Interprofessional Education and Practice // Carolina Digital Repository

Works (86)

51. A Stakeholder Analysis: Stakeholders' perceptions of chronic pain management in older adults who reside in a long-term care facility

Title Tesim:: A Stakeholder Analysis: Stakeholders' perceptions of chronic pain management in older adults who reside in a long-term care facility
Creator:: Freeman, Genevieve Clayton
Date Created:: April 7, 2017
Date of publication:: spring 2017
Abstract Tesim:: Chronic pain remains a major public health concern throughout the United States, but its high prevalence among older adults who reside in long-term care facilities (LTCF) emphasizes the need to focus research efforts on chronic pain management. Chronic pain in older adults who live in LTCFs is consistently undertreated and unrecognized by staff. The literature identifies the following four challenges to recognizing and managing chronic pain in older adults who live in LTCFs: generational differences; cognitive impairment; non-standardization of pain protocols and guidelines; and non-uniform pain assessment tools and pain scales. This honors project is part of a project funded by the North Carolina AHEC Innovation Grant in order to conduct a Quality Improvement Project on the quality issue of chronic pain management. The purpose of my project was to conduct a stakeholder analysis exploring the stakeholders’ perceptions of chronic pain management in older adults who reside in the LTCF. The analysis revealed nine themes that were presented to the School of Nursing team. We discussed and examined several potential areas of intervention to suggest to the leadership team at Happy Meadows. This Quality Improvement Project will not only aid the leadership team at Happy Meadows in developing a new pain management protocol, but also it will inform future quality improvement efforts to improve chronic pain management in LTCFs.
Resource type:: Honors Thesis
Academic Concentration:: Nursing
Affiliation Label Tesim:: School of Nursing
Award:: Honors
Degree:: Bachelor of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 5e4f35ae-5c1b-47bc-bc92-3e81ae9a218b
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/bpb5-gy60
Graduation Year:: 2017
Keyword:: stakeholder analysis, stakeholder, older adult, Chronic pain, and long-term care facility
Language Label:: English
Note:: Funding: None
ORCID:
Other Affiliation:
Person:: Beeber, Anna and Freeman, Genevieve Clayton
Rights Statement Label:: In Copyright

52. Interprofessional Communication in the Care of Adults with Cancer: Examining Providers’ Perceptions of Team Rounding

Title Tesim:: Interprofessional Communication in the Care of Adults with Cancer: Examining Providers’ Perceptions of Team Rounding
Creator:: Van Den Eynde, Morgan
Date Created:: April 8, 2019
Date of publication:: March 2019
Abstract Tesim:: Interprofessional communication is fundamental to the delivery of safe, effective, patient centered care. Healthcare providers are providing more complex care to chronically ill patients and as a result the demands on the interprofessional team are growing. In order to achieve optimal care, interprofessional communication is necessary and one tool used to accomplish meeting these needs is interdisciplinary team rounding. In this study, twelve interviews were conducted with providers from five different professions: Nursing Assistant, Registered Nurse, Pharmacy, Advanced Practice Provider, and Physician. The purpose of these semi-structured interviews was to explore providers’ perceptions of interprofessional communication on an in-patient adult oncology unit at a large southern medical hospital. Six major themes emerged from the data: provider’s perceptions of interprofessional communication, perceptions of rounding, lack of information or communication, how the role is understood by others, perceptions of other’s roles, perceptions of the team and communication, and challenges or barriers. Findings from this study indicate each profession had unique perceptions, but all had a positive outlook on the necessity of interprofessional communication in the delivery of optimal patient care.
Resource type:: Honors Thesis
Academic Concentration:: Nursing
Affiliation Label Tesim:: School of Nursing
Award:: Honors
Degree:: Bachelor of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 5cb84100-dbf9-4317-b751-d389784429f1
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/0p05-mf31
Graduation Year:: 2019
Keyword:: Interprofessional, interprofessional communication, communication, oncology, team rounding, and nursing
Language Label:: English
Note:: Funding: Rodney F. Hood Undergraduate Research Fund
ORCID:
Other Affiliation:
Person:: Bryant, Ashley and Van Den Eynde, Morgan

