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The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer Jan 2022

The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer

Walden Dissertations and Doctoral Studies

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke …


Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson Jan 2021

Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson

Walden Dissertations and Doctoral Studies

Healthcare acquired pressure injuries (HAPIs) are a serious and debilitating condition in the elderly, and it is therefore critical to reduce the incidence of HAPIs. Mitigation strategies are often implemented for patients who score in the highest risk categories on the Braden Scale for Predicting Pressure Sore Risk©. Yet, the evidence suggests vulnerable older adults who score in the midrange of the Braden Scale, and specifically, the mobility subscale, develop HAPI more frequently. The review question centered on the evaluation of the current evidence for early mitigation strategies in response to Braden Scale midrange mobility subscale scores. The gap addressed …


Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton Jan 2021

Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton

Walden Dissertations and Doctoral Studies

Falls among hospitalized, geriatric patients are a leading cause of injury. Geriatric patients with psychiatric illnesses are at an even greater risk of falls. The project site was experiencing an increase in the number of patient falls and identified a need for staff education on fall risk assessment and implementation of interventions specific to the hospitalized, geriatric, psychiatric patient. Thus, the practice-focused question for this project was whether an educational program on evidence-based assessment and fall prevention strategies would improve nurses’ knowledge and skills to assess risk for falls and implement appropriate interventions for inpatient, geriatric, psychiatric patients. Knowles’s adult …


Implementation Of A Fall Prevention Program For The Elderly In A Long-Term Care Facility, Maureen Orobosa Igharosa Jan 2021

Implementation Of A Fall Prevention Program For The Elderly In A Long-Term Care Facility, Maureen Orobosa Igharosa

Walden Dissertations and Doctoral Studies

One out of 4 older people fall each year. By the year 2030, it is estimated that 49 million older adults will fall and that 12 million will incur injuries as a result. A rise in the trend in falls among older adults represents a growing burden; the cost for falls billed to Medicare in the year 2015 was an aggregate of over $31 billion. The purpose of this quality improvement evaluation project was to assess the effectiveness of a fall preventative pilot program to reduce the number of falls among the residents of a rehabilitation and long-term care facility …


Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander Jan 2020

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …


Assessing Medical Expenditure Disparities Among U.S. Adults With Hiv Or Cardiovascular Diseases, Lorraine Nnacheta Jan 2019

Assessing Medical Expenditure Disparities Among U.S. Adults With Hiv Or Cardiovascular Diseases, Lorraine Nnacheta

Walden Dissertations and Doctoral Studies

Older adults with infectious and chronic diseases, such as cardiovascular disease and human immunodeficiency virus (HIV), are at high risk for associated chronic comorbidities, which are associated with increased medical expenditures to cover treatment costs. The purpose of this study was to investigate (a) whether adults 65 or older with either HIV or cardiovascular disease were predisposed to increased medical expenditures versus adults 64 and younger, and (b) the impact of race and type of health service used on total direct medical expenditures incurred among adults with HIV or cardiovascular disease. A quantitative, deductive, retrospective cross-sectional design was used, and …


Reducing Falls In The Vulnerable Elderly: Implementing An Inpatient Fall Prevention Program, Bibi Farida Khan Jan 2019

Reducing Falls In The Vulnerable Elderly: Implementing An Inpatient Fall Prevention Program, Bibi Farida Khan

Walden Dissertations and Doctoral Studies

Inpatient falls are a leading cause of fatal and serious injuries among hospitalized elderly patients, often with devastating consequences. This quality improvement project was conducted on a geriatric unit in a large southeastern U. S. hospital, following recognition of an increase in the number of falls with several sustained injuries. After an analysis of the previous fall prevention strategies, a panel of stakeholders who formed a falls prevention committee determined that implementing an evidence-based fall risk assessment tool to help identify risk factors, as well as implementing interventions to address those risk factors, would make fall prevention more patient specific …


Staff Education Project Using The Stop Elderly Accidents Deaths And Injuries (Steadi) Toolkit, Carla Fisher Jan 2019

Staff Education Project Using The Stop Elderly Accidents Deaths And Injuries (Steadi) Toolkit, Carla Fisher

Walden Dissertations and Doctoral Studies

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change …


Medication Reconciliation In The Elderly, Munjanja Yvonne Litell Jan 2018

Medication Reconciliation In The Elderly, Munjanja Yvonne Litell

Walden Dissertations and Doctoral Studies

Medication therapy is the most prevalent and critical intervention of health delivery and the source of most errors in healthcare. Medication errors and associated adverse drug events (ADE) have serious health and economic ramifications, and in elderly patients ADE are the leading cause of morbidity and mortality. Medication reconciliation is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing ADEs. This education project answered the question whether education provided to long term care staff would improve knowledge of medication reconciliation and be retained over time. The …


Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty Jan 2018

Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty

Walden Dissertations and Doctoral Studies

Incidents of falls among the elderly increase with age. About $31 million is spent annually in the United States on medical costs related to fall injuries in the elderly. This project evaluated the outcomes of a fall reduction program implemented in an assisted living facility (ALF). The Stop Elderly Accidents, Death & Injury program developed by the Centers for Disease Control and Prevention was implemented by the ALF for 60 days prior to the outcome evaluation project. The program included a convenience sample of 62 residents and involved medication evaluation, exercises, assistive devices, environmental risk reduction, and evaluation of blood …


Effect Of Self-Determination, Motivation, And Dispositional Optimism With Physical Therapy In Geriatric Patients, Leslie Yaneth Urias-Bodnar Jan 2017

Effect Of Self-Determination, Motivation, And Dispositional Optimism With Physical Therapy In Geriatric Patients, Leslie Yaneth Urias-Bodnar

Walden Dissertations and Doctoral Studies

Older people are frequently faced with physical conditions that require treatment. A better understanding of the components of engagement relating to the outcomes of treatment was the focus of the study. The purpose of this quantitative study was to examine whether there was an association between the independent variables of optimism, pessimism, motivation, and self-determination and their impact on the dependent variable of achieving physical activity goals in 86 geriatric patients, ages 65 to 80 receiving physical therapy services. The theoretical framework of self-determination, motivation, optimism, and pessimism was assessed by using two self-report questionnaires, The Self-Determination Scale and The …


Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey Jan 2017

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …


Multifamily Subsidized Housing Seniors' Awareness Of Aging And Disability Resource Center Services, Katrina Polk Jan 2017

Multifamily Subsidized Housing Seniors' Awareness Of Aging And Disability Resource Center Services, Katrina Polk

Walden Dissertations and Doctoral Studies

Over 75% of adults 60 years of age or older who live in Washington, D.C. are unaware of access to Aging and Disability Resource Centers' (ADRC) community-based services. Approximately 25% of these individuals are low-income and reside in multifamily subsidized housing. With a theoretical basis in Penchansky and Thomas' construct of access, this phenomenological study explored whether increased awareness of access to ADRC service delivery may potentially better meet the needs of this socioeconomically marginalized population. Data were collected through semi-structured interviews with 20 senior citizens in Washington, D.C. who received some programmatic assistance, such as housing or meal delivery, …


Impact And Prevention Of Psychiatric Polypharmacy In The Elderly, Rose Cordelia E Onyekwe Jan 2015

Impact And Prevention Of Psychiatric Polypharmacy In The Elderly, Rose Cordelia E Onyekwe

Walden Dissertations and Doctoral Studies

Adequate medication management is a focus of effective care that is often overlooked in caring for adults with comorbid psychiatric and physical conditions, especially in patients who are treated by multiple care providers and have a variety of health issues at the same time. The purpose of this project was to develop evidence-based policies and practice guidelines to reduce polypharmacy in elderly patients in a rural outpatient psychiatric clinic. Bandura's self-efficacy theory was used to inform the project for its value in assessing motivation, capacity for self-regulation, and perceptions of individual ability. An interdisciplinary team of stakeholders explored best practices …


Barriers To Receiving The Influenza Vaccine In Adults 65 Years And Older, Melissa Madalone Jan 2015

Barriers To Receiving The Influenza Vaccine In Adults 65 Years And Older, Melissa Madalone

Walden Dissertations and Doctoral Studies

Vaccination is regarded by many as the most effective means of reducing influenza infection and disease; however, many people in the United States are hospitalized from flu-related illness each year. Adults 65 years and older account for more than half of these hospitalizations and almost all flu-related deaths. This project aimed to identify barriers to receiving the influenza vaccine among the adult population (> 65 years of age) in a community setting. The goal was to develop a teaching tool that would assist practitioners towards improving influenza vaccination rates among this population. The Health Belief Model was the theoretical framework …


Current Capacity Building Needs Of Occupational Therapists Related To Older Driver Screening, Assessment, And Intervention, Ranyouri Hines Senia Jan 2015

Current Capacity Building Needs Of Occupational Therapists Related To Older Driver Screening, Assessment, And Intervention, Ranyouri Hines Senia

Walden Dissertations and Doctoral Studies

Older adult safe driving is a growing public health issue; however, the skill set of occupational therapists that provide services to these older clients is unclear. The extent to which occupational therapists possess the skills to evaluate an elderly person's ability to operate safely an automobile is unclear. Therefore, the purpose of this quantitative, cross-sectional survey was to determine the current capacity building needs of occupational therapists (OT) related to older driver screening, assessment, and intervention. The ecology of human performance framework was the theoretical base of the study. The independent variables were the OTs' training related to older drivers, …