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Walden Dissertations and Doctoral Studies

2017

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Full-Text Articles in Medicine and Health Sciences

Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson Jan 2017

Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson

Walden Dissertations and Doctoral Studies

Work environment influences the effectiveness of care for patients in any healthcare setting. It is even more important in settings such as the neonatal ICU (NICU) where this project took place. When the environment is not healthy, communication may suffer and result in poor patient outcomes and, family, patient, and staff dissatisfaction. The purpose of this quality improvement project was to understand how the implementation of the TeamSTEPPS program, for nurses in the NICU, could impact the safety culture as measured by the AACN Healthy Work Environment (HWE) tool. Lewin's professional practice change theory and the AHRQ change model were …


Use Of Social Cognitive Theory To Understand Veterans' Postservice Physical Activity Behavior, Geoffrey Bruce Miller Jan 2017

Use Of Social Cognitive Theory To Understand Veterans' Postservice Physical Activity Behavior, Geoffrey Bruce Miller

Walden Dissertations and Doctoral Studies

The health of the veteran population within the United States has become a matter of ever-increasing concern, and many individuals who have attained veteran status are experiencing health issues following their discharge from the military. Despite such concerns, there are often not enough resources available to assist these individuals to the degree necessary in an expedient manner. The purpose of this case study was to use social cognitive theory to understand the physical activity of veterans following their time in service. Through the use of social cognitive theory, this study explored the thoughts, perceptions, and behaviors of 11 veterans to …


Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul Jan 2017

Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul

Walden Dissertations and Doctoral Studies

An estimated 50% of older hospitalized patients experience delirium. This has created significant complications costing an estimated $164 billion or more per year worldwide. The ability to identify patients developing delirium would allow the implementation of specific interventions to decrease or eliminate the adverse effects of delirium. The purpose of this quality improvement project was to provide high quality delirium education to determine if medical unit nursing staff could successful implement the Confusion Assessment Method (CAM) screening tool to identify patients experiencing delirium as the first phase of an overall plan. Implementation of the project followed Roger's diffusion of innovations …


Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell Jan 2017

Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell

Walden Dissertations and Doctoral Studies

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to …


Influence Of Dual Process Decision-Making Theory In Patients Diagnosed With Cancer, Bonnie D. Quinonez Jan 2017

Influence Of Dual Process Decision-Making Theory In Patients Diagnosed With Cancer, Bonnie D. Quinonez

Walden Dissertations and Doctoral Studies

Each year millions of people face the medical decision-making cycle that comes with a diagnosis of cancer. For patients and their families, this can be a rollercoaster of confusion and fear. Researchers have indicated that the complexity of the decision-making process is underrepresented in the current approach of informed decision-making. The purpose of this study was to add to scientifically-validated research expanding the identification of factors that influence decision-making for individuals diagnosed with cancer. Fuzzy trace theory (FTT) is the dual process memory theory used as the framework for this study. Qualitative data were collected using semistructured interviews with 10 …


Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams Jan 2017

Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams

Walden Dissertations and Doctoral Studies

While there is considerable academic research on the intersection of comprehensive plans, finance policies, zoning policies and how these factors influence real estate developers' choice of what land to develop and what buildings to construct on that land, little is understood about whether these three variables promote or hinder real estate developers' choice of whether to build communities that promote healthy living. Using urban planning theory as the foundation, the purpose of this correlational study was to determine how real estate developers' decisions are made to support healthy New Urbanism development in the United States. Secondary data from the Urban …


Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi Jan 2017

Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi

Walden Dissertations and Doctoral Studies

Dental caries is the most prevalent childhood illness and disproportionately affects children from low socioeconomic backgrounds. Dental organizations are collaborating within communities to decrease oral health disparities among children by offering free preventive oral health events. These programs face the problem of low enrollment due to lack of informed parental consent. Also, gaps in the literature indicated the need to examine oral health perceptions and dental-care-seeking practices of culturally diverse low-income parents regarding preventive care for their children. The purpose of this qualitative case study was to explore the reasons why parents are not allowing their children to participate in …