53. An analysis of communication between nurses and physicians: Evidence from the literature

Title Tesim:: An analysis of communication between nurses and physicians: Evidence from the literature
Creator:: Wert, Laura
Date Created:: April 11, 2014
Date of publication:: spring 2014
Abstract Tesim:: Communication has been identified by many governing bodies to be important for the safety and well-being of patients. This study is an analysis of communication between nurses and physicians using evidence from literature. The ways that nurses and physicians communicate, the perceptions of nurses and physicians surrounding communication, the participation of nurses in physician rounding, the barriers to effective communication, and interventions to improve communication are presented and analyzed. Following this analysis, a research project is proposed for a manager of a floor to investigate the communication patterns between nurses and physicians on his or her floor. Tools are also provided for this research project. Using this research and the proposed research project, it is hoped that the outlined evidence-based interventions can be utilized by a nurse manager to improve communication between nurses and physicians, which in turn will lead to decreased costs, greater patient safety, and better patient outcomes.
Resource type:: Honors Thesis
Affiliation Label Tesim:: School of Nursing
Award:: Honors
Degree:: Bachelor of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 58cb9b6a-1b6d-4545-8dc8-7dee717017d4
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/553r-nf71
Extent:: 33 p.
Keyword:: assessment of communication, perceptions of nurse-physician communication, barriers to communication, nurse and physician communication, communication, interdisciplinary education, and interdisciplinary rounds
Note:: Funding: None
ORCID:
Other Affiliation:
Person:: Rodgers, Shielda and Wert, Laura
Rights Statement Label:: In Copyright

54. Gap Analysis of Interprofessional Communication Between Pharmacists and Oral Health Care Providers in Community Practices

Title Tesim:: Gap Analysis of Interprofessional Communication Between Pharmacists and Oral Health Care Providers in Community Practices
Creator:: Woodworth, Katharine
Date Created:: March 8, 2019
Date of publication:: March 1, 2019
Abstract Tesim:: Current interprofessional communication techniques are inefficient and ineffective, leading to provider frustration, suboptimal patient care, and community-wide implications. Oral health care providers (OHCPs) in the United States prescribe high numbers of antibiotics and immediate release opioids, and have practice sites that are physically isolated from other healthcare professionals, making communication more challenging. This study was conducted to identify barriers to effective communication between community pharmacists and oral health care providers in order to: (1) inform processes for improving provider education and (2) inform training methods of future pharmacists. A mixed-methods approach was used. Community pharmacists with an active North Carolina (NC) license were eligible to participate, and were recruited via email from Continuing Education offices. The electronic survey assessed current communication methods, obstacles to optimal communication, and comparisons of OHCPs to other prescribers. Survey participants were asked to self-identify their interest in telephone interviews, which used thematic coding to assess the role of the pharmacist in combatting public health issues such as opioid abuse through interprofessional collaboration. There were 125 participants (response rate 9%) for the survey and 7 participants for the interviews. The most common reasons pharmacists contact OHCPs are to address incomplete prescriptions (40%) and medication-related problems (35%), with the most common medication-related problems being adverse drug reactions (35%) or cost issues (25%). Obstacles to communication identified as more challenging included lack of time and lack of professional relationships. Pharmacists’ impressions of OHCPs were largely positive. Possible strategies to address identified communication barriers include creation of a universal communication system and establishment of networks between pharmacists and community providers. This study lays the groundwork for future efforts in the field of interprofessional education research and practice, which can be used to improve delivery of community-based care.
Resource type:: Honors Thesis
Academic Concentration:: Pharmacy
Affiliation Label Tesim:: Eshelman School of Pharmacy
Award:: Honors
Degree:: Bachelor of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: c7775388-ffbd-4065-8878-ef682a24a90a
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/6b54-7244
Graduation Year:: 2019
Keyword:: pharmacist, community pharmacy, continuing education, opioids, interprofessional collaboration, dental, prescribing errors, pharmacy practice, antibiotics, and oral health care provider
Language Label:: English
ORCID:
Other Affiliation:
Person:: Sanders, Kimberly and Woodworth, Katharine
Rights Statement Label:: In Copyright

