Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item Increasing oncology patient engagement in treatment decisions: a CNL driven educational approach(Montana State University - Bozeman, College of Nursing, 2022) Northrop, Kayla Marie; Chairperson, Graduate Committee: Denise RiveraCancer is the second leading cause of death in Montana affecting 40% of men and 38% of women (MCTR, 2019). In the state of Montana Cancer is attributed to 452 new cancer cases per every 100,000 people, or one in every four persons (MCTR, 2019). Current best practice treatment options for cancer include chemotherapy and biosimilar medications of chemotherapy also known as Biologicals. Biosimilar medication is a product that contains a similar but not identical, version of an active compound of that of the originator medication authorized by the FDA for treatment of cancer (Edwards and Bellinvia, 2020). A literature review was conducted containing fifteen journal articles that included: four systemic reviews, a randomized double-blind study, two observational studies, and one retrospective study. When evaluating the information gathered, it was clear that due to the recent development and lack of public knowledge of biosimilars there is missing and unknown information. The missing information could alter the education needed and topics patients may want to know in an educational program. The plan for this quality improvement project is to create an educational program for biosimilars in oncology offices for providers to use with patients that may need to switch to a biosimilar in their treatment plan and allow for increase patient outcome and safety.Item Standardizing documention of schedule II prescription in a primary care clinic(Montana State University - Bozeman, College of Nursing, 2019) Taylor, Lindsey Beth; Chairperson, Graduate Committee: Wade G. HillStandardization of processes and documentation in healthcare has continually been linked to quality of care. Implementation of new electronic health records (EHR), inadequate training, and lack of processes in place can all effect nursing documentation. The purpose of this project is to standardize documentation of charting the destruction of schedule II prescriptions in an Internal Medicine Clinic. Prior to the implementation of this project there was no standardized workflow for how or where to document the destruction of schedule II prescriptions. Lack of standardization and protocol contributed to prolonged time to complete refills, increased risk of duplicates, increased risk of harm to patients, and high nurse utilization. A pre and post-test was utilized to evaluate the nurse practice on documenting the destruction of controlled prescriptions. The pre-intervention results demonstrated inconsistent documentation which included: documenting in a communication encounter, documenting in the medication tab, a mixture of both documenting in the communication encounter and medication tab, or just not documenting. A standardized workflow was developed, presented to nursing staff, and competency assessment completed. The post-test demonstrated 100% compliance in documentation and made locating the documentation in the chart faster and easier reducing nurse workload.Item Attention deficit hyperactivity disorder treatment for pediatrics(Montana State University - Bozeman, College of Nursing, 2018) Brewer, John Mikkel; Chairperson, Graduate Committee: Tracy HellemAttention deficit, hyperactivity disorder (ADHD) is commonly diagnosed in children, and the frequency of this disorder being diagnosed and treated continues to rise each year. The research regarding treatment for pediatric ADHD has shown varied results ranging from pharmacological and behavioral therapies producing positive effects when combined to standalone behavioral therapy or medication producing positive effects with no therapeutic intervention. There are two published guidelines on the management of pediatric ADHD. The American Academy of Pediatrics and the National Collaborating Centre for Mental Health each created a guideline for evaluating, diagnosing, and treating pediatric patients with ADHD. This project analyzed ADHD treatments for children ages 4 to 18 years in an acute, inpatient psychiatric setting, and in an inpatient, residential-treatment-care setting. A comparison of these treatments with the national guidelines was conducted. This scholarly project compared pediatric ADHD treatment in an inpatient, acute-care unit versus a residential-care unit of a psychiatric children's hospital. Readmission rates within 30 days of discharge from a psychiatric children's hospital have been analyzed, and care practices have been compared with the national guidelines. Data was extracted from electronic medical records from the psychiatric children's hospital's healthcare record system. The types of data that were extracted included demographics, such as age, comorbid diagnoses, and concomitant medications; in addition to types of treatment, readmission rates, and treatment setting. Type-of-treatment data included type of medication versus treatment setting. The findings suggest that medications other than methylphenidate may have similar efficacy as methylphenidate for treating pediatric ADHD. The inpatient psychiatric unit is not necessarily following the National Clinical Guidelines for treating pediatric and adolescent ADHD, but the results reveal that methylphenidate versus non-methylphenidate treatment for ADHD does not demonstrate a statistically significant difference with respect to inpatient readmission rates. The research identified that patients receiving residential care for ADHD had a higher likelihood of being readmitted to the hospital than patients receiving acute care, and patients' readmission rates were not statistically significantly different regarding methylphenidate versus non-methylphenidate medication-treatment regimens. Overall, this research identified that medications other than methylphenidate can be effective in treating patients with ADHD.