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Methods To Increase The Rate Of Childhood Vaccinating, Mary Beth Tillman

Walden Dissertations and Doctoral Studies

Vaccinations such as polio, diphtheria, varicella, and meningitis help to protect a child from life-threatening illnesses which have previously been contained by routine vaccinations. However, misinformation, negative press, and other contributing factors, have influenced caregivers to refuse to vaccinate their children placing the children at risk for contracting the disease. The Centers for Disease Control and Prevention recommends regular vaccinations for children beginning as newborns, yet the vaccination rate remains below acceptable levels. This project was developed to provide an educational program guided by Orem’s self-care theory and intended to increase nurses’ knowledge of vaccination and ultimately vaccination rates. A …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

Use Of Managerial Epidemiology By Healthcare Leaders In Ambulatory Settings, Chantelle Schenning

Walden Dissertations and Doctoral Studies

Despite many health reforms, the United States continues to struggle with limited healthcare access, exponential healthcare costs, and poor quality of care. Overcoming these challenges requires healthcare leaders’ effective navigation of industry transformation towards population health and a shift in patient volume to ambulatory healthcare settings. Research has demonstrated that the use of managerial epidemiology, an application of epidemiology tools and principles to management decision-making within healthcare organizations, can better serve the health of the population and could improve the triple aim of inadequate access, high costs, and poor quality. However, the adoption of this practice is weak and its …

Measuring Knowledge Of Chronic Kidney Disease (Ckd) Among Community College Students, Jacquelyn Caldwell Moore

Walden Dissertations and Doctoral Studies

Chronic Kidney Disease (CKD) once detected is easily treated; however, it has become a major health problem associated with increased morbidity and mortality rates, creating an economic burden worldwide. While approximately 24 million Americans over the age of 20 suffer from CKD, there is a lack of awareness among the general population. Using a pre/post assessment, this quantitative study measured the impact of a 75-minute workshop on 126 community college students' knowledge of kidney disease, perception of its severity, and perceived susceptibility. The theoretical framework for the study was the health belief model, which suggests that individuals will make positive …

Evaluating The Hospitals General Service Readiness Index In Guinea For Enhancing Their Performances, Mohamed Elmahady Camara

Walden Dissertations and Doctoral Studies

The healthcare system of Guinea has reported low scores on service availability and readiness assessment (SARA); the scores indicated the low availability of quality drugs, vaccines, medical equipment, and other technologies and involves a continuous history of poor quality-performance metrics. Thus the operational health problems in Guinea could be summarized as health problems (high rate of maternal, neonatal, and infant mortality, high prevalence of communicable and non-communicable diseases) and health system problems (lack of appropriate governance). Therefore, amelioration of the quality of health care and patient safety is needed. The objective of this study was to consider Guinea hospital performance …

Mothers’ And Community Stakeholders’ Perspectives About The Vitamin A Supplementation Program In Nigeria, Olufolakemi Mercy Anjorin

Walden Dissertations and Doctoral Studies

Vitamin A deficiency (VAD) affects about one third of children under the age of five in Nigeria. There is low uptake of biannual Vitamin A supplementation (VAS) used since year 2010 as the national response to addressing VAD among children 6 to 59 months. Yet, there is limited research on barriers or facilitators to uptake of VAS. The purpose of this study was to examine the perspectives of stakeholders about the VAS program in Nigeria. The theoretical underpinning was the social marketing framework. The central question related to the views of stakeholders toward the VAS program, and their perception about …

Perinatal Staff Education On Opioid Use Disorder, Theresa J. Engle

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, opiate use disorder (OUD) crosses all demographic areas, ethnicities, and social classes. In 2016, over 42,000 Americans died from opiate overdose with more than two million Americans having OUD. The need to care for patients with OUD has crossed all realms of nursing, including the perinatal specialty. Framed within the Iowa model of evidence-based practice, the purpose of this project was to develop a perinatal staff education program on OUD focusing on addiction as a brain disorder with care of the perinatal woman and identification and treatment of the newborn with …

Effects Of Prerelease And Reentry Programs On Male Recidivism In The Midwest, Tenisha N. Mack

