Matching Items (33)

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Implementation of Adolescent Depression Care Guidelines into the Electronic Health Record at a Rural Pediatric Primary Care Clinic

Description

Background: Healthcare providers are encouraged to prepare their practice to effectively manage the care of mild to moderate adolescent depression. Cost-effective screening, diagnostic, and newly developed pediatric primary care depression

Background: Healthcare providers are encouraged to prepare their practice to effectively manage the care of mild to moderate adolescent depression. Cost-effective screening, diagnostic, and newly developed pediatric primary care depression management guidelines have been established. To integrate guidelines into practice, primary care providers (PCPs) must document effectively to ensure a complete treatment plan is in place in the patient’s electronic health record (EHR).

Intervention: Elements from a flowsheet were implemented into the EHR to promote thorough assessment and documentation of care delivered to adolescents with depression.

Methods: An initial chart review was completed on patients diagnosed with depression. An updated depression template was implemented within the EHR for six weeks. A follow-up chart review was completed post-intervention to determine if documentation of elements from the adolescent depression guidelines improved after the EHR update. Pre-intervention and post- intervention surveys were delivered to PCP’s to understand their perspective on adolescent depression management.

Outcomes: The chart review revealed that baseline PHQ-9 screenings were documented in 91% (n=43) of the charts reviewed in the pre-intervention timeframe. Only 78% (n=7) of the charts reviewed during post-intervention included PHQ-9 screenings. Early intervention treatment options documented in the pre-intervention timeframe included education 100% (n=47), medication prescriptions 53% (n=25), and psychotherapy referrals 18% (n=18). During post- intervention, education 100% (n=9), medication prescriptions 78% (7), and psychotherapy referrals 22% (n=7) were documented by the PCPs.

Recommendation: The quality improvement project focused heavily on documentation completed over a one year pre-intervention timeframe compared to a six-week post-intervention timeframe. Further evaluation and chart review over the next year will provide a more adequate comparison of documentation within primary care practice.

Contributors

Agent

Created

Date Created
  • 2020-05-01

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Enhanced Primary Care Electronic Medical Record Education to Improve the Use of Patient Portals

Description

Background: Health information technology (HIT) refers to the electronic health care systems organizations used to store, share and analyze healthcare information. A central component of the HIT infrastructure is an

Background: Health information technology (HIT) refers to the electronic health care systems organizations used to store, share and analyze healthcare information. A central component of the HIT infrastructure is an electronic health record (EMR) and although HIT has been shown to increase enthusiasm for patient care, decrease healthcare costs and improve patient outcomes overall utilization in the United States (US) remains low.

Methods: At an urban primary care pediatric office located in the southwestern US, an educational quality improvement project for healthcare practice providers and front office staff was conducted to increase the utilization of the existing EMR-linked patient portal. The healthcare providers were asked to complete a pre- and post- survey evaluation of their knowledge and usage of the patient portal. Provider and patient portal data usage was collected over a five-month period, September 2019 to January 2020.

Results: Data was analyzed using the Intellectus Statistics softwareTM. Significant results were found at the conclusion of the project in the number of active patient portal users, web-enabled, portal logins, labs published/viewed, messages sent, appointment reminders and Santovia utilization. At the end of the project no significance was found with messages received by the healthcare providers or staff through the patient portal. Survey results found significant differences between pre- and post- portal usage. No significance was found on providers’ knowledge on how to web-enable patients. Providers’ also demonstrated no significant change in their perceptions of the benefit in utilizing the portal in patient care after the educational intervention. Survey results allowed for additional analysis of commonly utilized portal functionalities, disease or health topics utilized in Santovia, and suggestions on how to make the use of the patient portal easier for providers.

Implications for Health Care Providers: This quality improvement project found that implementation an EMR-linked patient portal requires a comprehensive practice approach with structured education sessions. Including all employees can improve patient portal utilization. This educational project resulted in significant increases in most portal functionalities within 5 months. Further practice change evaluations are needed to evaluate how to improve patient portal utilization with a larger group of participants in a variety of outpatient settings.

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Agent

Created

Date Created
  • 2020-05-01

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Implementing a Multicomponent Pediatric Health Promotion Program

Description

Health statistics for physical activity, nutrition, and psychological wellbeing demonstrate the tenuous status of youth in the United States (US). These factors significantly affect growth and development during this critical

Health statistics for physical activity, nutrition, and psychological wellbeing demonstrate the tenuous status of youth in the United States (US). These factors significantly affect growth and development during this critical period and indelibly influence adult health. Consequently, the successful utilization of multicomponent pediatric health promotion programs could improve current and future health, saving billions in health-care costs. The analysis of a literature review on this topic led to the development and completion of an evidence-based project. The project was guided by two conceptual frameworks, Pender’s Health Promotion Model and the Stetler Model for Evidence-based Practice. The project was completed in partnership with a local after-school youth program.

