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Evaluating The Effectiveness Of The Comprehensive Unit-Based Safety Program In Reducing Hospital-Acquired Infections, Peta Ann Anderson
Evaluating The Effectiveness Of The Comprehensive Unit-Based Safety Program In Reducing Hospital-Acquired Infections, Peta Ann Anderson
Walden Dissertations and Doctoral Studies
This doctoral project is an evaluation of a quality improvement initiative that applied a mixed method approach to evaluate the impact of the Comprehensive Unit-based Safety Program (CUSP) on hand hygiene (HH) compliance and healthcare-associated infection rates. The project was conducted in the United States of America (USA), Florida in an acute care hospital. The practice problem addressed was the persistent low adherence to HH protocols among healthcare staff, a critical issue in nursing practice due to its direct link to preventable patient harm. Quantitative data demonstrated a substantial reduction in infection rates following the implementation of the CUSP program. …
The Association Between Unemployment, Income, Education, Healthcare Access, Mental Health And High-Risk Hiv Behavior In The United States, Tia Smith
Walden Dissertations and Doctoral Studies
High-risk HIV behavior remains a critical public health concern in the United States, particularly among socioeconomically and psychologically vulnerable populations. Despite extensive prevention efforts, a gap persists in understanding how structural and mental health factors jointly contribute to HIV risk. This study addresses that gap by examining the association between socioeconomic status (SES), including income, education, employment, and healthcare access, and mental health status (diagnosis of depression and days of poor mental health) on high-risk HIV behavior at the individual level. Guided by the social determinants of health (SDOH) theoretical framework, the study utilized secondary data for over 40,000 adults …
Childhood Vaccination In Mozambique Pre- And Post-Covid-19 Pandemic, Remy Mwamba
Childhood Vaccination In Mozambique Pre- And Post-Covid-19 Pandemic, Remy Mwamba
Walden Dissertations and Doctoral Studies
In 2019, infectious diseases and other conditions claimed the lives of over 5 million children under 5. Global immunization coverage remains below prepandemic levels, leaving behind over 14 million zero-dose children in 2022, of whom 84% lived in low- and middle-income countries. This quantitative cross-sectional study aimed to examine, using two consecutive Demographic and Health Surveys, whether the most significant household characteristics and health service utilization risk factors associated with nonvaccination before the COVID-19 pandemic still hold postpandemic in Mozambique. Andersen's behavioral model of healthcare service utilization was the foundation for this investigation. The sample included N=2034 children aged 12-35 …
Central Lines And Peripherally Inserted Central Line Reeducation, Monica Lyn Gallik
Central Lines And Peripherally Inserted Central Line Reeducation, Monica Lyn Gallik
Walden Dissertations and Doctoral Studies
Objective: Will a central line and peripherally inserted central line reeducation program increase the nurses’ knowledge pertaining to dressing changes, cap changes, and chlorohexidine baths? Method: 26 nurses on an observation unit were sent a power point presentation. Of the 26 nurses that received the power point 18 nurses participated. The power point presentation had a pretest and posttest embedded into it. Both the pretest and posttest consist3ed of the same 10 questions. The average of the pretest and posttest were used to calculate the normalized learning gained. Results: The average pretest score was 60, the average posttest score was …
Teachers' Perspectives On Teacher Retention In Early Childhood Programs, Christopher Lavon Curry
Teachers' Perspectives On Teacher Retention In Early Childhood Programs, Christopher Lavon Curry
Walden Dissertations and Doctoral Studies
In a Midwestern state, teacher shortages have intensified the retention challenges of prekindergarten and kindergarten (PreK–K) teachers in early childhood (EC) programs. The problem addressed in this study was the retention of PreK–K teachers in EC programs and schools at the local level. Grounded in dual-factor and coping-competence- context theories, the purpose of this basic qualitative study was to explore teachers’ perspectives of the factors affecting the retention of PreK–K teachers in EC programs at the local level. Data were collected through semistructured interviews with 12 PreK–K teachers in a Midwestern state, who had a minimum of 3 years of …
Intersectionality Gaps Among Multiple Social Determinants In U.S. Infant And Maternal Mortality Rates, Mary D. Kirkley
