Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
Browse
8 results
Search Results
Item Optimizing preoperative nutrition using enhanced recovery from surgery (ERAS) guidelines to improve clinical outcomes for patients undergoing total joint replacement(Montana State University - Bozeman, College of Nursing, 2022) Deshner-Miller, Kertrina Rae; Chairperson, Graduate Committee: Denise RiveraSurgical site infection (SSI) following total joint arthroplasty (TJA) is one of the most frequently encountered hospital-acquired conditions. Consequently, as the largest population of people in the United States known as the 'baby boomers' continue to age, the need for TJA to treat arthritis is projected to grow exponentially as is the incidence of SSI. Evidence-based enhanced recovery after surgery (ERAS) guidelines have been shown to decrease the prevalence of postoperative complications, hospital length of stay, improve the patient's return to normal function, and quality of life. ERAS guidelines recommend screening for risk of malnutrition with referral to a registered dietician and consumption of a preoperative oral carbohydrate (POC) the night before and the day of surgery. Current research does not directly link the use of POC to decreased occurrence of SSI. It is hypothesized that implementing nutritional screening and POC will be associated with a decreased occurrence of postoperative SSI. The primary goal of this project is to build a consistent preoperative nutritional optimization program utilizing ERAS guidelines in the pre-anesthesia clinic (PAC) for patients aged 50-70 and scheduled for elective TJA.Item Childcare as a protective factor for childhood obesity(Montana State University - Bozeman, College of Nursing, 2020) Carnahan, Brittany Anne; Chairperson, Graduate Committee: Susan RaphChildhood obesity is a major public health crisis. Obese children are at risk for developing chronic diseases and are more likely to become obese adults. Despite efforts to decrease the number of obese children, the rate has more than tripled since the 1980s. Since childhood obesity is multifactorial, any person involved in caring for a child outside of the home can have an impact on the child's life helping to minimize risk factors, such as poor nutrition, which is known to contribute to obesity. Purpose: The purpose of the project was to 1) assess ECE providers' understanding of national childhood nutrition guidelines in relation to whether or not they participate in the STARS to Quality program or the CACFP; 2) create and provide childhood nutrition education to ECE providers with the objective to reinforce or increase knowledge on childhood nutrition and the important role of the ECE provider to deliver sound nutrition; and 3) to evaluate the effectiveness and sustainability of the education tool in increasing ECE provider knowledge of national childhood nutrition guidelines. Methods: Licensed ECE programs in the State of Montana completed a demographic survey, pre-test, educational video viewing, and posttest regarding childhood nutrition recommendation guidelines. The project was developed using the National Dietary Guidelines for all Americans and the Child and Adult Care Food Program recommendations for reimbursable meals. Pre and posttest scores were compared and analyzed. Evaluation: Overall, there was an 11.5% improvement in correct answers from the pretest to the posttest indicating that viewing of the educational tool was successful in increasing knowledge. Discussion: The use of a guideline based educational tool for ECE programs has the potential to increase caregiver knowledge regarding childhood nutrition recommendations and contribute to prevention efforts concerning childhood obesity.Item A survey to determine the differences in child rearing practices and child development of a selected group of bottle and breast fed infants during the first year of life(Montana State University - Bozeman, College of Professional Schools, 1966) Dyas, Beverly JeanItem Applying the school health index to determine the physical activity and nutrition programs available to rural, elementary/middle (PK-8) students in Montana(Montana State University - Bozeman, College of Nursing, 2015) Addison, Lauren Marie; Chairperson, Graduate Committee: Charlene WintersObesity and overweight are the second and third leading causes of preventable death in the United States, accounting for an estimated 200,000 yearly deaths and $147 billion spent annually in direct medical costs. In 2009-2010, over 12.5 million American children and adolescents between the ages of 2-19 were obese. In Montana, the obesity rate has increased more than 80% over the last 15 years with 12.2% of its 2-5 year olds being obese. Growing attention has been paid to the increasing prevalence of obesity among rural children. Though numerous studies have identified rurality as a risk factor for childhood