Staffing Model To Improve Patient Outcomes In An Acute Inpatient Rehabilitation Facility, Ann Marie Evans Jan 2017

Staffing Model To Improve Patient Outcomes In An Acute Inpatient Rehabilitation Facility, Ann Marie Evans

Walden Dissertations and Doctoral Studies

The goal of the acute inpatient rehabilitation facility (IRF) is to rehabilitate patients and discharge them back into the community at their optimal level of functioning. The IRF patient is more acutely ill today than in the past, and due to a change in condition may be discharged back into the acute care hospital before achieving maximal level of function. An IRF was identified as discharging 14% of patients back into acute care, which indicated the IRF was not meeting its treatment goals. A chart review revealed a possible link between the nurse's role in patient care and the patient's …


Essential Executive Coaching Competencies For Enhancing Executive On-The-Job Performance: A Modified Delphi Study, Arturo Small Maxwell Jan 2017

Essential Executive Coaching Competencies For Enhancing Executive On-The-Job Performance: A Modified Delphi Study, Arturo Small Maxwell

Walden Dissertations and Doctoral Studies

Approximately 93% of Fortune 1000 companies in the United States rely upon executive coaching to accelerate executive performance. However, there is a lack of empirical research identifying effective executive coaching competencies. In this modified Delphi study, a panel of 17 executive coaching experts was purposefully selected from the International Coach Federation and the Society for Industrial and Organizational Psychology. Participant selection criteria included training in executive coaching, executive coaching credentialing, and -?¥3 years practicing executive coaching or purchasing executive coaching services. Participants used a 5 point Likert-type questionnaire to provide their expert opinion regarding essential executive coaching competencies for enhancing …


Strategies Hospital Leaders Use In Implementing Electronic Medical Record Systems, Shaunette Miller Jan 2017

Strategies Hospital Leaders Use In Implementing Electronic Medical Record Systems, Shaunette Miller

Walden Dissertations and Doctoral Studies

Some hospital leaders lacked strategies for implementing electronic medical record (EMR) systems. The purpose of this case study was to explore successful strategies that hospital leaders used in implementing EMR systems. The target population consisted of hospital leaders who succeeded in implementing EMR systems in a single healthcare organization located in the Los Angeles, California region. The conceptual framework used was Kotter's (1996) eight-step process for leading change, and data were collected from face-to-face recorded interviews with 5 participants and from company documents related to EMR design and development. Data were analyzed through methodological triangulation of data types, and exploring …


The Lived Experiences Of School Nurses: Transitioning From Hospital To School Worksite, Irene Campbell Jan 2017

The Lived Experiences Of School Nurses: Transitioning From Hospital To School Worksite, Irene Campbell

Walden Dissertations and Doctoral Studies

School nurses who transition from hospital or clinic-based settings to a school-based work environment often lack sufficient transitioning skills and orientation to cope with the roles and responsibilities of school-based nursing. The result is a high attrition rate among school-based nurses. School nurses may leave their positions due to experiences of marginalization, including isolation, role confusion, and barriers to practice. In this phenomenological study, the lived experiences of 12 school-based nurses who transitioned from hospital or clinical settings were explored. Bandura's self-efficacy and Spreitzer's psychological empowerment theories were used in interpreting the findings. Data were collected via face-to-face individual interviews …


Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters Jan 2017

Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters

Walden Dissertations and Doctoral Studies

Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality. Use of high-cost healthcare services is common, including hospitalizations and emergency department (ED) visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study addressed the impact of integrated care on physical health and ambulatory care sensitive (ACS) utilization via a program evaluation of an integrated health clinic (IHC) at a community mental health center (CMHC). The research questions assessed whether there was a predictive relationship between …


Nursing Approaches For Use And Sustainability Of Barcode Medication Administration Technology, Jackson Ngigi Njeru Jan 2017

Nursing Approaches For Use And Sustainability Of Barcode Medication Administration Technology, Jackson Ngigi Njeru