Intersectionality Gaps Among Multiple Social Determinants In U.S. Infant And Maternal Mortality Rates, Mary D. Kirkley
Walden Dissertations and Doctoral Studies
The purpose of this quantitative, cross-sectional study was to examine whether social determinants interactively influence U.S. maternal and infant mortality rates. Grounded in the Social Ecological Model, this study analyzed secondary data from the Centers for Disease Control and Prevention’s National Vital Statistics System were analyzed using multivariable logistic regression. The final sample included 110,402 maternal deaths and 55,839 infant deaths, with inclusion criteria requiring complete data on race, education, age, marital status, gender (for infants), residency, and year of death. Exclusion criteria included non-U.S. resident deaths or missing demographic data. Results revealed statistically significant interaction effects: race/ethnicity with education …
Havana To Port-Au-Prince: Cuba’S Medical Internationalism Aid To Haiti, Wilner Saint Cyr
Havana To Port-Au-Prince: Cuba’S Medical Internationalism Aid To Haiti, Wilner Saint Cyr
Walden Dissertations and Doctoral Studies
Haiti ranks among the lowest in healthcare quality in the Americas, according to the health indicators used by the World Health Organization. Despite national and international efforts to improve health service delivery, access to primary medical care and preventive services is limited, especially in rural areas. In response to a request from the Haitian government following the devastating Hurricane Georges, the arrival of the first Cuban doctors to support ongoing public health needs commenced in December 1998. Recognizing an opportunity for international cooperation, the Haitian president sought assistance from Cuba by signing a bilateral cooperation agreement for initial and ongoing …
Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity
Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity
Walden Dissertations and Doctoral Studies
This doctor of nursing practice (DNP) project was conducted to develop a clinical practice guideline (CPG) to address a gap at a southeastern hospital where frontline nurses often call rapid response teams for severe hypotension without a standard guideline for necessary interventions. Therefore, the practice gap identified at the project site was the lack of a CPG geared for rapid response nurses (RRNs) to use when responding to a call to intervene on a patient with hypotension. RRNs are nurses with advanced clinical training who provide immediate medical care to rapidly hemodynamically declining patients. The guiding question for this DNP …
Predictive Study Of The Relationship Between Self-Care And Professional Quality Of Life Among Licensed Counselors Impacted By Covid-19, Maria G. Billings
Predictive Study Of The Relationship Between Self-Care And Professional Quality Of Life Among Licensed Counselors Impacted By Covid-19, Maria G. Billings
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic has created unprecedented challenges for mental health professionals, significantly increasing burnout and secondary traumatic stress while reducing available resources and limiting opportunities for compassion satisfaction. The purpose of this cross-sectional, quantitative survey study was to determine whether self-care engagement predicts levels of burnout, secondary traumatic stress, and compassion satisfaction among counselors. Grounded in Stamm’s theoretical framework on compassion satisfaction and compassion fatigue, the Self-Care Assessment Worksheet (SCAW) was used to measure self-care engagement, and the Professional Quality of Life Scale (ProQOL-V) was used to assess burnout, secondary traumatic stress, and compassion satisfaction. The sample included 59 licensed …
Improvisation In Agile Environments To Manage Disruption From Vuca Events, Christopher J. Remediani
Improvisation In Agile Environments To Manage Disruption From Vuca Events, Christopher J. Remediani
Walden Dissertations and Doctoral Studies
Volatility, uncertainty, complexity, and ambiguity (VUCA) events have always existed and demonstrated increases in regularity as well as damage. Management’s ability to mitigate and manage VUCA events has been challenged as they and nonmanagement employees are required to engage in rapid problem analysis and decision-making outside of standard procedures to identify and implement solutions. The purpose of this hermeneutic phenomenological study was to explore lived experiences of Agile practitioners in the information technology (IT) industry regarding their integration of improvisation techniques to mitigate and manage VUCA disruptions. Semi-structured interviews with open-ended questions were used to guide the study and address …
Measuring Healthcare Quality For Sexual Minority Women, Francesca Antoine
