Matching Items (19)
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
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
Background: The cost of health care for end-stage kidney disease patients has exponentially increased over the years, costing 91,000 annually per patient. Peritoneal dialysis has proven to be a cost-effective renal replacement therapy compared to in-center hemodialysis. Quality evidence from a systematic literature review indicates that peritonitis is one of the leading causes of patients' ability to maintain peritoneal dialysis. Evidence suggests that enhanced patient education on infection control practices beyond standard education effectively reduces peritonitis incidents.
Methods: Enhanced education on infection control practices was delivered to 18 peritoneal dialysis patients in Southern Arizona through the application of determinants of the Health Belief Model utilizing the principles of the ADKAR framework. Data analysis will be available through facility-specific quality metrics of decreased peritonitis and modality loss episodes. Each of these measures is to have data compared to pre/post-intervention.
Results: All participants in the study were able to sustain peritoneal dialysis as their renal replacement therapy. Of the 18 participants, one patient episode of peritonitis occurred three months before the intervention, and zero episodes were reported during the first three months of monthly infection control education. Facility-specific peritonitis and modality loss measures are not available until after project publication.
Conclusion: To decrease peritonitis rates and modality loss, the intervention will continue for eight to 12 months to determine success. More time is needed to determine if patients adhere to monthly infection control practices taught during enhanced education.
ContributorsSchneeweis, A. Danielle (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29
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
Objective
A needs assessment identified a nursing knowledge gap of chemotherapy-induced neurotoxicity (CIN) symptoms as a significant factor in delayed recognition of patients' neurologic decline. The quality improvement (QI) project aimed to increase nursing comfort levels and knowledge related to screening for CIN in hospitalized pediatric hematology, oncology, and bone marrow transplant (Heme/Onc/BMT) patients.
Methods
Nursing CIN education and pre- and post-education assessment questions were created using best practice parameters to screen and monitor CIN in Heme/Onc/BMT pediatric patients. Pre- and post-surveys included a valid Likert-type scale to assess comfort levels using neurotoxicity screening tools (NST) followed by knowledge-based formative assessments. ASU IRB and hospital QI board standards were maintained.
Results
Heme/Onc/BMT nurses (n=37) participated. The most frequent pre-education comfort level was three or somewhat comfortable (n=13). Most frequent post-education comfort level is four or very comfortable (n=21). The two-tailed Wilcoxon signed rank test for pre- and post-education comfort levels was significant based on an alpha value of .05 and p < .001.
Conclusion
Nursing comfort and knowledge of screening for CIN increased. Early recognition of CIN will improve outcomes for high-risk hospitalized Heme/Onc/BMT pediatric patients.
ContributorsBest, Brianne (Author) / Bucci, Aimee (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
Description
Breast cancer is one of the leading causes of cancer-related deaths among women in the United States. Uninsured women are less likely to receive breast cancer screenings, more likely to be diagnosed at an advanced stage, and more likely to have poorer outcomes following a breast cancer diagnosis (Abdelsattar et al., 2016; Akinlotan et al., 2021; Ko et al., 2020; & Ntiri et al., 2018). Women in underserved communities often experience socioeconomic barriers which impact obtaining preventative screenings, such as mammograms. Lack of patient navigation, transportation, and financial concerns interfere with obtaining breast cancer screening (Akinlotan et al., 2021 & Miller et al., 2019). Through the intervention of mobile mammography, uninsured women in underserved communities can be reached and access to screening mammograms can be achieved (Stanley et al., 2017 & Vang et al., 2018). Two mobile mammography events were hosted at the project site which provided 35 women with screening mammograms. All scheduled mammogram time slots at the events were filled and completed. Offering mobile mammography to this population has the potential to increase breast cancer surveillance.
ContributorsGlessner-Vallee, Paula (Author) / Santerre, Jennifer (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
Description
Breast or formula feeding is a personal and challenging decision for any new parent. Breastfeeding goes beyond the mother-baby dyad, having profound implications across different societal contexts, including financially and medically. Although a natural form of feeding, breastfeeding can be difficult and isolating if it does not come easily. A mother's first contact for help is usually at her newborn's first primary care appointment. However, these appointments are insufficient in allowing the healthcare provider to answer breastfeeding concerns or questions. A quality improvement project was conducted at a pediatric primary care clinic in the southeast valley of Arizona after approval was granted by an Institutional Review Board. Eight participants were recruited, and four completed the project. This project focused on extending the newborn appointment by 15 minutes to provide an educational resource binder and address breastfeeding questions. The Bristol Breastfeeding Assessment Tool (BBAT) was utilized to determine the mother's self-efficacy towards breastfeeding since the Theory of Self-Efficacy was the foundation for this project. Weekly follow-up telephone calls were conducted to address the mother's questions. The project concluded at the one-month appointment, where BBAT was performed again. The BBAT scores demonstrated an increase in breastfeeding self-efficacy. The participants were also evaluated if the project aided their breastfeeding journey. Every participant was breastfeeding by the one-month appointment except one who was not exclusively breastfeeding. In addition, all preferred the extended-length newborn appointments, educational binder, and weekly phone calls. Qualitative theming supported the use and continuation of the project for future mothers.
ContributorsScott, Taryne (Author) / Bay, Sarah (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-28
Description
Objective: This cross sectional study aims to determine the effects of gender and parental perception of safety at school on children’s physical activity (PA) levels.
Materials and Methods: Parents of school aged Mexican children residing in Guadalajara, Mexico City, and Puerto Vallarta, completed surveys about their children’s PA measures. The physical activity indicators were evaluated using linear and logistical regression models.
Results: Analysis did not indicate that gender moderated the relationship between parental perception of safety and PA measures, but significant gender issues exist with girls participating less than boys in the three measures of PA in this study (p<0.001).
Conclusion: Results suggest the need for additional interventions promoting physical activity in girls in Mexico.
ContributorsHutchens, Amy (Author) / Soltero, Erica G. (Author) / Barquera, Simon (Author) / Levesque, Lucie (Author) / Jauregui, Edtna (Author) / Lopez y Taylor, Juan (Author) / Lee, Rebecca (Author) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2016-01
Description
Background: Physical activity (PA) public health programming has been widely used in Mexico; however, few studies have documented individual and organizational factors that might be used to evaluate their public health impact. The RE-AIM framework is an evaluation tool that examines individual and organizational factors of public health programs. The purpose of this study was to use the RE-AIM framework to determine the degree to which PA programs in Mexico reported individual and organizational factors and to investigate whether reporting differed by the program’s funding source.
Methods: Public health programs promoting PA were systematically identified during 2008–2013 and had to have an active program website. Initial searches produced 23 possible programs with 12 meeting inclusion criteria. A coding sheet was developed to capture behavioral, outcome and RE-AIM indicators from program websites.
Results: In addition to targeting PA, five (42%) programs also targeted dietary habits and the most commonly reported outcome was change in body composition (58%). Programs reported an average of 11.1 (±3.9) RE-AIM indicator items (out of 27 total). On average, 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. The proportion of RE-AIM indicators reported did not differ significantly for programs that were government supported (M = 10, SD = 3.1) and programs that were partially or wholly privately or corporately supported (M = 12.0, SD = 4.4).
Conclusion: While reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes before the public health impact of these programs can be established.
ContributorsJauregui, Edtna (Author) / Pacheco, Ann M. (Author) / Soltero, Erica G. (Author) / O'Connor, Teresia M. (Author) / Castro, Cynthia M. (Author) / Estabrooks, Paul A. (Author) / McNeill, Lorna H. (Author) / Lee, Rebecca (Author) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2015-01-27