Digital Commons Network^™

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 …

Identifying Strategies To Increase The Recruitment And Retention Of Minority Males In The Public Health Workforce: A Two-State Comparative Case Study Approach, Melicent R. Miller

College of Graduate Studies: Theses & Dissertations

Non-White males have higher rates of morbidity and mortality from chronic health conditions as compared to Whites. An essential element for achieving success in eliminating health disparities is to increase the presence of racial/ethnic minorities (i.e., people of color) within public health careers. One of the most important competencies for a public health professional is the ability to work in culturally and racially diverse populations. Yet, individuals are significantly more likely to receive their care and experience greater satisfaction from providers that are of the same racial or ethnic background. The racial/ethnic composition of the health professions workforce continues to …

Perceptions Of Local Board Of Health Effectiveness In Georgia, Amber Erickson

College of Graduate Studies: Theses & Dissertations

Objective: The purpose of this study is to examine the perceptions of the local board of health chairpersons in Georgia on their engagement in six governance functions and examining the challenges faced and facilitators perceived by local boards of health in performing the governance functions properly. Methods: For this descriptive mixed method study design, a survey was administered to all local board of health chairpersons and key informant interviews were conducted with a small selection of board of health chairpersons. Descriptive statistics were produced for recoded survey data variables and themes from qualitative data collected through the surveys and interviews …

Cultural Diversity In The Practice Of Physical Therapy: A Review Of The Literature, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Background: Cultural competence is a term that encompasses one’s capacity for understanding, communication, and effective interactions with individuals across the cultural spectrum. Recognition of these principles and practical training focused on relevant skills and abilities are needed to prevent discriminatory practices based on patient age, ethnicity, socioeconomic status, race, religion, gender identification, and sexual orientation. A culturally competent physical therapist will be able to use these skills and abilities to promote effective communication with all patients and remove barriers to obtaining appropriate health care.

Methods: Toward this end, this study includes a review of the recent literature and focuses on …

Burnout Among Healthcare Providers Of Covid-19; A Systematic Review Of Epidemiology And Recommendations, Mehrdad Sharifi, Ali Akbar Asadi-Pooya, Razieh Sadat Mousavi-Roknabadi

Department of Neurology Faculty Papers

Introduction: In the current systematic review, we intended to systematically review the epidemiology of burnout and the strategies and recommendations to prevent or reduce it among healthcare providers (HCPs) of COVID-19 wards, so that policymakers can make more appropriate decisions.

Methods: MEDLINE (accessed from PubMed), Science Direct, and Scopus electronic databases were systematically searched in English from December 01, 2019 to August 15, 2020, using MESH terms and related keywords. After reading the title and the abstract, unrelated studies were excluded. The full texts of the studies were evaluated by authors, independently, and the quality of the studies was determined. …

Antibiotic Stewardship: Decreasing Antibiotic Use For Viral Upper Respiratory Infections, Merkessie Taresa Redix

Walden Dissertations and Doctoral Studies

AbstractOverprescribing antibiotics for viral upper respiratory infections is a common practice in the United States. This overprescribing of antibiotics can cause several health issues and increase health care costs. Despite the current guidelines recommended by the Centers for Disease Control and Prevention (CDC) the overprescribing of antibiotics by providers remains an issue. The purpose of this project was to educate providers on antibiotic stewardship for viral upper respiratory infections. The practice question was used to explore whether an educational program using concepts from Lewin’s change theory and Kolb’s learning theory would increase provider’s knowledge about the current evidence- based prescriptive …

Smoothing Patient Flow By Improving Bed Turnover Time, Carrie Lanasha Percell

Walden Dissertations and Doctoral Studies

Bed Management Solutions (BMS) is a bed tracking system that provides real-time data into hospital activities, including admissions, transfers, discharges, bed turnover rates, and processing time frames. When BMS is used appropriately, it has the potential to improve bed turnover rates, reduce stress of clinical staff, improve patient satisfaction, and improve patients’ well-being. Delays in bed turnover times can create overcrowding, extended wait times, bottlenecking, delays in patient care, and significant patient flow problems. The purpose of this DNP project was to develop a staff education program to answer the question if the implementation of an educational training program could …

