Open Access. Powered by Scholars. Published by Universities.®
- Discipline
-
- Public Health (202)
- Nursing (200)
- Public Health Education and Promotion (169)
- Health and Medical Administration (79)
- Social and Behavioral Sciences (79)
-
- Education (61)
- Epidemiology (52)
- Business (38)
- Educational Administration and Supervision (28)
- Psychology (27)
- Arts and Humanities (26)
- Teacher Education and Professional Development (26)
- Sociology (22)
- Mental and Social Health (20)
- Psychiatric and Mental Health (20)
- Business Administration, Management, and Operations (16)
- Management Sciences and Quantitative Methods (16)
- Public Affairs, Public Policy and Public Administration (16)
- Race, Ethnicity and Post-Colonial Studies (16)
- African American Studies (15)
- Adult and Continuing Education Administration (14)
- Adult and Continuing Education and Teaching (14)
- Public Policy (13)
- Family, Life Course, and Society (12)
- Physical Sciences and Mathematics (11)
- Life Sciences (10)
- Organizational Behavior and Theory (10)
- Rehabilitation and Therapy (10)
- Higher Education Administration (9)
- Keyword
-
- Nursing (31)
- Leadership (19)
- Obesity (17)
- Retention (10)
- Education (9)
-
- Health (9)
- Healthcare (9)
- Barriers (7)
- Children (7)
- Communication (6)
- Diabetes (6)
- Emergency department (6)
- Falls (6)
- HIV/AIDS (6)
- Nurses (6)
- Phenomenology (6)
- Prevention (6)
- Safety (6)
- African American (5)
- Breast Cancer (5)
- Counseling (5)
- Evidence-based practice (5)
- HIV (5)
- Health literacy (5)
- Hospital (5)
- Nigeria (5)
- PTSD (5)
- Public Health (5)
- Self-efficacy (5)
- Women (5)
Articles 1 - 30 of 474
Full-Text Articles in Medicine and Health Sciences
Predictors Of Mastectomy In Male Breast Cancer, Esther Opara
Predictors Of Mastectomy In Male Breast Cancer, Esther Opara
Walden Dissertations and Doctoral Studies
Male breast cancer (MBC) is rare, and research on the predictors of MBC has been limited because of inadequate funding in and outside of the United States. One goal of this study was to eradicate the stereotyping of breast cancer as a female disease. The emergence of medical technology and education to benefit the public will help to ensure greater health awareness at the individual, community, and global levels. The purpose of this study was to understand the influence of the predictors of age; race (Black, White, and Other); and grade of cancer (I, II, or III) on the outcome …
Temporary Restaurant Closures And Food Handling Violations: Inspection Reports In British Columbia, Pam Mandarino
Temporary Restaurant Closures And Food Handling Violations: Inspection Reports In British Columbia, Pam Mandarino
Walden Dissertations and Doctoral Studies
Unsafe food handling practices are implicated in many restaurant-associated foodborne disease outbreaks. Factors that contribute to unsafe food handling in restaurants include inadequate food safety knowledge, employees who perceive that safe food handling is not under their control, and restaurant cultures that do not prioritize food safety. The purpose of this study was to determine whether temporary restaurant closures were associated with reduced food handling violations after closure in restaurants from the Vancouver Coastal Health Authority and the Fraser Health Authority, in British Columbia, Canada. The theoretical foundations used were the health action process approach and the theory of planned …
Evidence-Based Practice Project Proposal: Reducing Chfrr Through The Get Well Networks Chf Prevention Education Materials, Susan Kay Richmond
Evidence-Based Practice Project Proposal: Reducing Chfrr Through The Get Well Networks Chf Prevention Education Materials, Susan Kay Richmond
Walden Dissertations and Doctoral Studies
In the United States, congestive heart failure (CHF) impacts 6.5 million adults and costs about $39 billion year with a projected incidence increasing by 25% by 2030. CHF can be addressed by advancing patient self-care knowledge through interactive patient education. For this project, the Health Beliefs Model guided a strategy to stimulate behavior modification based on perceived benefits of self-care. The purpose of this quality improvement project was to implement an interactive patient education video system, called the Get Well Network, to encourage patient self-care to reduce CHF readmission rates at a veteran's administration hospital. Four evidence-based CHF video order …
Posthurricane Environment's Impact On Childhood Cancer Rates In Louisiana, 2004-2010, Lenora M. Robinson
Posthurricane Environment's Impact On Childhood Cancer Rates In Louisiana, 2004-2010, Lenora M. Robinson
Walden Dissertations and Doctoral Studies
Childhood cancer is the second leading cause of death in children aged 0-19 years. Research efforts to identify factors associated with or influencing this growing health problem are limited. The purpose of this research study was to examine, in reference to Louisiana during the period 2004-2010, the annual number of children diagnosed with cancer; the types of cancers; the possible effects of the environmental aftermath resulting from Hurricanes Katrina, Rita, and Gustav; and any correlation between environmental contaminants following these hurricanes with the number of children diagnosed with cancer. This study employed correlational quantitative methodology using archival data from the …
