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Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Walden Dissertations and Doctoral Studies
Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Walden Dissertations and Doctoral Studies
Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae
Walden Dissertations and Doctoral Studies
Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.
Role Of Intravenous Access Support In Novice Nurses’ Job Satisfaction And Intent To Stay, Shaji Kurian
Role Of Intravenous Access Support In Novice Nurses’ Job Satisfaction And Intent To Stay, Shaji Kurian
Walden Dissertations and Doctoral Studies
The nursing shortage is a growing concern across the country, especially due to the Covid-19 pandemic. Novice nurse retention is essential to solving this national problem. The purpose of this study was to examine whether intravenous (IV) access support influences job satisfaction and retention among novice nurses to improve their retention. Herzberg’s two-factor theory guided this research; IV access support acts as the hygiene factor. The absence of IV access support can result in dissatisfaction among novice nurses, contributing to higher turnover rates. This quantitative nonexperimental causal-comparative research design utilized a nurse work satisfaction questionnaire and intent to stay scale …
Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender
Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender
Walden Dissertations and Doctoral Studies
Substance use disorder continues to be a major health crisis in the United States. Thousands of people die yearly due to substance use and related criminal activity. Substance abuse treatment is a remedy to the disorder and treatment centers admit thousands of patients yearly to address the dilemma. Throughout the years retention has been an ongoing barrier to successful treatment. This study explored significant obstacles to retention: motivation and engagement. The Baldrige Excellence Framework was utilized to assess the training, supervision, procedures, and leadership roles at an intensive outpatient substance abuse treatment center. This study utilized a qualitative approach case …
Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall
Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall
Walden Dissertations and Doctoral Studies
The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …
Structural Empowerment And Employee Commitment Among Millennial Newly Registered Nurses, Janice Hill
Structural Empowerment And Employee Commitment Among Millennial Newly Registered Nurses, Janice Hill
Walden Dissertations and Doctoral Studies
AbstractThe nursing shortage is one of the most challenging issues in global healthcare. While not an all-encompassing solution, labor force retention could alleviate the crisis. The purpose of this study, guided by Kanter’s structural theory of organizational behavior, was to determine the relationships between access to power, opportunity for growth, structural empowerment (SE), and employee commitment among millennial newly registered nurses (NRNs) and to determine if there is a difference in SE between male and female millennial NRNs. Survey data collected from 148 participants were analyzed using Spearman rank-order correlation tests and showed statistically significant correlations between access to power …
An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane
An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane
Walden Dissertations and Doctoral Studies
Medical laboratory professionals have faced more than 20 years of workforce shortages. The causes of these workforce shortages include poor retention of new professionals and an insufficient number of new graduates who enter the workforce. The purpose of this qualitative case study was to explore the strategies that are used by managers in hospitals for the retention of laboratory professionals. The theoretical framework comprised Mobley’s theory of turnover and Porter’s organizational commitment theory. The research questions for this study addressed what managers perceived as the biggest challenges for the retention of laboratory professionals and what effective strategies they thought could …
Relationship Between Self-Determination And Employee Retention, Tiffany Edwards
Relationship Between Self-Determination And Employee Retention, Tiffany Edwards
Walden Dissertations and Doctoral Studies
Retention of registered nurses (RNs) is essential to the sustainability of quality health care services. More than 55% of hospitals in the United States have not translated retention initiatives into a formal retention strategy. The purpose of this study was to examine the relationship between training programs, new hire onboarding processes, frozen positions, and nurse retention. The self-determination theory was the theoretical framework for this study. Secondary data were collected from the 2016 Texas Hospital Nurse Staffing Survey. Data were analyzed using multiple linear regression. The results of the multiple linear regression were statistically significant, with F(3, 251) = .602, …
Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale
Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale
Walden Dissertations and Doctoral Studies
Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. …
Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman
Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman
Walden Dissertations and Doctoral Studies
Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, …
Strategies For Increasing Volunteer Engagement In Nonprofit Healthcare Organizations, Sanja Katina Hudson
