Doctor of Nursing Practice (DNP) Projects

Permanent URI for this collection

https://hdl.handle.net/20.500.14394/414

Browse

Pressured Touch Foot Care to Relieve Chronic Pain and Improve Quality of Life
(2023-05) Clayton-Jones, Mary C.
Background: Chronic pain affects many older adults and is a leading cause of disability. It is often treated pharmacologically, but evidence indicates touch therapy modalities are beneficial. Purpose: To implement a therapeutic touch program for adults enrolled in a Program of All-Inclusive Care for the Elderly (PACE) to help reduce chronic pain and improve quality of life for those patients enrolled in this project. Method: Twelve participants in an assisted living facility with chronic foot pain were initially selected by the PACE Family Nurse Practitioner (FNP) for home visits with this Doctor of Nursing Practice (DNP) student for a foot care and pressured touch intervention to occur once a month for 3 months. The McGill Pain and Quality of Life Scores questionnaires were administered before each intervention. Results: Four participants completed all three interventions. Every participant experienced a decrease in pain pre- and post-intervention and month-to-month of 15% or more. Three participants had experiences of complicated grief and had a decrease in quality-of-life scores over the 3 months. The participant without complicated grief had an improvement in the quality-of-life scores with pain reduction. Conclusions: This small home intervention project for chronic pain demonstrated that foot care and pressured touch may be a cost-effective adjunct therapy for reducing pain. Chronic pain can be complicated by grief, which must be considered when looking to support elder wellness and quality of life.
Improving Patient Knowledge of Postpartum Depression Through an Educational Awareness Campaign
(2024-05) Buendia, Stephanie A.
Background: In the United States, postpartum depression (PPD) affects approximately one in eight mothers. More than half of those affected do not receive treatment for PPD (Bauman et al., 2020). If left untreated, PPD can result in lasting consequences including impaired bonding between mother and child, impaired cognitive, social, and language development in the child, and increased risk for developing chronic mental illness in mothers (May & Kennedy, 2019). Purpose: This DNP project aimed to improve knowledge of PPD amongst pregnant and postpartum individuals. Methods: A pre- and post-survey design was used to assess the effectiveness of the intervention. The educational intervention included posters, pamphlets, and handouts. Surveys were administered to obtain information about pregnant and postpartum individuals’ knowledge and awareness of PPD before and after the intervention. Results: 73 pre-intervention surveys and 67 post-intervention surveys were collected. There was a significant difference in means for question two and five (How familiar are you with the treatment options for postpartum depression? How satisfied are you with the resources available at the office regarding postpartum depression?). There was no significant difference in means for questions one, three and four (How familiar are you with the signs and symptoms of postpartum depression? How comfortable are you with seeking out mental health care as needed? How supported do you feel by your healthcare team regarding your mental health?). There was no association found between age or education and the survey question responses. Conclusion: The use of an education based PPD awareness campaign was positively associated with an improvement in patient knowledge of PPD treatment and satisfaction with available resources at the clinic. Patient education should continue to be explored as a viable option to improve PPD treatment through increasing patient knowledge.
Caring for Patients from Underserved Communities: An Online Toolkit for Cultural Adaptation of Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) for Psychiatric Mental Health Nurse Practitioner (PMHNP) Students
(2024-05) Bunis, Jillian M.