Walden Dissertations and Doctoral Studies

Approximately 43.4% of medication errors occur at the time of administration despite the use of bar code medication administration (BCMA) System. This trend has prompted a national effort to mitigate this problem in the United States. Implementing BCMA in health care settings is one of those efforts. Studies focusing on the approaches employed by nurses when using this system are scant. The purpose of this qualitative case study was to investigate strategies nurses and their leaders use to ensure BCMA is implemented, maximized, and sustained. The technology acceptance model was used to guide the study. The 2 research questions addressed …


Design And Development Of An Educational Intervention On Nurse Perceptions Of Caring, John S. Norris Iii Jan 2017

Design And Development Of An Educational Intervention On Nurse Perceptions Of Caring, John S. Norris Iii

Walden Dissertations and Doctoral Studies

Caring is central to the nursing profession and important to patients and family members who expect nurses to display caring attributes. The acute care hospital in this study did not have an education program on caring practices for nursing staff although the organization acknowledged the importance of and need for a culture of caring practices in the organization. The purpose of this project was to design an educational program based on Watsons' theory of caring for registered nurses at the acute care hospital where the project took place. Rosswurm and Larrabee's model for change and Watson's theory of caring were …


Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan Jan 2017

Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan

Walden Dissertations and Doctoral Studies

Obesity is a risk factor for chronic diseases among the ethnic minorities for adult immigrants in the United States. There have been many research studies conducted to examine the relationship between the predictors and obesity in minority groups in the United States, that relationship was unknown in Meskhetian Turk (Ahiska) immigrant populations. Guided by social ecological model and acculturation theory, this study examined the predictors of obesity in the Meskhetian Turk (Ahiska) immigrant population in the western United States. Data were collected from 109 participants using CDC's Behavioral Risk Factor Surveillance System, Stephenson Multigroup Acculturation Scale, and Perceived Stress Scale. …


Self-Efficacy And Cultural Competency Assessment Of The Associate Degree Nursing Student, Deborah Smith Hartman Jan 2017

Self-Efficacy And Cultural Competency Assessment Of The Associate Degree Nursing Student, Deborah Smith Hartman

Walden Dissertations and Doctoral Studies

Effective nursing care can be threatened when nurses are not culturally attuned with their patients. Associate degree nursing (ADN) students receive information about diverse ethnicities in the nursing curriculum, but it may not be sufficient to provide the expertise necessary to care for patients of various cultural backgrounds. The purpose of this quantitative study was to explore the 2nd year ADN students' levels of cultural competence and their perceptions of self-efficacy in working with Caucasian, African American, Native American, Hispanic, and Asian ethnicities. The study used a cross-sectional survey design to determine if a relationship existed between the students' reported …


Exercise Adherence Among Active Working Women, Roxane Evonne Hearn Jan 2017

Exercise Adherence Among Active Working Women, Roxane Evonne Hearn

Walden Dissertations and Doctoral Studies

Low levels of exercise adherence has contributed to the increased prevalence of heart disease, cancer, and diabetes in American women. These low levels, coupled with high exercise program dropout rates, point to a need for strategies to increase exercise frequency in women who exercise, but not enough to improve their health and reduce risks. Real-time interventions, such as text messaging, could be useful in improving the cognitions that regulate adherence. Using a snowball sampling strategy, a cross-sectional sample of working women (N =130), ages 18-64, in the volitional stage of exercise behavior, completed a 60-item survey on exercise behavior. Social …


Strategies For Managing The Shortages Of Registered Nurses, Jody-Kay Mcfarlane Peterson Jan 2017

Strategies For Managing The Shortages Of Registered Nurses, Jody-Kay Mcfarlane Peterson

Walden Dissertations and Doctoral Studies

The purpose of this multiple case study was to explore strategies that healthcare facility leaders in Central Minnesota use to recruit and retain qualified nurses. Participants were 6 healthcare facility leaders including 2 nursing directors, 2 human resource personnel, 1 nurse supervisor/administrator, and 1 nurse recruiter who had the knowledge and experience in recruitment and retention of Registered Nurses (RNs) in healthcare facilities in Central Minnesota. The Herzberg 2-factor theory was the conceptual framework. Semistructured interviews were used to collect data. Data were analyzed using Morse's 4 steps data analysis process. The major themes were recruitment strategies and retention incentives. …