Strategies For Increasing Volunteer Engagement In Nonprofit Healthcare Organizations, Sanja Katina Hudson
Walden Dissertations and Doctoral Studies
Implementing effective strategies to address the challenges of volunteer engagement is critical for helping ensure the sustainability of nonprofit healthcare organizations. Nonprofit healthcare leaders seek strategies to increase the volunteer workforce and enhance volunteer engagement. Through the conceptual lens of Deci and Ryan's self-determination theory, the strategies nonprofit healthcare leaders used to reduce volunteer turnover were explored in this single-case study. Data were collected using semistructured interviews with 5 nonprofit healthcare leaders from a single organization in the southwestern United States. Analysis of internal and external organizational documents and publicly available data were manually coded and thematically organized. The use …
Nursing Candidates' Perceptions Of The Greatest Challenges To Becoming A Professional Nurse, Lee Ann Williams
Nursing Candidates' Perceptions Of The Greatest Challenges To Becoming A Professional Nurse, Lee Ann Williams
Walden Dissertations and Doctoral Studies
Nursing candidates' overall goal is to become a professional nurse. To reach this goal, the student must graduate from an associate or baccalaureate nursing program and pass the state board, National Council Licensure Examination (NCLEX). Student retention in nursing programs and passing the NCLEX continue to be a problem for educational institutions throughout the United States. The purpose of this study was to examine nursing candidates' perceptions of their greatest challenges in becoming a professional nurse. Wenger's social learning systems and the community of practice comprised the conceptual framework that guided this study. The research questions pertained to nursing students' …
Improvement In The Retention Of Graduate Nurses In A Long-Term Acute Care Hospital, Angie Lim Torres
Improvement In The Retention Of Graduate Nurses In A Long-Term Acute Care Hospital, Angie Lim Torres
Walden Dissertations and Doctoral Studies
The high turnover rate of graduate nurses is a challenge in the United States' hospitals because of high job dissatisfaction rates. The premature disaffiliation of the graduate nurses is costly for organizations and can significantly affect the quality and safety of patient care due to the inadequate supply of adequately prepared staff nurses, particularly in the long-term acute care hospitals. The purpose of the project was to decrease the turnover rate of graduate nurses in a long-term acute care setting from 40% to 20% through modification of the nurse residency program by applying an intervention based on Bauer and Erdogan's …
Retention Of The Experienced Nurse, Tina Melissa Brinegar
Retention Of The Experienced Nurse, Tina Melissa Brinegar
Walden Dissertations and Doctoral Studies
The nursing profession is facing a potentially devastating shortage of nurses by the year 2020. Contributing to the shortage is the retirement of experienced nurses who are over the age of 45, and an aging baby boomer population. The loss will place a considerable strain on the overloaded health systems. As a result, it is important to identify successful strategies for addressing the problem of experienced nurse retention. Therefore, the purpose of this project was to conduct a systematic review of literature to answer the question of what retention strategies have been used to prevent the loss of the experienced …
Differentiating Successful And Unsuccessful Nursing Students, Trilla Mays
Differentiating Successful And Unsuccessful Nursing Students, Trilla Mays
Walden Dissertations and Doctoral Studies
Administrators of nursing programs in community colleges are aware of the need to retain and to graduate students to meet the growing demand for licensed practical nurses (LPNs). High attrition in a 2-year nursing program in South Carolina affected the number of students either graduating as a LPN after completing the third semester, or continuing in the program to become a registered nurse (RN). Guided by Jeffreys's nursing undergraduate retention and success model, this causal comparative study investigated the differences between students who were and were not successful in the initial 3 semesters of the program. Archival student records for …
The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane
The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane
Walden Dissertations and Doctoral Studies
Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers' role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass' theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A …
Factors Related To Nursing Student Persistence In An Associate Degree Program, Patricia Ann Farley
Factors Related To Nursing Student Persistence In An Associate Degree Program, Patricia Ann Farley
Walden Dissertations and Doctoral Studies
The retention of nursing students remains a challenge in higher education, and the need for nurses in the United States is projected to increase. The purpose of this study was to investigate nursing student persistence in an associate degree program by examining differences in the presence of key social, environmental, and academic factors across 2 types of students: completers and non-completers of the 1st course in a registered nursing program. The study framework was based on Tinto's Student Integration Model and the Nursing Undergraduate Retention and Success Model, which identify key social, environmental, and academic factors as critical to student …