Background: Mental healthcare in the United States is in crisis, with a deficit in provider availability and accessibility nationwide. This deficit, coupled with unique challenges faced by underserved communities, highlights the need for culturally competent healthcare professionals. Unfortunately, many undergraduate and graduate nursing programs in the United States do not offer opportunities for in-depth learning when it comes to culturally adapting evidence-based therapies for minority and underserved populations. Purpose: To address this need, an online toolkit was developed to teach PMHNP students how to use culturally adapted Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) as a means of promoting mental health. The toolkit provided participants with the opportunity for in-depth learning and training in cultural adaptation of CBT and MI. It was hypothesized that after utilizing this online toolkit, participants would be better equipped to provide culturally responsive, appropriate, and effective clinical care to underserved communities. Methods: The toolkit was developed during Summer 2023 and was implemented with Psychiatric Nurse Practitioner students at the University in Fall 2023. The toolkit included video modules featuring CBT and MI experts reviewing basic concepts of both psychotherapy techniques, as well as lecture by a cultural adaptation expert reviewing why this concept is important and what it looks like in clinical practice. To demonstrate this, short role-play videos were included in the toolkit for participants to watch and review. The control group did not4 utilize the toolkit during the project, while the intervention group utilized it in a self-directed manner for approximately three months. They were encouraged to spend 30 minutes daily engaging with the content. Intervention effectiveness was measured with two metrics: the Cultural Capacity Survey (CCS), and the Inventory for Processing Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R). Surveys were completed pre-intervention, as well as three months post-intervention, in November 2023. Results: 40 subjects participated in this study. Most project participants were female (n=38, 95%), White (n=26, 65%), and were post-master level of education (n=24, 60%). The result of the ANCOVA for IAPCC-R data was significant (F(1, 34) = 5.958, p = 0.020). The intervention participants (mean=78.5294, SD=6.22613) perceived they were more culturally competent in healthcare delivery than the control participants (mean=74.2500, SD=5.87904) after the toolkit intervention. The result of the ANCOVA for CCS data was also significant (F(1, 37) = 10.555, p =.002). The CCS scores post-intervention were significantly different between the intervention and control group after controlling for the effect of pre-intervention CCS scores. The intervention participants (mean=76.6667, SD=9.73169) perceived that they had higher cultural capacity than the control participants (mean=73.1250, SD=7.42203) after the toolkit intervention. Many participants reported that they thoroughly enjoyed utilizing this toolkit and believed it contained very important information for healthcare providers to deliver high quality and culturally sensitive care. Implications: This project holds significant value as it effectively enhances advanced practice nurses’ awareness and proficiency in delivering culturally adapted psychotherapy techniques tailored to the unique needs of minority patient populations.
Increasing Awareness, Knowledge, and Confidence Level of Accessing Adolescent Sexual Reproductive Health Services and Resources for School Personnel at a Public Middle School
(2024-05) Leal Caceres, Marbella
Background: Many adolescents do not have access to adequate sexual and reproductive health (SRH) education and lack awareness and knowledge of services and resources. Adolescents spend more time in school than any other setting. School personnel play a crucial role in guiding youth to make informed and thoughtful decisions. They can promote access to available services but must have awareness, knowledge, and confidence about SRH education, services, and resources. The problem addressed in this project is low awareness and knowledge about adolescent SRH services and resources among middle school personnel. Purpose: This project aimed to increase middle school personnel’s awareness, knowledge, and confidence level of accessing SRH services and resources. Methods: A toolkit was created and implemented with an in-person educational training on local adolescent SRH education, services and resources. Measurements assessed awareness and knowledge, perceived helpfulness, and feedback prior, immediately post, and three-months post training. Questions from the Sexual Health Education for Professionals Scale (SHEPS) measured confidence level. Data was analyzed using descriptive statistics, frequencies, percentages, and content analysis. Results: All participants were health educators (n= 7). Participants’ awareness and knowledge of SRH services and resources improved after project implementation. The post-test (M= 20.16, SD=3.43) and three- month post-test (M= 19.33, SD= 4.45) SHEPS scores increased from the pre-test (M=16.3, SD= 4.54). Participants reported that the toolkit and presentation were helpful and that they referred back to the content. Conclusion: This project supports that a toolkit and educational training are effective in increasing school health educators’ awareness, knowledge and confidence level.
