• Acute Kidney Injury: Continuous Quality Improvement for Systems Change

      Bassett, Robin (University of Alaska Anchorage, 2016-12-01)
      Acute Kidney Injury (AKI) is reduced kidney function over hours to days which can be reversible but can lead to renal failure and death. AKI is diagnosed using serum creatinine and urine output but these factors are not sensitive or specific, and no biomarker has been found for more accurate diagnosis. International guidelines for AKI diagnosis and treatment were released in 2012 by the Kidney Disease: Improving Global Outcomes (KDIGO) group. Many providers are not aware of AKI and guidelines for treatment have not been implemented in practice. The purpose of this continuous quality improvement (CQI) project was to improve healthcare team member knowledge of AKI Guidelines and to develop electronic health records (EHR) tools to improve AKI recognition and diagnosis. EHR tools were developed for implementation during a two-month CQI practice initiative. An Excel spreadsheet for AKI diagnosis and EHR renal protection protocols were created and tested. Updates were made to the tools to allow ease of use based on interprofessional feedback. A trifold AKI educational pamphlet was developed following implementation to fill gaps in knowledge. The interprofessional critical care team survey reported the tools were helpful in facilitating AKI recognition and management according to published guidelines. More work is needed to find sustainable and significant improvements in AKI recognition, diagnosis, and treatment. AKI guidelines should be disseminated to non- nephrology professionals after revision to allow for increased diagnosis and management of this critical and common problem.
    • Alaska Army National Guard Construction Planning Process Improvement

      Nielson, Jeremy (University of Alaska Anchorage, 2016-12-01)
      The Alaska Army National Guard (AKARNG) is a jointly funded agency run under a cooperative agreement between the federal and state governments. Recognized as a state agency, the AKARNG reports to the governor for domestic response and trains for federal missions. With this relationship, the AKARNG receives funds from the National Guard Bureau (NGB) and the Alaska State Legislature for the execution of construction projects. Under the cooperative agreement, the AKARNG follows state procedures and uses the Alaska Department of Transportation and Public Facilities (ADOT/PF) to manage projects. The AKARNG Construction and Facilities Maintenance Officer (CFMO) ensures federal oversight of all AKARNG facilities. This project looks at the relationship between the AKARNG CFMO and ADOT/PF as they collaborate and plan construction projects for the AKARNG. The primary deliverables for this project are a current state swim lane chart (SLC) with written description and an improved state SLC with a written description. The goal of this project is to offer the AKARNG a roadmap for process improvement. The current and improved SLCs were produced by conducting research and engaging with stakeholders through interviews and questionnaires. Stakeholders were engaged throughout and offered quality oversight of the deliverables. The improved state SLC incorporated regulatory compliance and previously omitted policy requirements. When necessary, the improved state SLC included the addition or subtraction of steps to add value to the process. This project delivered the AKARNG a scalable depiction of their construction planning process and recommendations for improvement.
    • Alaska Greek Festival Event Management Plan

      Murrell, Allison (University of Alaska Anchorage, 2016-05-01)
      The annual Alaska Greek Festival in Anchorage, Alaska is an event managed by volunteers, a subcommittee and a chairperson. There are dozens of documents that relate to the operations of the event, and volunteers who know how things have happened in the past, but neither clear guidelines, nor standard practices. This lack of clarity leads to inefficiencies, conflicting ideas, confusion and waste. The festival’s history is 20 years old. The time is right for a positive shift to a more structured program. This shift will allow for policies and procedures to be codified, expectations to be made clear, the limited resources to be reviewed and efficiencies attained. The deliverable for this project would be the creation of a Greek Festival Best Practices Guide. This guide would include a volunteer/human resources management plan, quality assurance methods, as well as metrics gathering systems. The guide will also include tools that can help the festival subcommittee evaluate resource usage and find efficiencies in their current processes. This project’s deliverable would serve as a living document, for the community to reference and use to measure the success of meeting the festivals mission statement year after year.
    • Alaska Health Care Costs

      McCourtney, David (University of Alaska Anchorage, 2014-12-05)
    • Alaska Majestic Lodge Project