Measuring Healthcare Quality For Sexual Minority Women, Francesca Antoine
Walden Dissertations and Doctoral Studies
Women who identify as lesbian, bisexual, or other sexual orientations (i.e., sexual minority women) experience poorer health outcomes compared to heterosexual women. Despite the increasing prevalence of sexual minority women in the United States, little research exists to identify their unique health needs. Healthcare administrators play a critical role in promoting a higher standard of patient care by identifying systemic issues and leveraging data-driven solutions. The purpose of this study was to examine various aspects of care delivery in clinical encounters involving sexual minority women and evaluate their perception of care quality. Donabedian’s model of healthcare quality served as the …
Association Between Health Insurance, Antiretroviral Treatment, And Hiv Preexposure Prophylaxis In Men Aged 20–85 In Virginia, Lauren Elizabeth Maxwell
Association Between Health Insurance, Antiretroviral Treatment, And Hiv Preexposure Prophylaxis In Men Aged 20–85 In Virginia, Lauren Elizabeth Maxwell
Walden Dissertations and Doctoral Studies
HIV prevention and treatment disparities persist among men in Virginia, particularly in racial and ethnic minority groups. This study examined how insurance type and demographic factors influence prescriptions for antiretroviral treatment (ART) and preexposure prophylaxis (PrEP). Addressing these disparities is critical to advancing public health equity and reducing HIV rates. The purpose was to assess whether age, race, ethnicity, region, and insurance type are associated with the type of oral HIV medication prescribed. Guided by the HIV prevention and care cascade frameworks, the study focused on access and adherence. Using a cross-sectional quantitative design, the study analyzed secondary data from …
Evaluating The Impact Of Anti-Vaccine Online Search Trends During The Covid-19 Pandemic On Adolescent Pertussis-Containing Vaccine Completion, Deborah L. Fisher
Evaluating The Impact Of Anti-Vaccine Online Search Trends During The Covid-19 Pandemic On Adolescent Pertussis-Containing Vaccine Completion, Deborah L. Fisher
Walden Dissertations and Doctoral Studies
Adolescent completion of pertussis-containing vaccines is a public health concern, especially with rising online anti-vaccine misinformation. Incomplete vaccination increases risk for preventable diseases and impacts community health. A gap in the literature on the relationship between online anti-vaccine search trends during the COVID-19 pandemic and adolescent pertussis vaccine completion was addressed in this quantitative, repeated cross-sectional study. Andersen’s behavioral model of health services use guided the study. Secondary data from the 2019 and 2022 National Immunization Survey-Teen (NIS-Teen) compared adolescents aged 13–17 in the five U.S. states with the highest (n=5,464) versus the five with the lowest (n=3.031) population-adjusted anti-vaccine …
Impact Of Nursing Home Staff Hours And Administrator Turnover On Quality Of Care Post-Covid-19 Pandemic In Texas, Kendra King
Impact Of Nursing Home Staff Hours And Administrator Turnover On Quality Of Care Post-Covid-19 Pandemic In Texas, Kendra King
Walden Dissertations and Doctoral Studies
Nursing facilities experienced heightened unfavorable outcomes related to quality of care and staffing patterns during the COVID-19 pandemic. The purpose of this quantitative, quasi-experimental, retrospective study was to determine if there was a relationship between nursing home administrator turnover, total nurse staffing (i.e., LPN, RN, and nurse aides) hours per resident per day, and the quality of care as measured by the Long Stay Quality Measure (LSQM) rating in Texas after the COVID-19 pandemic in 2023. The Donabedian model, using the elements of structure, process, and outcomes, served as the theoretical framework for this study. Structure was represented by the …
Comorbidities, Therapy And Health System Factors Associated With Treatment Interruption Among Males With Tuberculosis In Nairobi County, Kenya, Lorraine Nkirote Mugambi-Nyaboga
Comorbidities, Therapy And Health System Factors Associated With Treatment Interruption Among Males With Tuberculosis In Nairobi County, Kenya, Lorraine Nkirote Mugambi-Nyaboga
Walden Dissertations and Doctoral Studies
While males are recognized as key drivers of tuberculosis (TB) transmission, the association between comorbidities (i.e., diabetes and malnutrition), adverse drug reactions (ADRs), and health system factors (i.e., frequency of drug refills) with TB treatment interruption, remains unclear. I aimed to determine the association between these factors and TB treatment interruption among males diagnosed with TB in Nairobi County, Kenya controlling for age, sub-county of residence, alcohol use, HIV co-infection, type of TB and presence of treatment supporter. Guided by WHO’s framework on adherence to long-term therapies, a quantitative, case-control study was conducted using secondary analysis of Kenya’s TB surveillance …