Organizational Complexity And Hospitals' Adoption Of Electronic Medical Records For Closed-Loop Medication Therapy Management, Ebenezer Siaw Adu
Organizational Complexity And Hospitals' Adoption Of Electronic Medical Records For Closed-Loop Medication Therapy Management, Ebenezer Siaw Adu
Walden Dissertations and Doctoral Studies
Over 700,000 adverse drug events (ADEs) result in emergency hospital visits annually, and many of these ADEs are preventable through the use of health information technology in hospitals. However, only 12.6% of U.S. hospitals have developed the capacity to adopt closed-loop electronic medical records (EMR). Organizational complexity may be a major factor influencing hospitals' adoption of closed-loop EMR. This quantitative study explored how organizational complexity influenced hospitals' adoption of closed-loop EMR. Diffusion of innovation theory was the foundation for this study. Logistic regression was used to establish possible relationships between organizational complexity and hospitals' adoption of EMR for closed-loop medication …
Perceptions Of Community-Based Participatory Research From Community And Academic Members, Ivonne G. Kanko
Perceptions Of Community-Based Participatory Research From Community And Academic Members, Ivonne G. Kanko
Walden Dissertations and Doctoral Studies
Community-based participatory research (CBPR) is an increasingly popular form of public health research. However, little is known about the application of CBPR and the levels of involvement for partners in specific phases of the partnership. This phenomenological study addressed the application of CBPR from the perspectives of 7 academic researchers and 6 community members experienced in CBPR. Arnstein's ladder of citizenship participation and the community coalition action theory provided the framework for the study. Semi-structured interviews addressed participants' levels of involvement in the CBPR process, as well as challenges, concerns, successes, and recommendations for improvement. Interview transcripts were analyzed by …
Factors Influencing Doctors Ordering Of Clinical Lab Tests: A Qualitative Study, Lakshmanan Suresh
Factors Influencing Doctors Ordering Of Clinical Lab Tests: A Qualitative Study, Lakshmanan Suresh
Walden Dissertations and Doctoral Studies
Qualitative studies exploring the factors behind a doctor's decisions to order clinical laboratory blood testing are lacking. A better understanding of these factors can help in formulating interventions that could improve the quality of health care and limit costs. The purpose of this qualitative case series study was to identify factors that influence a doctor's decision to order routine clinical laboratory blood tests. Fifteen doctors from Western New York, working in different hospital settings, were interviewed. There were 5 doctors in each case type: major, community, and private hospitals. When analyzed by case, there was a difference between the three …
Evaluating Nurses' Self-Efficacy In Caring For Patients With Dementia, Wendy Hopkins
Evaluating Nurses' Self-Efficacy In Caring For Patients With Dementia, Wendy Hopkins
Walden Dissertations and Doctoral Studies
In 2011, 5 million Americans had dementia and this number is predicted to increase. As the number of people with dementia increases, the need for quality nursing care, education, and treatment for patients with dementia increases. To address the need, nurses not only must be prepared with the knowledge, skills, and abilities to care for patients with dementia, but they must also have the self-efficacy to provide quality care. The practice focused question guiding the project was to determine the level of self-efficacy for caring for dementia patients among long-term care nursing staff. Using Bandura's social cognitive theory, the purpose …
How Parenting Behaviors Influence Weight And Health Status Of African American Adolescents, Natasha T. Hourel
How Parenting Behaviors Influence Weight And Health Status Of African American Adolescents, Natasha T. Hourel
Walden Dissertations and Doctoral Studies
There has been an upward trend in obesity among African American (AA) adolescents over the last 2 decades. While parenting characteristics (e.g., styles and practices) are linked to adolescent eating habits and weight status, related research has focused on European American children from 2-parent middle-class households or economically disadvantaged AA children from single mother households. The purpose of this quantitative secondary data analysis was to investigate the relationship between parenting characteristics on the weight status of adolescents aged 12 to 17 years (n = 325) among a broader population of AA mothers and fathers residing both inside and outside of …
Designing And Evaluating An Educational Initiative Promoting Condom Use Among Hiv+ Hispanic Men, Gilberto Andino
Designing And Evaluating An Educational Initiative Promoting Condom Use Among Hiv+ Hispanic Men, Gilberto Andino
Walden Dissertations and Doctoral Studies