An Examination Of The Absence Of A Comprehensive Smokefree Law In Georgia On College And University Campuses, Nakki Price

Walden Dissertations and Doctoral Studies

AbstractCigarette smoking is the number one preventable cause of death and disability in the United States. Although there are policies that govern the use of tobacco products, there are jurisdictions that do not employ these policies. Comprehensive smokefree laws govern private-sector entities and prohibit smoking in public places, specifically restaurants, bars, and workplaces. While states have the authority to implement these laws, some include exceptions that limit the intention of the law. Colleges and universities are specific communities for learning and serve as housing for students and an employer for the greater community. There is a gap in the literature …

Health Care Manager Electronic Medical Record Systems Implementation Strategies To Improve Patient Outcomes, Mcarthur Bruno Damis

Walden Dissertations and Doctoral Studies

Ineffective implementation of electronic medical record systems (EMRS) among health care outpatient clinics results in substantial financial loss. Health care managers (HCMs) in outpatient clinics who fail to implement EMRS adversely affect employee usage and performance. Grounded in fayolism theory, the purpose of this qualitative multiple case study was to explore the strategies health care managers used to implement EMRS in their organizations. The participants were six HCMs in a U.S East Coast city. Thematic analysis was used to analyze the data from semistructured interviews and internal company documents. Five themes emerged: internal communication, overcoming barriers, time management, compensation improving …

Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe

Walden Dissertations and Doctoral Studies

Hospital readmissions are a reflection of poor quality of care. The readmission rate in an acute care for the elderly (ACE) unit was above the national benchmark in 2017. The specific problem includes lack of communication, collaboration, and coordination among the interdisciplinary team. Further, in older adults, the problem is accentuated by health illiteracy, comorbidities, cognitive impairment, polypharmacy, and unclear discharge and follow-up care instructions. Poor care transition costs Medicare 17.4 billion dollars a year. Multidisciplinary rounds (MDRs) have been adopted by many hospitals as evidence-based interventions to reduce readmissions within 30 days. This Doctor of Nursing Practice (DNP) project …

Strategies For Managing Work-Related Stress In The Petroleum Industry, Esang Lazarus Esitikot

Walden Dissertations and Doctoral Studies

High work-related stress negatively impacts workers’ health and productivity in the Nigerian petroleum industry. Supervisors in the Nigerian petroleum industry who lack strategies to reduce work-related stress significantly lose worker health and organizational productivity. Grounded in person-environment fit theory, the purpose of this qualitative multiple case study was to explore strategies Nigerian petroleum industry supervisors use to manage work-related stress. Participants were six supervisors who have successfully used strategies to reduce work-related stress in the Nigerian petroleum industry. Data were collected from semistructured interviews and internal company documents relevant to reducing work-related stress and analyzed using thematic analysis. Three major …

Noncompetitive Subordinate Employees’ Descriptions Of Adaptive Performance Following An Internal Promotion, Yemisi Milledge

Walden Dissertations and Doctoral Studies

Employees’ views on internal promotions tend to influence outcomes such as support given to the promoted employee, employee organizational commitment, and employee job satisfaction. Research on the influence of internal promotions has focused primarily on the reactions of competitive non-promoted internal candidates and those of the promoted individuals. This qualitative study investigated how employees who did not compete for a promotion adapted to a coworker being promoted to become their supervisor and how the employees described the coworker’s adaptation to the promotion. A taxonomy of adaptive performance and generic qualitative research formed the conceptual frameworks, and the leader-member exchange theory …

An Educational Program For Nurses To Improve Culturally-Appropriate Mental Health Assessment For Nigerian Immigrant Youth In Central Florida, Blessing Anyaiwe Onyekachi