55. Understanding Interprofessional Communication in an Internal Medicine Transitions Clinic

Title Tesim:: Understanding Interprofessional Communication in an Internal Medicine Transitions Clinic
Creator:: Danneker, Megan
Date Created:: March 30, 2016
Date of publication:: spring 2016
Abstract Tesim:: Background: Effective communication amongst healthcare professionals is essential to improve handoffs for patients as they move through the healthcare system, thus reducing readmission rates and improving care. The purpose of this research was to identify where communication is strongest, where breakdowns occur, and what can be done to improve interprofessional communication in a primary care clinic. Methods: Three employees at the UNC Transitions Clinic were interviewed: one pharmacist, social worker, and resident. Each employee was emailed a copy of the questions before the interview. The interview was conducted one-on-one, audio recorded, and transcribed into a word document. Themes from each response were identified and organized into an excel spreadsheet, then analyzed by two reviewers. Results: Three major themes stood out in the responses: effective communication, communication challenges, and the need for interprofessional learning. The individuals interviewed each spoke about these three topics and their personal experiences, coming from three different professional backgrounds. Conclusion: The most effective way that participants communicated was in morning, face-to-face huddles. It is an important time to discuss priorities for patients and keep everyone communicating effectively. However due to time constraints, this often is rushed through or doesn’t happen at all. The biggest communication challenge reported was lack of time. Being rushed causes communication breakdown that results in redundant care and inefficiency. The biggest need identified was a need for interdisciplinary education. It is highly important for various healthcare related disciplines to be able to communicate effectively, however, we have yet to integrate this into the curriculum.
Resource type:: Honors Thesis
Affiliation Label Tesim:: School of Nursing
Award:: Honors
Degree:: Bachelor of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 8e696a7a-24f4-4cc9-9c4a-25cd4d99ca16
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/03bt-8d81
Extent:: 17
Keyword:: Interprofessional, Hotspotting, and Communication
Note:: Funding: Michael P. and Jean W. Carter Research Fund
ORCID:
Other Affiliation:
Person:: Zomorodi, Meg and Danneker, Megan
Rights Statement Label:: In Copyright

56. Access to Palliative Care in Intensive Care Units and the Role of Nursing in its Promotion

Title Tesim:: Access to Palliative Care in Intensive Care Units and the Role of Nursing in its Promotion
Creator:: McGee, Jonathan M.
Date Created:: April 6, 2017
Date of publication:: spring 2017
Abstract Tesim:: Barriers to palliative care in the ICU are well known and documented in the literature, and there is ample research on how to increase referral rates to palliative and hospice care in the ICU in general. However, none of these interventions will change patient care if there is not a desire to employ them that comes from an understanding of the importance and value of good end-of-life care. Necessary to developing this understanding is openness to talking about death not just as professionals, but also as individual persons. We must accept the ineluctability of death as a personal as well as a professional reality so that we might appreciate the value of end-of-life care. A reflection on patterns of end-of-life care in and around the ICU provides an opportunity to reflect on attitudes surrounding death so that nursing can, as a profession, be conscientious of the role it needs to play in advocating for quality end-of-life care in the ICU and change how it educates new nurses accordingly.
Resource type:: Honors Thesis
Academic Concentration:: Nursing
Affiliation Label Tesim:: School of Nursing
Award:: Honors
Degree:: Bachelor of Science
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 78b27570-7081-402e-9a49-39b639e35d97
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/qm37-xd58
Graduation Year:: 2017
Keyword:: advocacy, hospice care, intensive care, nursing, critical care, Palliative care, and end of life
Language Label:: English
Note:: Funding: None
ORCID:
Other Affiliation:
Person:: Leonard, Christina and McGee, Jonathan M.
Rights Statement Label:: In Copyright

57. Interprofessional Service-Learning in a Community Setting: A Model for National Dissemination

Title Tesim:: Interprofessional Service-Learning in a Community Setting: A Model for National Dissemination
Creator:: Buff, Scotty
Date Created:: March 17, 2015
Date of publication:: December 2012
Abstract Tesim:: Interprofessional education is becoming more popular in higher education and service-learning has been a successful method to facilitate experiences that foster teamwork between professions. While clinical service-learning projects may directly translate to professional experiences, community projects offer the opportunity to promote civic engagement and address societal needs, in addition to improving education. Higher education curricula in health professions contain many clinical rotations that typically focus on delivery of patient care, while increased skill and confidence in working with the community and community engagement are not essential components. The project outlined in this paper introduces a guided interprofessional curriculum, using state-wide SC Area Health Education Consortium (AHEC) Health Professional Student (HPS) coordinators as facilitators, and an established health promotion program, Junior Doctors of Health (JDOH), to promote interprofessional teamwork in serving public health needs. Descriptive statistics analysis of surveys from 149 health professional and biomedical science students demonstrated that over 70% of students found the learning activity improved their knowledge of other professions and teamwork skills. Challenges to implementation, strategies for sustainability and dissemination, and long-term effects are discussed.
Resource type:: Masters Paper
Affiliation Label Tesim:: Public Health Leadership Program
Degree:: Master of Public Health
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 564d1737-ca9b-4211-9c3e-c1926665c3df
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/q30w-f802
Graduation Year:: 2012
Language Label:: English
Note:: Paper type: Research or research design and Track: Leadership
ORCID:
Other Affiliation:
Person:: Steffen, David, Blue, Amy, and Buff, Scotty
Rights Statement Label:: In Copyright