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this qualitative case study was to determine the effectiveness of prerelease and reentry programs on recidivism from the perspective of male ex-offenders. The prison population in the United States in 2.3 million according to the Bureau of Justice Statistics. Most ex-offenders recidivate in the first 3 years. Prerelease and reentry programs are responsible for successful reintegration for many ex-offenders. However, this study revealed that a holistic approach to rehabilitation pre-and postrelease contributed to a better quality of life for ex-offenders, their families, and communities. The operant conditioning and social cognitive theories provided the theoretical foundation for this …

Parents’ Perceptions Of Healthcare Influences On Their Decisions To Vaccinate Their Children, Patricia Frances Badiola Harris

Walden Dissertations and Doctoral Studies

Declining immunization rates are associated with higher incidents of vaccine-preventable diseases. The purpose of this qualitative phenomenological inquiry was to explore the perceptions of vaccine-hesitant parents regarding their healthcare experiences. Ajzen and Fishbein‘s theory of reasoned actions and its key concepts (the intention to perform behaviors, attitudes, subjective norms, and external variables) was used as a framework to understand influences on parents' decisions to vaccinate their children. The research questions for the study examined the healthcare experiences of vaccine-hesitant parents, how these experiences influenced their decisions to vaccinate their children, and how this group perceived the current strategies promoting vaccinations …

Planned Behavior And Congolese Physicians’ Practice: Predicting Advanced Preventive Health Services Provision, Jean-Clément Milabu Mumbusi

Walden Dissertations and Doctoral Studies

The provision of preventive services, health promotion, and health maintenance has become the cornerstone of primary care practice in the United States and other Western countries to prevent morbidity and premature mortality and to increase the quality and years of a healthy life. Unfortunately, the delivery of these advanced preventive health services (APHS) has been sporadic in the Democratic Republic of Congo, a country with poor health indicators. The purpose of this cross-sectional mixed-method study was to apply Ajzen’s theory of planned behavior (TPB) to predict the intention of Congolese primary care physicians (PCPs) in the provision of APHS. Using …

Strategies To Reduce Absenteeism In The Public Sector Workplace, Dr. John G. Turner

Walden Dissertations and Doctoral Studies

When unplanned absences occur, employers incur lost productivity and additional costs. In the United States, missed work because of employee absence costs organizations about $202 billion dollars annually. Grounded in Burn’s transformational leadership theory, the purpose of this qualitative single case study was to explore effective strategies public works department leaders use to reduce absenteeism in the workplace. The participants included 9 leaders who worked in a chosen department in the local government who successfully reduced absenteeism in the workplace. The data collection process included conducting semistructured interviews and reviewing organizational documents. The data were analyzed using a thematic analysis …

Strategies For Teaching New Mothers The Importance Of Vaccination, Halimat Akojie

Walden Dissertations and Doctoral Studies

Vaccinations provide protection against a number of severe childhood communicable diseases, such as polio, measles, and pertussis. However, not all parents follow the recommended immunization schedules for their young children, a decision which could lead to increased disease incidence and prevalence. The purpose of this DNP project was to address the gap-in-practice related to ineffective strategies to reduce vaccination refusal among parents. This systematic review sought to understand strategies effective at teaching new mothers the importance of vaccinating their children. The theoretical foundation for addressing this question is Rogers’ protection motivation theory, which explains that sources of information, mediating cognitive …

Improving Sedation Management In Mechanically Ventilated Patients, Jannette Lord

Walden Dissertations and Doctoral Studies

Abstract

In the intensive care unit (ICU), sedation management of the critically ill, mechanically

ventilated patient is a source of concern. Optimal sedation management is integral to

critical care practice, yet optimal levels of sedation are not consistently applied.

