Matching Items (5)

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Diabetes Self-Management Education Effects on Hemoglobin A1c

Description

Diabetes, a common chronic condition, effects many individuals causing poor quality of life, expensive medical bills, and devastating medical complications. While health care providers try to manage diabetes during short

Diabetes, a common chronic condition, effects many individuals causing poor quality of life, expensive medical bills, and devastating medical complications. While health care providers try to manage diabetes during short office visits, many patients still struggle to control their diabetes at home. Lack of diabetes self-management (DSM) is a potential barrier for people with diabetes having to maintain healthy hemoglobin A1cs (HgA1c).

In hopes of addressing this concern, an evidenced-based intervention; diabetic education and phone calls, using the chronic care model as its framework was implemented. The intervention targeted people with type II diabetes at a transitional care setting. Measured variables included HgA1c and DSM. Statistically significant improvements were seen in reported physical activity. Average improvements were seen in HgA1c and DSM after three months of diabetes self-management education (DSME). Attrition, cultural sensitivity, and increasing DSME hours should be further evaluated for future projects.

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Agent

Created

Date Created
  • 2020-08-13

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Pressure Injury Prevention in the Inpatient Setting

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

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.

Contributors

Agent

Created

Date Created
  • 2020-04-16

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Improving Glycemic Control in Patients with Type 2 Diabetes Through Formal Education

Description

Background and Purpose: Over 30 million people in the United States (U.S.) have diabetes mellitus, which comprises about 9% of the population, and about 90% of individuals with diabetes have

Background and Purpose: Over 30 million people in the United States (U.S.) have diabetes mellitus, which comprises about 9% of the population, and about 90% of individuals with diabetes have type 2 diabetes (Centers for Disease Control and Prevention [CDC], 2017). Adults with type 2 diabetes at a local internal medicine clinic were consistently having high glycated hemoglobin (HbA1C) levels, demonstrated by data collected from the electronic health record (EHR), and there was no ordering process for referring patients to diabetes management education and support (DSMES) services. The purpose of this project was to improve glycemic control, demonstrated by lower HbA1C levels, and reach a diabetes education attendance rate of 62.5% at an internal medicine clinic in Chandler, Arizona.

Methods: An electronic health record (EHR) template was created and brief staff training was completed to connect patients with diabetes in the community to a local formal diabetes education program. HbA1C levels were measured before and three months after adults with education program. HbA1C levels were measured before and three months after adults with type 2 diabetes mellitus (T2DM) received physicians’ orders for a DSMES program, and rates of attendance to the program were calculated. Data was collected through the EHR and through feedback from the DSMES program. Descriptive statistics were used in data analysis.

Outcomes: The participants’ results did not demonstrate significant differences in pre-referral and post-referral HbA1C results after they were ordered DSMES services (p = .506). The proportion of education attendance (30%) was lower than the project goal of 62.5%, but increased from the clinic baseline.

Conclusions: EHR template implementation for referral to DSMES may increase rates of formal diabetes education and improve glycemic control. Larger sample sizes, longer project periods, alternative methods of communication, and increased follow-up of participants may be required to produce significant results.

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Agent

Created

Date Created
  • 2020-04-30

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Improving End-of-Life Care in the Primary Care Setting: Implementation of the Serious Illness Care Program

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

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.

Contributors

Agent

Created

Date Created
  • 2019-05-02

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The Adverse Impact of Partisan Politics on Women’s Sexual and Reproductive Health and Rights: How Political Polarization Inhibits Women from Achieving Reproductive Justice

Description

My thesis aims to examine how partisan politics and politicization of women’s health issues adversely impacts the health and wellbeing of women. I will explore this topic within the broader

My thesis aims to examine how partisan politics and politicization of women’s health issues adversely impacts the health and wellbeing of women. I will explore this topic within the broader context of partisanship, morality, feminism, and social justice in an attempt to dissect the arguments propagated by both the pro-life and pro-choice spheres. Political polarization results in limitations for reproductive health resources for women, particularly low-income and minority women who rely on government-funded healthcare to meet their needs. Moreover, reducing women’s healthcare decision-making opportunities not only has a destructive impact on their health and financial security, but also poses significant human rights implications concerning bodily autonomy and gender equality. Through the literature review, I intend on highlighting the role of conservative politics in diminishing available services, to the detriment of women, particularly low-income and marginalized women. I plan to demonstrate this hypothesis through a literature review, analysis of Roe v. Wade, and a review of the historical trajectory that illuminates factors related to the availability and accessibility of reproductive resources. Lastly, I will critique the political narratives pushed by both liberal and conservative media and highlight the need for a comprehensive reproductive justice framework for achieving positive SHRH outcomes.

Contributors

Created

Date Created
  • 2021-05