      Goode, Kelvin (University of Alaska Anchorage, 2015-12-01)
      The Alaska Majestic Lodge Project proposed to deliver a remote wilderness fishing lodge business plan. The project proposal was derived from a business opportunity that entailed capitalizing on a niche in a sport fishing market in the Becharof National Wildlife Refuge. When in operation, the business is expected to be the only 100% Alaskan Native owned lodge in the region and shall provide services for up to two hundred people seasonally from May to October. The significance of the project can be demonstrated in reviewing the summer visitor year of 2011. Nearly 1.2 million Alaskan tourists spent an estimated $1.5 billion in the State. In 2013 the visitor volume increased to 1.96 million people, with a rise in spending to about $1.82 billion. Southwest Alaska received nearly $93 million in the summer of 2014. The journey to capture the opportunity has shown that there is a forecasted net profit of fifty-five percent with a return on the investment of four years, assuming the lodge meets sixty percent capacity. The process undertaken to perform industry and market research allowed for the furnishing of steps necessary to deliver a business plan that incorporated the uniqueness of the business, the profitability of it and the opportunity for guests to see the region through the eyes of its indigenous people.
    • Alaska Nurse Practitioner Practices Regarding Adolescent Indoor Tanning

      Perez-Verdia, Monica H. (University of Alaska Anchorage, 2016-08-01)
      Skin cancer is the most prevalent form of cancer in the United States and melanoma is the second most common form of cancer in adolescents. Indoor tanning increases the risk of skin cancer especially when exposure begins at an early age. A significant percentage of adolescents indoor tan begining at an early age. Guidelines recommend that clinicians address indoor tanning use and avoidance behaviors with adolescents and their guardians. The purpose of this project is to assess Alaska nurse practitioner practices regarding adolescent indoor tanning and to provide nurse practitioners with evidence‐based tools for counseling that are current with clinical recommendations. Alaska nurse practitioners (N = 177) were surveyed on practices regarding adolescent indoor tanning, compliance with current recommendations, barriers preventing assessment and education, and awareness of, and support for, a minor indoor tanning ban in Alaska. Findings show that more than half of respondents do not ask adolescents about indoor tanning use and do not educate adolescents or their guardians regarding the associated risks and that one third of respondents feel that indoor tanning is of low priority. Additionally, nurse practitioners are not utilizing counseling tools sufficiently and are not employing evidence‐based techniques when they do; in regards to supporting legislation for change, the majority of them would support an indoor tanning ban for minors in Alaska.
    • Alaska Nurse Practitioners Barriers to Use of Prescription Drug Monitoring Program

      Christianson, Heath (University of Alaska Anchorage, 2016-05-01)
      Prescription drug monitoring programs (PDMPs) are still in their infancy but have begun to demonstrate themselves as potentially useful tools to enhance safe and responsible prescribing of controlled substances. However, little is known about how Nurse Practitioners (NPs) use these programs and the potential barriers they face. The purpose of this project was to describe Alaskan Nurse Practitioner’s (NPs) current practice, beliefs, and barriers regarding the use of the Alaska PDMP. A questionnaire was sent to 635 Alaskan Advanced Nurse Practitioners and a total of 204 valid questionnaires were returned. The survey results provided data regarding prescribing habits, barriers to the use of the PDMP, and barriers registering for the PDMP, as well as opinions on items that could make the PDMP easier to use and more useful in clinical practice. It was found that more attention is needed to maximize its exposure and incorporation into daily workflow if it is to achieve its full potential for reducing drug misuse and abuse while increasing patient safety. Additional consideration should be given to authorizing registered users to delegate authority to a licensed person on their staff to access the PDMP in an attempt to reduce time commitments and increase its usage. Many providers felt that assigning each individual a unique patient identifier could prevent consumers from filling prescriptions under aliases or using multiple addresses, which undermines the effectiveness of the PDMP. Finally, an overwhelming majority of users want faster data entry and proactive reports. This project begins the exploration of the differences between PDMP users and nonusers and how NPs believe the process can be improved. A better understanding PDMP use will aide providers in safe prescribing practices while curbing the prescription drug epidemic and ultimately reducing abuse, misuse, and death from overdose.
    • Alaska State Trooper Critical Incident Response Team and Peer Support Program Development

      Miller, Cari (2015-12-01)
      Law enforcement officers experience enormous job-related stress burdens in comparison to other career fields. Officers routinely encounter stressful situations from sources specific to their occupation, particularly their frequent exposure to dangerous situations, violence, and witnessing human suffering and depravity. Negative effects of occupational stress are exhibited in physical, physiological, emotional, and psychological changes. Law enforcement stress management programs are developed to provide resources to offset the negative effects, provide positive coping strategies to reduce stress, and increase the officer’s quality of life. This project developed program documents, policies, and procedures for the Critical Incident Response Team (CIRT) and Peer Support Program (PSP), for the Alaska State Troopers utilizing best practice recommendations. The CIRT supports troopers immediately following critical incidents, such as violent crimes, homicides, suicides, or officer involved shootings. The PSP operates in nonimmediate ways, helping troopers who experience difficulty coping, in the long-term, with occupational stress.
    • Alaska Wind Toolkit Revision

