Nursing (Doctor of Nursing Practice)

There is existing research noting a possible correlation between vitamin D insufficiency and irritable bowel syndrome. The etiology of irritable bowel syndrome is unknown with the goal of the health care provider being symptom control. There are studies suggesting insufficient vitamin D levels may cause an inflammatory response in the gut leading to symptoms of irritable bowel syndrome. Out of 118 patients in a private gastroenterology practice in rural Western Pennsylvania, 62 individuals with the diagnosis of irritable bowel syndrome had vitamin D blood levels drawn within the last 5 years. The diagnosis of irritable bowel syndrome was broken down into IBS/ diarrhea, IBS/ constipation, and IBS/mixed. The expected value from the Chi-Square test as derived from a proportional analysis of low vitamin D levels in the general population of the United States is 19.8. The observed value from this study is 30, a 10.2 value higher than the expected value. The Chi-square test indicated significance, thereby the (30) IBS patients (48.3%) the total patients with low levels of vitamin D as compared (32) IBS patients (51.1%) of the total patients with normal levels of Vitamin D, where Chi-square (1, n = 62) = 7.6, p < .006. The study showed a possible correlation between insufficient vitamin D levels and irritable bowel syndrome in a small rural gastroenterology practice in Western Pennsylvania. Further investigation into a possible correlation between vitamin D insufficiency and symptoms of irritable bowel syndrome in the adult patient would be a positive step towards this challenging functional bowel disorder.

The aim of this study was to evaluate the difference in patient satisfaction scores between lesbian, gay, bisexual, transgender, questioning or queer, intersex, and asexual (LGBTQIA+) individuals who receive healthcare from LGBTQIA+ inclusion clinics and LGBTQIA+ individuals who receive healthcare from traditional clinics. LGBTQIA+ individuals have unique healthcare needs and require safe, affirming, culturally competent, and inclusive healthcare environments that will meet these unique needs, eliminate health disparities and inequities, and improve patient reported outcomes such as patient satisfaction.

The purpose of this evidence-based practice project is to evaluate the effectiveness of a pilot mental health knowledge questionnaire tool used to assess for change in knowledge. Currently, there are limited tools being used to assess mental health and depression knowledge in vulnerable communities. This study’s objective and goal is to improve the current practice for community mental health education in vulnerable communities with the intent to increase awareness and dispel cultural misconception of mental health. A self-reported pre-test was administered to assess baseline knowledge of mental health and depression followed by the educational program on mental health and depression. The data was analyzed utilizing the Statistical Package for the Social Sciences (SPSS) 23 for descriptive and inferential statistics. The scores from a paired t-test were compared to determine the effectiveness of the educational intervention. This study sought participants aged 18 and older, fluent in speaking, reading, and understanding English. The findings reflect a positive improvement in knowledge recorded on the post-test responses. Results also showed an increase in correct responses on the post-test after the implementation of the mental health depression educational program. Finally, the promotion of educational programs on mental health and depression in vulnerable communities are beneficial in bring awareness of mental illness.

Colorectal cancer is a leading cause of death in the United States with colonoscopy fundamental to any colorectal cancer screening program. Open access colonoscopy allows procedures to be performed in a timely manner to detect adenomas. The efficacy of adenoma detection is largely dependent on the quality of colonoscopy bowel preparation. Adenoma detection rate of open access screening colonoscopies and quality of split dosed bowel preparation was measured in a rural private gastroenterology practice in Central Pennsylvania using the 2017 Registry Individual Measure Flow created by the Centers for Medicare & Medicaid Services (CMS) noting the quality of bowel preparation at time of review. Open access screening colonoscopy reports were reviewed for ICD-10 codes for 3 risk factors for colorectal cancer, age 50 years and greater, and CPT codes for colonoscopy procedure without modifiers resulting in early termination of the procedure. The annual adenoma detection rate of open access screening colonoscopy patients who met the inclusion criteria was 44.47 % with 96.7% of open access screening colonoscopies rated to have optimal bowel preparations. These findings suggest that open access screening colonoscopy can be a timely, patient-centered method of effective, high quality colorectal cancer screening.

This descriptive study explores the reasons individuals bringing their child(ren) to the pediatric office are not using the patient portal. There was negligible use of the patient portal as shown by a retrospective review of data usage reports via the eClinicalWorks software. Additionally, staff reported that they still answered many calls for information (immunization records, lab results, medication refills, appointment scheduling, and care-related questions), all of which were easily obtained through the portal. The objective of this study is to determine the reasons why individuals bringing the child(ren) to a rural pediatric practice in Central Pennsylvania are not using the patient portal. The scope of the survey is broad, as overall knowledge of the patient portal and its capabilities is assumed to be low based on current usage data. A convenience sample of individuals was pursued. The survey questions focused on the potential contributing factors to the individual’s lack of portal usage. Demographic data were obtained as part of the survey to identify the characteristics of the participants. The results revealed that the lack of patient portal usage would be responsive to change with some practice planning and education.