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Articles 31 - 60 of 248
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Improving Staff Knowledge And Competency In Saint Louis University Mental Status Dementia Screening, Arteece Noel Crum
Improving Staff Knowledge And Competency In Saint Louis University Mental Status Dementia Screening, Arteece Noel Crum
Walden Dissertations and Doctoral Studies
Summary Early recognition of cognitive decline is vital to improving outcomes and maintaining patient safety across healthcare settings. The Saint Louis University Mental Status (SLUMS) screening tool assists nurses in detecting early cognitive changes; however, inconsistent administration and interpretation of the screening tool can reduce its effectiveness. A gap in staff knowledge regarding scoring, education-level adjustments, and documentation accuracy was identified at the practice site. To address this gap in practice, I developed and implemented a staff education program focusing on SLUMS administration and evidence-based clinical response to abnormal scores. The practice-focused question guiding this Doctor of Nursing Practice project …
Improving Retention Of Newly Hired Nurses In Home Care, Chidi D. Ihezue
Improving Retention Of Newly Hired Nurses In Home Care, Chidi D. Ihezue
Walden Dissertations and Doctoral Studies
In the home care setting, there is an increasing need for home care services due to aging populations and the rising prevalence of chronic diseases, as well as a scarcity of qualified home care staff to meet the health needs of patients in this setting. A home care agency's onboarding program, particularly its capacity to deliver comprehensive orientation and robust mentoring for new nurses, plays a crucial role in supporting the retention of newly employed nursing staff within the home care environment. Research indicates that without ongoing support and close monitoring, newly hired nurses may disengage during the onboarding and …
Subjective Excessive Daytime Sleepiness And Frailty Progression In Veterans Over 50 With Insomnia, Mona Amirmazaheri
Subjective Excessive Daytime Sleepiness And Frailty Progression In Veterans Over 50 With Insomnia, Mona Amirmazaheri
Walden Dissertations and Doctoral Studies
Frailty is common in aging veterans and linked to adverse outcomes. This retrospective cohort study of 6,824 veterans with insomnia examined whether excessive daytime sleepiness, sleep treatments, and PTSD affected frailty progression over four years. Frailty was measured using a validated index, with models adjusted for demographics and comorbidities, including chronic coronary insufficiency. Manuscript 1 showed that a higher Epworth Sleepiness Scale (ESS) score (range 0-24) was independently associated with a higher frailty index (FI) (p < .001). A clinical threshold of ≥11 indicated EDS and greater odds of frailty worsening compared to scores <11 (adjusted odds ratio (aOR) = 1.16, 95% CI [1.02, 1.32], p = .021). There was no significant interaction between ESS and time, suggesting that sEDS reflects persistently elevated frailty levels rather than accelerated decline. Manuscript 2 showed that nonpharmacologic sleep interventions were protective, while pharmacotherapy was associated with increased frailty risk. Cognitive behavioral therapy for insomnia was associated with lower odds of frailty worsening (aOR = 0.31, 95% CI [0.19, 0.53], p < .001), and continuous positive airway pressure therapy also reduced risk (aOR = 0.55, 95% CI [0.39, 0.76], p < .001). In contrast, sleep medications were associated with increased odds of frailty progression (aOR = 1.16, 95% CI [1.02, 1.32], p = .021). Manuscript 3 showed that PTSD was not associated with baseline frailty levels but showed a significant time interaction (B = 0.001, p = .008), indicating modest acceleration of frailty progression among affected veterans. Findings support positive social change through early sEDS screening and trauma-informed, nonpharmacologic sleep care to reduce frailty in veterans.
