Theses and Dissertations at Montana State University (MSU)
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Item A quality improvement project to address veteran obesity(Montana State University - Bozeman, College of Nursing, 2022) Anderson, Mary Rebecca; Chairperson, Graduate Committee: Susan LuparellObesity is rising, and veterans have more risk factors than the general public. The health implications and financial burden are enormous. Established guidelines recommend weekly in-person intensive lifestyle counseling focused on diet, exercise, goal-setting, and self-monitoring. Despite referrals to free obesity management classes, few veterans choose to engage. Alternatives to these referrals include provider engagement and nurse follow-up. Research shows promising evidence that self-monitoring with the use of smart phone apps with nurse phone support results in reductions of BMI for some patients. By establishing a clinic workflow, this QI project sought to show that primary care teams can manage obesity alongside other chronic health conditions. The healthcare teams screened, assessed, and began treatment for obesity over an 8-week implementation period. Data from the pilot implementation show greater than 90% staff compliance with process measures. Provider referral rates increased 20% suggesting increased comfort with discussions about weight over time. The project demonstrated that the clinic process is feasible for staff to deliver. Future implementations can focus on patient-level outcomes, such as reduction in BMI and acceptability of the intervention to patients.Item Nurses' perceptions, barriers, and perceived need for a smartphone application guiding wound care(Montana State University - Bozeman, College of Nursing, 2014) Cottom, Nicole Lorraine; Chairperson, Graduate Committee: Karen ZulkowskiLiving and working in a rural community has many advantages and disadvantages. One disadvantage is lack of resources and specialty in the medical field. One of these specialty fields lacking in countless rural areas is wound care. In the United States, approximately 6.5 million people develop chronic wounds annually. Economically, rural health care facilities are unable to send people for training and the limited number of people in rural areas with wounds would make it difficult for a wound expert to stay current in a rapidly changing field. However, inappropriate diagnosis and treatment of these wounds can be detrimental to the patient's life and be very expensive for the healthcare system. The development of a smartphone application guiding wound management using telehealth is in progress. This easy to use software application on a smartphone would enable rural facilities to have immediate, secure access to wound experts for help with diagnosis, treatment, management, appropriate dressings, and suggestion for the need to perform additional physiologic testing. This smartphone application will only be useful if healthcare staff are willing to use it. This research evaluated nurses' perceptions, barriers, and perceived need for this advancing technology. If these barriers and perceptions can be overcome, staff may be more willing to use this tool to provide the best quality wound care to their patients.