Walden Dissertations and Doctoral Studies

AbstractNigerians, like other immigrants, face many health issues with rising waves of conflict and political instability that contribute to high migration rates. As a result, when they arrive in other countries, these immigrants not only have to deal with the trauma they left behind but face issues such as cultural stereotypes, stigma, lack of insurance, cultural and language barriers, poor communication, social discrimination, and low socioeconomic status. The question that this project addressed was whether an educational program for nurses would improve knowledge on culturally-appropriate mental health assessment for Nigerian immigrant youth in Central Florida. This was a nursing staff …

Perceptions Of Integrated Mental And Behavioral Health In Pediatric Specialty Care Settings: A Mixed-Methods Study, Desireé Nicole Williford

Graduate Theses, Dissertations, and Problem Reports (ETD)

Pediatric patients are at an increased risk of experiencing mental and behavioral health concerns, which have direct associations with HRQOL, physiological health, and likelihood that youth will engage in health promoting behavior. Researchers and practitioners have increased their awareness of these concerns and identified strategies for improving the mental and behavioral health of these youth, specifically via implementing organizational efforts (i.e., task forces) and guidelines around integrating psychosocial screening and other services into routine practice. Despite this, there are several identified barriers to families receiving mental/behavioral health care in these settings. These barriers exist at all levels, including at the …

Change Fatigue, Job Satisfaction, And Organizational Commitment Among Nurses, Melissa Kapping

Walden Dissertations and Doctoral Studies

The healthcare environment is complex and ever-changing, which has a direct impact on the nurse. The effects of the constant change to the nurse may result in the development of change fatigue, which causes the loss of trust in the organization, a feeling of resentment, and a sense of apprehension while depleting the individual’s reserves. The purpose of this correlational study guided by Lazarus and Folkman’s stress and coping theory was to determine if there is a relationship between (a) job satisfaction and change fatigue and (b) organizational commitment and change fatigue in nurses who work in an outpatient clinical …

Enhanced Breastfeeding Support Using Video Education To Improve Exclusive Breastfeeding Rates In A Baby-Friendly Acute Care Facility, Carol Mayernik

Doctor of Nursing Practice Projects

Exclusive breastfeeding (EBF) provides health benefits and is recommended by professional health organizations including the American Academy of Pediatrics, The World Health Organization, and the Centers for Disease Control and Prevention. Healthcare facilities support families to achieve EBF by educating clinicians and patients about the benefits of exclusive breastfeeding, providing prenatal education and hospital support to patients, and by achieving Baby-Friendly Designation through the Baby-Friendly USA, as endorsed by the World Health Organization/UNICEF. Most pregnant patients desire to exclusively breastfeed yet multiple barriers exist to achieve this goal. Evidence supports the use of video learning as an effective way to …

The 21st Century Global Digital Economies Revolution And The Aftermath Of Covid-19 Pandemic: Some Anticipated Implication Changes For Developing Nations, Agyei Fosu

ASEAN Journal of Community Engagement

The 21^st century digital global economies era changed developmental approaches drastically to a point where most researchers, policy makers, and developers have asserted that to achieve economic development for developing nations; it is paramount for Information and Communications Technologies (ICTs) investments in all sectors contributing to their economy. The current COVID-19 pandemic and the various measures taken by governments such as lockdown, curfew, companies asking employees to work from home, and the use of e-learning by schools to curb the disease brings into perspective the assertion raised by various scholars about the need for developing nations to invest in …

Using Drawings In Qualitative Interviews: An Introduction To The Practice, Alexios Brailas

The Qualitative Report

Drawings are employed by qualitative researchers in many creative ways, and in many different contexts, and a variety of different terms are used to describe similar techniques. I present here a concise description of two basic approaches to integrating participants’ produced drawings into verbal qualitative research interviews, along with characteristic cases of empirical research demonstrating how these approaches have been applied. I also provide a list of best practices and I discuss ethical issues. It is common for qualitative researchers to mix techniques in order to creatively address real-world research challenges. The proposed categorization, augmented by the list of best …

Development And Implementation Of An Orthopedic Enhanced Recovery After Surgery Protocol, Beth Mccoy

