Nursing (Doctor of Nursing Practice)

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.

Migraines are a common and debilitating medical issue. Many patients are turning to complementary and alternative medicine to either augment or replace conventional medical treatment for this. However, it is unclear what their primary care providers’ attitudes are toward the use of CAM and the PCP’s knowledge base in this area. This study was designed to determine PCPs’ attitudes towards CAM and if a brief educational presentation regarding CAM modalities frequently used for migraines had any impact on their attitude towards CAM. There was a pre survey, a Power Point presentation discussing common CAM used for migraines, and a post survey. This was a small study, with 13 participants completing the pre survey and 10 completing the post survey. There was no significant difference between the pre and post intervention groups (p=0.46, significance level of <0.05). However, both groups had a mostly favorable attitude towards CAM. Gender, work setting, and credentials did not impact attitudes towards CAM. Acupuncture, relaxation therapy, massage, and chiropractic care were the CAM modalities that the providers felt the most comfortable discussing. The findings from this study can be used as a guide for future educational offerings and CAM services in the area. Suggestions for future research include offering a continuing medical education credit to boost participation.