This program evaluation was undertaken to improve patient safety and access to U-500R insulin by improving 'spoke' clinicians' knowledge of safe delivery and management of U-500R insulin. We created an order template for U-500R insulin, a patient education template, and pharmacy processes to ensure that all clinicians are able to co-manage U-500R insulin. The national epidemic of diabetes and the exposure of Vietnam veterans to Agent Orange has led to insulin resistance requiring concentrated insulin (U-500R) for glycemic control. Initiation of U-500R insulin is limited to endocrinology expertise housed at 'hub' Veterans Health Administration's (VHA's) located hours away from smaller 'spoke' facilities. To overcome the potential health care disparities and improve patient safety, a program was developed ensuring that all clinicians could co-manage U-500R insulin. Our program enhanced health care process and increased provider knowledge and confidence of delivery and management of U-500R insulin for veterans.

The current research sought to understand which factors contributed to medication adherence and non-adherence in a sample of patients with Type 2 Diabetes receiving care at a suburban walk-in clinic located in Southwestern PA.

Patients with osteoarthritis (OA) face physical challenges due to pain. Osteoarthritis of the knee joint can be treated surgically with a total knee replacement (TKR). After surgical intervention with TKR, optimizing a patient's pain control for promotion of early ambulation is important. Femoral nerve block (FNB) is one method that has been shown to reduce postoperative pain. A non-experimental, comparative case-control study was conducted to compare pain levels and the length of stay (LOS) for FNB versus non-FNB TKR patients. A convenience sample of 20 FNB and 20 non-FNB patients was obtained. The physical context of Katharine Kolcaba's comfort theory served as the conceptual framework in this study.

This study utilized a non-experimental, descriptive correlational design in order to determine if EMS professionals in Northwestern Pennsylvania, who practice self-care, experience less compassion fatigue than those who do not. A survey which was comprised of The Professional Quality of Life (ProQOL) scale, as well as, the Health Promotion Lifestyle Profile (HPLP) II was completed by 164 EMS professionals in Northwestern Pennsylvania. Spearman's rank correlation coefficient was utilized to determine the relationship between self-care and compassion fatigue.

The purpose of this project was to see if the PAMS [Provider Admission Medication Screen] would reduce the percentage of falls in older adults ≥65 residing in the SNF setting. Fall percentage data was compared between residents who had been admitted 4-8 months prior to the project with those who had the tool utilized within 48 hours of admission.

This retrospective, observational study examined 327 STEMI patients treated with percutaneous coronary intervention with stenting in a large Central Pennsylvania hospital system. Patients were placed in an early discharge category (≤ 2 nights) or traditional discharge category (> 2 nights). These categories were further broken down into male and female groups. Adverse events within thirty-days of discharge (mortality and/or readmission) were evaluated to determine if common themes existed. Only eighteen patients experienced an adverse event during the two-year study timeframe.

RN to BSN and MSN students experience a degree of stress on the job and in the classroom that could lead to negative personal and professional consequences, which in turn may contribute to negative trends in the nursing field including job dissatisfaction, burnout, and compassion fatigue. Guided by Tsai's Theory of Caregiver Stress, this study examines whether a relationship exists between stress level and intensity of life experiences in 84 nursing students in Clarion University's RN to BSN (n=51) and MSN programs (n=33). Participants were asked to complete the Perceived Stress Scale and Survey of Recent Life Experience reporting their stress levels and perceived stressors over the course of the previous month, as well as a short demographic survey. The correlation between stress and life events was then examined, as well as the relationship of stress to demographic covariates such as age, gender, marital status, years of nursing experience, and enrollment status. As anticipated, a strong positive correlation was found between stress level and life intensity in both RN to BSN and MSN student participants (p=<0.0001).

This study investigated the rate of hand hygiene compliance among health care providers in a rural Pennsylvania emergency department. Hand hygiene is well studied in healthcare but few studies were related to the emergency department. This study sought to answer the following questions. How compliant with hand hygiene are healthcare workers in the emergency room setting? Is there a difference in hand hygiene compliance rates between entering and exiting a patient's room? How often is hand sanitizer used versus soap and water for hand hygiene? During the study, Healthcare providers were observed entering and exiting a patient's room, results of hand hygiene compliance were recorded as well as if the provider used soap and water or hand sanitizer. Overall 56% of providers were compliant with hand sanitizer being used more often. The results also revealed that 27% of the healthcare providers were completely non-compliant with hand hygiene.

The negative effects of work-related stress is an important health topic. Primary care providers regularly manage conditions related to the effects of stress on the body and mind, which is a valid health concern. Research shows the link between stress and individual health and its impact on organizational and business outcomes. Studies have found a long-term relationship between stresses and developing chronic illness and health problems, however, few studies have shown the long-term effects of stress management interventions on reducing stress levels and improving health. Employers who choose to address work stresses consistently for employees can benefit from their action. Understanding the effects of work-related stress supports implementation of measures, which effectively manage work stresses through education, communication, and supportive measures. This study was conducted on employees of an industrial manufacturing company to determine if available on-site interventions positively affected perceived stress levels experienced. The Health Promotion theory model by Nola Pender served as the theoretical framework upon which the research was based. The data collected attempted to show a relationship between use of measures and achieved outcomes. The study identified the consistent presence of perceived stress in the work environment with no significant correlation found between use of specific interventions.

This before and after study was undertaken to determine if an algorithm constructed in an electronic health record (EHR) template in Centricity would assist in diagnosing interstitial cystitis. Data were collected from medical providers (MDs, DOs, PAs, NPs) in family practice, internal medicine, and OB/GYN specialties. A convenience sample of providers was used. Data were collected using The Post-Study Usability Questionnaire and Perceived Competence Scale. Twenty-three common bladder ICD-10 codes were compared before and after providers were introduced to the algorithm and EHR template. Data provided information on the usability of an algorithm and the Centricity EHR template for the purpose of correctly diagnosing chronic urinary symptoms including interstitial cystitis. Assessing ICD-10 codes demonstrated a change in diagnostic practices with an increase in the diagnosis of interstitial cystitis four months after implementation of the template. Conclusions from this study provide a starting point for the development of a usable template algorithm to help determine who may have interstitial cystitis instead of another chronic urinary tract issue.

Using a pre-test and post-test survey, the authors conclude that parents who attended an educational session on concussion symptoms, treatment, and long-term sequelae had an improvement in knowledge.

This study evaluated barriers to diagnosing and management of asthma in school age children in Northwestern Pennsylvania utilizing a modification of the Physician Asthma Care Education (PACE) presentation and survey.