Staff Education On Oral Health To Night Shift Staff, Uzoamaka Mbionwu
Staff Education On Oral Health To Night Shift Staff, Uzoamaka Mbionwu
Walden Dissertations and Doctoral Studies
Hospital-acquired pneumonia (HAP) remains the most common hospital-acquired infection in the United States, with nonventilated adult patients particularly at risk. This doctoral project focused on improving oral care practices among night shift nursing staff on a medical-surgical unit to reduce the risk of HAP. The practice gap identified was the inconsistent and inadequate delivery of oral hygiene during night shifts, primarily due to staff knowledge deficits, time constraints, and a lack of standardized procedures. The project was guided by the Johns Hopkins Evidence-Based Practice model and addressed the following question: In adult patients on a medical-surgical unit, will staff education …
Staff Education Project To Reduce Falls In Assisted Living Through Improved Caregiver Knowledge, Attitude, And Skill, Crystal Morrow
Staff Education Project To Reduce Falls In Assisted Living Through Improved Caregiver Knowledge, Attitude, And Skill, Crystal Morrow
Walden Dissertations and Doctoral Studies
Wisconsin has the highest death rates from falls in the nation. In a brief, the Wisconsin Aging Advocacy Network indicated that most falls among individuals over 65 occur in residential settings. Further, a significant number of elderly people will fall each year, resulting in hospitalizations or fatalities. The purpose of this project was to provide staff education in one Wisconsin assisted living facility to effectively improve knowledge, attitude, and skill among frontline staff for fall prevention management. A formal Fall Education Day was provided to improve knowledge and shape positive attitudes among staff. A pretest-posttest design was used to measure …
Resilient Families, Thriving Communities, Melanie Phillips
Resilient Families, Thriving Communities, Melanie Phillips
Selected Social Change Portfolios in Prevention, Intervention, and Consultation
Goal Statement: My goal as a future marriage counselor is to reduce the number of marriages that end in divorce in my community. I aim to achieve this through preventative measures designed to increase relationship resilience and promote the overall well-being of families and the community. Significant Findings: This paper explores the rising divorce rates in Thatcher, Arizona, and highlights preventative measures to strengthen marriages in order to reduce marital dissolution. Key findings suggest that proactive interventions, such as marriage education programs and the passing of pro-marriage public policies, are more cost-effective than addressing the consequences of divorce (U.S. National …
The Impact Of A Major Educational Shift On Cognitive Load: A Cross-Sectional Study Of Uae University Students, Yousef Aljawarneh, Hasan Al-Omari
The Impact Of A Major Educational Shift On Cognitive Load: A Cross-Sectional Study Of Uae University Students, Yousef Aljawarneh, Hasan Al-Omari
Journal of Social, Behavioral, and Health Sciences
The shift to remote learning has significantly influenced cognitive load among university students, impacting their ability to learn and comprehend effectively. In this study, we assessed cognitive load among students at the Higher Colleges of Technology (HCT) in the United Arab Emirates (UAE) during the COVID-19 pandemic. Using a cross-sectional descriptive design, we collected data from 2,085 students via self-administered questionnaires between February and May of 2021. The sample was predominantly female (78.5%) and single (91.3%). The Cognitive Load Scale (subscale range: 0-40) revealed moderate mean scores of 19.59 for intrinsic load (ICL) and 16.69 for extraneous load (ECL), with …
Impact Of Primary Care Providers’ Beliefs On Intentions To Conduct Brief Cognitive Assessments, Debra Antista-Bianchi
Impact Of Primary Care Providers’ Beliefs On Intentions To Conduct Brief Cognitive Assessments, Debra Antista-Bianchi
Walden Dissertations and Doctoral Studies
The 2011 Patient Protection and Affordable Care Act (PPACA) mandated that Primary Care Providers (PCPs) offer brief cognitive assessments during the Medicare Annual Wellness Visit (AWV), but this practice was inconsistent at best. This study investigated factors that influenced PCPs intentions to routinely assess cognition during the AWV. The theory of planned behavior (TPB) was used to assess the relationship between PCPs' behavior beliefs, subjective norm beliefs, perceived behavioral control (PBC) beliefs, and external control factors and their intentions to conduct brief cognitive assessments during the AWV. Using a quantitative correlational design, a cross-sectional online survey was administered to 86 …
Staff Education To Promote Medication Adherence In Hypertension, Amie Sankoh
Staff Education To Promote Medication Adherence In Hypertension, Amie Sankoh
