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- Creators: Arizona State University. College of Nursing & Healthcare Innovation
- Creators: Mangold, Kara
Description
Background: Breastmilk is the optimal source of nutrition for infants as recommended by the American Academy of Pediatrics and the World Health Organization (WHO). Despite proven benefits, rates of breastfeeding have shown to decrease drastically at six months of age.
Purpose: The purpose of this project is to assess the effectiveness of virtual peer support and infant education in increasing/improving a mother’s wellbeing and breastfeeding relationship. This project was guided by the theory of self-efficacy.
Methods: Participants were recruited utilizing flyers that were posted to social media and distributed at a breastfeeding center in Southwestern United States. Six breastfeeding mothers were recruited, and each participated in four, one-hour peer support sessions that were held weekly via Zoom. Participants completed the WHO Well Being Index and the Breastfeeding Relationship scale before and after the intervention. Pre- and post-implementation scores were compared.
Ethical Considerations: The research was approved by the IRB board at Arizona State University and was in compliance with ethical considerations and standards of the institution.
Results: Descriptive analysis conducted on the WHO Well-Being Index showed the same results or improvement for 80% of the questionnaire. Descriptive analysis conducted on the Breastfeeding Relationship Scale showed improvement on 81% of questions.
Conclusions/Discussion: Breastfeeding can be taxing and overwhelming for mothers leading them to discontinue earlier than planned. Peer support has been identified to be substantial to women going through this process in helping them initiate and continue to breastfeed their infant.
ContributorsLopez, Danielle (Author) / Reifsnider, Elizabeth (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Police officers have more mental health issues than the general population and face barriers to seeking help, such as stigma, organizational masculinity, and concerns about confidentiality. This project took place in an urban police department in Arizona and aimed to increase the frequency of officers seeking peer support or counseling and reduce mental health stigma. Peer support volunteers increased officer contact following exposure to traumatic incidents. Officers viewed an educational video on mental health and available resources, and sergeants were provided with a quick reference guide on mental health warning signs. Rates of
counselor fund utilization by officers pre-and post-intervention were monitored, and all officers were emailed a Likert-scale peer support satisfaction survey. Survey results (n=39) showed officers were moderately satisfied with peer support and knowledge, but many were not comfortable contacting peer support for personal issues. Of officers surveyed, 74.4% (n=29) did not seek counselor services after contact with peer support. Counselor fund utilization slightly increased post-intervention, but further study is needed to determine the correlation to interventions. This project was unable to definitively demonstrate that peer support and education for officers and leadership increases help-seeking behaviors. Future projects should focus on improving peer support volunteer training and education.
ContributorsManchak, Nicole (Author) / Helman, Jonathan (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-03
Description
Background: An evidence-based project was performed to train and increase skills among healthcare providers to perform advance care planning. Training decreases barriers and improves attitudes and confidence to perform advance care planning. Advance care planning can include the Physician Order for Life-sustaining Treatment, an out-of-hospital order that directs emergency medical services of a patient’s wishes. Internal evidence found that many providers are unfamiliar with the Physician Order for Life-Sustaining Treatment form. The Theory of Planned Behavior was used to guide the project.
Objectives: To improve advanced care planning processes in a healthcare organization.
Design: A quality improvement project was performed at a medical center with outpatient provider groups. Virtual training was provided by the Arizona Hospital and Healthcare Association on the Physician Order for Life-Sustaining Treatment. Participants completed a three-part survey to measure skills for advance care planning after a training event.
Setting/Subjects: Five (n=5) American palliative and primary care providers at a medical center.
Measurements: The East Midlands Evaluation Toolkit is a validated survey tool that measures confidence and competence in advance care planning after training.
Results: Descriptive statistics, Friedman’s test, and the Kruskal-Wallis test were used for data analysis. Results provided evidence to the healthcare facility that there is a significant need to train their healthcare professionals on advance care planning.
Conclusions: Recommendations are made to focus research on larger studies looking at the types of advance care planning, and differences in disciplines and specialties.
ContributorsPate, A. Shurine (Author) / Rauton, Monica (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Background: Advance Care Planning (ACP) conversations are discussions between patients, providers, and loved ones addressing key care decisions in the event of incapacity. Nearly twothirds of US adults have not completed an Advance Directive (AD), yet ACP conversations rarely occur in practice. The objective of this quality improvement project was to implement workflow changes with a reminder system to facilitate ACP conversations during Medicare Wellness Visits (MWV).
Method: Social Cognitive Theory describes the complex relationship between variables that can influence an individual’s decision to address ACP. Providers in a primary care office in the Southwestern United States participated in an ACP education session and confidence survey. Patients presenting for the MWV were screened for ACP, and visual reminders were attached outside the exam room for provider review. Aggregate data were used to evaluate provider surveys. Descriptive statistics were used to evaluate patient characteristics and the Chi-square Test of Independence, and Fisher’s test was used to compare the pre-and post-intervention advance directive documentation.
Results: Qualitative feedback from the survey indicates reminders and easily accessible resources may help facilitate ACP conversations. Of the 251 MWVs, 21 (8%) had an AD documented, significantly less than the nationally reported rate of 37.7% (p < 0.05, z = -2.39).
Conclusions: Healthcare providers face multiple barriers preventing or delaying ACP conversations in practice. System-level changes and provider education can improve the rate of ACP conversations and impact patients’ care at the end of life.
ContributorsSmith, E. Elizabeth (Author) / Reifsnider, Elizabeth (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Advance care planning (ACP) is the act of deciding ones wishes at the end-of-life and making those wishes known. Healthcare providers rely on these wishes to provide end-of-life care. Despite the impact ACP has on quality of life at the end-of-life, most conversations remain undocumented. Even when ACP conversations take place, completion rates remain at an all-time low. This report explored the impact of appointment call reminders and patient portal messages on advance directive (AD) completion and documentation in the EHR. Following completion, a primary care practice experienced an increase in ACP conversation and ACP completion in the EHR. This report will discuss the methods utilized to improve ACP completion.
ContributorsDaily, Stephanie M. (Author) / Mangold, Kara (Thesis advisor)
Created2019-04-28
Description
The health benefits of breastfeeding are well documented and exclusive breastfeeding for at least the first six months of life is the target of national and global health care organizations. Although initial breastfeeding is on the rise, the percentage of infants still breastfeeding at six months drops significantly. In the population of newly delivered mothers of an obstetric practice, there is no readily accessible breastfeeding support offered following hospital discharge. A review of relevant literature revealed that lack of support is often cited as a key factor in the discontinuation of breastfeeding, whereas the evidence shows that participation in peer support has a positive effect on breastfeeding self-efficacy, which can have a positive effect on breastfeeding duration.
To address this problem, the initiation of a breastfeeding closed social network Facebook group for this practice setting population was developed and implemented to provide readily accessible peer support and have a positive effect on the outcome of breastfeeding self-efficacy. Three months after initiation of the Facebook group, an anonymous voluntary survey was offered to group members, and 25 members participated in the survey. Responses demonstrated that peer support is helpful with breastfeeding confidence and that, following participation in the group, the respondents wanted to continue breastfeeding.
ContributorsStorto, Pamela (Author) / Mangold, Kara (Thesis advisor)
Created2018-05-03