In 2013, the Centers for Disease Control and Prevention estimated that between 252,000 and 312,000 Hispanic men and women in the United States were unaware of their risk for transmitting HV/AIDS. Guided by the logic model and Leininger's theory, the purpose of this project was to design a culturally sensitive HIV/AIDS educational program for HIV+ Hispanic males and to evaluate the program content with the staff at a medical center in South Florida, with the goal of implementing the program at that center. The educational program content focused on increasing the knowledge of Hispanic HIV+ men on the effectiveness of …
The Association Between Medical Marijuana Laws And Maternal Marijuana Use, Joseph Timothy Jones
The Association Between Medical Marijuana Laws And Maternal Marijuana Use, Joseph Timothy Jones
Walden Dissertations and Doctoral Studies
Marijuana is the most common illicit drug that is abused by pregnant women, and recently many states have adopted various levels of relaxed marijuana policies. The purpose of this study was to evaluate a potential association between residing in a state that allows medical marijuana use and maternal marijuana usage. Grounded in the theory of planned behavior, this study evaluated the prevalence and extent of maternal marijuana use in states that allow and states that do not allow medical marijuana use using the National Survey of Drug Use and Health (NSDUH). It was anticipated that more lenient subjective norms toward …
Appraisal Of Nonpharmacological Chronic Pain Management, Yvonne Larue Anthony
Appraisal Of Nonpharmacological Chronic Pain Management, Yvonne Larue Anthony
Walden Dissertations and Doctoral Studies
Chronic pain is a condition that impacts millions of men and women around the globe. It is a compelling disease that particularly impacts quality of life (QOL) for many veterans with undertreated or untreated pain. The focus of this systematic literature review was the appraisal of articles and clinical practice guidelines to better understand best-practice nonpharmacological strategies for management of chronic pain. Key words used in the literature search included chronic pain and veterans, complementary alternative medicine (yoga, tai chi, music therapy, acupuncture, and massage), and cognitive behavioral therapy (CBT). The articles included in the review were limited to those …
The Impact Of Maternity Healthcare Employees Professional Development On Pregnant Teen Health, Patricia.Kelley Kelley
The Impact Of Maternity Healthcare Employees Professional Development On Pregnant Teen Health, Patricia.Kelley Kelley
Walden Dissertations and Doctoral Studies
Knowledge gaps exist related to the care and education of pregnant teens. This project study addressed the problem of an inadequate amount of professional development (PD) and training for healthcare professionals (HCPs) caring for pregnant teens at a maternity clinic in the Southeastern United States. Unless HCPs are appropriately trained, the ability to meet the needs of pregnant teens is deficient and negative health outcomes for these patients are likely to be exacerbated. The humanistic learning theory was used in this phenomenological exploratory study to explore perception of 9 HCPs who had the responsibility for patient teaching, clinical care, and …
Walking Versus Jogging In Patients With Cardiac Problems Including Congestive Heart Failure, Rosalie Roberta Garcia
Walking Versus Jogging In Patients With Cardiac Problems Including Congestive Heart Failure, Rosalie Roberta Garcia
Walden Dissertations and Doctoral Studies
Congestive heart failure (CHF) is a growing epidemic that affects more than 50% of the world's population. CHF is a preventable disease, but prevention requires a healthy lifestyle from a young age. Most patients already diagnosed with CHF receive advice and strict instructions for care to prevent further cardiac injury. This quantitative descriptive research study was designed to address walking and jogging as the best exercises for patients diagnosed with CHF and in patients diagnosed with other cardiac problems. The results revealed that walking is the best exercise to improve patients' resting heart rate and overall cardiac function. This study …
Alleviating Discharge Confusion For Older Patients Using The Teach-Back Method, Tracey Marie Haire
Alleviating Discharge Confusion For Older Patients Using The Teach-Back Method, Tracey Marie Haire
Walden Dissertations and Doctoral Studies
Discharge instructions and medication directions can be overwhelming for older adults, which can lead to potential medication errors, noncompliance, readmissions, and patient safety concerns. At a specialty lung clinic, the goal is to improve patient safety and to decrease the chance of errors by standardizing the discharge process via a Teach-Back education policy and protocol. Without consistency, there is a potential for mistakes and misunderstandings. The Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) considers the Teach-Back discharge method as best practice and should be considered universal practice among health care workers. Using the …
Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk
Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk
Walden Dissertations and Doctoral Studies
Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow's hierarchy of needs theory, and the opposing theory, Vroom's expectancy theory. Semistructured interviews occurred with 5 leaders. The review …
Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch
Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch
Walden Dissertations and Doctoral Studies