Walden Dissertations and Doctoral Studies
A primary care medical clinic experienced an increase in hospital readmission for hypertensive patients, as evidenced by a consistent lack of standardized patient education on medication adherence and a notable increase in readmission rates for uncontrolled hypertension. Hypertension is a significant public health problem associated with an elevated risk of heart disease, stroke, and kidney disease. The gap in practice identified was a lack of knowledge among the medical staff in teaching patients about hypertension medication adherence. The practice-focused question was: Does educating primary care medical staff on the importance of medication adherence in hypertension improve knowledge, as evidenced by …
Educating Primary Care Professionals On The Management And Treatment Of Dementia Patients, Rosemarie Ashmeade
Educating Primary Care Professionals On The Management And Treatment Of Dementia Patients, Rosemarie Ashmeade
Walden Dissertations and Doctoral Studies
This quality improvement staff education program addressed the delayed treatment of patients with dementia at the outpatient project facility. Patients with depression were treated according to protocol; however, the practitioners were not recognizing that some of these patients with depression had dementia and required a different plan of treatment. This knowledge gap had the potential to result in delayed diagnosis, inadequate patient support, and less favorable patient outcomes. This evidence-based education program was developed to increase healthcare practitioners’ competency in recognizing dementia and providing early referral and treatment. I determined the effectiveness of the educational intervention by analyzing the data …
Staff Education Program To Improve Nursing Knowledge On Fall Prevention Strategies, Chioma C. Achonye
Staff Education Program To Improve Nursing Knowledge On Fall Prevention Strategies, Chioma C. Achonye
Walden Dissertations and Doctoral Studies
In nursing practice, falls among adults aged 65 and above are a critical concern due to their potential to cause serious injuries and complications. As a result, fall prevention has become a top priority for healthcare providers striving to ensure patient safety and quality. The Doctor of Nursing Practice (DNP) project was designed to address the issue of falls in long-term care facilities by implementing a staff education program focused on patient fall risk assessment, identifying intrinsic and extrinsic factors influencing falls, and implementing evidence-based interventions. The DNP project practice-focused question was Does an education program on fall prevention strategies …
Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan
Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan
Walden Dissertations and Doctoral Studies
Falls are the most common adverse events leading to increased injury, length of hospital stay, and costs among hospitalized patients. I developed a staff education project to address the identified practice problem of increased fall rates on the cardiac floor of the project site. The practice-focused question guiding this Doctor of Nursing Practice (DNP) project was whether a comprehensive staff education program on evidence-based fall prevention strategies could improve the nurses’ knowledge when compared to standard fall prevention practices. The purpose of this DNP project was to provide staff education to increase nurses’ knowledge about the early identification of fall …
Staff Education To Improve Fall Prevention Practices In The Home Health Setting, Chinemelum Okoye
Staff Education To Improve Fall Prevention Practices In The Home Health Setting, Chinemelum Okoye
Walden Dissertations and Doctoral Studies
Falls among adults aged 65 and older represent a significant public health concern, as they are the leading cause of injury and hospitalization within this demographic. According to the Centers for Disease Control and Prevention (CDC), nearly one in four older adults experiences a fall annually, leading to over 3 million emergency department visits. In home health settings, the risk of falls is heightened due to uncontrolled environments and insufficient staff training. This quality improvement project assessed the effectiveness of an educational intervention aimed at fall prevention strategies for home health staff, including registered nurses (RNs) and certified nursing assistants …
Lgbt Young Adults’ Experience Of Exiting Foster Care, Shaylon Joseph
Lgbt Young Adults’ Experience Of Exiting Foster Care, Shaylon Joseph
Walden Dissertations and Doctoral Studies