Suboptimal sedation carries significant risks for patients, as inadequate sedation or

oversedation may lead to prolonged ventilator days, ventilator-associated pneumonia

(VAP), extended length of ICU stay, and costs. The purpose of this quality improvement

(QI) project was to improve sedation management of mechanically ventilated patients by

improving staff nurses’ knowledge of and attitudes toward sedation management,

ultimately achieving a zero-ventilated associated …

The Dietary Decision-Making Process Of Women In Nigeria, Gachomo Joanne Mapis

Walden Dissertations and Doctoral Studies

Nigerians have been opting for a more processed Western diet. These changes in dietary choices have aligned with obesity and undernutrition, attributable to micronutrient deficiencies or malnutrition. Many scholars have presented varying intervention strategies ranging from consumption of a variety of foods containing the necessary micronutrients to food fortification. The purpose of this grounded theory study was to explore the perceptions of women in an urban city in Nigeria on indigenous foods and Western dietary influences to determine social interactions, the consequence of the interactions, and the women’s current perceptions of food choices. The social-ecological model was used to explore …

Evaluation Of The Tuberculosis Management Program In Ghana, Boampong Akese

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major health issue estimated to be affecting about 1/3 of the world’s population. TB is a major health problem in Ghana primarily because of weak health infrastructure and poor TB case detection and management practices. Measuring and evaluating the performance of health programs is an important aspect of health care services in any country. The purpose of this quantitative study was to evaluate the TB management program in Ghana. A cross-sectional research design was used to answer the research questions. Secondary data were obtained from the Ghana District Health Information Management System database. The theoretical foundation …

Homelessness And Hiv Risk: Experiences, Perceptions, And Beliefs Of Transgender Youth, Darcia Bryden-Currie

Walden Dissertations and Doctoral Studies

Human ImmunodeficiencyVirus (HIV) continues to be a public health concern in the United States, with increased rates of infection among transgender youth. The phenomenon of homelessness is also a significant challenge for transgender youth. Gender expression often results in stigma, and discrimination, many trans youth experience poverty, rejection, and low self-esteem, which are precursors to homelessness. The purpose of this qualitative phenomenological study was to explore the influence that homelessness has on sexual risk associated behaviors in transgender youth. The theoretical framework that guided this study was Bandura’s social cognitive theory. The research questions sought to explore how this population …

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

Antibiotic Stewardship And The Quality Of Life For Residents Over 65 Years, Reshma Beharry-Guest

Walden Dissertations and Doctoral Studies

Antibiotics were often over-prescribed in long term care facilities (LTCFs) and antibiotic stewardship guidelines, established by the CDC were not followed. The nursing home administrator was responsible for the quality of care for the residents and ensured that the facility met and/or exceeded the CMS antibiotic stewardship standard of care. The purpose of this quantitative study was to analyze operational secondary data collected from a Texas LTCF regarding antibiotic utilization for male and female residents over 65 years. The theoretical framework of the social cognitive theory was applicable for quality improvement in the LTCF setting. The data analysis showed that …

Best Practices For Screening And Early Treatment For Hiv In The Hispanic Community, Juliana Deboviel

Walden Dissertations and Doctoral Studies

The Hispanic community is among the ethnic minorities that are adversely affected by HIV/AIDS in the United States. HIV transmission rates and rates of death are high among Hispanic communities because of delays in HIV testing and late participation in HIV treatment, especially in the state where this study was conducted. However, advanced practices for screening and early treatment of HIV can improve patient outcomes and inform practice. Thus, this systematic review was conducted to identify the best available evidence for HIV screening and care in the Hispanic population in the Western United States that shares a border with Mexico. …

Impact Of Demographic Characteristics And Therapy On Tuberculosis Incident Cases, Iliedor Garcon

Walden Dissertations and Doctoral Studies

For more than two decades, tuberculosis (TB) has ranked second among the top killers of infectious diseases, with an estimated 10.4 million incident cases in 2018. Demographic characteristics and drug susceptibility influence TB incidence worldwide. Using a retrospective cohort design, the purpose of this quantitative study was to investigate whether race/ethnicity, age, sex (gender), therapy completion within one year (COT), and testing for isoniazid and rifampin susceptibility (TIRS) were predictors of 672 cases of TB in New York-Newark-Jersey City from 1993 to 2017. Guided by the epidemiological triad theory, this research was conducted using a secondary TB dataset from the …

Comparison Of Health Factors And Outcomes Between Accredited And Nonaccredited Health Departments, Deborah Koester

Walden Dissertations and Doctoral Studies

The launch of the Public Health Accreditation Board in 2012 established national public standards. This study examined possible correlations between the accreditation status of local health departments and specific indicators for health, including communicable disease, disease prevention and health promotion, and maternal child health factors, and outcomes of premature death and infant mortality. The population for the intervention group included all 212 local health departments accredited from September 2012 through December 2017. Accredited health departments were matched with nonaccredited health departments based on population, rurality, agency type, governance authority, and state public health structure. Linear regression analysis was performed on …

