Matching Items (18)
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
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
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
Background: There is growing evidence that persistent exposure to the adverse effects of stressful work conditions, abuse, and re-traumatization without proper intervention leads to compassion fatigue (CF) and reduced compassion satisfaction (CS). Without appropriate intervention, the outcome of CF affects the patient, staff, and the organization. Despite proposed self-care measures, mental health (MH) workers continue to struggle with CF and lack the resources to combat the issue.
Objectives: Ongoing awareness on the implications of trauma and its impact on one's behavior, supports the use of Trauma-informed care (TIC) skills in creating a conducive work environment. This quality improvement project examines the efficacy of TIC education as an intervention for CF pre/post-one-hour education session among MH workers.
Methods: MH nurses (n=8) from diverse backgrounds in a Phoenix inpatient psychiatric hospital gave consent for the study. Participation was sought via flyers and entailed attending the one-hour education session, filling out a demographic, and pre/post-professional quality of life (ProQol) surveys. The ProQol standardized tool measures CF, CS, and burnout with reliability >0.70. Expected outcomes include a reduction in CF and an improvement in CS. Data analysis using intellectus software involved descriptive analysis and paired t-tests to compare outcomes.
Results: Pre/post data analysis was statistically significant, P = 0.003, which shows a reduction in CF and an improvement in CS.
Conclusion: TIC as an intervention for CF looks promising. MH nurses can manage their stress symptoms and that of their patients using TIC skills.
ContributorsOnyia, Nneka (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29
Description
Substance use disorder has been increasing in the United States year after year. Modern treatments fail as often as they succeed. The current standards of practice fail to provide patients with the ability to harness thoughts and control anxiety. Mindfulness practices are currently being adapted as a therapeutic technique to address some of these concerns. An exhaustive literature review was conducted to investigate how various mindfulness techniques impact substance use disorder. Ten high-quality studies were retained and synthesized to show current understandings of the effectiveness of a mindfulness therapeutic technique. An evidence-based intervention is suggested for implementing mindfulness-based relapse prevention into a residential treatment facility. The intervention created incorporates the self-efficacy theory and an adapted health-belief model. Adults in a residential treatment facility for substance use disorder were given eight mindfulness sessions over the course of four weeks. Participants were given pre- and post-intervention screenings for mindful attention and anxiety. The data analysis after two-tailed paired T-tests showed that anxiety significantly decreased (α=.05, p<.001) and mindful attention increased significantly (α=.05, p=.015). Overall, mindfulness shows promise in its potential to reduce substance abuse.
ContributorsWandler, Ryan (Author) / Nunez, Diane (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
Description
An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth.
Methods:
This project was implemented among students attending an alternative high school in Arizona. Nine students participated in four different mindfulness, hands-on activities during two classes- 1 hour each. Participants completed a pre and a post-test with the 10-item questionnaire Perceived Stress Scale (PSS), and a 3-question survey to evaluate the program at the end of the second week.
Results: Among the 9 participants (mean age = 16 SD=2.06), the stress levels were considered low to moderate in the pretest (mean=16.56) and the post-test (mean=15.89). Stress level scores were reduced after the education although the difference was not statistically significant. Furthermore, all participants agreed that the content and activities were appropriate, 88.9% agreed they had a "better understanding of how to reduce stress," and 77.8% stated their "knowledge of stress has improved."
Discussion/Conclusion:
This project aimed to help reduce vulnerable adolescents' stress level through mindfulness activities. Mental health education like this may help adolescents better manage stress and consequently promote their overall well-being. Future projects should recruit a larger sample and implement a longer time for larger and longer effects.
ContributorsQualman, Stephanie (Author) / Chen, Angela (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-10
Description
Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental health literacy (MHL) in adolescents would improve while decreasing stigma and improving help-seeking behaviors after a program of enhanced mental health education. Partnering with a large Arizona suburban school district social work department, a teen Mental Health First Aid (tMHFA) pilot program was implemented for a class of nine (n = 9) adolescent students (aged 17-18 years) old during the school day. tMHFA was delivered in three 90-minute class days. Using the Mental Health Literacy questionnaire (MHLq), a pre and post-test design revealed a significant (p value=less than 0.05) increase in the students' MHL, help-seeking behaviors, and decreased stigma after delivery. This quality improvement project was IRB approved, and all human subjects' rights were protected. In conclusion, there is strong evidence that enhanced mental health programming, such as tMHFA, effectively educates adolescents about mental health challenges and, perhaps, could promote behavioral changes in future generations.