Safety Practices On Lead Poisoning Among Battery Technicians In Lagos Nigeria, Tajudeen Olusegun Rasheed Jan 2017

Safety Practices On Lead Poisoning Among Battery Technicians In Lagos Nigeria, Tajudeen Olusegun Rasheed

Walden Dissertations and Doctoral Studies

Maintaining due diligence on safety practices at the workplace of battery technicians is the most cost-effective intervention against lead-related hazards. The safety practice on lead poisoning in Nigeria is below average, and the compliance level is far from the expected target of 90%. Using Dejoy's workplace self-protective behavior theory, this study investigated multilevel factors that influence safety practices on lead poisoning and compared the rate of utilization of personal protective equipment by battery technicians in the organized and roadside settings. The study was a quantitative, cross-sectional survey design, and a multistage and systematic sampling technique was used to select 293 …


Social Workers' Perceptions Of A Rural Emergency Mental Health Trauma Service, William L. Getz Jan 2017

Social Workers' Perceptions Of A Rural Emergency Mental Health Trauma Service, William L. Getz

Walden Dissertations and Doctoral Studies

Studies have shown that emergency mental health trauma (EMHT) services can significantly reduce the long-term effects of trauma after a disaster. However, rural municipalities may find they do not have the capacity to create such a service, or may not realize that their disaster planning includes no provision for emergency mental health care. Such was the case in a rural island community in the state of Washington, where, in 2014, several residents initiated a discussion that helped to identify the community's lack of EMHT services. This project, framed by action research and based on collaboration theory, sought to advance the …


The Soldier 360°Orgram: Strengthening Combat-Exposed, Noncommisioned U.S. Army Officers' Interpersonal Sensitivity, Anne Harper Jan 2017

The Soldier 360°Orgram: Strengthening Combat-Exposed, Noncommisioned U.S. Army Officers' Interpersonal Sensitivity, Anne Harper

Walden Dissertations and Doctoral Studies

Interpersonal sensitivity is a foundational component of interpersonal relationships. It encompasses an individual's self-concept and self-identity, which are formed as the individual develops. An individual's self-concept develops from the norms and mores of his or her society. Soldiers in the U.S. Army have been trained to form a repurposed self to engage in combat and work in combat-focused jobs. The consequence of this training in many cases has been diminished interpersonal sensitivity that has been detrimental to their interpersonal relationships. The Soldier 360° course is a comprehensive treatment program that takes a holistic approach to providing soldiers with self-empowering tools …


Assessing Teachers' Confidence In Implementing Food Allergy Emergency Plans, Keturah Elizabeth Hawkins Jan 2017

Assessing Teachers' Confidence In Implementing Food Allergy Emergency Plans, Keturah Elizabeth Hawkins

Walden Dissertations and Doctoral Studies

Food allergies are an increasing health concern in the United States, affecting nearly 6 million children under the age of 18 years. Research has suggested that 18% of school-age children will have their first allergic reactions at school. Life-threatening allergic reactions experienced by children in the school setting are on the rise; however, little is known about how schools implement policies and practices in response to this issue. The purpose of this quantitative cross-sectional study was to narrow the knowledge gap by examining teachers' knowledge, ability, and confidence level caring for students with food allergies. Bandura's social cognitive theory, which …


Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser Jan 2017

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …


The Impact Of Adaptive Leadership Capacity On Complex Organizational Health Systems Outcomes, Laura Lentenbrink Jan 2017

The Impact Of Adaptive Leadership Capacity On Complex Organizational Health Systems Outcomes, Laura Lentenbrink

Walden Dissertations and Doctoral Studies

Nonlinear and chaotic environmental changes characterize health services organizations as complex adaptive systems in which leaders must exercise non-traditional leadership practices to succeed. Health services leaders who have learned and implemented traditional linear management approaches are ill prepared to lead in complex environments. This study tested complexity and adaptive leadership theories of agility and resilience in complex health systems. The purpose of this quantitative cross-sectional internet-based survey study was to quantify relationships between independent variables of agility and resilience and secondary dependent variables of financial, patient satisfaction, quality and human capital outcomes. The impact of turbulence was also examined. Included …


