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Walden Dissertations and Doctoral Studies

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Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia Jan 2020

Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia

Walden Dissertations and Doctoral Studies

Patient satisfaction presents an emerging area of research for healthcare providers because major healthcare providers like Medicare/Medicaid control the finances of healthcare institutions as based on their patient and customer satisfaction. The purpose of this study was to examine the impact of servant leadership on customer service, and patient satisfaction, in the Inland Empire Region of Southern California. The theoretical framework applied to this study was the servant leadership theory. Participants consisted of 82 managerial staff within the University Health System, which is comprised of a teaching hospital, 5 behavioral health centers, 10 federally qualified health centers, and a ...


Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan Jan 2020

Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's ...


Educating Nurses About Poststroke Depression And Using The Phq-2/9, Mary Mcmullen Jan 2020

Educating Nurses About Poststroke Depression And Using The Phq-2/9, Mary Mcmullen

Walden Dissertations and Doctoral Studies

Stroke has affected more than 7 million people and up to 33% of those patients reporting depression. The lack of screening for depression for patients post stroke can delay treatment for depression and hinder or lengthen recovery. The purpose of this project was to develop a nursing staff education program on using the Patient Health Questionnaire (PHQ) tools (PHQ-2 and PHQ-9) at the bedside to detect signs and symptoms of depression and identify nurse-driven interventions. Using the Johns Hopkins nursing evidence-based practice model and Orem's self-care model for guidance, an interdisciplinary team was assembled to collaborate on the development ...


Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes Jan 2020

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether ...


Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson Jan 2020

Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson

Walden Dissertations and Doctoral Studies

Falls, with and without injury, in acute care hospitals are quite common but can be prevented if appropriate interventions are in place to address this issue. It is imperative that nurses assess fall risks of all patients admitted to the hospital and advocate for appropriate interventions to prevent falls in those who are found to be at risk. The purpose of this project was to recommend changes to the current fall prevention protocol in the project facility, an acute care hospital, based on best practices identified in a systematic review of the literature. At the time of the project, the ...


Adolescent Substance Abuse Screening, Wesley W. Lynch Jan 2020

Adolescent Substance Abuse Screening, Wesley W. Lynch

Walden Dissertations and Doctoral Studies

Adolescent substance use is a key public health problem in rural Ohio. Primary care nurses lack substance use screening knowledge and skills. Early screening and detection of possible substance use issues aids in directing patients to appropriate health services. This project involved the implementation of an educational intervention on the CRAFFT screening tool for primary care nurses in rural Ohio. Guided by Kurt Lewin's 3-step model to emphasize prevalence of substance use and need for screening among adolescents, the purpose of this project was to provide training on the CRAFFT screening approach and share guidelines to implement routine substance ...


Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson Jan 2020

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test ...


Quality Of Life For Persons With Chronic Disease Utilizing Mobile Integrated Healthcare, Dr John Robert Ash Jan 2020

Quality Of Life For Persons With Chronic Disease Utilizing Mobile Integrated Healthcare, Dr John Robert Ash

Walden Dissertations and Doctoral Studies

The use of mobile integrated healthcare-community paramedicine (MIH-CP) has the potential to be integrated into existing chronic disease management initiatives as a means of reducing unnecessary hospitalizations and costs as well as improving quality of life (QOL). The purpose of this study was to analyze the relationships between demographics, noncommunicable disease type (NCD), and changes in self-perceived, self-reported QOL for those who have participated in an MIH-CP program. The research design for this study was a pretest/posttest design using secondary data that were obtained from a research partner using the MIH-CP intervention and collecting QOL data using the Euroqol ...


Factors Affecting Cervical Cancer Screening Among Dominican Women Living In The United States, Cybil Bonhomme Jan 2020

Factors Affecting Cervical Cancer Screening Among Dominican Women Living In The United States, Cybil Bonhomme

Walden Dissertations and Doctoral Studies

The highest incidence and mortality rates of cervical cancer are seen among minority women groups in the United States. Hispanic women have the highest rate of cervical cancer, contributing to the 2nd highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared with other groups of U.S. women, but researchers have not examined cervical cancer screening practices, specifically for U.S. Dominican women. The purpose of this study was to examine the correlation between compliance with cervical cancer screening and major influences including acculturation, socioeconomic status, immigration status ...