Bioterrorism: Exploring Factors For Improving Nurse Preparedness, Policies, And Practices, Leone Okey Tom-James

Walden Dissertations and Doctoral Studies

Ebola virus release/attack in New Jersey could go unnoticed but have immediate and long-lasting effects on the broader population and security. The risk underscores the need to prepare and enhance the state’s efforts to deal with a release and treat the confirmed cases. This descriptive single case research explored factors for improving nurses’ preparedness, policies, and practices for a bioterrorism release/attack. The epidemiological triangle conceptual framework was used descriptively in exploring, and developing a knowledge base of Ebola virus pathogenicity, characteristics, routes of transmission, and infection. The unit of analysis was Summit Ridge Genesis Healthcare Center. The theory of robust …

Perception Of Breast Cancer Screening Among African Immigrant Women In Dallas., Phillipa Akuwa Anuwe

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of cancer-related deaths in women, and mammography is proven to detect breast cancer at its earliest stage; however, studies show that Black women have the lowest rate of breast cancer screening. The purpose of this descriptive, qualitative study was to explore the perceptions of African-born immigrant women about breast cancer screening. Data were collected by conducting individual interviews with 10 purposefully selected, African, immigrant women in Dallas, between 35 to 65 years old. Data were analyzed using NVivo software and coded based on the conceptual framework, which was the health belief model. Participants’ perception …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Clostridium Difficile Incidence In Acute Care Hospitals: Patient And Hospital Characteristics, Angela Nwachuku

Walden Dissertations and Doctoral Studies

Hospital acquired infections (HAIs) calls for the attention of public research because it allows for investigation of the health practices, resources, and barriers of different health facilities and their surrounding communities. This research study examined the relationship between hospital acquired clostridium difficile infection (CDI) and patient, socioeconomic, and hospital characteristics in the state of New Mexico to determine their correlation with the increased incidence of CDI between 2013 and 2015 and if significant differences exist. The research questions were explored with the implication of the fundamental cause model and the pathways model. New Mexico patients over the age of 18 …

Educational Program For Decreasing Catheter-Associated Urinary Tract Infections, Josephine Crentsil

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infection (CAUTI) is the most common hospital-acquired illness. Insertion and maintenance of urinary catheters are critical factors that predispose patients to CAUTI. Studies have shown that many nurses have a knowledge deficit regarding evidence-based practices in the insertion and management of urinary catheters, which can help prevent CAUTI. This is a concern because nurses are typically the first point of contact with patients and are responsible for the promotion of evidence-based practice and preventative measures. Therefore, this project aimed to develop an educational intervention for nurses with a focus on proper insertion and maintenance of indwelling urinary …

Association Of Landfall Atlantic Tropical Storms And Human Cases Of Locally Acquired West Nile Virus Infection In Florida, Jackson G. Mosley

Walden Dissertations and Doctoral Studies

West Nile virus (WNv) is the most widely distributed flavivirus and considered a vector-borne pathogen of global significance. During the study period from 2002 to 2018, WNv had the highest incidence of locally acquired human cases when compared to any other mosquito borne illness in Florida with 373 cases documented during the study period. The purpose of the study is to determine if there is an association between Florida landfall tropical storms (LTS) and the incidence of locally acquired human WNv cases from 2002 through 2018. The study used a retrospective ecological study design guided by the epidemiological triad model …

Population-Level Determinants Of Cholera Incidence In African Countries, Ngoy Nsenga

Walden Dissertations and Doctoral Studies

Cholera remains endemic in Africa, with limited access to safe drinking water and inadequate sanitation as 2 of the main drivers of its dissemination. Few studies have examined the impact of health system capacity, even though it plays an important role in prevention, early detection, and response to a cholera outbreak. Grounded in the ecosocial theory of infectious disease dissemination, this quantitative ecological study explored the effect of social vulnerability (as measured by access to safe drinking water and sanitation, rate of open defecation, poverty, income inequality, gender inequality, and adult literacy) and health system (as measured by health financing …