      McKay, Maggie (University of Alaska Anchorage, 2015-04-18)
      The Alaska Wind Working Group is a collaboration of government agencies, nonprofit organizations, businesses and individuals interested in identifying specific concerns and barriers to and opportunities for wind development in Alaska. The group holds meetings quarterly to share information and discuss wind power in Alaska. The Alaska Wind Working Group is dedicated to the smart and successful wind power development in Alaska, and is open to any interested party that supports the group's mission. During the fall quarterly wind working group session it was acknowledged by the group that the Alaska Wind Toolkit publication is out of date and not current with industry best practices. The group would like to see the document updated, republished and distributed. This project will be review and revise the Community Wind Toolkit that was published by the Renewable Energy Alaska Project (REAP) in March 2011. This project will provide the planning, literature review, survey, interviews, document revisions, and draft review. Additionally, all procedures and processes as required by PM686A and 686B will be incorporated into the project. The project will be initiated with the acceptance and signature of the charter and will conclude April 27th, 2015 with the successful completion of 686B.
    • Alaska Young Driver Safety: Distracted Driving, Seat Belt Use and Drinking and Driving

      Savage, Shannon (University of Alaska Anchorage, 2015-12-01)
      United States teenagers have the highest crash rate of any group in the nation. The data tell us that there are eight identified leading causes of teen injuries and deaths associated with vehicle collisions: Driver inexperience; driving with teen passengers; nighttime driving; not using seat belts; distracted driving; drowsy driving; reckless driving; and impaired driving (CDC, 2014). Alaska data tell a similar story. The leading causes of crashes for Alaskan teen drivers are: driver inattention, unsafe speed, failure to yield and driver inexperience (Alaska Injury Prevention Center, 2012). In partnership with the Alaska Injury Prevention Center, this practicum project created a resource guide identifying best practices in teen driving interventions connected to three of these areas: distracted driving, seat belt use and drinking and driving. The Strategies to Support Safe Teen Driving in Alaska resource guide is intended as a tool for community partners to access information about interventions for distracted driving, seat belt use and drinking and driving for Alaska teens and to work to put those interventions into action in their local communities. Project research efforts included a synthesis review of available intervention reports, including a multi-step filtering process that distilled available program literature down to a final collection of strategies based on best available evidence. These resulting strategies were categorized into a taxonomy identifying currently available approaches, and were also classified into levels of promise associated with certainty of effectiveness and potential population impact. Upon evaluation of intervention types within a Promise Table structure, the strategies found to be most promising were all public policy efforts surrounding graduated drivers’ licensing programs, a minimum legal drinking age at 21, cell phone restrictions while driving and seat belt requirements. In addition, the community role of creating partnerships to prevent unsafe teen driving behaviors, as well as the parental role of boundary setting and monitoring their teen’s driving behavior, were found to have equal levels of promise. Of most significance was the finding identifying the importance of executing teen driving strategies with diverse influences, including all levels of the Social Ecological Model’s influence (i.e. public policy, community, organizational, interpersonal and intrapersonal). Additional priority areas included attention to matters of community culture, public policy, enforcement and parental influence. Resulting recommendations include multiple public policy enhancements in the state of Alaska, including graduated driver’s license program modifications, enhancement of the state’s zero-tolerance policy and broad scale restrictions of driver cell-phone use.
    • Alaska's Local Option Law and its Impacts on Underage Drinking Outcomes

      Pineda, Natasha M. (University of Alaska Anchorage, 2014-03-01)
      The purposes of this project were to explore the relationship between alcohol bans and 1) age of first use, 2) 30-day use and perceptions of harm among high school students, and 3) intentional and unintentional injury among adolescents. Methods involved secondary data analyses of two samples from the Alaska Youth Risk Behavior Survey (YRBS), the Alaska Trauma Registry (ATR), and the Alaska Violent Death Reporting System (AKVDRS) – including 49 communities without a ban on possession, and including 11 villages with a ban on sales, importation and possession. Lower rates of self-reported alcohol consumption in underage persons in communities with a ban on possession were not found. Moreover, data from the YRBS indicates youth in communities with a ban on alcohol possession had increased odds of lifetime use of alcohol (OR 1.621) as well as use before age of 13 (OR 1.903) and increased odds of lower reported peer approval related to drinking (OR .531). No significant differences were identified between the two communities on 30-day use of alcohol; 30-day binge drinking; drinking on school property; perceptions of risk related to daily use of alcohol; and parental approval for regular alcohol use. Communities with a ban on possession had lower number of suspected or proven alcohol use related injuries and deaths. Study findings suggest that it is insufficient to address alcohol-related problems among youth based on a single environmental level policy. Communities need to look beyond a single factor to solve a public health problem and consider the complex interactions between the individual, interpersonal, and other environmental-level.
    • Analysis of Thermal Interconnectivity of Utilities in Rural Alaska

