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- All Subjects: Education
Over the last two decades, opioid prescription and prevalence has increased to account for over 33,000 deaths per year (Soelberg, Brown, Du Vivier, Meyer & Ramachandran, 2017). This is not only due to overdose, but misuse, abuse, and addiction. The abrupt increase in prescriptions, pills dispensed, and opioid-related deaths have encouraged the involvement of multiple entities.
In 2016, the opioid crisis gained the attention of communities that released guidelines to regulate prescription of opioid pain management. Such entities include the Center for Disease Control and Prevention (CDC), National Institute on Drug Abuse, Agency for Healthcare Research and Quality (AHRQ), Arizona Department of Health Services (AZDHS), and Substance Abuse and Mental Health Services Administration (SAMHSA). Evidence shows that prescribing practices between providers vary. It also shows that providers lack knowledge of appropriate opioid prescribing and management. To address this problem, provider education on an opioid policy is the most effective way to uniform opioid prescribing.
Diabetes mellitus (DM) is a detrimental disease that afflicts approximately 23.6 million Americans and costs $176 billion dollars annually in direct medical expenses (American Diabetes Association [ADA], 2015). Approximately 208,000 children and adolescents with diabetes are under the age of 20 years (ADA, 105; CDC, 2014). Currently, the standard of medical practice in school-aged children and adolescents with type 1 diabetes is to administer insulin after the child or teen has eaten. The most current evidence has demonstrated a decrease hemoglobin A1C (HbA1c) and preference for pre-prandial insulin administration (Cobry et al., 2010; Danne et al., 2003; DePalma et al., 2011; Enander et al., 2012; Luijf et al., 2010; Scaramuzza et al., 2010).
This Doctor of Nursing Practice (DNP) project delivered an educational program for parents of school age children and adolescents with type 1 diabetes and instituted pre-prandial insulin administration as the standard of care in an outpatient pediatric endocrine clinic. Education was delivered in both verbal and written formats. Data collection included weekly blood glucose reports and HbA1c at initial and follow-up sessions. Descriptive statistics were utilized to analyze the data. No post intervention data was able to be collected due to participant drop out. Future directions to promote this practice change are discussed.
Background and Significance: Evidence shows primary care providers (PCPs) are not adhering to the GOLD Guidelines for COPD screening.
Methods: Guideline education with pre/post-intervention survey and percent of eligible participants screened.
Results: Pre-intervention surveys (n=10) and post-intervention surveys (n=8) completed. Significant increase in knowledge regarding the CAT score (M score = 11.50, U = 24.000, p<.05). Part 2) 24% (n=6) of participants were screened with the CAT questionnaire.
Conclusions: PCPs are aware of the GOLD Guidelines, but do not always adhere to its recommendations. Future research should concentrate on effective ways to implement the GOLD Guidelines screening recommendations in primary care clinics.
Background: The consequences of poor communication or non-therapeutic communication cannot be overemphasized; these can include non-adherence to treatment plan, reduced treatment compliance, higher psychological morbidity, dissatisfaction with care and poor patient-caregiver relationship. Patients’ perception of how they are being treated affects how they respond to treatment plans and medication regimens
Method: The project consisted of providing education on the principles of therapeutic communication to healthcare workers in an outpatient psychiatric clinic. Follow up materials on therapeutic communication principles were provided on a weekly basis for one month. A pre-survey questionnaire was given to patients before intervention and a post-survey questionnaire after intervention to determine patient satisfaction with care and degree of communication with healthcare workers. The Short Assessment of Patient Satisfaction (SAPS) and the Communication Assessment Tool-Team (CAT-T) were the instruments utilized in this project.
Finding: Patient satisfaction and communication with staff were statistically and significantly improved after education on therapeutic communication was given to staff.
Conclusion: Education on therapeutic communication is an effective intervention tool in improving patient’s satisfaction and communication with staff and health care team members in a psychiatric outpatient clinic.
Methods: This quasi-experimental pre/post design project was guided by the ACE Star Model and Leininger’s Theory of Cultural Care. The affiliated University’s IRB approved this project. The Diabetes Empowerment Education Program (DEEP) was implemented in a free, community clinic in a medically underserved area. Spanish speaking patients (n = 15) with A1C levels
> 8mg/dl were recruited to participate in a 6-week group educational program facilitated by community health workers. Outcomes included A1C levels, weight, and two surveys from the Michigan Diabetes Research Center - DM knowledge test and the DM empowerment scale.
Results: Paired sample t-tests were used to analyze the outcomes. The participants had an average pre-A1C of 8.82 mg/dl with post-A1C of 8.01 mg/dl (p = .028). Pre-knowledge test scores averaged 9.40 with post-test average of 12.07 (p < .001). Empowerment scores increased from 4.09 to 4.63 (p = .001). The reduction between the average pre-and post-weight measures were not statistically significant (p = .681).
Discussion: The implementation of a culturally-tailored DM educational program in a medically underserved community had a significant impact on reducing A1C levels, improving DM knowledge, and enhancing empowerment levels. Although the sample size was small and limited to one clinic, applying these programs can have a measurable clinical impact in the treatment of Hispanic DM patients. Future research can further exam how to duplicate this project on a larger scale and over a sustained period.
Purpose: Assess provider perceptions on care coordination, collaboration, teamwork, and shared decision-making practices pre and post a brief educational intervention on interprofessional collaboration (IPC).
Background and significance: A lack of care coordination and active follow up in the outpatient setting of individuals living with mental illness places this population at high risk for developing various comorbidities. Care coordination across care providers and patients in a IPC, patient-centered treatment model of care is an intervention that can reduce this barrier to care.
Methods: At a behavioral health clinic in the southwestern United States (U.S.) twenty-two participants were assessed via the Collaborative Practice Assessment Tool (CPAT), before and after an educational presentation on IPC care. The CPAT is a tool that was developed to assess collaborative practice within teams and help identify needs for professional development.
Results: Statistical significance was found from pretest to posttest scores (t(21) = -1.936, p = .066). Statistical significance was found in two of the eight domains; mission, meaningful purpose, and goals (p = .009) and decision-making and conflict management (p = .058). Increases in posttest scores were seen in all eight domains.
Conclusions: Training behavioral health professionals in IPC practice and teambuilding may facilitate improved clinical team experiences and communication. Behavioral health professionals treating individuals living with serious mental illness (SMI), IPC training could prepare providers to work more effectively and efficiently in the delivery of patient-centered care in this population with complex health care needs.