Digital Commons Network^™

Perinatal Nursing Education Related To Opioid Use Disorder, Britney Taniguchi

Walden Dissertations and Doctoral Studies

Opioid use disorder (OUD) contributes to severe perinatal and neonatal morbidity and mortality in the United States, leading to alarming complications for pregnant women, mothers, and newborns. Complications the mother experiences with OUD include increased mortality, overdose, infections, endocarditis, narcotic bowel syndrome, and accident-related injury. Complications the newborn can suffer include neonatal abstinence syndrome, respiratory depression, microcephaly, and sudden infant death syndrome. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, this project aimed to plan, implement, and evaluate a staff education program on opioid use disorder. The staff education program was presented to 13 perinatal …

Lived Experience Of Women Veterans Navigating The Veteran Healthcare System, Candance Willett

Walden Dissertations and Doctoral Studies

Many women veterans who navigate the Veterans Affairs (VA) healthcare system across the United States have felt that their voices have not been heard regarding their input and lived experiences concerning inclusion to the quality-of-care delivery for their health needs. The purpose of this study was to explore the lived experiences of women veterans who were currently facing or had previously faced difficulty navigating the VA healthcare system. The framework used for this qualitative study was interpretive phenomenological analysis. The qualitative method used was hermeneutics which was designed by Edmund Husserl and Martin Heidegger. Semi structured interviews were of 12 …

Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry

Doctor of Nursing Practice Projects

Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Mental Health Promotion, Early Identification & Treatment Services And Supports In Public K-12 School Districts: Three Case Studies To Explore Available Resources, Interventions, And Community Partnerships, Keenan Krick

Theses & Dissertations

Objective: This study: 1) identifies the multi-tiered efforts public K-12 school districts in a large Midwestern metropolitan area use to support mental health promotion activities and comprehensive mental health services, and 2) compares district efforts to domains defined by the National Center for School Mental Health (NCSMH). Participants: A sample of public K-12 school districts (n=12) in a large Midwestern metropolitan area participated in this study from August 2021 to October 2022. Methods: Using the Multi-Tiered Systems of Support (MTSS) intervention framework, a series of three case studies identify the resources public K-12 school districts utilize to support mental health …

Depression And Parenting: A Mixed Method Analysis Of Some Protective Factors For Depression Among African American Fathers Using A Community-Based Participatory Research Approach, Tatiana Tchouankam

Theses & Dissertations

In the United States (US), African American (AA) men often face oppression, discrimination, negative interactions with the justice system, and significant economic, neighborhood, and social hardships over their life course. These challenges increase the risk of chronic exposure to stressful events with negative mental health outcomes, such as depression. Most of the research on parenting and parental depression has focused on mothers based on the premise that women are more often primary caregivers for their children, especially during early childhood. However, a growing number of fathers take on childcare responsibilities. Despite dealing with different life stressors and negative circumstances, AA …

Expanding The Focus Of Occupational Safety And Health: Lessons From A Series Of Linked Scientific Meetings, Paul A Schulte, George L Delclos, Sarah A Felknor, Jessica M K Streit, Michelle Mcdaniel, L Casey Chosewood, Lee S Newman, Faiyaz A Bhojani, Rene Pana-Cryan, Naomi G Swanson

Faculty, Staff and Student Publications

There is widespread recognition that the world of work is changing, and agreement is growing that the occupational safety and health (OSH) field must change to contribute to the protection of workers now and in the future. Discourse on the evolution of OSH has been active for many decades, but formalized support of an expanded focus for OSH has greatly increased over the past 20 years. Development of approaches such as the National Institute for Occupational Safety and Health (NIOSH)'s total Worker Health

The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter

Electronic Theses and Dissertations

Mental health clinicians working in a hospital setting are at a high risk of experiencing burnout due to the stressful demands of their caseloads, compassion fatigue, limited resources, and unsupportive leadership. While there is ample research regarding the cause and effect of burnout on clinicians there is a gap in the literature when it comes to the impact leadership has on mental heath clinician burnout. The purpose of this quantitative, correlational study is to determine if and to what extent there is a correlation between Transformational Leadership and mental health clinician burnout. Participants for this study consisted of 200 mental …