      Mercer, Christopher J. (University of Alaska Anchorage, 2014-12-19)
      Throughout the arctic there are two primary community utilities with dramatically contrary thermodynamic concerns. These are the intensely exothermic diesel electric power generation, and the strongly endothermic water and sewer utility. In this context exothermic processes must expel excess heat while endothermic process requires heat input. Failure of engineers, community planners, funding agencies, and interest groups to recognize the full social, economic, and environmental impact to the sustainability of utilities has come at tremendous cost. This is exemplified in many remote Alaskan communities such as Toksook Bay, Minto, Deering, and Kotlik.
    • Anchorage Certification Center (AC2) feasibility study project

      Ming, Andrew R. (University of Alaska Anchorage, 2018-12-01)
      This project conducted a feasibility study in the City of Anchorage to determine the demand and need for an Information Technology (IT) boot-camp-style training and certification center. This business will be aimed at utilizing a small business concept to capitalize on the demands and needs of local businesses that employ IT-certified professionals. The feasibility study was conducted by analyzing past business data through the Alaska Small Business Development Center, along with conducting electronic surveys and subject-matter expert interviews, specifically targeting what employers are expecting from potential and current IT employees. Internet searches across different employment advertising agencies were also used in order to gather employment requirements of such professionals. Upon conclusion of the research, a detailed feasibility study was presented to the Project Sponsor which also included Return on Investment (ROI) estimates based upon approximate costs to start, establish and maintain such business. The Project Sponsor also received a simple business plan as a foundation to start the business. All deliverables were compiled using data collected during the research phase of the project and contained adequate information for an informed decision from the Project Sponsor on whether to pursue the investment opportunity.
    • Application of Revolving Door Technology in Reducing Energy Loss in Anchorage, Alaska

      Ballard, Raymond A. C. (University of Alaska Anchorage, 2016-12-01)
      Arctic entryways (vestibules) are an important building feature in Alaska for energy savings. Vestibules and revolving doors are often designed to reduce air infiltration rates and ultimately reduce building energy costs. In Anchorage, most buildings utilize vestibule technology for building entrances but revolving door technology is also a viable option to consider. In Anchorage, Alaska, reduction of energy consumption is necessary for long-term sustainability of most buildings and businesses. The project included a review of relevant literature publications to select methods to predict air infiltration rate due to vestibules versus revolving doors; calculations for energy usage of various Anchorage public buildings with existing doorways versus with revolving doors; and an analysis of the energy savings. The case study selected six Anchorage public buildings for evaluation based on differences in building size, utility, and availability of energy data. The study found that while revolving door technology can technically save some energy costs, the additional cost was not justifiable in most of the buildings selected for study due to lack the occupancy throughput, building height, and quantity of wind. One exception was East High School (East entrance) where a vestibule or revolving door should be added. It was observed that sufficient space exists for most Anchorage public buildings to install vestibules, and that in existing revolving door locations the adjacent sliding doors are often preferred by users. A case study for restaurants and strip malls in Alaska would be beneficial as these building types may be more energy efficient with revolving doors due to higher user throughput.
    • Best Practices and Guidelines for Scheduling Oil Drill Rig Resources for Projects on Alaska's North Slope

      Mici, Alket (University of Alaska Anchorage, 2015-12-01)
      The recent increase in the number of the projects and activities on the North Slope of Alaska has become challenging, leading to numerous scheduling conflicts for equipment and resources. This project explains steps that can be taken to improve resource allocation and guidelines for scheduling oil drill rig work activities for oil and gas projects on Alaska’s North Slope. The project includes insights from two years of research to improve the oil drill rig scheduling process, a survey of subject matter experts involved in the oil drill rig scheduling process, research of similar Arctic environment projects, and the researchers professional experience identifying and mitigating risks and schedule conflicts in the mid-term planning phase of oil and gas projects. Implementing the proposed guidelines has improved the oil drill rig scheduling process, roles and responsibilities are more clearly defined, communication among groups has been improved and support groups have adequate time to complete their work. Results include reduction of oil drill rig move downtime and a reduction in the time to produce oil after the oil drill rig leaves the well site.
    • Better Understanding the Modifiers of Domestic Water Consumption: An Investigation Project

