Theses and Dissertations at Montana State University (MSU)

Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733

Browse

Search Results

Now showing 1 - 9 of 9
  • Thumbnail Image
    Item
    Standardizing translation services for home visiting staff to improve health equity among Latinx clients served by Gallatin city-county health department
    (Montana State University - Bozeman, College of Nursing, 2023) Reed, Samantha Alicia; Chairperson, Graduate Committee: Elizabeth A. Johnson
    On a national level, the Latinx population has grown by 43%, amounting to 57 million people as of 2020. On a local level, Montana is now home to 34,000 Spanish-speaking people, and the population is growing every year. Montana has seen an impact with the influx of Spanish Spanish-speaking populations in healthcare settings, and patients with limited English proficiency (LEP) are at a disadvantage to translation services, particularly in rural and frontier communities. Recently, the Gallatin City-County Health Department has experienced an influx in Latinx persons needing maternal child health home visiting services. Yet, with current translators in place, there is still a need for improved language access in care for waitlisted Spanish Spanish-speaking families. The goal of this quality improvement project is to implement a standardized interpretation process for Spanish Spanish-speaking families in need of maternal child health home visiting services. Technologies assessed include Time Kettle Translation Technology and the Language Link Live Translator Technology delivered on an iPad. A PDSA model for implementation was used, and multiple cycles for improvement were assessed. Results showed patient satisfaction and confidence level of 100% using Language Link Video Interpretation in contrast confidence and satisfaction level of 50% with Time Kettle eEar pPods. All patients were satisfied with the point of care they received with from the nurse or social worker based off on post -satisfaction survey results. Staff satisfaction and confidence level decreased with Time Kettle Ear Pods when used in the field as this could be related to reading from a script in comparison to a more natural conversation. Recommendations include improving staff support and education to adequality serve this population and continued assessment of the staff self-readiness to implement translation technology independently. Lastly, each staff member will have to determine whether technology is right for current needs and, if so, how to create a solution that pairs the best of technology with human capabilities.
  • Thumbnail Image
    Item
    Standardizing lactation education for home visiting staff to improve breastfeeding duration rates
    (Montana State University - Bozeman, College of Nursing, 2020) Reed, Samantha Alicia; Chairperson, Graduate Committee: Angela Jukkala
    Breastfeeding has been shown to improve short-and long-term health outcomes to both mother and child. Health departments are in a unique role to provide community level support in breastfeeding. Gallatin-City County Health Department provides breastfeeding support through multiple programs within the community, including maternal child health home visiting. Based on a recent survey, results showed that half of home visitors did not feel confident in educating prenatal clients on breastfeeding. In addition to this, home visitors did not feel they were providing the same education on breastfeeding. Stemming from this, the need for a standardized lactation curriculum was researched. Ready, Set, Baby is an evidence-based standardized curriculum that increases a mother's knowledge of breastfeeding benefits and practices. This scholarly project examines home visiting staff education on Ready, Set, Baby curriculum, improved breastfeeding education with home visiting families, and improved breastfeeding duration rates.
  • Thumbnail Image
    Item
    Motivational interviewing education for home visiting asthma nurses
    (Montana State University - Bozeman, College of Nursing, 2020) Romine, Rebecca Ann; Chairperson, Graduate Committee: Polly Petersen
    Montana Asthma Program (MAP) nurses currently do not receive motivational interviewing (MI) training and have identified it as an area of development. The desired outcome for this Doctor of Nursing Practice (DNP) scholarly project is to positively affect MAP nurses' knowledge of MI strategies and theories and self-efficacy, or each nurses' belief that they can successfully execute behaviors necessary to produce an MI therapeutic interaction. A brief MI training to increase MI knowledge and self-efficacy of the MAP nurse by 1) attendance of a three-hour asthma-focused MI foundational training course and 2) triad of patient-nurse-recorder role-playing using MI foundations. Content was delivered using PowerPoint slides and lectures with integrated use of role-playing as skills and principles are introduced. A tool used in a previous study by Pyle (2015) was identified as an appropriate self-assessment of self-efficacy and knowledge after completing MI training. Nurses completed this assessment pre and immediately post-training as well as seven months after the educational intervention to see if there was a change. Knowledge question scores ranged from pre-test 3.5 to 2.3 (n = 9) M = 3.05, (SD = 0.33); post-test scores ranged from 3.4 to 3.7 (n = 9) M = 3.57, (SD = .09); and post-test seven-month scores ranged from 3.5 to 3.8 (n = 6) M = 3.6, (SD = 0.07). Self-efficacy question scores ranged from pre-test 2.6 to 3.6 (n = 9) M = 3.21, (SD = 0.37); post-test scores ranged from 3.4 to 3.8 (n = 9) M = 3.62, (SD = .14); and post-test seven-month scores ranged from 3.4 to 4.0 (n = 6) M = 3.67, (S = .18). Knowledge score improvements suggest education retention of background concepts and theories related to MI (Bailey et. al, 2017). Of particular interest is the increase in scores between the post-test and post-test seven-month assessments. The overall increase of mean scores, from pre-test, post-test, and post-seven-month tests indicates an increase in the understanding and self-efficacy of the nurses as it is related to their MI knowledge and use as a communication style.