A Mentorship Program For Newly Licensed Registered Nurses, Omin Chandler Jan 2020

A Mentorship Program For Newly Licensed Registered Nurses, Omin Chandler

Walden Dissertations and Doctoral Studies

The retention of new nurses remains a challenge for most healthcare organizations. Approximately 75% of newly licensed registered nurses (NLRNs) resign their positions within the first year of employment due to transition shock from the academic setting to the practicum setting. Other reasons for resignation include lack of confidence, poor critical thinking skills, and feeling overwhelmed to provide quality patient care. This loss of retention among NLRNs poses a significant threat to the delivery of quality and safe patient care. Nurses who assume the role of mentor to newly licensed nurses face many barriers to fulfilling their role effectively, including ...


Nurse Practitioner-Led Education Program For Heart Failure Patients, Shay Felecia Clarke Jan 2020

Nurse Practitioner-Led Education Program For Heart Failure Patients, Shay Felecia Clarke

Walden Dissertations and Doctoral Studies

Heart failure (HF) affects 5.7 million Americans and continues to be a leading cause of hospitalizations and deaths in the United States, posing an enormous burden on patients, families, and the health care system. Readmission rates for HF within 30 days post hospital discharge at small rural acute care facility in the southeast are consistently higher than the national average. The gap in nursing practice was the lack of up to date patient education postdischarge guidelines on HF for the socioeconomically disadvantaged, culturally diverse patient population located in this small rural town. The purpose of this project was to ...


Georgia Government Leaders' Lived Experience Creating And Implementing Health Equity Policies, Tracy M. Clopton Jan 2020

Georgia Government Leaders' Lived Experience Creating And Implementing Health Equity Policies, Tracy M. Clopton

Walden Dissertations and Doctoral Studies

Georgia’s racial and ethnic minority communities have a continual problem of disproportionately worse health outcomes, including higher chronic disease and behavioral risk factors, compared to their nonminority counterparts. The average cost per year for chronic disease between 2016 and 2030 could be $64.6 billion in medical costs and $26.8 billion in lost employee productivity for Georgia. The purpose of this study was to explore the lived experience of Georgia legislators and health program staff to determine policy solutions to reduce chronic disease and behavioral risk factor disparities in the racial and ethnic minority population. The theoretical lens ...


Reducing Morbidity: Establishing A Relationship Between Perioperative Normothermia And Colon Surgical Site Infections, Nychie Dotson Jan 2020

Reducing Morbidity: Establishing A Relationship Between Perioperative Normothermia And Colon Surgical Site Infections, Nychie Dotson

Walden Dissertations and Doctoral Studies

Healthcare-associated infections (HAIs) are an emerging public health threat. Every day in the United States, HAIs impact 1 in 31 hospitalized patients. Surgical site infections (SSIs) account for over 40% of all reported HAIs and have an increased risk for morbidity and mortality. Surgery associated with colon procedures present an increased risk for infection, morbidity, and mortality. There has been vast work to prevent colon SSIs; however, there remain areas for improvement and exploration. The main research question evaluated the relationship between maintaining perioperative normothermia and colon SSIs. Secondary research questions explored additional risk factors to include age, gender, obesity ...


Fertility Treatments Of Women In Nigeria: Using Long Versus Short Protocols, Michael Egwu Jan 2020

Fertility Treatments Of Women In Nigeria: Using Long Versus Short Protocols, Michael Egwu

Walden Dissertations and Doctoral Studies

A global estimate indicates that over 70 million heterosexual married couples live with the burden of infertility, and Nigeria accounts for about 30%. Although protocols exist, it appears there are no standardized treatment guidelines for practicing fertility experts in Nigeria. This study, therefore, aimed to determine which protocol provides a better outcome across a given population of infertile women in Nigeria as a method to move towards developing standardized treatment guidelines. The study was grounded using the Patient-Centered Care Treatment Model, and the method of inquiry was a retrospective, cross-sectional, quantitative, and nonexperimental technique, and the influence of the patient ...