ContributorsJones, M. Christina (Author) / Schiller, Zita (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-15
Description
Background: Diabetes (DM) is a costly disease that negatively impacts patients and the healthcare system that requires complex and structured management. Literature has shown a gap in effective, structured diabetic education and management for providers and patients.
Objective: The purpose of this quality improvement project was to investigate the impact of how outreach, through a structured educational care plan, affects healthcare team experience, perception, and impact on their ability to communicate and comanage patients' chronic diabetes. Utilizing telemedicine as an alternative to the office visit healthcare model to address a gap in care by providing ongoing, structured diabetes education and management.
Methods: A small-scale study initially included ten participants, with five that completed the study. This included the Population Outreach Team (POT), one provider, and four auxiliary support staff. They were introduced to and utilized a care plan tool (CPT) to assist providers and auxiliary health team communication and education delivery to patients with DM. The theoretical and implementation framework that guided the study was based on the nudge theory, focused on altering habits and behavior, and the Model for Improvement supporting future alterations and improvement as identified. A CPT was designed based on HEDIS diabetes measures and the American Diabetic Association (ADA). Improvement was measured through nine question pre- and post-surveys with an additional four questions specific to the CPT use based on a modified RAND Likert scale patient satisfaction survey. A post-qualitative interview with the provider was conducted to gain further insight into CPT use and perception.
Results: A total of ten healthcare and auxiliary participants joined the study; of these, five completed it. The data, including the pre- and post-perception surveys, were collected over a 6-week study period with a post-implementation interview with one provider. Data analysis was captured through descriptive statistics. Pre-perception, M = 19.6 (SD. 4.04, 14 – 25). Post-perception, M = 7.60 (SD. 1.34, 6 – 9). CPT perception post, M = 14.4 (SD. 3.65, 10 – 18). A lower score indicated improvement. The interview identified the following barriers that impacted the CPT's success, including the patient-provider relationship, EHR "easability", patient readiness, and patient education barriers.
Conclusion: This small study indicated the positive impact structured, ongoing education provides to improve communication and comanage patients' with DM through the POT improved perception with CPT use. Barriers identified will assist with future implementations and other areas for improvement, which may increase success in the objective of this study and the delivery of healthcare for patients with DM. Future utilization of this intervention may be easily translated to other primary care environments. The intention is that successful DM management may lead to decreased medical management, complications, and financial strain.
ContributorsWilde, Daniella (Author) / Moffett, Carol (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-01
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
According to The Joint Commission, most sentinel events in healthcare can be attributed to errors in communication. Thousands of medical students in the United States lack adequate communication training. Current literature illustrated that communication skills training programs increase confidence and communication skills of medical students and residents. These programs vary in techniques, with many including lectures and role play exercises. This project aimed to improve outcomes at a forensic facility in Arizona by utilizing a student role play intervention and lecture. Outcomes were measured utilizing developed pre- and post-intervention surveys. The surveys included a validated tool which measured four communication skill categories. A convenience sample consisted of pre-medical interns who participated in the project. The small sample size (four) led to descriptive statistics utilization to provide preliminary data. Prior to the intervention, communication skill average scores were as follows: listening (15), giving and getting feedback (12), sending clear messages (13.75), and handling emotional interactions (11.5). Post-intervention, the average scores for the communication skills were as follows: listening (18.25), giving and getting feedback (13), sending clear messages (16), and handling emotional interactions (12.75). Average scores for each category showed an increase after the implementation of the intervention. The survey was completed for four (100%) of participants, and 75 percent of participants stated they felt more confident with utilizing communication skills in their internship. A communication skills training program can enhance communication skills of medical trainees by providing structured support. Further research is needed on effective techniques to train medical trainees.
ContributorsIliescu, Michelle (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26