Evaluating the Impact of a Modified AVADE Program on Health Care Workers’ Confidence in Managing Patient Agitation
(2024-05) Cappucci, Jessica
Background: In a one-year period (2021-2022) a Massachusetts hospital reported an increase from 283 assaults on staff to 360 assaults. Assaults on health care workers are associated with increased turnover rates, job dissatisfaction, emotional trauma, and incomplete tasks. Purpose: The purpose of this DNP proposal was to evaluate the effectiveness of a multifaceted program intended to increase healthcare worker knowledge and confidence in managing agitation and violence among patients. Methods: The project used a pre and post one-group design to evaluate an educational intervention, a modified AVADE program, using Thackery's (1987) Confidence in Coping with Patient Aggression, a 30-day post-intervention follow-up, and a post-violent incident follow-up. Quantitative data were analyzed using descriptive statistics and paired t-test, and qualitative data were analyzed using content analysis of an open response question on the post violence survey and the 30 day follow up survey. Results: The modified AVADE program was found to increase confidence in coping with patient aggression. The education was reportedly used in practice within one month of taking the course and during violent events. Discussion: An educational intervention that focuses on de-escalation, awareness, defense, proper restrain use, legal components, and case studies increased healthcare workers' confidence in coping with patient aggression. The educational intervention was found to be used in violent events, and in practice within one month of taking the course. Conclusion: Providing education to healthcare workers in managing patient aggression increases their confidence in coping with patient aggression and offers tools they can use in practice.
Education and Supports for Informal Caregivers of People Living with Dementia
(2024-05) Zahra, Heidi
Background: The Centers for Disease Control and Prevention estimate five to six million Americans currently live with dementia. As dementia advances, individuals experience a gradual decline in their ability to live independently, eventually needing assistance with almost all daily activities. The intense demands of caregiving often lead to signs of caregiver role strain including physical and mental illness and social isolation. Informal caregivers report a need for more information about the symptoms and progression of dementia closer to the time of diagnosis. This project provided timely information to informal caregivers related to dementia progression and local resources. Methods: Caregiver information sessions were presented at local senior centers and were attended voluntarily. A pre-posttest design was used to measure caregiver knowledge before and after the information session and was analyzed using Wilcoxon signed rank test. A survey related to caregiver knowledge of local resources was administered after the session. Results: After the information session, caregivers showed an 11% increase in dementia knowledge as measured by the Dementia Knowledge Assessment Tool (version 2). Based on Wilcoxon test, the increase was found to be statistically significant at a p-value of 0.005. Caregivers also reported increased knowledge of local resources. Conclusion: In-person information sessions at senior centers can be an effective tool for educating and therefore empowering caregivers of people with dementia.
Improving The Perceptions of Psychiatric and Mental Health in the Ghanaian Community
(2024-05) Appiah, Ahmed
Background: Psychiatric and mental health disorders are among the leading causes of disability worldwide. The stigma surrounding psychiatric and mental health disorders creates a barrier for individuals to accept their diagnosis and seek appropriate care, particularly in the Ghanaian community. This project aimed to educate the Ghanaian community in Massachusetts about the science behind psychiatric and mental health disorders. Methods: A church-based educational intervention to improve the knowledge base and debunk the myths about psychiatric and mental health disorders were presented. A pre-test survey assessing beliefs towards mental health questionnaire was administered prior to determine the church’s predominately Ghanaian community's perception of psychiatric and mental disorders. After the educational presentation at the church, 30 surveys were distributed. Results: Of the 30 surveys distributed, 27 participants returned their questionnaires. Participant’s negative perceptions towards mental illness were reduced, particularly on perceived dangerousness of individuals with mental illness (by 20%), the likelihood of being assaulted by an individual with a psychiatric disorder (by 30%), embarrassment if others knew that a respondent had dated an individual with a psychiatric disorder (by 22%), individuals with mental illness should have jobs with minor responsibilities (by 20%), and individuals with psychiatric disorders are unpredictable (by 12%). Conclusion: The modest results are encouraging and give hope for measurable success with a sustained effort at educating the community members. The educational activity has assured that sustained education about the stigma of psychiatric and mental health disorders will make a positive impression on the community.
An evaluation of mental health services on college campuses: Meeting the needs of students post pandemic
(2024-09) Daly, Tamara T.
