Matching Items (5)
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- All Subjects: Primary Health Care
- Creators: Nunez, Diane
- Creators: Ochieng, Judith
Description
Background: Pressure injuries inflict a major, preventable burden onto hospital systems, healthcare providers, and patients. The purpose of this evidence based project was to evaluate the impact of a pressure injury prevention education program on nursing staff knowledge and pressure injury rates in an Arizona post-cardiac care unit.
Method: A single group pre-test post-test design was utilized to evaluate nursing staff knowledge before and after an education program on pressure injury prevention. Staff knowledge was evaluated using a modified version of the Pressure Ulcer Knowledge Assessment Tool 2.0. Participants completed pre- and post-education surveys. Rates of hospital acquired pressure injuries were obtained via chart review.
Results: Pre- and post-education scores were analyzed in participants who completed both surveys using a paired t-test. Post-education scores (M = 0.73, SD = 0.07) were significantly higher than pre-education scores (M = 0.59, SD = 0.09); t(7) = -5.39, p = .001. Pre- and post-education median scores of all participants were analyzed using two-tailed Mann-Whitney U test. Post-education scores (Mdn = 0.71) were significantly higher compared to pre-education scores (Mdn = 0.56); U = 102.5, z = -4.05, p = .001. Monthly incidence of pressure injuries on the unit increased following education.
Discussion: Increase in scores from pre- to post-education surveys indicate staff knowledge improved. The increased incidence of pressure injuries is thought to be secondary to staff’s increased ability to detect pressure injuries. Staff education is recommended, but more research is needed regarding the impact on pressure injury rates.
Method: A single group pre-test post-test design was utilized to evaluate nursing staff knowledge before and after an education program on pressure injury prevention. Staff knowledge was evaluated using a modified version of the Pressure Ulcer Knowledge Assessment Tool 2.0. Participants completed pre- and post-education surveys. Rates of hospital acquired pressure injuries were obtained via chart review.
Results: Pre- and post-education scores were analyzed in participants who completed both surveys using a paired t-test. Post-education scores (M = 0.73, SD = 0.07) were significantly higher than pre-education scores (M = 0.59, SD = 0.09); t(7) = -5.39, p = .001. Pre- and post-education median scores of all participants were analyzed using two-tailed Mann-Whitney U test. Post-education scores (Mdn = 0.71) were significantly higher compared to pre-education scores (Mdn = 0.56); U = 102.5, z = -4.05, p = .001. Monthly incidence of pressure injuries on the unit increased following education.
Discussion: Increase in scores from pre- to post-education surveys indicate staff knowledge improved. The increased incidence of pressure injuries is thought to be secondary to staff’s increased ability to detect pressure injuries. Staff education is recommended, but more research is needed regarding the impact on pressure injury rates.
ContributorsHolloway, Jonathan (Author) / Ochieng, Judith (Thesis advisor)
Created2020-04-16
Implementation of a Suicidal Ideation Treatment Algorithm in a Military Medicine Primary Care Clinic
Description
Primary care providers (PCPs) are frequently the first line of treatment for suicidal ideation (SI) patients. Many PCPs report low self-efficacy in treating suicidal patients, leading to inappropriate treatment plans or avoidance of discussing SI. This quality improvement project based on the Uncertainty Reduction theory aimed to evaluate PCP's perceptions of an SI treatment algorithm and its impact on self-efficacy. Secondary aims included assessing PCP's confidence in treating suicidal patients and current treatment practices. A pre- then post-intervention survey design was utilized. All PCPs treating patients in a military medicine clinic were invited to participate in the project. Participants were sent a recruitment email containing the suicidal ideation treatment algorithm and a link to a survey developed with Qualtrics software. Participants were asked to review the SI algorithm, answer the baseline survey questions, and complete a second eight-week survey. For human subjects' protection, the survey responses were anonymous. Demographic data collected included years of clinical experience and licensure type. The data were evaluated with Intellectus software. Due to limited participation, N=4, there was insufficient data to determine the significance of implementing the SI algorithm in a primary care clinic. Central tendencies showed that most providers (n=3, 75.00%) felt less than confident treating suicidal patients. Half of the providers asked non-mental health patients about suicide less than 40% of the time (n=2, 50.00%). The data suggest that PCPs feel uncomfortable treating suicidal patients and may benefit from additional resources and training in this area.
ContributorsGale, Mianna (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
Description
Problem Statement: The onset of the COVID-19 pandemic led to intense challenges for health care providers. Outpatient primary care practices rapidly moved from in-person practice to video-conferencing telehealth appointments. This shift requires study, particularly how this has impacted the lived experience of providers.
Purpose: This project aims to explore primary care provider satisfaction with telehealth in the wake of the COVID-19 pandemic.