Methodology included a project intervention comprised of a single specialized training session. Data was collected using a pretest-posttest format with repeated measures from a survey adapted from the Organization Readiness to Change Assessment (ORCA) tool. Survey questions focused on participant’s knowledge, skills, attitudes, and use of the selected health promotion program. Descriptive Statistics, the Wilcoxon-Signed Rank Test, and the Friedman Test were completed for data analysis using IBM SPSS v25. Using a critical value p < .1, results from the data indicated improvement in median scores for participant’s knowledge and skills (p-value’s range = .05 - .082). Other changes were not statistically significant (p-value’s range = .135 - .317). The results indicate the project intervention’s efficacy. Future research may focus on optimal training formats, a comparison of repeat sessions versus supplemental web-accessible resources, and program sustainability via refresher sessions and/or designated management.

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Agent

Created

Date Created
  • 2020-04-25

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The Pediatric Oral Health Initiative

Description

Oral health in the pediatric population is an overlooked topic in primary care, yet it is vital to their overall health. Dental caries, otherwise known as cavities, are a significant

Oral health in the pediatric population is an overlooked topic in primary care, yet it is vital to their overall health. Dental caries, otherwise known as cavities, are a significant problem among the pediatric population. Dental caries is the most common non-transmittable disease across the globe. Dental caries can have painful effects that can lead to serious health implications and reduce the quality of life. Prevention is key when addressing dental caries and oral health care. Oral health prevention and education should begin early on in life and continue throughout the lifetime.

Pediatricians and primary care practitioners play a vital role in the prevention identification, and treatment of dental caries. Individuals in these care roles must become familiar with dental caries and the best evidence-based practices. Furthermore, these health care providers can have an active role in policy creation and change within the community to address the issue. A project was conducted to help improve oral health in the pediatric population. The project consisted of a well-child template modification at the 9-month well-child visit that would prompt providers to encourage a dental visit by the 12-month appointment. The results were limited, and the outcomes were not statistically significant. A recommendation for future studies will be to verbalize the recommendation and provide a handout or recommend a specific pediatric dentist.

Contributors

Agent

Created

Date Created
  • 2020-05-01

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A Multimedia Approach in Asthma Medication Education

Description

In the United States, more than 22 million people are estimated to be affected by the chronic illness, asthma (American Lung Association [ALA], 2014). Of those 22 million, approximately 7.1

In the United States, more than 22 million people are estimated to be affected by the chronic illness, asthma (American Lung Association [ALA], 2014). Of those 22 million, approximately 7.1 million are children (ALA, 2014). An important factor in trying to curb the frequency of asthma attacks is education. Particular elements of asthma education include symptom recognition, self-management skills, correct administration, and understanding how medications are used to control asthma. A review of the literature shows that multimedia education holds some promise in increasing asthma-knowledge retention. This creative project involved the creation of an asthma-education video with a concomitant asthma-education comic book. Of the two creations, the asthma-education video was used in a former Doctorate of Nursing Practice (DNP) student’s study to supplement a session at a clinic with an asthma educator. The tools included in the study, the Asthma Medication Use Questionnaire (Moya, 2014) and the Asthma Control TestTM (ACTTM; QualityMetric Incorporated, 2002), were completed by the participants prior to and after the implementation of the session that incorporated the video. The results suggested that the video had an effect on asthma control as measured by the ACTTM (QualityMetric Incorporated, 2002), but not on daily preventative asthma inhaler usage as measured by the Asthma Medication Use Questionnaire (Moya, 2014). The comic book has not been evaluated yet. Both multimedia education tools—the comic book and the video—were created as a requirement for the Barrett thesis.

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Agent

Created

Date Created
  • 2015-05

Seizure Discharge Education for Pediatric Patients: An Online Platform

Description

There is a shortage of online resources for children who have epilepsy. Most of the current online resources are designed for populations with a higher health literacy. This creative project

There is a shortage of online resources for children who have epilepsy. Most of the current online resources are designed for populations with a higher health literacy. This creative project addresses this shortage by offering education for children with epilepsy that they are able to access and utilize online to understand their disease in greater depth. Comprehending discharge information after hospitalization can be difficult for children and families, which is why providing an accessible resource that also can be utilized at home increases understanding about the disorder and ability to manage the disorder. Basic information on epilepsy, safety tips for daily living, medication explanation, first aid information, and interactive resources are included on the website and are all geared toward children. A website developer, Sylvestri Customization™, assisted with creating the website utilizing template, search engine optimization and strategies for website sustainability. The website was created after completing a thorough review of current research literature and reviewing multiple, similar hospital educational websites while also consulting with healthcare professionals to ensure the information was evidence-based. While the website provides supplemental education via an online platform for children with epilepsy to explore, there is a need for future research to test the acceptability and efficacy of the website.