Background: College campuses have been faced with rising rates of mental health concerns among students for the past two decades. During the Coronavirus pandemic these demands increased, with students presenting in higher numbers and with higher acuity of illness, requesting mental health services. Campus administrators and healthcare providers have struggled to find models of care that meet the increased demand. Purpose: The purpose of the proposed project is to evaluate the state of mental health services across college campuses. Methods: A mixed-method program evaluation design was used to engage key stakeholders in an assessment of current practices, perceived problems, challenges, and potential solutions to improve mental health care on their campuses. Surveys and individual interviews were used to gather data from colleges across the United States.
Implementing Adverse Childhood Experiences Screening in Reproductive Age Women
(2024-05) Vaillancourt, Sarah
Background: Adverse Childhood Experiences (ACEs), including childhood abuse, neglect, and household dysfunction, have been linked to negative mental and physical health outcomes including chronic illness, mental illness, and high-risk behaviors. Opportunity for ACEs screening exists in outpatient women’s health and prenatal settings due to regularity of services and the existing sensitivity of services provided. There is also the opportunity to intervene through ACEs screening to prevent ACEs in the families and children of women of reproductive age. Purpose: The purpose of this DNP project was to increase ACEs screening among reproductive age women in this community health setting and to provide additional resources as indicated by screening. Methods: This project screened women of reproductive age between ages 18 and 45 who present for perinatal care, and routine wellness visits. Additional interventions of education and appropriate referrals were provided upon screening. Data was collected via ACEs screening results with education and referrals completed, a patient acceptability survey, appointment time, and participant demographics. Results: A total of 65 participants were enrolled. The average ACEs score was 1.6, with around half of screening results being negative. All participants received education, and all moderate and high-risk participants received intervention and referrals. Discussion: Overall, this project was successful and identified as feasible and sustainable if future iterations are pursued, based on number of participants enrolled, participants who received intervention, and positive participant acceptability. The positive outcomes of this implementation project imply feasibility and sustainability of an ACEs screening process in reproductive age women.
Increasing Health Prevention Services in the Military Population
(2024-05) Shagory, Ariel R.
Background: Readiness in the military is vital to our national security. With greater education, screening, and policy on prevention, readiness will improve. There are required vaccines in the military based on location; optional vaccines are often not screened for. Due to everchanging environments, there are gaps in education and training relating to health prevention. Purpose: The purpose of this DNP project was to educate military healthcare professionals and Army medical recruiters about available preventive health care services with an emphasis on COVID-19 and human papillomavirus (HPV) vaccines. Methods: This quality improvement project targeted 145 Soldiers in a Northeast Medical Recruiting Battalion and included education sessions regarding preventive medicine. A paired t-test was conducted in the population sampled to compare perceived knowledge and vaccine hesitancy pre and post education intervention. Measurements were vaccine hesitancy and perceived knowledge using two distinct surveys as instruments. Results: A total of 30 participants attended the education sessions. There was improvement in perceived knowledge from an education intervention. The paired t (27) =-2.788, p= 0.005 validate the achievement of education and perceived knowledge increase. However, there was no significant differences in vaccine hesitancy following the education intervention, paired t (15) = 1.371, p= 0.095. Conclusion: Education is a start, however, not enough to have an impact on vaccine hesitancy and acceptance rates. There are missed opportunities in the military primary care setting and policy development that will aid in force health protection. Implications: Actions need to be taken to elevate and maintain the health of the force.