Burnout, Life Satisfaction, And Meaning-Focused Coping In Correctional Mental Health Providers, Danielle Janet Tsamouris
Burnout, Life Satisfaction, And Meaning-Focused Coping In Correctional Mental Health Providers, Danielle Janet Tsamouris
Walden Dissertations and Doctoral Studies
Studies have found that burnout among correctional mental health providers is related to unique stressors that impact their physical, psychological, and emotional health, including the perceived and actual threat of violence. Using the transactional theory of stress and coping, the purpose of this quantitative study was to examine the influence of burnout and meaning-focused coping strategies on life satisfaction in correctional mental health providers. Online survey data from 102 master’s-holding correctional mental health professionals were recruited by SurveyMonkey who also administered the survey. Results from a standard multiple regression analysis suggested that meaning-focused coping strategies significantly and positively influenced life …
Impact Of Safety Practices On Laboratory-Acquired Infections In Clinical Laboratories From 2018 To 2023, Lori Bane
Walden Dissertations and Doctoral Studies
Laboratorians identifying unknown pandemic pathogens face elevated risks of laboratory-acquired infections yet limited research examines how regulated safety practices influence these risks. This quantitative, correlational study used the Centers for Disease Control and Prevention’s secondary data (2018–2023) to examine two research questions. The first one questioned whether there were differences in safety incidents between registered and exempt clinical laboratories. The second research question investigated whether there was an association of laboratory incidents between BSL-2 and BSL-3 laboratories. The research was limited to incident reports from registered and exempted clinical laboratories working in BSL-2 and BSL-3 conditions. Guided by the Health …
Community Health Workers’ Lived Experience Of Using Videoconferencing With Community Members, Valdora Lejune Avery
Community Health Workers’ Lived Experience Of Using Videoconferencing With Community Members, Valdora Lejune Avery
Walden Dissertations and Doctoral Studies
Community health workers in the United States faced significant challenges in conducting in-person community practice during the COVID-19 pandemic, which adversely affected their communication, training, and service delivery outcomes. Videoconferencing enabled workers to connect with underserved populations for individual and community crisis response. The purpose of this study was to describe the lived experiences of community health workers in the Rural Community Health Worker Network (RCHWN) regarding the use of videoconferencing among community members in practice and how members in RCHWN perceive the availability of videoconferencing devices to communicate in the community. Transcendental phenomenology provided the conceptual framework and research …
Trust-Related Health Beliefs In Medical Systems Among Black Americans Since Covid-19, Monique Johnson Dixon
Trust-Related Health Beliefs In Medical Systems Among Black Americans Since Covid-19, Monique Johnson Dixon
Walden Dissertations and Doctoral Studies
COVID-19 highlighted the longstanding systemic and structural racism that produced poor health outcomes in Black communities. Black minorities in the United States were disproportionately affected by the COVID-19 pandemic, with less access to health resources, low vaccine rates, and mistrust of healthcare providers and organizations. This interpretative phenomenological analysis (IPA) explored trust-related health beliefs with medical systems among Black Americans since COVID-19. The study explored the trust-related health beliefs through the six constructs of the health belief model—perceived susceptibility, perceived severity, perceived barriers, perceived benefits, cues to action, and self-efficacy. Data was collected through semi-structured interviews of six participants who …
Effects Of Age And Employment On Covid-19 Rates By Nonmetro/Metro Location, Amanda Jean Keith
Effects Of Age And Employment On Covid-19 Rates By Nonmetro/Metro Location, Amanda Jean Keith
Walden Dissertations and Doctoral Studies