The scholarly community understands little about the experiences of lesbian, gay, bisexual, and transgender (LGBT) young adults as they transition out of the foster care system. This study explored the lived experiences and difficulties encountered by LGBT young adults after exiting foster care. Grounded in Erikson’s theory of psychosocial development, this qualitative dissertation employed a phenomenological design to interpret how participants made sense of their transitions. Recruitment was conducted through a flyer posted on Facebook and the Department of Children and Family Services; 10 LGBT young adults participated in 60-minute interviews. Using interpretative phenomenological analysis, the study revealed six overarching …
Factors Associated With Falls Among Nursing Home Residents, Dorsenia Hendrix
Factors Associated With Falls Among Nursing Home Residents, Dorsenia Hendrix
Walden Dissertations and Doctoral Studies
Falls in nursing home facilities are prevalent, and numbers continue to rise as residents grow older and antipsychotic (AP) medications are prescribed more frequently. The purpose of this quantitative study was to investigate whether frequency of falls was related to the use of AP medications. Data (N=100) were collected from 2020 incident reports, investigation sheets, and patient charts generated by the State Department of Public Health regarding resident falls and the use of AP medications in a nursing home Facility located in the Southern United States. Social Cognitive Theory (SCT) was used to understand specific behavior patterns such as personal, …
Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha
Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha
Walden Dissertations and Doctoral Studies
This project was developed as a staff education program using the analyze, design, develop, implement, and evaluate (ADDIE) model with a focus on discharge planning in a medical clinic in northern Maryland. There is a gap in discharge planning for older adults due to shortage of providers and inadequate education related to care transitions among the elderly. The care transition process can be improved through education. The practice focused question was: “Does an educational project for nurses on care transitions for the elderly increase knowledge as compared pre-to post education?” The Johns Hopkins evidence-based practice model (Appendix A) was the …
Perceptions And Experiences Of Kenyan Immigrants On Culturally Appropriate Cancer Health Education In Washington State: A Qualitative Study, Rael Odengo, Patricia Talbert, Joy Anderson
Perceptions And Experiences Of Kenyan Immigrants On Culturally Appropriate Cancer Health Education In Washington State: A Qualitative Study, Rael Odengo, Patricia Talbert, Joy Anderson
Journal of Social, Behavioral, and Health Sciences
Access to culturally appropriate cancer health education (CACHE), such as cancer information in languages other than English, that considers a group’s cultural beliefs, traditions, values, and practices, is increasingly recognized as a global health communication priority. CACHE is essential for reducing healthcare disparities and improving service accessibility among African immigrants, a rapidly growing demographic in the United States. This study explored the perceptions and experiences of Kenyan immigrants in Washington State regarding CACHE. We used a qualitative descriptive design, with a purposive sample of ten participants from the Kenyan immigrant community in Washington State. The Andersen Behavioral Model of Healthcare …
A Systematic Review Of Brief Cognitive Test Used Among The Veteran Population, Joel Mcpherson
A Systematic Review Of Brief Cognitive Test Used Among The Veteran Population, Joel Mcpherson
Walden Dissertations and Doctoral Studies
The practice problem this DNP project addressed was the lack of a of consensus for a brief cognitive screening (BCS) tool that can be most predictive of mild cognitive disorder (MCI) and dementia in a Veteran Affairs (VA) outpatient clinic. Addressing this gap in practice is important because the veteran population may be at increased risk of MCI and dementia due to age, a history of traumatic brain injury, and posttraumatic stress disorder. This DNP project was a systematic review of the literature. A population, exposure, outcome (PEO) framework and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) theory guided …
Staff Education To Increase Knowledge And Education Of Urinary Tract Infection To Reduce Rehospitalization, Yia Lor
Walden Dissertations and Doctoral Studies
Urinary tract infections (UTIs) are considered the most common infections in healthcare, particularly in nursing homes. If appropriate preventive measures are taken, infection rates will be reduced. The DNP project aimed to enhance clinicians' knowledge to reduce and prevent UTIs in nursing homes. This knowledge expansion also significantly has potential to reduce the risk of unnecessary hospitalizations. A knowledge gap was identified that focused on the necessary preventive measures to impact patient outcomes positively. Addressing this in nursing is essential because it can help reduce mortality risks. The participants consisted of six registered nurses and six certified nurse assistants who …
Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason
Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason
Walden Dissertations and Doctoral Studies
In this staff education initiative, I focused on fall prevention in long-term care facilities (LTCFs) by reinforcing the Morse Fall Scale fall risk assessment tool. Falls in LTCFs are a significant concern, leading to injuries, hospitalization, and declining residents' quality of life. The practice problem stems from insufficient staff training, contributing to inadequate patient care and an increased risk of falls. The practice-focused question was used to explore whether education about fall prevention measures and guidelines improves long-term care nurses’ knowledge and intent to follow these guidelines; a total of 23 participants were involved in this project. Pre- and post-education …
Staff Education On Medicaid And Medicare Programs, Angela R. Smith
Staff Education On Medicaid And Medicare Programs, Angela R. Smith
Walden Dissertations and Doctoral Studies
Case managers at the practice site are responsible for helping older and disabled clients receive services from Medicare and Medicaid. The gap in practice was that case managers were failing to recognize the benefit and eligibility differences between these federal and state-run programs. Case managers must be well-informed regarding these programs to effectively manage their clients’ care. The goal of this project was to plan, implement, and evaluate a staff education program on Medicare and Medicaid services. The practice-focused question centered on whether participants demonstrated increased knowledge about Medicare and Medicaid services available to Waiver Program clients. The theoretical framework …
Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda
Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda
Walden Dissertations and Doctoral Studies
Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …
The Impact Of Functional Disabilities On The Quality Of Life Of Older U.S. Adults, Bernadette Lavender
The Impact Of Functional Disabilities On The Quality Of Life Of Older U.S. Adults, Bernadette Lavender
Walden Dissertations and Doctoral Studies
Among older U.S. adults, functional disabilities are critical determinants of quality of life (QoL), influencing mobility, social engagement, and independence. Despite growing evidence of these impacts, limited research examines how healthcare access, social support, and socioeconomic factors moderate this relationship. This quantitative study explored the effects of functional disabilities on QoL, operationalized through self-reported health, while examining the moderating roles of key social determinants. Using a cross-sectional design, secondary data from the Health and Retirement Study (HRS) were analyzed. The sample included 42,405 participants aged 60 years and above from all 50 states. Multiple regression analyses and ANOVA were employed …
The Lived Experiences Of Registered Behavior Technicians Using Applied Behavior Analysis With Children With Autism Spectrum Disorder, Rebecca Rene Wyble
The Lived Experiences Of Registered Behavior Technicians Using Applied Behavior Analysis With Children With Autism Spectrum Disorder, Rebecca Rene Wyble
Walden Dissertations and Doctoral Studies
The prevalence of autism spectrum disorder (ASD) has increased dramatically over the past 20 years; the Centers for Disease Control describe ASD as an epidemic of need. Individuals with ASD need proper treatment and support services. One of the most significant needs is for applied behavior analysis (ABA), which is considered the most effective treatment for ASD, yet several barriers impede caregivers’ ability to access ABA, such as the shortage of ABA practitioners, including registered behavior technicians (RBTs). This qualitative phenomenological study explored the lived experiences of RBTs working with children with ASD in ABA settings in the United States. …
Staff Education On Evidence-Based Educational Content For Patient Fall Prevention Measures, Ogochukwu Vera Nnakwe
Staff Education On Evidence-Based Educational Content For Patient Fall Prevention Measures, Ogochukwu Vera Nnakwe
Walden Dissertations and Doctoral Studies
Patient falls continue to be a challenge due to the injury associated with them. They can be disabling, costly, and most often lead to increased morbidity and mortality. Falls at home lead to hospitalization of the patient and complication of other health issues and/or aggravation of preexisting health problems. The practice problem was that the clinic did not have patient education content in place for fall prevention measures to discuss with patient at discharge. The practice-focused question was, Will a staff education on evidence-based falls prevention measures result in an increase in staff knowledge on fall prevention? The purpose of …