Methods: A point-in-time survey was administered to primary care providers at a large university health system. Participants were recruited at a monthly provider meeting and invited to complete an anonymous online survey. Satisfaction with video-conferencing patient visits was explored via Likert scale and write-in responses. Providers highlighted specific complaints, problems, and successes that impacted their practice and patients. Aggregate health data from this organization was also obtained for comparison. Statistical analysis was performed and recommendations made for future practice.
Findings: The provider experience of telehealth was overwhelmingly positive. 85% (n=11) of providers agreed or strongly agreed that telehealth allows them to manage their patients effectively. Lack of physical exam findings was the most commonly cited concern (n=9). 100% (n=13) of providers would like to continue seeing patients via telehealth in the future.
Conclusion: Videoconferencing appointments in university health primary care promote high provider satisfaction. Future policies and innovations should support the use of a telehealth platform.
ContributorsMcKernan, M. Katherine (Author) / Nunez, Diane (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29
Description
Early and effective end-of-life care are associated with increased quality of life for those patients who may be nearing the end-of-life (EOL). However, evidence suggests that most non-palliative healthcare providers lack the skills and confidence to initiate EOL conversations. Consequently, about 70% of Americans would prefer to die at home with their families, yet only 25% die according to their wishes (State of California Department of Justice, n.d). In alignment with the Peaceful End of Life Theory, the purpose of this evidence-based project is to increase primary healthcare providers’ level of skills and confidence in end-of-life discussions.
This project utilized a pre and post study design. A total of 11 participants were recruited using convenience sampling from three primary care clinics in Phoenix, Arizona. Due to the small sample size and assumption of a non-normal distribution of the data, Wilcoxon Signed Ranks test and Pearson correlation coefficient were used for statistical analysis. There were clinical and statistical significant improvements in the EOL knowledge of the participants after the implementation of the two-and-a-half-hour Serious Illness Care Program (Z = -2.950, p = .003) with a large effect size (r = -0.62).
The project evaluation also demonstrated that most participants deemed that the intervention was effective. A brief and systematic education session, such as the SICP can be utilized to improve non-palliative healthcare providers’ skills in having more and effective end-of-life conversations.
ContributorsManalese, Rey Jericoh (Author) / Ochieng, Judith (Thesis advisor)
Created2019-05-02
Description
Purpose: To assess study participants behavioral responses and perception of effectiveness of an activity tracking device to increase physical activity. Obesity is an endemic health issue in the U.S. and continues to gain concern for increasing morbidity and mortality rates. Benefits of physical activity are firmly established across healthcare disciplines to combat and prevent obesity, yet sedentary behaviors continue to be on the rise. The use of wearable technology, that provides real-time feedback of activity, has been identified as a promising tool for increasing physical activity.
Methods: Analysis of a subset of questions from a larger survey was used to evaluate wearable device attitudes and behavior changes over time. Convenience sample (n=10), ages >18, required enrollment in a clinic-based weight and wellness program (WWP) to participate. The survey questions assessed effectiveness of wearable device on a 0-10 motivation scale to increase physical activity and a self- assessment of behavioral changes at specific intervals over a 6-month period. Descriptive statistics and non-parametric, two-tailed tests will be used to analyze the data. Due to the necessity of detecting minute differences with the small sample size, the significance level will be tested at the p<0.10.
Results: Participants >18 years of age, enrolled in a WWP (n=10) included 20% male and 80% female. Although a 12.3% increase in the mean score was found from week-1 to 6-months, the results were not statistically conclusive to the effectiveness of self-motivation to increase activity by participants wearing an activity tracking device; however, results are statistically significant for participants to increase activity with behavior changes based on device dashboard.
Conclusions: It is recommended for primary care providers to encourage the use of an activity tracking wearable device for behavior change to increase activity.
Methods: Analysis of a subset of questions from a larger survey was used to evaluate wearable device attitudes and behavior changes over time. Convenience sample (n=10), ages >18, required enrollment in a clinic-based weight and wellness program (WWP) to participate. The survey questions assessed effectiveness of wearable device on a 0-10 motivation scale to increase physical activity and a self- assessment of behavioral changes at specific intervals over a 6-month period. Descriptive statistics and non-parametric, two-tailed tests will be used to analyze the data. Due to the necessity of detecting minute differences with the small sample size, the significance level will be tested at the p<0.10.
Results: Participants >18 years of age, enrolled in a WWP (n=10) included 20% male and 80% female. Although a 12.3% increase in the mean score was found from week-1 to 6-months, the results were not statistically conclusive to the effectiveness of self-motivation to increase activity by participants wearing an activity tracking device; however, results are statistically significant for participants to increase activity with behavior changes based on device dashboard.
Conclusions: It is recommended for primary care providers to encourage the use of an activity tracking wearable device for behavior change to increase activity.
ContributorsCarroccio, Tanya (Author) / Nunez, Diane (Thesis advisor)
Created2018-04-28