A Provider Education Program Addressing Barriers To Diabetic Patients’ Self-Care, Henrietta O. Emokidi Jan 2020

A Provider Education Program Addressing Barriers To Diabetic Patients’ Self-Care, Henrietta O. Emokidi

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among American Indian/Alaskan Natives and the 7th leading cause of death in the United States. Type 2 diabetes (T2DM) affects 9% of the U.S. population and costs the United States an estimated $245 billion annually. The purpose of this project was to identify patients’ concerns related to their disease and to develop an education program for providers to address these concerns. The project was framed using Orem’s theory of self-care and the middle-range theory of self-care of chronic illness. Five providers in an underserved clinic in Alaska conducted assessments during ...


Atheoretical Versus Theory-Based Approaches In Promoting Safer Adhd-Medication Prescribing For Adults, Kathleen A. Fairman Jan 2020

Atheoretical Versus Theory-Based Approaches In Promoting Safer Adhd-Medication Prescribing For Adults, Kathleen A. Fairman

Walden Dissertations and Doctoral Studies

Gaps between treatment guidelines and medical decisions persist despite interventions with physicians, which are mostly atheoretical. The purpose of this retrospective cross-sectional study was to compare atheoretical and theory-based logistic regression models of a binary outcome: potentially unsafe prescribing of attention-deficit hyperactivity disorder (ADHD) medications to adults. Social cognitive theory and self-determination theory provided the framework for the study. Predictors were framed as social cognitive theoretical constructs: knowledge (e.g., physician specialty) and environmental influence (e.g., interventions). Atheoretical hypotheses were based on legislation mandating meaningful use of electronic health records and computerized decision support (CDS). Theory-based hypotheses were derived ...


Nitrous Oxide For Pain Management In The Emergency Department, Jagmohan Kaur Ghotra Jan 2020

Nitrous Oxide For Pain Management In The Emergency Department, Jagmohan Kaur Ghotra

Walden Dissertations and Doctoral Studies

The clinical practice problem addressed was pain control in emergency department (ED) patients. The purpose of this project was to establish situations when inhaled nitrous oxide (N2O) could be used to manage pain in the ED. Specifically, a systematic review provided answers to questions related to appropriate uses of N2O in acute pain management, the effectiveness of inhaled N2O in managing acute pain, and the benefits of and barriers to N2O use in the ED. The middle range nursing theory of acute pain management published by the Agency for Health Care Policy and Research served as the theoretical support for ...


Evaluating The Impact Of An Early Alert Team Implementation On Sepsis Mortality Rates, Shelley Ann Hyndman Jan 2020

Evaluating The Impact Of An Early Alert Team Implementation On Sepsis Mortality Rates, Shelley Ann Hyndman

Walden Dissertations and Doctoral Studies

Sepsis is ranked as one of the leading causes of death among hospitalized patients in the United States. Early identification and treatment of sepsis according to time-sensitive evidence-based protocols is essential to improve outcomes. Existing sepsis research focused on fostering consensus on sepsis definitions and evidence-based treatment protocols; yet, the literature lacks prescriptive evidence regarding organizational structures that reduce patient mortality. The purpose of this quantitative study was to understand how a change in organizational infrastructure could influence the delivery of sepsis-focused care. Using Donabedian’s theoretical framework, the research questions for this study focused on an implementation of an ...


The Effects Of A Clinical Coaching Education On Clinical Faculty’S Coaching Behaviors, Kara L. Kaldawi Jan 2020

The Effects Of A Clinical Coaching Education On Clinical Faculty’S Coaching Behaviors, Kara L. Kaldawi

Walden Dissertations and Doctoral Studies

New graduates’ readiness to provide safe nursing care is a goal of nursing programs and employers. However, new graduate nurses do not always have the skills to make decisions in the clinical setting during a patient situation, which can result in poor patient outcomes. But clinical coaching is a faculty teaching framework that promotes the development of clinical reasoning through the deliberate practice of questioning and feedback after a patient situation. Thus, the purpose of this study was to determine whether participation in a clinical coaching education program improved the coaching behaviors of clinical nurse educators. Knowles’ theory of adult ...