      Lespin, Eric J. (University of Alaska Anchorage, 2014-04)
      Around the world different living circumstances have an enormous yet poorly quantified impact on human water consumption. Water consumption levels are in turn closely linked to health and quality of life, particularly where access to water is limited. These facts place significant water and health impacts in the hands of those who make design and implementation decisions about living circumstances – professionals who are not necessarily experts in matters of water. This investigation was an examination of the abundant yet discordant and atomized data on human water consumption, providing a summary of water consumption modifiers and water consumption numbers over a wide range of circumstances, in table form, to those involved with dwelling infrastructure, water/sanitation, hygiene, or other water-impacted fields. Disambiguation of the water consumption concept was necessary, which encompasses three categories of consumption: footprint, domestic, and ingestion. Footprint water consumption was documented to be greater than domestic consumption by an order of magnitude. Domestic consumption was found to be ~99% defined by our surroundings and to vary between 7 and 600 lpcd. Principal modifiers of domestic consumption are service level, sanitation decision (dry vs. flush), presence of metering, use of low flow fixtures, residential lot or compound size, and climate. Sanitation decision is linked to substantial health externalities. Price appeared to have a less-than-anticipated impact, due likely to social/health restraints in applying strict economic principles. Dwelling size was found not to be a modifier. Relative impact of modifiers discussed.
    • Blended Learning in Culinary Arts: A Case Study in Learning and Perception

      Everett, Naomi S. (University of Alaska Anchorage, 2016-05-01)
      There is great need for skillful culinary employees for a wide variety of positions in the hospitality, hotel, and restaurant industry. Culinary school provides a baseline educational experience for students looking to pursue this career field. Culinary instructors find themselves obligated to discover ways to promote student learning in classic culinary competencies while evolving with a population that is tech-savvy and requires more than the standard lecture and rote memorization of materials. This paper describes an exploratory study that incorporated videos as part of a blended learning model in a traditional face-to-face culinary arts class at the University of Alaska Anchorage. The curriculum was on poultry fabrication, and data collection focused on students’ skills and their perceptions of the blended learning activities. Initial feedback suggest that including videos in the culinary arts classroom facilitates learning, and though they cannot replace in-class live demonstrations, are beneficial educational accompaniments. Recommendations for practice and implications are discussed.
    • Business Improvement Recommendation

      Youlo, Walter Y. (University of Alaska Anchorage, 2016-05-01)
      The purpose of the ProBrainiac Project Management Plan (PMP) document is to provide the project stakeholders with an approved working guide for how the project will be managed during execution. The PMP outlines how the project work will be managed by the Project Manager (PM), project sponsor throughout the project phases ensuring efficient, timely, execution of the project and deliverable as outlined in the project charter.
    • Career Exploration in the Anchorage School District

      Daniels, Adele M. (University of Alaska Anchorage, 2014-05)
      Job shadow opportunities for middle and high school students provides valuable exposure to workplace environments as students look at future career choices. This type of career exploration can help to connect students to careers of interest as part of a career pathway. These experiences can help a student recognize the skills that are needed for a particular job, as well as the day-to-day duties for a person working in a given field. Military installations located near local school districts are an untapped resource for the career exploration opportunities that are available. Many military and civilian occupations are very similar in nature, allowing for useful connections to be made by students. Making the connections more simplified, for both partners, could allow for more opportunities to take place. This paper will provide a suggested template to follow when planning an event in any school district located near a military installation.
    • Caregiver Burden and Perceived Health Competence when Caring for Family Members Diagnosed with Alzheimer’s Disease and Related Dementia

      Bailes, Christine (University of Alaska Anchorage, 2015-02-01)
      Purpose: To identify if there is a relationship between perceived health competence and burden of care of informal caregivers of family members with Alzheimer’s Disease and Related Dementia (ADRD). Methods: Informal caregivers 18 years and older who received services from the Alzheimer’s Resource of Alaska were invited to complete a survey. Conclusion: Findings indicate that there was a significant negative correlation between Perceived Health Competence and Burden of Care (N = 64, r = -.54, p <.001). Furthermore, the three subscales of the Modified Montgomery-Borgatta Caregiver Burden Scale: Relationship burden (r = -.29, p = .021), Objective burden (r = -.65, p = < .001) and Stress burden (r = -.41, p = .001) indicated that different types of burden affect informal caregivers’ health competence. Implications for practice: Based on the findings of this study, it is important to ensure that informal caregivers do have time for themselves as well as taking care of their own health needs. Nurse Practitioners can play an important role in early detection and prevention, with periodic screening to help identify current needs and to ensure optimal health for these informal caregivers.