Executive Summary: Clinical Practice Guideline Primary Care Management Of Overweight/Obesity In Adult Women, Getrude Tate Nguatem
Executive Summary: Clinical Practice Guideline Primary Care Management Of Overweight/Obesity In Adult Women, Getrude Tate Nguatem
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project was a clinical practice guideline project focused on overweight and obesity management of adult women in primary care. The practice problem identified was the lack of an evidence-based clinical practice guideline to manage overweight/obesity in adult women. It was important to address this problem because overweight and obesity were significant health concerns at this clinical site in the United States and the world. The practice-focused question was the following: “Does the evidence support the development and Appraisal of Guideline for Research and Evaluation (AGREE) II instrument quality scoring of a clinical practice guideline on …
An Educational Intervention Focused On The Care Of Older Adults, Michele Orzehoski
An Educational Intervention Focused On The Care Of Older Adults, Michele Orzehoski
Walden Dissertations and Doctoral Studies
It is estimated that by 2050, individuals ages 65 and older will comprise 20% of the U.S. population. Further, research has demonstrated that among these aging adults, 80% have one chronic condition with 77% having at least two chronic conditions. Given this, the Institute for Healthcare Improvement (IHI) developed the Age-Friendly Health System framework for the care of older adults centering on what matters, medication, mentation, and mobility, or the 4Ms. In the local organization, leadership determined there was a need for an older adult-centered care model given their population includes aging individuals. Thus, the purpose of this doctor of …
Virtual Reality Simulation In Nursing Program: A Staff Education Initiative, Nekpen Isibor
Virtual Reality Simulation In Nursing Program: A Staff Education Initiative, Nekpen Isibor
Walden Dissertations and Doctoral Studies
Summary This executive summary highlights critical aspects of a Doctor of Nursing Practice staff education initiative. The doctoral project aimed to measure faculty members’ knowledge and confidence in using virtual reality (VR) simulation to address nursing students limited clinical opportunities. The initiative sought to align faculty practices with the National Council of State Boards of Nursing (NCSBN) recommendation of 25% clinical training through simulation. The guiding practice-focused question was, “Among nursing department faculty members, would staff education enhance simulation knowledge and confidence?” Sources of evidence were peer-reviewed literature and pre/post-test surveys administered to assess faculty knowledge and confidence changes. The …
Virtual Reality Simulation In Nursing Program: A Staff Education Initiative, Nekpen Isibor
Virtual Reality Simulation In Nursing Program: A Staff Education Initiative, Nekpen Isibor
Walden Dissertations and Doctoral Studies
Summary This executive summary highlights critical aspects of a Doctor of Nursing Practice staff education initiative. The doctoral project aimed to measure faculty members’ knowledge and confidence in using virtual reality (VR) simulation to address nursing students limited clinical opportunities. The initiative sought to align faculty practices with the National Council of State Boards of Nursing (NCSBN) recommendation of 25% clinical training through simulation. The guiding practice-focused question was, “Among nursing department faculty members, would staff education enhance simulation knowledge and confidence?” Sources of evidence were peer-reviewed literature and pre/post-test surveys administered to assess faculty knowledge and confidence changes. The …
Counselors’ Lived Experiences Supporting Emerging Adults With Psychiatric Disorders Secure Competitive Employment, Cheryl Lakisha Andrews
Counselors’ Lived Experiences Supporting Emerging Adults With Psychiatric Disorders Secure Competitive Employment, Cheryl Lakisha Andrews
Walden Dissertations and Doctoral Studies
Transitioning from childhood to adulthood is a challenging life experience, further intensified for individuals with psychiatric disorders. While strong social support serves as a key resilience factor, emerging adults with psychiatric disorders face unique challenges in addition to those encountered by their peers. This population is at heightened risk for adverse outcomes, including difficulty securing employment, a critical milestone for adult independence. Counselors play a pivotal role in supporting these individuals but often report feelings of inadequacy and reluctance to engage with this complex developmental stage. This qualitative hermeneutic phenomenology study explores the lived experiences of counselors who assist emerging …