Promotion Of Lifestyle Changes By Community Pharmacists Among Adults With Hypertension In Nigeria, Olanike Olawunmi Kehinde Jan 2020

Promotion Of Lifestyle Changes By Community Pharmacists Among Adults With Hypertension In Nigeria, Olanike Olawunmi Kehinde

Walden Dissertations and Doctoral Studies

The growing prevalence of hypertension is a global public health problem. Lifestyle modification is the first-line best practice for the management of hypertension, however there is not enough focus on healthcare professionals’ competencies in managing hypertension in Nigeria. The perspectives of Community Pharmacists (CPs) about promotion of lifestyle modification (PLM) among adults with hypertension have not been explored in Nigeria though they play an essential role in healthcare in the community. This phenomenological study was conducted to document the experiences of CPs about PLM by using in-depth interviews. Social cognitive theory and the health promotion model were used as frameworks ...


Evidence-Based Practice Guideline: Breastfeeding Support Of The Active Duty Servicewoman, Heidi A. Koslo Jan 2020

Evidence-Based Practice Guideline: Breastfeeding Support Of The Active Duty Servicewoman, Heidi A. Koslo

Walden Dissertations and Doctoral Studies

There is no policy on breastfeeding support of the active duty military servicewoman at the targeted military treatment facility, and no global policy serving active duty personnel applicable at the Department of Defense and Defense Health Agency (DoD/DHA) level to span across branches of the U.S. military. Nurses, as members of the most trusted profession, are often expected to know how to assist a mother in meeting her feeding goals. Creation of an evidence-based practice guideline (EBPG) for support of the active duty servicewoman in the military health system was the purpose of this project. The project was ...


Impact Of Advanced Access Scheduling On Missed Appointment Rates In Primary Care, Helen Yvonne Krippel Jan 2020

Impact Of Advanced Access Scheduling On Missed Appointment Rates In Primary Care, Helen Yvonne Krippel

Walden Dissertations and Doctoral Studies

A major problem encountered within outpatient physician offices are missed appointments. Missed appointment research revealed how no-show rates remain a focus for healthcare administrators as decreasing no-show rates may reverse harmful health consequences. The purpose of this study, which also addressed the research gap, was to determine if there was an association between advanced access scheduling and no-show rates for patients scheduled with preferred primary care physicians versus nonpreferred primary care physicians. The health belief model was the conceptual framework as missing a prescheduled appointment is a health behavior. The 1st and 2nd research questions examined whether there was a ...


Use Of The Smoking Cessation Power Plan In An Observation Unit, Joycelyn Kennedy Land Jan 2020

Use Of The Smoking Cessation Power Plan In An Observation Unit, Joycelyn Kennedy Land

Walden Dissertations and Doctoral Studies

Of 34.2 million adults who use tobacco, nearly 50% of the population living in the United States, or 16.5 million people, have a smoking-related disease. The purpose of this DNP project, conducted on an observational unit located in an acute care hospital, was to address the evidenced-based practice gap of the limited use of assessing tobacco use and the initiation of a readily available smoking cessation power plan (SCPP) intervention by nurses and healthcare providers. The practice-focused questions were whether an educational intervention for nursing staff would increase use of the 3As assessment (Ask and record smoking status ...


Evaluating The Effects Of A Total Joint Education Class On Patient Outcomes, Kevin Marshall Jan 2020

Evaluating The Effects Of A Total Joint Education Class On Patient Outcomes, Kevin Marshall

Walden Dissertations and Doctoral Studies

As the population ages and as people live longer, there is a growing demand for total hip and total knee procedures. Possible outcomes for these procedures is a postoperative joint infection (PJI) that can cause long postoperative lengths of stay (LOS) in the hospital. The PJIs can also negatively impact the quality of life for the patient. Using the roadmap of the continuous quality improvement theory, the purpose of this quantitative study was to examine the relationship between the independent variables (joint education class participation, body mass index [BMI], A1c, and smoking) and dependent variables (PJI and LOS). To evaluate ...


Correlations To Financial Performance In The Pharmaceutical Industry, Fred Mcclellan Jan 2020

Correlations To Financial Performance In The Pharmaceutical Industry, Fred Mcclellan

Walden Dissertations and Doctoral Studies

There exist conflicting priorities for leaders when considering ethical leadership behaviors and organizational financial performance. The purpose of this quantitative study was to examine correlations between top manager ethical leadership levels and organizational financial performance, within the pharmaceutical industry. The Ethical leadership theory was used to frame the study. Relationships between top managers’ perceived ethics levels and organizational financial performance were studied, as well as, whether top managers’ practices, purposes, and virtues acted as mediators. A goal of 184 participants were recruited from 338 pharmaceutical companies. Five top managers and 17 of their direct report team members took part in ...