Doctor of Nursing Practice Projects

Abstract

As life expectancy rates have grown and individuals desire a more active lifestyle the number of total hip arthroplasty and total knee arthroplasty surgeries performed has grown significantly. Enhanced recovery after surgery (ERAS) protocols have been shown to decrease the financial impact and improve patient outcomes in total joint surgeries. After a literature review a multidisciplinary team met and developed an ERAS protocol for total joint replacement surgeries to be implemented at a 250-bed community hospital in central Illinois. After an eleven-question pre-test was given to 34 participants consisting of perioperative nursing staff, anesthesia, and surgeons assessing their knowledge …

A Program Evaluation Of Violence Prevention Task Force To Address Type Ii Workplace Violence Utilizing Precede/Proceed Model, Stephanie Autry

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Aim: The primary aim of this project was to complete a program evaluation of the institution’s Violence Prevention Task Force. Evaluation allowed for assessment of outcomes including 1). decrease in assaultive incidents; 2). decrease in assaults leading to injury; 3). increase in team member reporting of assaultive incidents; and 4). demonstrate the program’s adherence to published guidelines on workplace violence prevention.

Background: Violence against healthcare workers has been an increasing problem in our nation’s healthcare system. Type II workplace violence is defined as patient, family member, or visitor as the perpetrator directing violent/aggressive behavior towards healthcare worker and is described …

Standardizing Patient Handoffs In The Icu – Implementing The “I Put Patients First” Tool., Wislande Joseph

Master's Projects and Capstones

Abstract

Background. Ineffective patient handoff can result in poor nurse communication, increasing the likelihood of adverse events including medication and documentation errors.

Context/Problem. In one 20-bed ICU unit in a northern California community hospital, 48 patient handoffs were observed over 2 weeks. Only 29% occurred at the patient’s bedside; 39.5% used a standardized handoff tool; and 54% included the patient and/or family. These findings indicate significant quality gaps in the unit’s ICU patient handoff processes.

Intervention. The educational intervention consisted of one introductory and two follow-up teaching sessions related to best practices for handoff processes followed by implementation …

Improving Quality Of Care Through Discharge Planning, Maria Pasillas

Master's Projects and Capstones

Providing good education for the new mother is key to improving the quality of care for both mom and baby. Since nurses are frontline health care providers who perform the most postpartum education, it is imperative they work to improve discharge education so information provided is consistent, appropriate, and evidence based (Suplee et al., 2016).

The aim of this project is to improve the discharge planning process of a local community hospital utilizing evidence-based research (EBR) with the intent to increase patient satisfaction scores in care transitions to above 65% within 3 months.

The community hospital is a 122-bed acute …

From Team Huddle To Team Cuddle: Rekindling Caring, Self-Compassion, And Joy In Work!, Amerizza Quemada

Master's Projects and Capstones

Problem: The healthcare industry suffers from a high level of burnout and unhealthy work environments, which has been heightened by the COVID-19 pandemic. The consequences of burnout may be expressed in both individuals and teams as a lack of caring, disengagement, incivility, and staff turnover.

Context: One department in an integrated healthcare organization displayed a pattern of annual low employee engagement scores and alleged workplace bullying. Team members also observed that employees failed to speak up when experiencing incivility. The Clinical Nurse Leader (CNL) student determined that an improvement initiative was needed to create a culture of caring to improve …

A Performance Improvement Nursing Fellowship To Enhance Timely Access To Care, Cheryl Reinking

Doctor of Nursing Practice (DNP) Projects

This scholarly report describes a Doctorate of Nursing Practice (DNP) project that advanced the performance improvement (PI) knowledge of frontline nurses to improve timely access to acute care during a 6-month PI/Lean management nursing fellowship. Patient flow issues delay access to care and result in negative patient quality outcomes and safety failures. Patient experience, confidence, and satisfaction in healthcare organizations erode when timeliness and efficiency are deficient. The project site is a 443-bed, two-campus, not for profit community hospital in Northern California. This project included the implementation of a PI/Lean nursing fellowship program as an evidence-based intervention to address patient …

Identification Of Victims Of Human Trafficking: Leading Change Through A Global Pandemic, Connie Clemmons-Brown

