the impact of ACEs on children.
ContributorsGohlke, Melissa (Author) / Thrall, Charlotte (Thesis advisor)
Created2020-05-04