While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …
Roles Of Community Pharmacists In Improving Oral Health Awareness In Plateau State, Northern Nigeria, Olaniyi O. Taiwo
Roles Of Community Pharmacists In Improving Oral Health Awareness In Plateau State, Northern Nigeria, Olaniyi O. Taiwo
Walden Dissertations and Doctoral Studies
There is poor oral health awareness in Nigeria. This is mainly attributed to limited access to correct information on oral health as well as a lack of oral health care providers. The impact of the poor oral health awareness is worse in Northern Nigeria due to the uneven distribution of oral health care workers and training facilities. The purpose of this cross-sectional study was to describe the roles of community pharmacists (CPs) in Plateau State, Nigeria as sources of oral health information. Theoretical framework for this study was the theory of planned behavior (TPB). Background knowledge and practices of oral …
Translation And Validation Of The Spanish Version Of The Rapid Estimate Of Adult Literacy In Dentistry-30, Wilma Luquis
Translation And Validation Of The Spanish Version Of The Rapid Estimate Of Adult Literacy In Dentistry-30, Wilma Luquis
Walden Dissertations and Doctoral Studies
Low or marginal health literacy affect nearly 90 million citizens in the United States, compromising health outcomes, including oral health. Oral health literacy has been studied in diverse populations, yet the assessments used were developed and validated for English-speaking populations. A validated Spanish-language oral health literacy assessment was needed to help researchers and practitioners evaluate oral health literacy in the Hispanic population. Using the oral health literacy framework, the purpose of this study was to translate, culturally adapt, and validate a Spanish version of a previously validated English-language oral health literacy. A translation-back-translation process was applied to the English version …
Assessment Of Postoperative And Postdischarge Wound Infection After Abdominal Hysterectomy, Jinni J. Amin
Assessment Of Postoperative And Postdischarge Wound Infection After Abdominal Hysterectomy, Jinni J. Amin
Walden Dissertations and Doctoral Studies
Surgical site infection (SSI) is the most common healthcare-associated infection. Approximately 2% to 14% of surgical patients are diagnosed with SSI, which may extend length of stay in the hospital or lead to readmission and may necessitate another surgical procedure. Patient readmission due to SSI costs health care industries about $3,000 to $29,000 per case and a total of $10 billion per year. The purpose of this quantitative cross-sectional retrospective study was to examine the association between SSI and teaching status, hospital ownership, and number of beds in the hospital. The epidemiological triad was used as a framework to describe …
Impact Of A Standardized Tool On Handoff Quality In Nurse Change-Of-Shift Reports, Wilma Lonzame Ayala
Impact Of A Standardized Tool On Handoff Quality In Nurse Change-Of-Shift Reports, Wilma Lonzame Ayala
Walden Dissertations and Doctoral Studies
Within the context of healthcare delivery, human lives are at risk when health care professionals fail to communicate effectively. Audits by The Joint Commission from 1995 to 2005 revealed that 65% of sentinel events occurred as a result of staff miscommunication, prompting the requirement that standardized handoff tools be deployed. Therefore, this project was completed to improve safety in the hospital through implementation of a standardized tool that could enhance the quality of nurse handoff communication. Mohorek & Webb's (2015) linear model of communication, which emphasizes the importance of encoding, transmission, and decoding in the communication process, provided the framework …
Composite Risk Behaviors That Enhance The Transmission Of Malaria In Pregnancy, John Olusegun Dada
Composite Risk Behaviors That Enhance The Transmission Of Malaria In Pregnancy, John Olusegun Dada
Walden Dissertations and Doctoral Studies
Malaria causes high morbidity and mortality, especially among the most vulnerable populations, including pregnant women. Malaria in pregnancy (MiP) can be prevented by compliance with the 3 core measures: sleeping under insecticide-treated nets (ITNs), 3 doses of sulfadoxine-pyrimethamine as intermittent preventive treatment (IPTp-SP), and effective case management of malaria and anemia. The purpose of this cross-sectional household survey was to examine the composite risk behaviors that enhance the transmission of MiP. Stratified and multistage sampling methods were used to select a sample of 300 pregnant women in Abuja, Nigeria. Bivariate and multivariate analysis were conducted. According to study findings, participants' …
A Phenomenological Study Of Correctional Officers' Perceived Emotions On The Job, Heather Susan Grammatico
A Phenomenological Study Of Correctional Officers' Perceived Emotions On The Job, Heather Susan Grammatico
Walden Dissertations and Doctoral Studies