58. A Case for On-Site Occupational and Non-Occupational Health Care for Health Care Workers

Title Tesim:: A Case for On-Site Occupational and Non-Occupational Health Care for Health Care Workers
Creator:: Siemering, Karen
Date Created:: December 16, 2013
Date of publication:: December 2013
Abstract Tesim:: The cost of health care in the United States is high and is expected to steadily increase. Hospitals and health care systems are affected by the rising costs in the form of expenditures on behalf of their employees' health care needs. Health care workers (HCWs) have higher utilization rates and carry a higher burden of chronic illness than employees in other market segments. Finding better ways to manage risk levels of these employees is critical to reducing costs. Current health care strategies include wellness programs and health conscious worksites. Many employers in an array of industries have instituted on-site primary care clinics to not only take care of minor acute illnesses but to provide management of chronic conditions for employees realizing that a healthy employee is a more productive employee. These clinics are a convenient way for employees to receive medical treatment without having to go too far from the worksite and, at the same time, offer an opportunity for the employee to learn about other health- related services covered under the employer's company plan. This paper addresses the special circumstance of the higher than average health care cost for HCWs, how this might be addressed, and to make a case for on-site urgent and primary care options utilizing the concepts of the patient-centered medical home model in addition to the presently offered employer-sponsored occupational health and wellness services. With such an integrated and comprehensive health care system comes an expanded role for occupational health nurses and occupational health nurse practitioners to join with other health care professionals in devising and implementing effective methods of improving patient outcomes. Key words: Workplace Medical Clinics, Primary Health Care for Health Care Workers, Occupational Health Nursing
Resource type:: Masters Paper
Affiliation Label Tesim:: Public Health Leadership Program
Degree:: Master of Public Health
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: a5e011be-a75e-4ee5-8f42-b5e16b5806a5
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/r8z3-qd09
Graduation Year:: 2013
Language Label:: English
Note:: Track: OHN and Paper type: Systematic review
ORCID:
Other Affiliation:
Person:: Rogers, Bonnie, Randolph, Susan, and Siemering, Karen
Rights Statement Label:: In Copyright

59. An Interprofessional Education Program Featuring Simulated Patient Encounters for Medical, Nursing, and Pharmacy Students: A Review of Significance within an Era Teamwork Training Models

Title Tesim:: An Interprofessional Education Program Featuring Simulated Patient Encounters for Medical, Nursing, and Pharmacy Students: A Review of Significance within an Era Teamwork Training Models
Creator:: Meier, Brianna
Date Created:: July 12, 2015
Date of publication:: July 2015
Abstract Tesim:: Introduction: Based on research that revealed the poor state of patient safety in the U.S. health care system, the Institute of Medicine drafted a landmark report titled To Err is Human: Building a Safer Health System. Attention to the value of training providers to work effectively in teams as a strategy for increasing safety was a major theme in this report and in all the action that followed its publication. Training programs teaching teamwork and interprofessional or interdisciplinary understanding are now given the title Interprofessional Education (IPE), and early training in IPE is one of the most effective ways to make teamwork instrumental to improving patient safety. Objective: Can an IPE intervention for medical, nursing, and pharmacy students alter student attitudes, knowledge, skills, team performance, and/or team outcomes in a direction conducive to improving teamwork? Methods: Analysis of survey data gathered from students in University of North Carolina health affairs schools (medicine, nursing, and pharmacy), to evaluate the change in student attitudes toward their colleagues in other disciplines, students' knowledge of teamwork in the clinical setting, students' skills in teamwork activities, understanding of the teamwork process and the shared mental model, and team outcomes and performance following an IPE intervention by testing change over two simulated patient encounters Results: Survey data analysis revealed statistically significant changes in attitudes about other health care professionals in medical, nursing, and pharmacy students among almost all of the attitude variables assessed. The data regarding the knowledge of students about teamwork and how to run through a clinical scenario with respect to seven teamwork multiple choice questions was not conclusive. Surveys in which students assessed their teammates across disciplines after initial and second simulated patient encounters were also inconclusive, and appropriate statistical analysis to mine these data further was beyond the scope of this paper. Finally, survey data from observers of students' teamwork process skills, understanding of a shared mental model, and teamwork outcomes and performance show significant inter-encounter change in a few key areas after students had been exposed to IPE. Conclusion: This study's demonstration of statistically significant change in student attitudes following an IPE intervention suggest that this program may be a model for IPE to fulfill the goals of improved patient safety through improved teamwork. Although at present little evidence shows how IPE can be effectively incorporated into undergraduate health care curricula, the evidence presented in this paper will add to this growing field of research and, the investigators hope, will spur the implementation of more projects. Creating a cultural shift in the U.S. health care system can most efficiently and effectively be accomplished through starting to train the youngest members of that system to acquire a mindset that embraces the necessarily changing set of values and attitudes. This study is encouraging for advocates of supporting teamwork improvement through IPE, and for moving such training to an earlier point in the training of health care providers. Going forward, studies of program interventions should be more robust, including long-term evaluative studies to assess actual patient safety outcomes resulting from student training in IPE. This is the intended endpoint of these trainings, and currently it is very difficult to assess how trainings such as these are influencing the long term goals of improving patient safety, changing the health system culture, and making health care less fragmented.
Resource type:: Masters Paper
Affiliation Label Tesim:: Public Health Leadership Program
Degree:: Master of Public Health
Degree Granting Institution:: University of North Carolina at Chapel Hill
Deposit Record:: 40f9affe-cc42-4c0e-bfab-314330b0c86b
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/hyj3-jc31
Graduation Year:: 2015
Language Label:: English
Note:: Track: HC&P and Paper type: Policy
ORCID:
Other Affiliation:
Person:: Tolleson-Rinehart, Sue, McNeal-Trice, Kenya, and Meier, Brianna
Rights Statement Label:: In Copyright

