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    A Therapeutic Intervention to Improve Depression, Loneliness and Psychological Well-Being in Elderly Assisted Living Residents
    (2023-07-26) Manning, Oksana
    Background: As the US population continues to age and people move to nursing homes, interventions are needed to help prevent depression and loneliness that affect quality of life. Art therapy offers a broad range of activities that promote connectedness among assisted living residents. Research has shown that coloring mandala patterns in a group is beneficial in terms of social collaboration and engagement than individual activity. Purpose: The purpose of this DNP project was to determine if group mandala coloring sessions would affect depression, loneliness and well-being of the elderly assisted living residents. Methods: Residents’ loneliness, depression and well-being were measured with three easy-to-administer and publicly available scales pre- and post- intervention. Results: The general findings demonstrated that residents of this AL facility had symptoms of depression and loneliness as well as decreased well-being scores. The mandala coloring sessions positively affected the scores for depression but did not significantly influence loneliness and well-being in the elderly AL residents. The participants enjoyed the activity that promoted communication, socialization, and creativity.
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    Implementation of a Pressure Ulcer Prevention Training Program in a Rural Nigerian Missionary Teaching Hospital
    (2023-08-01) Ukwu, Ugonna
    The purpose of this quality improvement project was to address inadequate knowledge-to-action in Hospital Acquired Press Ulcers (HAPU) prevention with comprehensive HAPU prevention training based on the Agency for Healthcare Research and Quality “Preventing Pressure Ulcers in Hospitals” toolkit at a rural Nigerian missionary hospital. HAPU prevention training significantly improved HAPU prevention knowledge but did not translate to robust performance and documentation of HAPU prevention best practices. Optimizing nurse to patient ratios and HAPU prevention aids can improve adoption of HAPU prevention best practices.
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    Effectiveness of an Educational Program on the Reduction of Urinary Tract Infections in Long Term Care Residents
    (2023-05-26) Williams, Andrea
    Problem: Urinary tract infections (UTIs) are a common, costly, yet preventable problem among residents in long-term care. Unlicensed staff are the primary caregivers of residents in long-term care and can implement strategies to prevent UTIs. Objective: The purpose of this quality improvement project was to determine if an evidence-based education presentation would increase the knowledge of unlicensed staff related to UTIs and prevention and reduce their occurrence. Methods: An evidence based education program was developed and presented to unlicensed staff who participated in the project. A validated pre- and post-assessment questionnaire was used to measure knowledge gained from the education. Results: The average score for pre- to post-assessment increased from 69.39 to 85.32. Retrospective chart reviews were completed for 94 patients three months before and three months after education was provided to determine if the intervention was effective in preventing UTIs. The result was a reduction from 19 to 12 UTIs, a 36.8% decrease between pre-intervention and post-intervention. Conclusion: Educating caregivers on prevention strategies for UTIs increased knowledge and reduced the number of UTIs documented in the facility.
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    Adverse Childhood Experiences Screening in Primary Care
    (2023-05-09) Haro, Monica
    Background: Adverse childhood experiences (ACES) are associated with poor mental and physical childhood outcomes. ACES are an important health topic with lack of awareness and education in the pediatric population. The American Academy of Pediatrics encourages providers to screen for ACES to mitigate toxic stress and build resilience (Isakson et al.,2020). Purpose: The purpose of this quality improvement project was to educate pediatric primary care providers on ACES, ACE screenings, and community resources for high-risk children. Increasing ACES awareness using evidence-based research and education may increase the frequency of ACE screenings in the primary care setting. Method: A quantitative design was used to measure the frequency of screening for Adverse Childhood Experiences (ACES) by pediatric primary care providers (PCPs). Participants consisted of 131 patients who attended various medical visits, including certain well child visits, behavioral visits, attention deficit hyperactivity disorder (ADHD) visits, and healthy lifestyle visits. The primary outcome measure of this study was to educate PCPs on ACES and increase the frequency of ACES screenings in their practice. Results: Following education and implementation of ACES screening, 75% of the providers expressed being more comfortable discussing ACES with patients and families and agreed to incorporate ACES screening in future practice. A Kruskal-Wallis rank sum test indicated a significant difference in ACES score between the levels of treatment, based on an alpha value of .05, χ2(4) = 63.20, p < .001. The average ACES score was 1.63, indicating most children included in this project have experienced at least one adverse childhood experience. Conclusion: Educating pediatric primary care providers on ACES and how to use the screening tool, led to 131 children being screened. With knowledge of patients’ adverse experiences, providers were able to connect patients and families to community resources to improve current health and reduce the risk of chronic diseases in adulthood. Keywords: ACES, adverse childhood experiences, pediatric primary care, pediatrics, resilience, ACE screening
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    Promoting Weight Loss: A Primary Care Intervention
    (2023-05-09) Walters, Shanna
    Problem: Approximately 80 million people in the United States are affected by obesity and the prevalence has increased by approximately 11% from 2017-2020. Providers are aware of the obesity risk factors and co-morbidities, but some still lack the knowledge to educate patients properly on weight reduction. Methods: Data was collected over a four-month period in a primary care setting related to weight loss and education for patients with obesity. Descriptive statistics were summarized, and a quantitative analysis was used to determine if an educational toolkit was provided by the provider to patients with a BMI>35% and if the provider documented the patients’ correct BMIs within the Electronic Health Record. Results: The average patient age was 65.7 and males and females were equally represented. Although the toolkit was consistently given to patients. the McNemars chi-square test performed did not show a significant difference in the documentation of weight loss education. Results of a Kruskal-Wallis rank sum test indicated that there was not a significant difference in BMIs pre- and post-implementation but 28.6% of patients experienced weight loss and 25% maintained their weight without additional gain. Conclusion: Providers and patients received benefits from having access to an educational toolkit. Twenty-eight percent of patients experienced weight loss and 25% maintained their weight without any gain. There was a mild improvement in weight loss education documented by providers and the correct BMI was updated in the EMR for all patients in the study. Keywords: weight loss, obese, BMI>35, eating habits, weight loss education, ICD 10 codes