The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori Jan 2017

The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori

Walden Dissertations and Doctoral Studies

Type 2 diabetes has more than doubled in the past decade among Black Americans. Researchers have suggested that Black Seventh-day Adventists, who follow a plant-based diet, are concerned about preventing the complications from this disease. The purpose of this qualitative ethnographic study was to explore the chance and perceptions of complications from type 2 diabetes among 10 purposefully sampled Black Seventh-day Adventists. The health belief model (HBM) served as the conceptual framework. Two constructs, education and income, were chosen for this study. Education was chosen to increase understanding about the chronic nature of the disease, and income was chosen because …


Educating Nurses How To Critique Research Reports, Jacqueline Carol Pinkowski Jan 2017

Educating Nurses How To Critique Research Reports, Jacqueline Carol Pinkowski

Walden Dissertations and Doctoral Studies

When bedside acute care nurses support their clinical practice with current best evidence, patient outcomes improve. Most bedside acute care nurses base their clinical decision-making on tradition and not the application of evidence based practice (EBP). The ability to appraise research is a critical component in the application of EBP and best care practices. The purpose of the DNP project was to obtain 5 content experts' evaluations of an education module for bedside nurses on how to analyze a research report, complete a literature review, and create a table of evidence (TOE). The theoretical framework guiding the project was the …


Attitudes Of Women Offenders Towards Medicaid Enrollment And Coverage Under The Affordable Care Act, Morrisa Barbara Rice Jan 2017

Attitudes Of Women Offenders Towards Medicaid Enrollment And Coverage Under The Affordable Care Act, Morrisa Barbara Rice

Walden Dissertations and Doctoral Studies

Although women offenders face barriers to successful reentry into their communities, as yet, no research has explored their experiences in accessing health care reentry services. Medicaid enrollment, the process of applying for Medicaid coverage, can be offered as a health care reentry service. Women offenders in jails have shorter sentencing times compared to those in prison, which presents Medicaid enrollment opportunities before release. The Second Chance Act provides the opportunity for reentry services, and the Affordable Care Act provides the opportunity for Medicaid coverage for women offenders. This phenomenological study explored the attitudes of women offenders about Medicaid enrollment and …


Role Of Midline Catheters In Patient Care, Tina K. Schlegel Jan 2017

Role Of Midline Catheters In Patient Care, Tina K. Schlegel

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSIs) are responsible for 100,000 patient deaths per year, creating a critical need for prevention of these deadly infections that occur with central venous lines (CVLs). Alternative forms of IV access such as midline catheters (MLCs) may offer lower rates of infection than those seen with CVLs. MLCs were implemented at the practice setting in 2016; however, no evaluation of their effectiveness had been conducted. The purpose of this project was to evaluate the effectiveness of MLCs using a retrospective, pre- post- comparison of CLABSI rates and device utilization rates (DUR) obtained from the practice setting …


Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens Jan 2017

Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens

Walden Dissertations and Doctoral Studies

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General systems theory and the Donabedian model of health care quality provided the framework for the project. Electronic databases PubMed and the Cumulative Index of Nursing and Allied Health were searched for articles addressing electronic nursing documentation practices. The Cochrane systematic review methodology was used to analyze the articles. Articles were excluded if published before 2001 …


Motivating Allied Health Students To Successfully Complete Core Courses, Lisa Renee Trusclair Jan 2017

Motivating Allied Health Students To Successfully Complete Core Courses, Lisa Renee Trusclair

Walden Dissertations and Doctoral Studies

This project study addressed the problem of a decline in retention of students at a local allied health college. The need for allied health professionals is projected to exceed the availability by 2020, so it is important to identify strategies to help allied health students succeed. The purpose of this case study was to explore perceptions of students and faculty about motivating factors and learning strategies that foster successful progression in allied health programs. Ryan and Deci's self-determination theory, focused on the relationship between motivation and success, served as the framework for the study. Research questions addressed intrinsic and extrinsic …