  • Thumbnail Image
    Item
    Medicaid's home and community-based alternatives to institutionalization in Montana
    (Montana State University - Bozeman, 1984) Walsh, J. W.
  • Thumbnail Image
    Item
  • Thumbnail Image
    Item
    Ostomy adjustment in the first year following surgery
    (Montana State University - Bozeman, College of Nursing, 1996) Graves, Kelle Maria
  • Thumbnail Image
    Item
    A study of the initial problems encountered by home dialysis patients related to proximity to the home training center
    (Montana State University - Bozeman, College of Nursing, 1979) Snyder, Teresa Elizabeth Kelly
  • Thumbnail Image
    Item
    Exploring trust in the provider - patient DYAD : capturing the mother's voice in her own words
    (Montana State University - Bozeman, College of Nursing, 2014) Cline, Elize Marie; Chairperson, Graduate Committee: Sandra Kuntz
    In 2013, Montana was ranked 50th, or the lowest ranking state, for child health status according to the Annie E. Casey Foundation. The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) was created when the Patient Protection and Affordable Care Act was signed into law. Several counties within Montana adopted the evidence-based Nurse-Family Partnership (NFP) home visiting program under the direction of MIECHV. The NFP program delivers care to at-risk pregnant mothers and their children. The purpose of this paper was to conduct a review of the literature to investigate communication approaches that the NFP nurse uses or could use during a home visit with the mother, that strengthens the ability of the nurse to capture and empower the mother's voice as customer. Three databases were utilized with a total of ten search terms. A total of five qualitative articles were found that directly examined the voice of the mother receiving home visiting services. Trust was the key term used to examine components of the dyad relationship. Trust within the provider-patient relationship is important as it is tied directly to program engagement and positive outcomes. After analysis of the articles, six themes surfaced that the mothers expressed and included personality, friendship, availability, empowerment, reducing vulnerability, and testing. Additional sub themes included emotional support, knowing, control, verbal praise, advocacy, and respect. Little research exists that directly examines and seeks to garner the experiences of at-risk mothers participating in home visiting programs. Complicating the literature search was the finding that trust is poorly defined in nursing literature and the health science literature as a whole. Further research and inquiry is needed to understand, according to the patient perspective, how trust is built, maintained, broken, and repaired. Understanding the concept of trust according to the patient perspective is imperative as home visiting programs are implemented within the state of Montana. Capturing the voice of the customer is not only a mandate but is imperative to improve the health status of our State.
  • Thumbnail Image
    Item
    Use of an assessment tool to facilitate evidence based management of home health heart failure patients
    (Montana State University - Bozeman, College of Nursing, 2013) Mullins, Lovetta Maureen; Chairperson, Graduate Committee: Sandra Kuntz
    Heart failure (HF) is a costly and debilitating disease that impacts the quality of life of not only the patients who suffer from its effects but also the ones who care for them. Home health is a post-acute care service that has the potential to impact the effects heart failure has on patients, their caregivers, and the healthcare system. Evidence-based management of home health HF patients improves self-care and decreases readmission and admission rates. Currently no standardized HF needs assessment tools exist for use in the target home health agency. Visiting clinicians need a tool to identify patient/caregiver self-care deficits in order to appropriately provide education and interventions. The purpose of this project is to utilize an existing guideline to create a HF needs assessment tool. This tool was implemented by home health clinicians when admitting a HF patient to services. The design of the tool was guided by the literature reviewed and customized to the home health setting. Age, gender, and race were included on the tool to capture basic demographic information. Other data consisted of differentiating HF type, class, and whether it is the patient's primary or secondary diagnosis. The tool was then divided into different assessment areas: Daily weight practices; Patient/caregiver's knowledge of reporting a weight gain; Guidelines for recommended medications; Knowledge of sodium intake; Knowledge of food labels; Past/present smoking; and Patient/caregiver's independence with identifying signs and symptoms of worsening heart failure. Fifteen females and fifteen males were assessed with the heart failure tool. The results showed that the majority of patients with any class or type of heart failure were not meeting the recommended guidelines. The reasons identified for not meeting the guidelines consisted of knowledge deficit, functional limitations, forgetfulness, lack of equipment, and refused. Many of the medication guidelines were not met due to the drug not being ordered. It is recommended that interventions be designed to address each assessment area and an evaluation tool be implemented to determine if the intervention made a difference. Information gathered should be stored electronically for quality improvement initiatives.
Copyright (c) 2002-2022, LYRASIS. All rights reserved.