Home Based Exercise for Fall Prevention Among Community-Dwelling Older Adults
(2024-05) Alex, Dona
Background: Older adults have a high susceptibility to falls due to their impaired gait and deteriorating muscle strength and balance. Fall risk factors are modifiable with the help of appropriate individualized and group therapies. Otago Exercise Program (OEP), among the various other fall prevention measures, has shown promising effects in fall prevention among older adults. Purpose: The purpose of the proposed project was to evaluate the effectiveness of OEP in the prevention of falls among community-dwelling older adults. Method: Eligible participants (n= 25) residing in independent and assisted living facilities were selected and the OEP was implemented. The effectiveness of OEP was evaluated using previously validated screening tools namely Timed Up & Go (TUG), 30-second Chair Stand Test (CST), self-rated Fall Risk Questionnaire (FRQ), and 4-stage balance test. A weekly exercise log was used to track the number of falls per day. Descriptive statistics analyzed the demographic data, and the McNemar test was used to compare the fall risks pre- and post-intervention. Results: The implementation of OEP among older adults has shown appreciable changes in reducing fall risks. The statistical significance of TUG (p= 0.008), 30-second CST (p=0.031), 4-stage balance test (p= 0.002), and the number of falls (p= 0.002) promotes the use of OEP.The subjective fall risk assessment using the self-rated FRQ (p>0.05) was not statistically significant. The average number of days and the exercises performed each week were 3.72 and 10.17, respectively. Conclusion: The use of OEP in older adults has shown remarkable improvement in fall prevention which is evident from the changes in the scores of the assessment tools that evaluated the risk of falls. The improvement in muscle strength and balance was associated with a decrease in fall risk, the number of falls, and increased adherence to fall prevention strategies.
Improving Practice in Adolescent Substance Use Screening Using the CRAFFT
(2024-05) Tauscher, Julianne
Background The problem addressed in this Doctor of Nursing Practice (DNP) Capstone quality improvement project was the lack of substance use screening by primary care providers for adolescents ages 12-17 in Massachusetts with a validated screening tool. The Centers for Disease Control and Prevention (CDC) reports that among high school-aged students, 15 percent have reported trying an illicit drug. Opioid misuse is reported in 14 percent of high school students. Purpose The purpose of this project was to implement a process for primary care providers to screen for substance use using the CRAFFT tool at wellness visits for patients ages 12-17 seen at a family medicine office in Western Massachusetts. Methods The goal was to screen 100% of adolescents at physicals between the ages of 12-17 years old using the CRAFFT tool, and as appropriate, provide an intervention. The outcomes were measured by a chart review post-implementation of the screening tool. A decision support tool with talking points was included with the screener as well as a referral resource list for clinician decision support. Results Twelve providers screened 53 of 76 patients (69.74%) with the CRAFFT at the annual visit. Post-implementation chart review found five charts documented risk of positive substance use, or 6.57 % of patients. Pre-implementation there were no documented cases of a validated tool used for screening, only the self-report teen questionnaires were utilized. In the pre-implementation chart review, two of 79 patient charts (2.54%) documented a risk of positive substance use. Conclusion The implementation was successful in screening 69.74% of adolescents and identifying five patients for intervention at risk for substance use. Challenges with staffing turnover likely affected the distribution of the screener as well as time limitations in visits.
Increasing Palliative Care Integration in Chronic Heart Failure Management
(2024-05) Ruby, Andrea
ACEs Education in HIV Specialty Care Clinic
(2024-05) Savaille, Marissa
Background: Adverse childhood experiences (ACEs) are traumatic events occurring during childhood that include various forms of abuse, neglect, and exposure to toxic social environments. Early trauma may lead to chronic health problems in adulthood. However, ACE screening, as a routine part of trauma informed care, may lead to improved health outcomes. Purpose: The purpose of this DNP project was to provide clinicians with the knowledge needed to address adverse childhood experiences using evidence-based strategies and an effective screening tool to improve patient screening. Method: A pre and post survey design was used to assess the effectiveness of an educational intervention. Surveys were used to query participants' knowledge, comfort level, and attitudes toward screening for childhood adversity. Descriptive statistics was used to analyze data from the questionnaires. Results: From the results of the surveys, it was evident that the participants were familiar with concepts related to ACEs and trauma informed care but had never used an ACE screening tool at the facility. Conclusion: Continuous education regarding ACEs and trauma informed care will be essential for successful implementation of ACEs screening and use of an ACE screening tool.
