2018
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Item An Educational Intervention to Improve Knowledge and Communication Skills for Nurses(2018) Regan, Eileen M. MSN, AGPCNP-BC, OCNBackground: The process of informed consent (IC) for clinical trials is based on historic events, federal regulations and ethical principles. Deficiencies in patient understanding of IC are taken seriously by the research community, yet research dedicated to find ways to improve patient understanding has yielded mixed results. Teach-back is an evidence-based tool recommended for use during IC discussions. Nurse role in the IC process is important, particularly for patient education and advocacy. Objective: Initiate and evaluate an educational program for nurses to improve knowledge and communication skills used in IC for cancer clinical trials. Methods: An educational program, including the history of IC for clinical trials, review of current literature, assessment of patient understanding and health-literacy, the role of the nurse, and teach-back as a communication skill was presented to nurses at a Northeast Cancer Center. Anonymous pre/post/one-month post surveys measured nurses’ knowledge of research and importance and confidence using teach-back during IC discussions. Findings: Nurses had high research knowledge scores and statistically significant improvement in pre/post-test scores of conviction and confidence using teach-back. Nurses employed essential elements of teach-back before the program, however had greater recognition of elements after the program.Item HEPATITIS C SCREENING, DIAGNOSIS AND FOLLOW-UP CARE(2018) Flynn, Constance MaryChronic Hepatitis C Virus (HCV) infection causes more deaths than all infectious diseases combined. Direct acting antivirals (DAAs) may cure over 90% of HCV infections. The Center for Disease Control (CDC) recommends screening high risk and baby boomer birth cohorts (CDC, 2015a). Those testing positive for HCV antibodies require HCV RNA to confirm infection. Positive HCV RNA necessitates follow-up with a primary care provider (PCP) or HCV specialist. This project was designed to determine if educating a group of PCPs on CDC HCV testing sequence would improve diagnosis and follow-up care. An educational presentation on CDC HCV guidelines was provided to group of PCPs. Rates of HCV screening, diagnosis and follow-up appointments were collected three months pre/post intervention. Descriptive statistics were used to compare rates of HCV screening, RNA confirmation and follow-up care. Although pre-post screening rates were nearly identical with all HCV positive patients receiving confirmatory diagnosis and follow-up, the overall project impact was not anticipated. The end result led to automated reflex HCV RNA confirmatory testing, formation of a hospital/ community task force to examine HCV treatment access, and establishment of a hospital based HCV clinic. In addition, there were multiple HCV educational presentations for providers and allied health personnel. There was increased local media attention (television, newspaper) on the HCV epidemic, which improved community awareness of the need for HCV screening and treatment.Item Addressing Workplace Bullying Among Nurses at a Community Hospital(2018) Downey Luhrmann, SusanBullying and incivility are forms of workplace violence (WV) that occur frequently in nursing. This violence is costly and detrimental to the nursing profession, healthcare organizations, and patients. Increasing awareness, education and addressing workplace bullying (WB) immediately and consistently deters the violence. This project included an educational intervention based on the American Nurses Association’s (ANA) Code of Ethics (COE) and was designed for staff registered nurses (RN) in non-management roles. The objectives were to measure the RNs’ perceived exposure to WB; and to measure the effectiveness of an online educational intervention on RNs’ awareness of responsibilities in addressing WB. A quasi-experimental design utilizing the Negative Acts Questionnaire Revised (NAQ-R) was used to measure RNs’ perceived exposure to WB. Knowledge of and responsibilities to address these behaviors were assessed and compared in the pre and post-survey. The Michigan Organizational Assessment Questionnaire (MOAQ) was used to measure RNs’ intent to leave their current position. Positive responses were elicited in all questions of the NAQ-R. Knowledge improved after the educational intervention by as much as 63%. The MOAQ revealed that over 40% of participants were likely to leave their current position for a new job within the next year related to WB. Addressing WB is crucial in preserving the integrity of the nursing profession.Item An Intervention to Increase HPV Vaccine Initiation Rates in Adolescent Males(2018) Marchand-Ciriello, LisaAbstract Introduction: In 2016, the Centers for Disease Control and Prevention reported the average Human Papillomavirus, (HPV) vaccine initiation rate among males was 50% versus 63% for females. The objective of this project was to increase HPV vaccine initiation rates among males aged 11-21. Methods: Quasi-experimental design investigated pre-and post-HPV vaccine initiation rates at a pediatric practice that serves a diverse population. The intervention included an electronic medical record (EMR) prompt, an educational presentation, and monthly email updates to providers. De-identified HPV vaccine initiation rate data were collected, pre-and post-intervention and matched with providers. Results: A paired two-sample t-test evaluated differences in pre-post vaccine initiation rates. HPV vaccine initiation rates increased overall by 6.5% during the twelve-week project period. The EMR prompt was favored by 75% of participating pediatric providers. Discussion: Small gains can be made over a short period of time to improve HPV vaccine initiation rates among adolescent males. Keywords: HPV Vaccine and Males, Intervention and HPV Vaccine, Provider Barriers and HPV Vaccine Rates.