Stakeholder Engagement In Adoption, Implementation, And Sustainment Of An Evidence-Based Intervention To Increase Mammography Adherence Among Low-Income Women, Jennifer Holcomb, Gayla M Ferguson, Jiali Sun, Gretchen H Walton, Linda Highfield

Faculty, Staff and Student Publications

Multi-level organizational stakeholder engagement plays an important role across the research process in a clinical setting. Stakeholders provide organizational specific adaptions in evidence-based interventions to ensure effective adoption, implementation, and sustainability. Stakeholder engagement strategies involve building mutual trust, providing clear communication, and seeking feedback. Using constructs from the Consolidated Framework for Implementation Research and The International Association for Public Participation spectrum, a conceptual framework was created to guide stakeholder engagement in an evidence-based intervention to increase mammography appointment adherence in underserved and low-income women. A document review was used to explore the alignment of the conceptual framework with intervention activities …

Assessing The Testability Of The Multi-Theory Model (Mtm) In Predicting Vaping Quitting Behavior Among Young Adults In The United States: A Cross-Sectional Survey, Manoj Sharma, Kavita Batra, Ravi Batra, Chia-Liang Dai, Traci Hayes, Melinda J. Ickes, Tejinder Pal Singh

Social and Behavioral Health Faculty Research

Purpose: Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. Methods: A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18–24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to …

Workforce Diversity And Health Equity: The Role Of Schools Of Public Health, Adashima Oyo

Dissertations, Theses, and Capstone Projects

The goal to eliminate health disparities and achieve health equity has remained a consistent public health and social welfare challenge for the United States. Schools of public health, despite being disproportionately White, are charged with the important task of training a diverse workforce of master and doctoral-level public health students to protect and promote the overall health of the nation with research, policy, and practice. Experiences and practices related to the recruitment, admission, enrollment, and graduation of students of color, specifically Blacks and Latinx, warrant further research. Positive deviance theory, critical race theory, and organizational culture theory informed this research. …

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC …

A Commentary On The Healthy Community Stores Case Study Project: Implications For Retailers, Policy, And Future Research, Samantha M. Sundermeir, Megan R. Winkler, Sara John, Uriyoán Colón-Ramos, Ravneet Kuar, Ashley Hickson, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Julia Deangelo, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as …

Developing Standards For Cultural Competency Training For Health Care Providers To Care For Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, And Asexual Persons: Consensus Recommendations From A National Panel, Mandi L. Pratt-Chapman, Kristen Eckstrand, Amorie Robinson, Lauren B. Beach, Charles Kamen, Alex S. Keuroghlian, Scott Cook, Asa Radix, Markus P. Bidell, Daniel Bruner, Liz Margolies

Publications and Research

Purpose: Lesbian, gay, bisexual, transgender, queer, intersex, and/or asexual and other sexual and gender diverse persons (LGBTQIA + or SGD persons) experience barriers to equitable health care. The purpose of this article is to describe a collaborative process that resulted in core cultural competency recommendations addressing training for those who provide health care and/or social services to LGBTQIA + patients.

Methods: In 2018 and 2019, Whitman-Walker Health, a Federally Qualified Community Health Center in Washing- ton, DC, and the National LGBT Cancer Network purposively selected leaders of community clinics and community-based organizations, cultural competency trainers, and clinicians and researchers with …

Exploring Extension Agent Capacity And Readiness To Adopt Policy, Systems And Environmental Change Approaches, Lisa T. Washburn, Heather Norman-Burgdolf, Natalie Jones, Lauren E. Kennedy, Soghra Jarvandi

Dietetics and Human Nutrition Faculty Publications

Introduction: Enhanced Extension outreach strategies combine traditional direct education programs with public health approaches like policy, systems, and environmental (PSE) change. However, the Cooperative Extension system and county-based Family and Consumer Sciences (FCS) Extension agents have historically prioritized direct education programming and diffusion of enhanced outreach strategies has varied. Extension personnel may lack capacity and readiness for successful PSE change implementation. This study explored perceived acceptability, capacity, and readiness for PSE change work among FCS Extension agents in two states.

Method: A survey was developed framed by selected domains from the Consolidated Framework for Implementation Research: Intervention Characteristics, Inner Setting, …

Integrating Culturally Tailored Interventions To Increase Cervical Cancer Screening: A Quality Improvement Initiative In A Primary Care Clinic, Marife Centeno Solomon

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: While the incidence of cervical cancer in the US has significantly decreased due to the utilization of vaccination and screening tests, Asian, Native Hawaiian, and other Pacific Islander women consistently have the lowest rate of cervical cancer screening, making them at risk for undetected cervical cancer disease.