Fall Prevention in the Community
(2024-05) Scott, Jacqueline
Background: Falls at home among older people have been a significant problem for years. The purpose of this project was to identify older adults in the community aged 60 and over and at risk for a fall at home and link them to a home safety assessment and educational intervention to decrease their fall risk. Methods: A community-based intervention using a pre-post-test design was used for at risk patients being discharged age 60 and over from an urban medical center. An at home comprehensive safety assessment and educational information were provided to decrease their risk of falling at home. Results: Of the 49 people identified to participate in chart review Eight participants accepted. The results of this project determined that 100% of the participants who completed both the education and in-home assessment found these interventions to be useful in the prevention of falling at home and; 100% had remained fall free at time of posttest and; 66.7% of participants followed the recommendations that were made at the time of the in-home safety assessment. Discussion: Hospitals are an excellent place to identify one’s risk for falling at home and; providing hospitalized patients with education on fall prevention and assessment of their living space can decrease the current fall rate.
A Smoking Cessation Education in the Emergency Room for Patients with Cardiovascular and Pulmonary Disease
(2024-05) Placanico, Angelino
Background: Smoking has been identified as a leading cause of preventable death. More education is needed at point of care. The Emergency Department is a place of choice for primary care for many of individuals with chronic diseases. Purpose: The purpose of this project was to implement and evaluate a dedicated education and resource packet on smoking cessation for cardiovascular and pulmonary patients being discharged from the emergency department. Methods: Smoking cessation education and resource materials were delivered by the DNP student with to participants in an urban medical center ED. A pre-education survey on their views on prior smoking education and whether they have taken steps to quit smoking was given. The post-education survey consisted of a phone call, four weeks after the session about use of smoking cessation materials and if they had tried to quit. Results: A total of 18 participants were recruited for this project. Forty-four percent (n=8) of the participants made attempts to quit smoking and 22% (n=4) of that group were still smoke free four weeks after the intervention. Those that maintained abstinence cited Nicotine Replacement Therapy as a factor in their abstinence. Conclusion: Brief in-depth and specific smoking education and resources could increase readiness to quit. Readiness to quit, combined with Nicotine Replacement could increase cessation.
Postpartum Depression Screening in Pediatric Primary Care
(2024-05) Potter, Kayla
Background: Postpartum depression (PPD) is a distressing yet under-diagnosed obstetric complication. Pediatricians are in an advantageous position to screen mothers for PPD at routine well child visits. Despite this recommendation, many pediatric providers do not consistently or effectively execute standardized PPD screening. Purpose: The primary purpose of this project was to increase provider knowledge, comfort, and attitudes toward PPD screening, and to understand barriers to PPD screening in the pediatric setting. The secondary purpose was to create a clinical decision support algorithm for pediatric providers detailing the screening process and appropriate follow-up procedures. Methods: The quality improvement project used a pre- and post-educational intervention survey design to determine whether formal PPD education increases pediatric provider knowledge, comfort, and attitudes in PPD screening. The intervention consisted of a recorded PowerPoint presentation administered to pediatricians at a local private pediatric practice. A clinical decision support algorithm was created to establish a procedure for screening mothers during well-child visits in the pediatric primary care setting. Results: Nine board-certified pediatricians completed the educational intervention and surveys. Following the educational intervention, there was a 54.8% increase in knowledge, a 25.8% increase in comfort, and an 8.9% increase in provider attitudes related to PPD screening. Discussion: Formal PPD education for pediatric providers is a successful method by which to increase provider knowledge, comfort, and attitudes toward PPD screening in the primary care arena. Conclusion: While pediatric providers are not accountable for the ongoing treatment of PPD, they do have a responsibility to support at-risk parents by recognizing the signs of PPD, adhering to standardized screening protocols, and ensuring that care is adequately transferred to the appropriate personnel.