obesity, the causes for this relationship require more exploration. This quantitative research study utilized a descriptive design to determine the physical activity and nutrition programs available to rural, elementary/middle (PK-8) students in Montana. A non-random, convenience sample of 217 rural, elementary/middle (PK-8) school principals with less than 200 students in attendance were asked to participate in this study. Data were collected via electronic surveys, and questions were drawn from the CDC's School Health Index for elementary schools. Data were recorded and analyzed using Qualtrics software. Forty-two eligible surveys were returned for a response rate of 19.4%. Those participating counties in Central and Northeastern Montana with the lowest population densities scored the highest on the physical education/activity module, whereas Northwestern Montana had the highest population density and the highest score on the nutrition module; Southeastern Montana had the lowest scores on both modules. Students have greater access to nutritional services than physical education/activity programs; however, the average module scores from all of the schools combined indicate these schools generally have more strengths than weaknesses when it comes to the physical education/activity and nutritional services they offer. More research on the relationship between rurality and childhood obesity, community influences, and barriers to healthy eating and physical activity in rural areas is needed. Primary care providers in rural areas should use every opportunity to screen, counsel and initiate early interventions to combat childhood obesity, and they should consider the unique factors contributing to obesity in their area to better promote physical activity and nutrition.Item Weight loss outcomes and health locus of control following gastric stapling surgery(Montana State University - Bozeman, College of Nursing, 1984) Hook, Colleen BethItem Dietary intake of pregnant farmworkers : patterns among migrant workers in Montana(Montana State University - Bozeman, College of Nursing, 2001) Stearns, Candace KayeItem Dental and nutritional status of rural elderly in Montana(Montana State University - Bozeman, College of Nursing, 2002) Albrecht, Dorothy KarnisItem A descriptive study of childhood obesity monitoring practices used by Montana pediatric providers(Montana State University - Bozeman, College of Nursing, 2008) Schwarzkopf, Nancy Denise; Chairperson, Graduate Committee: Sandra KuntzINTRODUCTION: The global prevalence of childhood obesity is increasing. Overweight children face risks of compromised physical and mental well being, increased incidence of disease processes, and increased risk of adult obesity. Pediatric providers play a unique role in reversing the prevalence of obesity, yet there is little understanding of what practices are utilized to monitor children's weight. PROBLEM: Identifying children who are obese or are at risk for becoming obese may rely on evidence based weight monitoring practices. For many providers there may be a gap in knowledge regarding recommended practices for measuring growth in children. The purpose of this study was to describe current practices for monitoring obesity of children used by Montana primary pediatric providers. METHODS: A descriptive, cross-sectional study was conducted using a mailed pencil and paper survey, sent to 300 primary pediatric providers in Montana selected from 900 Child Health Insurance Plan (CHIP) providers. Eighty-five surveys were returned for a response rate of 28%. Data analysis utilized SAS software; results were analyzed using frequencies and percentages. RESULTS: A total of 85.7% of respondents offered care in family practice settings; 17.6% are pediatric specialists, 31.8% are practicing rurally and 57.6% of providers saw 5 or fewer children/per day. Over 95% of providers measured height and weight, 61.2% calculated body mass index (BMI). Just 55.8% of those who measure BMI accurately plotted it on age/gender specific chart, or 34% of total respondents. All respondents perceived childhood obesity as a concern, with patient/parent resistance cited as the most common barrier to treatment. CONCLUSION: Health disparities in Montana associated with rural populations include fewer pediatric specialists, fewer child healthcare visits, and barriers of access, education level and money for patient and their families. In Montana, height and weight measurements are used predominately to monitor children's growth; BMI was accurately used by one third of respondents which may interfere with the provider's ability to accurately identify adiposity. These findings suggest a focus area for provider education, promoting BMI guidelines for children. Perceptions of barriers: patient/parent resistance, time constraints, and reimbursement; suggest treatment protocols could improve outcomes for childhood obesity.