Problem: The low cervical cancer screening uptake can be attributed to a knowledge deficit about cervical cancer and its screening and the importance of early detection. Being an immigrant and with limited English proficiency can hinder women of Asian, Native Hawaiian, and other Pacific Islander from getting screened for cervical …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

“This Isn’T Just Busy, This Is Scary”: Stress, Social Support, And Coping Experiences Of Frontline Nurses During The Covid-19 Pandemic, Erin S. Craw, Tess M. Buckley, Michelle Miller-Day

Communication Faculty Articles and Research

Despite having previous experience and extensive trauma training, the COVID-19 pandemic presented unprecedented challenges for nurses working in hospital settings. During the pandemic, nurses struggle to care for patients and protect themselves from infection, while navigating ongoing organizational changes. Guided by prior literature on social support and coping, this study explores nurses’ experiences of coping with stress while treating COVID-19 patients during the pandemic. In-depth semi-structured interviews were conducted with 14 active staff nurses working in hospitals and one licensed practical nurse (LPN) at a rehabilitation center who treated COVID-19 patients during the pandemic. An inductive thematic analysis was employed …

Applying Evidence-Based Intervention (Ebi) Mapping To Identify The Components And Logic Of Colorectal Cancer Screening Interventions, Jacob Szeszulski, Derek W Craig, Timothy J Walker, Maya Foster, Patricia Dolan Mullen, Maria E Fernandez

Faculty, Staff and Student Publications

Implementation of evidence-based interventions (EBIs) can help to increase colorectal cancer screening (CRCS). Potential users of CRCS EBIs are often unclear about the specific features, logic, and core elements of existing EBIs, making it challenging to use or adapt them. We used EBI Mapping, a systematic process developed from Intervention Mapping that identifies an EBI's components and logic, to characterize existing CRCS EBIs from the National Cancer Institute's Evidence-Based Cancer Control Programs website. The resulting information can facilitate intervention adoption, adaptation, and/or implementation. Two trained coders independently coded intervention materials to describe intervention components and logic (n = 20). We …

Local Public Health System Comprehensiveness And Opioid Overdose Mortality, 2012-2018, Stephanie Courtney

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Deaths due to opioid overdose are a significant public health burden in the United States. Studies suggest that local public health systems that perform a high number of essential activities where local health departments contribute to the delivery of the activities and promote increased partnership may positively influence population health outcomes such as overdose mortality. Studies have shown that comprehensive public health systems are associated with improved health outcomes, but this association has not been addressed in the context of opioid overdose deaths. Study Aim: The purpose of this study is to evaluate the associations between local public health …

Implementation Of Physical Activity In Kentucky Public Schools: From Theory To Policy, Nancy Kearns

Theses and Dissertations--Rehabilitation Sciences

Physical activity in schools improves academic performance and fitness measures in children. However, state policy supporting implementation of physical activity remains poor. Identifying specific barriers to implementing physical activity minutes in Kentucky public schools is pivotal in preserving the cognitive and physical health of our children. This is of particular interest as physical activity minutes remain low despite the positive effects of exercise on cognition. The purpose of this dissertation is to provide policymakers and school administrators a method of identifying current policies, attitudes and infrastructure that inhibit the implementation of physical activity minutes in public schools. Thus, the findings, …

Worker Experience A Year Into Covid: Job Demands And Resources In The Philippines, Emerald Jay D. Ilac, Jaimee Felice Caringal-Go, Ma Tonirose De Guzman Mactal, Mendiola Teng-Calleja

Psychology Department Faculty Publications

This study aimed to examine the positive and negative job characteristics that impact employees’ working experience in a country located in the Global South during the COVID-19 pandemic using the job demands and resources (JDR) theory as a framework. Data collection happened approximately one year after the onset of the COVID-19 pandemic in the Philippines. Data came from a qualitative online survey of 122 workers which was then subjected to thematic analysis. For both demands and resources, four superordinate themes emerged: intrapersonal, interpersonal, work or task-related, and organization- related. Intrapersonal job demands included health and safety, and the complexity of …