Improving Home-Base Rehabilitation for Women 65 Years and Older with Congestive Heart Failure
(2024-05) Ogbonna, Geraldine
Background: Low rehabilitation uptake for older people with congestive heart failure (CHF) is a cause for concern. Although cardiac rehabilitation services are available in some healthcare facilities, they are underutilized due to financial constraints, distance, poor health, and lack of information about CHF management. The purpose of this quality improvement project was to determine to what extent the implementation of home-based rehabilitation among women 65 years and older with congestive heart failure impacted exacerbation of CHF symptoms. Methods: Participants were identified by screening electronic medical records (EMR) to determine their eligibility. A pre-post-test assessment with a home-based rehabilitation to determine its effect on CHF exacerbation in a long-term care hospital offering CHF patient services. Participants were identified by screening electronic medical records to determine those who have been recently admitted because of CHF. The DNP student visited the patient at home initially with follow up done by telehealth. Results: Twenty patients were recruited, but one died of a heart attack, and one went to hospice for readmission due to breathing issues. Although the project did not achieve the objective of a 30% reduction in all CHF symptoms, there was a 35% reduction in reports of dizziness, fatigue, and weakness as well as a 20% decrease in trouble with breathing while lying flat. Conclusion: Home-based rehabilitation among women 65 years and older with CHF in this small project were effective in reducing CHF exacerbation among many of the participants.
Increasing Knowledge of Inhaler Technique in Adult Asthma and COPD Patients
(2024-05) Abassa, Essi N.
Background: Inhalers serve as the primary mode of delivering medication for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Inhalers effectiveness is based upon the patient's ability to self-administer them correctly and being taught how. Purpose:This quality improvement project aims to enhance the knowledge of asthma and COPD patients in using inhalers by providing them with demonstrations of proper techniques. Methods: A pre-post design focused on outpatient adult asthma and COPD patients at an urban primary care clinic. Baseline assessments were conducted using the CDC inhaler usage guidelines demonstration of correct inhaler techniques and these were compared with post-evaluation results obtained immediately after the intervention. Results: The 21 asthma and COPD patients who participated had significant increases in confidence levels and knowledge acquisition. The intervention ensured that all participants performed the inhaler usage technique with 100% effectiveness. Conclusion: This intervention focused on enhancing confidence levels, knowledge acquisition, and practical skills, potentially leading to improved asthma management outcomes. The results support the literature review findings that patients with asthma and COPD not only need a structured standardized education on the proper inhaler usage technique using an interactive type of education such as the teach back method, but their technique also needs to be reviewed and education reinforced at each clinic visit.
Implementation of an Evidence-Based Educational Toolkit to Enhance Self-Management in Individuals with Chronic Kidney Disease
(2024-05) Noce, Elyssa
Background: Chronic kidney disease (CKD) is a complex chronic condition requiring patient engagement in management. Clinical practice guidelines for CKD encourage use of self-management for improved patient outcomes though there is inconsistent use of self-management support in routine nephrology practice. The purpose of this project was to implement an evidence-based educational toolkit in an ambulatory nephrology practice utilizing a self-management approach to enhance patient knowledge and engagement in the management of their CKD. Methods: An educational toolkit entitled CKD Coach was created with content regarding self-management strategies in the form of short modules targeting patients with CKD stage 3 at. Modules were sent to participants over the course of nine weeks. Demographic data and health literacy assessment was collected prior to education. Assessment of self-efficacy, perception of illness, and knowledge of CKD self-management were collected pre- and post-intervention. Qualitative review of patient experience with the modules was collected post-education. Results: 54 patients completed data collection pre-education and 46 patients completed data collection post-education. There was a significant increase in self-efficacy (Wilcoxon Z=-5.635, p<0.001), cognitive perception of illness (Wilcoxon Z=-3.611, p<0.001), emotional perception of illness (paired t(45)=-7.05, p<0.001), and understanding of illness (Wilcoxon Z=-2.523, p=0.012) following educational intervention. There was also a significant increase in knowledge in those with and without diabetes (Wilcoxon Z=-2.84, p=0.005 and Z=-4.275, p<0.001, respectively). Perceived knowledge increased significantly following education (Wilcoxon Z=-4.443, p<0.001). All participants reported the content was beneficial. Conclusion: CKD Coach was effective in increasing self-efficacy, illness perception, and knowledge in the project population. Implications: Implementation of educational programs for patients with CKD could improve self-efficacy, perception, and knowledge and should be used to inspire behavior change in this population to incorporate self-management strategies in their care.

Browse

Recent Submissions