RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Obesity and Delinquency in Ontario Public Schools: A prescription for better schools and healthier kids. Project Date: 4/30/2007 The pediatric population is unique in that for six-to-seven hours in a given day they spend their time in a controlled environment. The objective of this study was to review the literature and make recommendations that could be instituted by the school district to address two concerns in this population: obesity and delinquency. Many comments were made by health care professionals and community leaders about these problems, particularly the increased disruptive behavior, drug and gang activity in the middle school. Though the school district was restructuring its schools to meet these new challenges, alternative solutions were being sought. A review of the literature revealed a number of strategies that could be implemented by the school district to decrease disruptive behavior and the trend in obesity. First and foremost, returning sixth graders to the elementary schools will decrease disruptive behavior in the middle schools and will decrease the likelihood that these children will continue such behavior into later school years. In addition, scheduling recess before lunch can decrease after-lunch classroom rowdiness and increase instruction time by up to 10 minutes. In addition, children make healthier food choices and waste less food; this can translate into cost-savings for the school district. Lastly, instituting a universal school breakfast program also contributes to children making healthier eating habits during these impressionable years. Effectiveness of hypertension management in Astoria, OR. Project Date: 10/16/2006 Hypertension (HTN) incidence and prevalence continues to increase across the country, with a higher disease burden found in some rural areas. In fact, it was the most frequent diagnosis recorded for all routine health checks (4.1%) in the US, and in a small Family Practice clinic in Astoria, OR, HTN was the reason for 6.1% of visits per day. However, recent studies show only 20-30% of those with HTN have optimally controlled blood pressures (BP). I researched current recommendations for successful management of HTN in the literature, and used this information to investigate the effectiveness of HTN management in this small Family Practice clinic in Astoria, OR. A flowsheet was created to focus on these guidelines and a chart review of 35 patients was done using this tool. Data was collected, including weight, BMI, BP, risk factors/secondary causes, PE and labs done, medications, and expected follow-up. Results showed that these two Family Practitioners did an outstanding job of overall BP management, with almost ¾ of their patients at or below their goal BP, and timely lab follow-up. Areas of improvement include stricter use of recommended medications for specific co-morbidities, consistently including fundoscopic exam as part of the PE, and ordering EKGs. This information can be used as a background for future HTN management in this clinic, with utilization of the flowsheet to aide in the improvements discussed. Choosing the Path Less Traveled: Walking for Health in Reedsport, Oregon Project Date: 7/3/2006 This paper introduces the concept of the “walkable” community and discusses opportunities for incorporating exercise into the daily routines of residents in the Reedsport, Winchester Bay, and Gardiner area. Past community health efforts and student research projects have reiterated the importance of health promotion in this population. Interviews with local residents and a literature search revealed the need for a more extensive list and map of pedestrian routes in the area to highlight a variety of walking and jogging options close to home. A survey of the Dunes Family Health Care clinicians demonstrated that exercise is important to medical providers, and a patient survey identified the need for better outreach to make health handouts available at multiple locations in the area. The final product is an easily reproducible brochure of walking and jogging trails in the Reedsport, Winchester Bay, and Gardiner area. Mental Health Care Resources in Linn County Project Date: 1/2/2006 Mental healthcare delivery everywhere is being provided to greater extents by primary care physicians than ever before, especially in rural settings where community mental health resources are lacking. This report assesses the prevalence and disease burden of mental illness in the U.S. overall, and in our rural communities like Linn County. Second, it discusses barriers to mental health care in rural settings. Next, it poses possible solutions to rural disparities in mental health care. Finally I discuss my project. The goal of this project was to examine the need for mental health services in Linn County, identify mental health resources in Linn County, and formulate a consolidated list of local mental health resources including their areas of expertise for use by local health care providers and community members. Hospitalization of Hospice Patients Project Date: 3/21/2005 OBJECTIVES: To identify reasons why hospice patients are admitted to the hospital, evaluate what treatments they receive, and identify any violations of hospice philosophy. DESIGN: Retrospective analysis of hospital charts and hospice nursing case notes from 2000 to 2005. SETTING: Newport, OR PARTICIPANTS: Hospitalized patients enrolled in Pacific Communities Hospice prior to hospital admission from 2000 to 2005. MEASUREMENTS: Specific information was gathered on each patient including: hospice admit date, hospice diagnosis, primary insurance, hospital admit date, reason for admission, route of hospital entry, length of hospital stay, treatments and procedures received in the hospital, discharge destination, date of death and place of death. RESULTS: Seven hospice patients were hospitalized between 2000 and 2005. The average age of hospice enrollment was 62 years old. Lung cancer was the most frequent terminal diagnosis. The average length of time from hospice enrollment to hospital admission was 62 days. Out of the 7 patients admitted to the hospital, 3 were admitted for pain control and 2 for seizure control. The average length of stay was 2.5 days. Three of seven patients died during their hospital stay. Various treatments were provided to these patients although one patient received the same care that had been provided at home. Two patients received peripheral IV’s. One patient received a blood transfusion. Two patients had a central line placed and a head CT. CONCLUSION: From reviewing charts of hospitalized hospice patients it appears that each admission was due to symptom management issues. Non-invasive studies performed, including head CT and EKG on 2 patients, were done to aid in symptom relief management. The invasive procedures done, which included blood transfusion and central line placement, were done to provide symptomatic relief in accordance with hospice philosophy. Newborn Discharge Packet for Siskiyou Pediatric Clinic Patients Project Date: 9/13/2004 This project was designed to provide a brochure of important information for parents of newborns at the Three Rivers Community Hospital in Grants Pass, OR. Multiple resources exist to provide support and advice to parents of newborn infants. However, most of these require the use of internet access or the financial ability to purchase parenting books. Pediatricians supply many free handouts that parents can collect, but many of the parents I talked with indicated a desire for a quick reference source that gave them bulleted points outlining key information and guiding them in when to access their pediatrician. Interviews were conducted with new parents, nurses in the Family Birth Center and the pediatricians at Siskiyou Pediatric Clinic in Grants Pass, OR in an attempt to determine the most important topics to include and what the best format to present this information. A brochure format was believed to provide the best presentation of information for this community. Further data collection determined five main areas for the newborn brochure, including newborn safety, immunizations, well-child checks, local contact numbers and guidance on when a new parent should call the pediatrician. The product of this project is a brochure entitled "Newborn Information That Every Parent Needs to Get Started" that will be given to every parent in the Family Birth Center before discharge from the hospital. Colorectal Cancer Screening Practices at the Dunes Family Health Care Clinic Project Date: 9/ 24/2001 This study sought to examine the colorectal cancer (CRC) screening practices and rates among the family practice providers at Dunes Family Health Care in Reedsport, Oregon, as well as to increase patient awareness about the disease. There were four components of the study: a) written survey of the providers' screening preferences, b) chart review to determine screening rates, c) review of the adjoining hospital's surgery logbook to examine colonoscopy rates, d) creation of an article on screening for CRC to be included in the clinic's newsletter to patients. The providers' screening practices were also compared to national guidelines for screening recommendations. There was found to be an overall high rate of screening at the Dunes clinic, although this was provider-dependent. There was some variation in preference for screening exams among the providers, but all screening plans were within the bounds of most guidelines. Finally, some suggestions were made on how to increase screening rates, and patient groups at increased risk of not receiving screening were identified. Back to subject search page or search by preceptor site