The Healthy Native Youth Implementation Toolbox: Using Implementation Mapping To Adapt An Online Decision Support System To Promote Culturally-Relevant Sexual Health Education For American Indian And Alaska Native Youth, Christine M Markham, Stephanie Craig Rushing, Jane Manthei, Michelle Singer, Cornelia Jessen, Gwenda Gorman, Melissa F Peskin, Belinda F Hernandez, Lea Sacca, Gabrielle S Evans, Claudia Luna-Meza, Zoe Merritt, Ross Shegog

Faculty, Staff and Student Publications

BACKGROUND: American Indian and Alaska Native (AI/AN) youth experience serious disparities in sexual and reproductive health, including the highest teen birth rate among racial/ethnic groups, and disproportionate rates of sexually transmitted infections (STI), including HIV. A growing number of evidence-based programs (EBPs) that integrate the strengths and cultural teachings of Native communities exist. Yet, multiple factors, including lack of trained personnel, limited resources, and geographic isolation, may hinder their adoption and implementation. Innovative implementation strategies that facilitate the adoption and implementation of sexual health EBPs in Native communities may help reduce these disparities.

METHODS: We applied Implementation Mapping, a systematic …

Development, Implementation, And Evaluation Of Teach Back Curriculum For Community Health Workers, Jennifer Holcomb, Gayla M Ferguson, Logan Thornton, Linda Highfield

Faculty, Staff and Student Publications

Teach Back is a commonly used communication method to improve patient understanding and retention of health information. The method has been shown to be effective in improving patient and healthcare system outcomes, including patient health literacy and hospital readmissions. Community health workers (CHWs) are frontline healthcare workers who can help address patient health and social needs associated with hospital readmissions. However, a gap exists in Teach Back curricula and training methods reflecting the scope of work for CHWs. The objective of this training was to provide CHWs with didactic information and skill building practice curriculum focused on the integration of …

Barriers And Facilitators To Implementation Of The Accountable Health Communities (Ahc) Model: Findings From A Between-Site Qualitative Assessment Of Implementation Strategies, Linda Highfield, Gayla M Ferguson, Jennifer Holcomb

Faculty, Staff and Student Publications

INTRODUCTION: A multitude of HRSN interventions are undergoing testing in the U.S., with the CMS Accountable Health Communities (AHC) Model as the largest. HRSN interventions typically include screening for social needs, referral to community resources, and patient navigation to ensure needs are met. There is currently a paucity of evidence on implementation of HRSN interventions. The Consolidated Framework for Implementation Research (CFIR) is a determinant framework widely used to plan and assess implementation. to the authors knowledge, there are no published studies assessing CFIR constructs for HRSN intervention implementation in the U.S. In the Assessment step of the Strengthening Peer …

The Relationship Between Team Engagement And Physician Engagement, Lynne Miles

Walden Dissertations and Doctoral Studies

AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

Staff Nurses Lack Of Knowledge And Opioid Use At The Veteran Administration, Cathy J. Ramey

Walden Dissertations and Doctoral Studies

AbstractStaff Nurses’ Lack of Knowledge and Opioid Use at the Veteran Administration By Cathy Ramey

MS, University of Phoenix, 2014BS, Chamberlain University, 2008

Dissertation Submitted in Partial Fulfillment Of the Requirements for the Degree of Doctor of Nursing Practice

Walden University November 2022

Abstract Opioids are often prescribed for pain management, which may have led to high rates of opioid addiction among veteran populations. The problem identified in this DNP project was the nurses’ lack of knowledge regarding pain management and the use of opioids in the veteran’s (VA) hospital where the project commenced. Using the Analyse, Design, Develop, Implement, …

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …

Improving Medication Administration Safety In A Correctional Facility With An Electronic Medication Administration System, Rosalinda Salazar

Master's Projects and Capstones

Problem: According to the World Health Organization (2020), medication errors are one of the leading causes of injury and avoidable harm in health care globally.

Context: The county jail houses approximately 700 inmates/patients on a daily basis, and the potential for error when administering medications is high as medications are prepared manually using a paper medication administration record.

Interventions: The jail began using an electronic health record/barcode administration system on October 19, 2020.

Measures: Unusual occurrence reports related to medication errors were reviewed. The time frame included 6 months before electronic implementation, and 6 months after implementation.

Results: Unusual occurrence …