In the United States, the combination of a highly transmissible virus and the preexisting vulnerability of rural areas amplifies the impact of COVID-19 surges in the rural population compared to the urban counterpart. This quantitative non-experimental ex-post facto study aimed to determine whether there is a relationship between metro and non-metro locations and COVID-19 infection and mortality, and how age and employment status influence the outcomes. The theoretical framework was the rural nursing theory, with the social determinants of health providing the framework for integrating the underlying concept through the five domains of economic stability, education, health and health care, …
How Do African American Women In Halfway Housing Perceive Their Experiences With Mental And Emotional Rehabilitation, Eiyana Middleton
How Do African American Women In Halfway Housing Perceive Their Experiences With Mental And Emotional Rehabilitation, Eiyana Middleton
Walden Dissertations and Doctoral Studies
After reviewing the literature, Black women living in halfway housing needed more culturally accommodative and responsive access to mental health care. Despite recent efforts to improve the access and quality of mental health services for Black Americans, some of the most common barriers that continued to exist include and were not limited to the following: stigma associated with mental illness and distrust of the health care system. The purpose of this hermeneutic phenomenological study was to understand Black women’s perceptions of their mental and emotional rehabilitation while living in halfway housing. The hermeneutic phenomenology theory was most appropriate as it …
Staff Education For Infection Control Prevention, Beatrice I. Cesar
Staff Education For Infection Control Prevention, Beatrice I. Cesar
Walden Dissertations and Doctoral Studies
This project was a quality improvement staff education program to address the increase in hospital-acquired infections in the project facility. The hospital administrator identified that staff were overwhelmed and may not be consistently implementing appropriate infection control practices. If infection control practices are not addressed in hospitals system, there would be a much higher rate of hospital-acquired diseases among hospitalized patients and the staff. A staff education program about evidence-based strategies relating to infection control prevention was implemented to increase the nurses’ knowledge about strategies to decrease the spread of infection in the project facility. Eleven registered nurses participated in …
Parental Vaccine Hesitancy And The Decision To Vaccinate Children Against Covid-19, Jessica Mckee
Parental Vaccine Hesitancy And The Decision To Vaccinate Children Against Covid-19, Jessica Mckee
Walden Dissertations and Doctoral Studies
While there is a significant body of literature regarding vaccine hesitancy, there is a gap in the literature on its impact to parents’ decisions to vaccinate their children against a pandemic pathogen. The purpose of this study was to examine the relationship between parental vaccine hesitancy, measured using the health belief model (HBM) theoretical framework constructs of the Vaccine Hesitancy Scale (VHS; the degree to which an individual trusts in vaccine efficacy, safety, the reliability and trustworthiness of vaccine programs, community impact, perceived risks, and the importance of childhood vaccinations), and parents’ decision to vaccinate their children against COVID-19 with …
Effective Professional Education And Training Program In A Long-Term Acute Care Hospital, Matthew Hamilton
Effective Professional Education And Training Program In A Long-Term Acute Care Hospital, Matthew Hamilton
Walden Dissertations and Doctoral Studies
The determinants contributing to successful professional development programs in long-term acute care (LTAC) facilities, which enhance clinical staff performance and healthcare outcomes, remain unclear. Guided by Bandura’s social learning theory, the purpose of this basic qualitative study was to explore clinicians’ perspectives on the key determinants of an effective professional education and training program in an LTAC hospital in a Northeast U.S. metro area. Semistructured interviews were conducted with 11 clinicians who were recruited from an LTAC facility. Thematic analysis, following Saldaña’s framework, identified institutional barriers, financial constraints, time limitations, and unmet training needs as major challenges. Participants emphasized the …
The Leading Causes Of Homelessness In Two Southeastern Counties Of Pennsylvania, Lucia Christine Spargo
The Leading Causes Of Homelessness In Two Southeastern Counties Of Pennsylvania, Lucia Christine Spargo
Walden Dissertations and Doctoral Studies