Correctional officers work in a stressful environment and are regularly exposed to dangerous and emotionally charged situations. Researchers have detailed the potential negative outcomes of this occupation, yet little research has examined the extent to which correctional officers experience emotion while on their shifts, and how those emotions may translate into stress, divorce, substance abuse issues, domestic violence, and high mortality rates upon retirement. The purpose of this phenomenological study was to learn how correctional officers experience their felt and expressed emotions while at work. Data collection was done using a 15-item open ended questionnaire designed by the researcher and …
Perceived Job Stress And Life Style Behaviors' Effects On The Quality Of Life Of Registered Nurses, Jennifer Rose Limongiello
Perceived Job Stress And Life Style Behaviors' Effects On The Quality Of Life Of Registered Nurses, Jennifer Rose Limongiello
Walden Dissertations and Doctoral Studies
The purpose of this quantitative study was to examine to what extent work demands as measured by perceived job stress affected the health-related quality of life (HRQOL) as determined by the number of unhealthy days of registered nurses in the United States. This study was also an investigation of the extent to which other variables such as body-mass index (BMI) and certain lifestyle behaviors affected the HRQOL (number of unhealthy days). The independent variables were perceived job stress, weight (BMI), and lifestyle factors such as tobacco and alcohol use, physical inactivity, and the mindful eating score, and the dependent variable …
Improving New Nurses' Transition To Practice, Merri Morgan
Improving New Nurses' Transition To Practice, Merri Morgan
Walden Dissertations and Doctoral Studies
Almost 30% of new nurse graduates leave the position within the first year of practice, and almost 60% leave within 2 years. When new nurse graduates do not effectively transition into practice, nursing satisfaction is affected, and additional costs are incurred by their organizations through continual hiring of nurses. The purpose of this project was to develop a comprehensive, evidence-based nurse residency program (NRP) for new nurse graduates working in a 16-bed intensive care unit (ICU) of a 160-bed community hospital in the mid-Atlantic region of the United States. Using a team approach, Rosswurm and Larrabee's model of evidence-based practice …
Comparing Outcomes Of Laparoscopic Adjustable Banding And Laparoscopic Sleeve Gastrectomy Bariatric Surgery, Seth Kojo Ananse Baffoe
Comparing Outcomes Of Laparoscopic Adjustable Banding And Laparoscopic Sleeve Gastrectomy Bariatric Surgery, Seth Kojo Ananse Baffoe
Walden Dissertations and Doctoral Studies
Bariatric surgery is an effective procedure type for morbidly obese patients when all else fails. Because obesity is a chronic disease, prolonged assessment and understanding of the credibility of procedure types and their effects on bariatric surgery outcomes are essential, yet current evidence shows decreasing utilization of one of the dominant procedure types. To better compare outcomes of procedure type, this research was designed to control for volume, hospital size, age, gender, season, month, year, and ethnicity. The goal of the study was to compare the outcomes of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) bariatric surgery …
Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell
Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell
Walden Dissertations and Doctoral Studies
Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients …
Development Of A Plan For A Navigator Program, Linda Dunaway
Development Of A Plan For A Navigator Program, Linda Dunaway
Walden Dissertations and Doctoral Studies
Following implementation of the Patient Protection and Affordable Care Act, hospitals have seen a reduction in Medicare reimbursement for 30-day post-discharge readmissions of acute myocardial infarction patient. The purpose of this project was to develop a plan for a navigator program to improve a patient's health status post discharge and reduce readmission rates. The Johns Hopkins nursing evidence-based practice model and guidelines were used in determining the quality of obtained experimental and non-experimental studies with or without meta-analysis and popular source articles. The literature revealed the most successful programs involved providing best practices for a navigator program allowed better patient …
Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day
Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day
Walden Dissertations and Doctoral Studies
Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the …
Preoperative Chlorhexidine Skin Preparation For Patients Undergoing Vascular Surgery, Janine Lee-Anne Duquette
Preoperative Chlorhexidine Skin Preparation For Patients Undergoing Vascular Surgery, Janine Lee-Anne Duquette
Walden Dissertations and Doctoral Studies
In response to improving quality patient care, combined with the growing rates of surgical site infections (SSIs) in vascular patients, the need to explore current practice trends with current evidence has been identified. SSIs affect quality patient care and compromise patient safety. Empirical evidence has recommended the use of a chlorhexidine wash preoperatively to reduce SSIs. Despite this recommended practice, vascular patients were not receiving it in their routine plan of care within a hospital organization in southern Ontario. Guided by Lewin's theory of planned change, this project explored how the planning of a chlorhexidine preoperative surgical skin preparation protocol …