Mental Health Care Practitioners, Self-Care, And Men Who Are Postincarcerated, Aduke Mccoy Jan 2020

Mental Health Care Practitioners, Self-Care, And Men Who Are Postincarcerated, Aduke Mccoy

Walden Dissertations and Doctoral Studies

Mental health practitioners often suffer physical exhaustion, burnout, and increased stress from providing care to postincarcerated men with elevated mental illness. When working in these high environments, helping professionals, may neglect self-care when caring for clients under stressful conditions. Neglected self-care can have adverse implications for both the patient and the mental health professional. The research question aligned with the purpose of this study was to understand what grounded theory that explains how mental health practitioners manage self-care while providing services to postincarcerated men with elevated mental illness. Self-care theory was used as a conceptual framework for this qualitative grounded ...


Perceptions And Beliefs Of African American Men And Women 30 Years And Older About The Health Care System In The United States, Jacqueline Chadwick Mcnair Jan 2020

Perceptions And Beliefs Of African American Men And Women 30 Years And Older About The Health Care System In The United States, Jacqueline Chadwick Mcnair

Walden Dissertations and Doctoral Studies

This qualitative study described perceptions and beliefs of African American men and women ages 30 and over regarding their experiences with the health care system in the United States. The health belief model was the theory that drove this research, and it was grounded in the concept of cultural competency. The study used grounded theory methodology as well as phenomenology to describe the lived experiences of the participants and ethnography to describe the cultural characteristics of African American men and women ages 30 and over as related to their perceptions and beliefs about health care in the United States. The ...


Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram Jan 2020

Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram

Walden Dissertations and Doctoral Studies

Microcystins (MCs) are toxic secondary metabolites produced by freshwater cyanobacteria. Algal bloom subsidence can stimulate MC release, which can impair liver function if orally exposed to in large doses. The purpose of this retrospective, U.S. ecological study was to determine if MC exposure represented an environmental risk factor for liver disease mortality using a socioecological approach. A longitudinal ecological substudy investigated the association between average total MCs in Lake Washington and Lake Manatee and age-adjusted chronic liver disease (CLD)/cirrhosis death rates in Brevard County and Manatee County, Florida (FL). A prediction model of total MCs was deduced by ...


Decreasing Hiv Stigmatization For Care Of Young Men Of Color Who Have Sex With Men, Alethea Arnett Miller Jan 2020

Decreasing Hiv Stigmatization For Care Of Young Men Of Color Who Have Sex With Men, Alethea Arnett Miller

Walden Dissertations and Doctoral Studies

HIV-related stigma from healthcare provider attitudes, beliefs, perceptions, or misconceptions has been a barrier to healthcare delivery. This project was conducted to examine whether an HIV-related stigma education provided to healthcare clinic staff with a focus on advance practice registered nurses can improve knowledge and empathy toward young men of color who have sex with men (MSM), which can lead to improved overall quality of healthcare through increased health behaviors and retention in care. An educational intervention was conducted utilizing a blended-learning environment focused on social cognitive theory to influence social behavior change among healthcare professionals, increasing their exposure, knowledge ...


Effect Of Bundled Interventions By Patient Type To Reduce Falls, Celia Nurse Jan 2020

Effect Of Bundled Interventions By Patient Type To Reduce Falls, Celia Nurse

Walden Dissertations and Doctoral Studies

Despite consistent efforts in the healthcare field, 700,000 to 1 million patients fall in hospitals each year. There is a gap in the literature regarding identification of optimal bundles of fall prevention interventions (FPIs) for patients by type, and though patients of all ages fall in hospitals, older adults fall more, which may mean that the influence of FPIs may differ for patients by age. The purpose of this descriptive, retrospective, quantitative secondary data analysis study, guided by Virginia Henderson’s need theory, was to examine the differences in the influence of bundled FPIs in reducing the number of ...