60. Care coordination among pediatricians and dentists: a cross-sectional study of opinions of North Carolina dentists

Title Tesim:: Care coordination among pediatricians and dentists: a cross-sectional study of opinions of North Carolina dentists
Creator:: Kranz, Ashley M., Long, Marshall, Quinonez, Rocio B., and Rozier, R. Gary
Date Created:: August 26, 2015
Date of publication:: April 7, 2014
Abstract Tesim:: Abstract: Background: Care coordination between physicians and dentists remains a challenge. This study of dentists providing pediatric dental care examined their opinions about physicians’ role in oral health and identified factors associated with these opinions. Methods: North Carolina general and pediatric dentists were surveyed on their opinions of how physicians should proceed after caries risk assessment and evaluation of an 18-month-old, low risk child. We estimated two multinomial logistic regression models to examine dentists’ responses to the scenario under the circumstances of an adequate and a limited dental workforce. Results: Among 376 dentists, 52% of dentists indicated physicians should immediately refer this child to a dental home with an adequate dental workforce. With a limited workforce, 34% recommended immediate referral. Regression analysis indicated that with an adequate workforce guideline awareness was associated with a significantly lower relative risk of dentists’ recommending the child remain in the medical home than immediate referral. Conclusions: Dentists’ opinions and professional guidelines on how physicians should promote early childhood oral health differ and warrant strategies to address such inconsistencies. Without consistent guidelines and their application, there is a missed opportunity to influence provider opinions to improve access to dental care.
Resource type:: Article
Access Right:: Open Access
Affiliation Label Tesim:: School of Dentistry, Department of Pediatrics, Department of Pediatric Dentistry, and Department of Health Policy and Management
Bibliographic Citation:: BMC Oral Health. 2014 Apr 07;14(1):33
Deposit Record:: a9d75501-b2dc-4ab4-99e4-eb7107f45dce
Type:: http://purl.org/dc/dcmitype/Text
DOI:: https://doi.org/10.17615/j17a-a702
Identifier:: 24708785 and https://doi.org/10.1186/1472-6831-14-33
ISSN:: 1472-6831
Journal Issue:: 1
Journal Title:: BMC Oral Health
Journal Volume:: 14
Language Label:: English
License Label:: http://creativecommons.org/licenses/by/2.0
ORCID:
Other Affiliation:: and Private Practice, Charlotte, NC, USA
Page Start:: 33
Peer Review Status:: Yes
Person:: Kranz, Ashley M., Long, Marshall, Quinonez, Rocio B., and Rozier, R. Gary
Publisher:: BioMed Central Ltd
Rights Holder:: Rocio B Quinonez et al.; licensee BioMed Central Ltd.
Rights Statement Label:: In Copyright
Source:: 9306t202f

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