Homelessness is a complex and multifaceted leading social issue in the United States. Society tends to focus on the individual as the cause of their own homelessness, blaming the victim rather than larger social and/or economic factors. There is an excess amount of data surrounding why/how an individual becomes homeless, but there is very little research examining the leading causes of homelessness in smaller geographic areas, such as counties. This study provides a better understanding and analysis of the leading causes of homelessness in two suburban counties in Southeastern Pennsylvania using binary logistic regression. Using ArcGIS, the study identified potential …
Relationship Between Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, Inflammatory Biomarkers, And Hospital Length Of Stay Among Covid-19 Patients., Alice Aghamie Osuji
Relationship Between Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, Inflammatory Biomarkers, And Hospital Length Of Stay Among Covid-19 Patients., Alice Aghamie Osuji
Walden Dissertations and Doctoral Studies
COVID-19 has put immense pressure on healthcare facilities, especially in managing patients with comorbidity. This study addressed the association between two important coinfections, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and their effect on hospital length of stay (LOS) among COVID-19 patients. The study also explored the predictive role of the inflammatory biomarker C-reactive protein (CRP) in prolonged hospitalization, also considering the influence of age and race. This study applied the Biopsychosocial Model and Chronic Care Model (CCM) to examine health outcomes and resource use. A retrospective cohort research design was used to examine medical records of …
Higher Education Leaders’ Perspectives About Communication Challenges During Crises, Carey-Ann Marie Balkwill
Higher Education Leaders’ Perspectives About Communication Challenges During Crises, Carey-Ann Marie Balkwill
Walden Dissertations and Doctoral Studies
The problem was that while impact and problems of crisis communication have been identified in the literature, little is known about the perspectives of leaders in higher education when facing communication issues in times of crisis. Guided by crisis communication theory and leadership theory, the purpose of this basic qualitative study was to explore higher education leadership team members’ perspectives of communication challenges in times of crisis. Four research questions guided the study on the perspectives of higher education leadership team members about (a) how their own leadership and communication changed during a crisis, (b) how internal communications evolved during …
Emergency Operations Plan To Sufficiently Support Prison Disaster Preparedness, Nyhrie Love Chapman
Emergency Operations Plan To Sufficiently Support Prison Disaster Preparedness, Nyhrie Love Chapman
Walden Dissertations and Doctoral Studies
Emergency management in correctional facilities is a critical aspect of institutional safety and security. Natural disasters and public health crises have exposed significant gaps in preparedness, leaving incarcerated individuals and staff vulnerable during emergencies. This qualitative study was conducted to examine prison staff members’ perspectives on the effectiveness of emergency operations plans (EOPs) in responding to natural and human-made disasters. Guided by social vulnerability theory and policy implementation and effectiveness theory, this study employed a phenomenological approach to explore staff experiences. Through 12 in-depth interviews, participants described challenges related to resource limitations, training deficiencies, and breakdowns in communication between agencies. …
Investigation Of Sprinkler Requirements In One-Or-Two-Family Newly Constructed Homes, Courtney Catrillo
Investigation Of Sprinkler Requirements In One-Or-Two-Family Newly Constructed Homes, Courtney Catrillo
Walden Dissertations and Doctoral Studies
Multiple case studies and available data supported the effectiveness of residential fire sprinklers. Despite this, 48 states have not implemented a requirement for residential sprinklers in newly constructed homes and 46 have eliminated the requirement. The purpose of this study was to examine which states have adopted the recommendation and to what extent. This generic qualitative study is an exploration of the reasons behind the lack of adoption. Data from reports, charts, and tables from publicly available sources, including government and stakeholder websites, were analyzed using expected utility theory to compile a findings table. The results indicated that only Maryland …
Culturally Appropriate Mental Health Awareness To Reduce Mental Health Stigmatization And Improve Quality Of Life Among People Of African Descent., Nicoline Frinwie
Culturally Appropriate Mental Health Awareness To Reduce Mental Health Stigmatization And Improve Quality Of Life Among People Of African Descent., Nicoline Frinwie
Walden Dissertations and Doctoral Studies
No abstract provided.