Relationships Between Early Academic Indicators And Accelerated-Baccalaureate Student Nurse Success, Bonnie J. White
Relationships Between Early Academic Indicators And Accelerated-Baccalaureate Student Nurse Success, Bonnie J. White
Walden Dissertations and Doctoral Studies
In 2013, the National Council Licensure Examination for Registered Nurses' (NCLEX-RN) passing standard was increased, leading to a decrease in NCLEX-RN pass rates. The passing standard increase was prompted by an advisory panel's determination that a gap in safe, competent practice existed among new graduate nurses. New graduates' success on NCLEX-RN is critical to meet workplace demand for new nurses. The purpose of this study was to examine whether cumulative grade point average at completion of 200-level nursing courses and scores on the standardized final exam in the 200-level fundamentals course were related to on-time nursing program completion and a …
Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller
Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller
Walden Dissertations and Doctoral Studies
New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining …
Case Study Of Stakeholders' Views On Retention And Self-Efficacy In Texas Nursing Programs, Durcilla Kay Williams
Case Study Of Stakeholders' Views On Retention And Self-Efficacy In Texas Nursing Programs, Durcilla Kay Williams
Walden Dissertations and Doctoral Studies
Retention of students through the completion of the nursing degree is a problem that exists at local Texas nursing programs, adding to the nursing shortage at local Texas hospitals. The purpose of this qualitative research study was to identify the best practices used by a local Texas college with graduation rates above the benchmark of 85% set by the Texas Higher Education Coordinating Board. The study framework was based on Bandura's theory of self-efficacy and Tinto's theory of student retention. The research questions for the study focused on reasons the college maintained a high retention rate, best practices currently used, …
Health Science Adminstrators' Perception Of Remediation With Students In The Professional Track Programs, Yvonne Jackson Jackson
Health Science Adminstrators' Perception Of Remediation With Students In The Professional Track Programs, Yvonne Jackson Jackson
Walden Dissertations and Doctoral Studies
Remediation to improve student retention is rapidly becoming an important part of health science programs in higher education. A career college located in the midwestern United States implemented remediation for students to address declining enrollment health science professional-track programs. The purpose of this qualitative case study was to explore how remediation was carried out by college instructors and their perceptions of instructional best practices for students in health science programs in the context of current research. The conceptual framework that guided this study was based on constructivism and adult learning theory. Research questions focused on how instructors were carrying out …
Evaluating Retention Strategies For At-Risk Undergraduate Nursing Students, Joanna L. Ramsden-Meier
Evaluating Retention Strategies For At-Risk Undergraduate Nursing Students, Joanna L. Ramsden-Meier
Walden Dissertations and Doctoral Studies
As there continues to be a nursing shortage and a lack of diversity in the nursing profession, it is important to retain at-risk students who have been admitted to nursing programs. The purpose of this program evaluation was to compare at-risk students who had not received retention services to at-risk students who had received retention services at a Midwestern college. A formative evaluation was conducted using information from three sources: the college, the students, and the community. Guided by a constructivist theory defined by Ponticell, this study examined the effectiveness of the retention program in terms of its impact on …
Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant
Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant
Walden Dissertations and Doctoral Studies
Health care professionals and nurse educators are concerned about increasing percentage of first time test takers failing the NCLEX-RN exam. The purpose of this retrospective study was to examine predictive accuracy of the Assessment Technologies Institute (ATI) RN Comprehensive Predictor for passing or failing the NCLEX-RN exam in a cohort of nursing students (N = 195). South Eastern Technical College in South Carolina is in jeopardy of losing accreditation for their nursing program because of the low percentage of first time test takers failing. The college's pass rate on the NCLEX-RN exam has been below the national and state averages …
Healthy Work Environment Orientation Training And Psychiatric Nurse Retention, Lawanda Rollins
Healthy Work Environment Orientation Training And Psychiatric Nurse Retention, Lawanda Rollins
Walden Dissertations and Doctoral Studies
According to recent research, more than 75% of newly employed nurses leave employment within 6 months. Changes in organizational training programs are needed in order to improve psychiatric nurse retention, nationally and globally. A healthy work environment (HWE) has been described as an environment that includes mentoring for good communication skills; it is also one that explores collaborative strategies for safe practice; professional advancement; and empowerment through research, education, and skill development. Examination of the impact of this HWE psychiatric nurse orientation training program on nurse retention was done using Rogers' theory of diffusion. Study variables included the length of …