Contributors

Agent

Created

Date Created
  • 2016-12

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Operation Toothbrush: Understanding Pediatric Dentistry in Low Income Communities

Description

Operation Toothbrush is an initiative established to combat the oral healthcare disparity within young children who reside in Arizona. By working with elementary and preschool children, the project educated them

Operation Toothbrush is an initiative established to combat the oral healthcare disparity within young children who reside in Arizona. By working with elementary and preschool children, the project educated them and their families about the importance of oral hygiene in informative and intuitive manner. The project incorporated the help of Pre-Dental volunteers, dental practices, and the Woodside Grant to obtain the supplies, information, and assistance necessary to conduct the initiative.

Contributors

Agent

Created

Date Created
  • 2017-05

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A Retroactive Study of Parsons Center for Pediatric Dentistry Patient Parents/Guardians: Uncovering Motive for Seeking Specialty Dental Treatment

Description

Parents of patients receiving treatment at Parsons Center for Pediatric Dentistry and Orthodontics were surveyed in this study in an effort to uncover their motivations to seek specialty dental treatment

Parents of patients receiving treatment at Parsons Center for Pediatric Dentistry and Orthodontics were surveyed in this study in an effort to uncover their motivations to seek specialty dental treatment for their children. Parsons Center for Pediatric Dentistry and Orthodontics is a specialty dental clinic that focuses on increasing the accessibility of dental care, serving both insured and uninsured patients in Phoenix, Arizona. The demographic of this study is assumed to be the surrounding areas, including Maricopa County and the zip code to which Parsons pertains, 85009. Approximately half of the population in this area are low income individuals, and a large percentage of the population are of Hispanic/Latino heritage. Over the course of this investigation, eighty participating parents completed a short survey to determine factors relevant in their decision to obtain pediatric, as opposed to general (family) dental treatment, for their children. Parents were asked questions regarding their age, the age and dental treatment history of their children, and the relevance of six factors in their decision to visit the Parsons Center. Overall, "professional/personal recommendation" was the decision factor with the highest average relevance valuation followed by "Spanish-speaking staff," "location," "lack of insurance," "insurance accepted," and "past (patient) traumatic experience." Results suggest the importance of quality care and word-of-mouth recommendations as well as the significance of understanding and serving the needs of one's surrounding population effectively.

Contributors

Agent

Created

Date Created
  • 2017-05

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Coping Skills Used by Nurses After the Death of a Pediatric Patient

Description

As the complexity and severity of hospitalized patients increase, nurses working in an acute care setting will experience patient deaths. From novice to expert, nurses may utilize a range of

As the complexity and severity of hospitalized patients increase, nurses working in an acute care setting will experience patient deaths. From novice to expert, nurses may utilize a range of coping strategies. When the patient is a pediatric patient, the coping strategies become critical. The purpose of this study is to explore the coping strategies used by novice and expert nurses when a pediatric patient dies. The second objective is to compare the coping strategies used by novice and expert nurses. The final objective is to determine if nurses feel nursing school and employee training prepared them for the death of a pediatric patient. Research has shown that nurses use many different coping strategies when faced with a patient's death (Abdullah, 2015; Kellogg, Baker, & McCune, 2014; Plante & Cry, 2011). Expert nurses who have years of experience should have more options for coping strategies than novice nurses, yet there is little evidence to support this. This qualitative descriptive study used structured in-depth interviews to explore the coping strategies of pediatric nurses when experiencing a patient's death. Using thematic analysis, transcripts of the interviews were coded such that themes emerged. Themes for novice nurses were compared to expert nurses. These themes were also placed into concepts that encompassed many similar themes. The findings help determine that there is a difference in the coping mechanisms used by novice and expert nurses, and there is a need for more education on coping strategies after the death of a pediatric patient.

Contributors

Agent

Created

Date Created
  • 2017-05

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The Lighthouse: Improving Pediatric Palliative and Hospice Care

Description

5 With over 55,000 pediatric deaths per year in the United States, there is a tremendous need for pediatric palliative and hospice care facilities. While this programmatic typology exists in

5 With over 55,000 pediatric deaths per year in the United States, there is a tremendous need for pediatric palliative and hospice care facilities. While this programmatic typology exists in several countries around the world - including over 45 centers in the United Kingdom alone - only two pediatric palliative and hospice facilities are operational in the United States. Offering a spectrum of care that extends from respite to end-of-life, these facilities would benefit over 8,600 children daily in the U.S. In addition to compiling research in order to build a case for the express need for such a facility, I propose that this typology requires a unique organizational scheme that diverges from the traditional program of home or hospital. Rather than adhering to the hierarchies found in a singlefamily residence, upon which the current model is organized, this new type of design revolves around the Nurses' Station as the nucleus of the facility. Additionally, the design relies heavily upon biophilic stratagem and play therapy, which further influence the program and form of the building. These tactics are used to enhance the psychological state of the patient, family, and medical staff and to mitigate the impact of a life-threatening or life-limiting illness.

Contributors

Agent

Created

Date Created
  • 2016-05