Doctor of Nursing Practice (DNP) Projects

Human trafficking is a multi-billion-dollar global industry, generating $150 billion annually (International Labour Organization [ILO], 2014), and driven by the exploitation of victims of all ages, primarily for forced labor or commercial sex. Victims endure frequent and prolonged abuse, suffering illnesses, and injuries. When accessing the health care system, they often go unrecognized by health care providers and nurses. Recognition requires training to raise awareness and the right tools to capture the information necessary to identify victims and address opportunities to improve their safety, care, and support. The aim of this Doctor of Nursing Practice (DNP) evidence-based change project was …

Chief Nurse Executive Work Engagement: System Leadership Through A Natural Disaster, Strike, And Pandemic, Ryan Fuller

Doctor of Nursing Practice (DNP) Projects

Problem. In a 21-hospital region of a 39-hospital integrated health system, CNE turnover peaked at 63% (12 CNEs) in 2015. Interviews were conducted in 2019 with 12 CNEs across the region to understand potential issues related to CNE job satisfaction. Responses revealed concerns regarding empowerment, alignment, work-life balance, information transparency/sharing, and recognition. While identifying a solution to address CNE concerns, the organization experienced successive crisis events during a 12-month period that included a record-setting wildfire, multiple labor union strikes, and a novel pandemic. The regional leadership team (RLT) required new approaches to facilitate effective communication during a crisis between the …

#Leadershipaccelerated: A Coach Mindset Focused Leadership Development Program, Diane Rindlisbacher

Doctor of Nursing Practice (DNP) Projects

Problem: Developing leaders to lead in environments that are dynamic, complex, and ambiguous is an area of focus for healthcare leaders. How leaders lead and how organizations develop leaders is tied to the outcomes they achieve (Development Dimensions International [DDI], 2019; Moldoveanu & Narayandas, 2019; Till, Dutta, & McKimm, 2016). To create a climate of trust and safety where teams succeed requires leaders to embed key attributes and competencies into their day-to-day work.

Context: A leader’s ability to create a climate of trust and safety and to adopt and apply a coach mindset to their work is intended to help …

The Clinically Aligned Pain Assessment Tool (Capa) Evidenced-Based Change Project- Benchmark Study, Mary Vitullo

MSN Capstone Projects

Pain is one of the main reasons people seek medical treatment in the United States (National Institutes of Health, 2017). Frequently, pain is inappropriately managed leading to negative patient outcomes that lead to prolonged discharge time that increases hospital costs (Trzeciak et al., 2018). This is due to improper assessment of pain which leads to challenges in pain management interventions, ultimately decreasing patient safety and satisfaction. By nature, pain reporting by patients is subjective. Various scales are utilized in the hospital setting, but these assessment scales only reflect pain intensity and are unidimensional, as opposed to pain experience and multidimensional …

Reducing Patient Falls By Realigning Nursing Hours Per Patient Days, Hermes Vargas

Student Scholarly Projects

Patient falls are the “second leading cause of unintentional injury death” (World Health Organization [WHO] (2018), para. 3) and increase healthcare costs by an estimated $13,806 per fall (Walsh et al., 2018). These fall-related costs translate to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change project experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019).

The PICOT question that guided this project was: In a medical/surgical inpatient population in acute care (P) how does realigning the Nursing Hours per Patient Days (NHPPD) (I) compared …

Improving Door To Transfer Times For St Segment Elevation Myocardial Infarction In Small Emergency Departments: A Quality Performance Improvement Project, Amber Ryals

Doctoral Projects

Heart disease is a leading cause of death in the United States (Centers for Disease Control [CDC], 2020). ST-elevation myocardial infarctions are around 38% of all coronary syndrome patients that present to the emergency department (Akbar et al., 2020). Smaller, outlying facilities can be at a disadvantage due to the lack of readily available specialties and services, such as a cardiac catheterization laboratory, which has the potential to cause a delay in inpatient care. With standardized cardiac protocols in place at many facilities, initial identification and treatment of myocardial infarctions are begun long before a patient enters a facility, often …