Medicine and Health Sciences Commons^™

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Exploring Barriers To Accessing Funding For Individuals With Dementia Who Reside In Long-Term Care Facilities, Gwendolyn Cox Smith

Walden Dissertations and Doctoral Studies

AbstractMedicare and Medicaid are the most used funding sources for long term care (LTC); however, they are insufficient to pay for all social activities needed by individuals with dementia who reside in LTC facilities in the United States. Barriers in accessing funding to provide social activities for these individuals were explored though the theoretical lens of a logic model related to funding. A qualitative exploratory case study design was used to find not only the barriers of accessing funding but also the type of available funding and the eligibility criteria for receiving funds for social activities for those with dementia …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Barriers, Challenges &Successes Among Human Service Professionals Stigma Reduction Treatment Among People With Mental Illness, Maureen Epps

Walden Dissertations and Doctoral Studies

According to the National Alliance on Mental Illness, over 9 million people in the United States suffer from a mental illness (MI). Although human service professionals seek the best practices to treat people with MI, people with MI sometimes struggle to seek treatment because of stigma. The purpose of this generic qualitative study was to explore the barriers and challenges of human service professionals who experienced using a stigma reduction treatment on a person with MI. The mental illness stigma framework and Goffman’s stigma theory provided the conceptual framework for the study. Data were collected through semistructured interviews with eight …

Exploring Barriers To Accessing Funding For Individuals With Dementia Who Reside In Long-Term Care Facilities, Gwendolyn Cox Smith

Walden Dissertations and Doctoral Studies

AbstractMedicare and Medicaid are the most used funding sources for long term care (LTC); however, they are insufficient to pay for all social activities needed by individuals with dementia who reside in LTC facilities in the United States. Barriers in accessing funding to provide social activities for these individuals were explored though the theoretical lens of a logic model related to funding. A qualitative exploratory case study design was used to find not only the barriers of accessing funding but also the type of available funding and the eligibility criteria for receiving funds for social activities for those with dementia …

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …

Oncology Providers Barriers To Providing Quality Healthcare Services For Caribbean Women Of Color With Breast Cancer, Michelle Charmaine Garcia

Walden Dissertations and Doctoral Studies

Breast cancer is a global public health issue, and oncology healthcare providers (OHPs’) play a pivotal role in ensuring access to cancer care for their patient population. Caribbean women of color in the United States have the highest death rate of any racial or ethnic group. Strategies have been introduced to reduce this gap, and they still have not addressed the needs of Caribbean women of color, who tend to be diagnosed after developing late-stage breast cancer. No previous studies have explored OHPs' perceptions and lived experiences regarding barriers to healthcare service delivery and access for Caribbean women of color …

Barriers To Effective Personal Protective Equipment Use In Public Health Workers, Sheila Storr-Mathis

Walden Dissertations and Doctoral Studies

Exposure to infections continues to be a significant concern for nursing practice and for other health care professionals. Personal protective equipment (PPE) minimizes occupational exposure; however, their use is subject to variability. This quality improvement project addressed the impact of an educational intervention on attitudes and barriers to proper use of PPE for public health workers at the study site. The health belief model and the literature review provided theoretical support for the project and evidence of current trends in PPE use. There were 44 employees who completed the preintervention survey and 22 who completed the postintervention survey to gauge …

Emergency Encounters: A Cross Sectional Study Of A Rural Emergency Room, Selynto Rodrecca Anderson

Walden Dissertations and Doctoral Studies

It is very difficult for certain populations to obtain access to healthcare within the United States, particularly in rural areas. Typically, individuals who live in rural areas are far less healthy than those who live in more urbanized areas. Although there have been some improvements made to ensure there is adequate health care for all, barriers still exist. A few examples of these barriers are socioeconomic status, education, and job status. In this study, adult patients from a rural Southeastern hospital were surveyed via those who came to the emergency room seeking care, and via those who came to the …

Lived Experiences Of African American Nursing Students In An Associate Degree Nursing Program, Monique Renee Merritt

Walden Dissertations and Doctoral Studies

Despite recognition of the barriers that African American nursing students encounter while pursuing nursing education, leaders of U.S. nursing programs continue to struggle to retain these students and promote their degree completion. Poor retention and lack of completion contributes to the unequal representation of African American nurses in the U.S. healthcare workforce compared to the overall population. The purpose of this qualitative study was to examine the experiences that helped to promote African American nursing students’ success or served as barriers to successful completion of an Associate Degree Nursing program. Tinto’s integration model was used as the theoretical framework. Semistructured …

Rural Practical Nursing Students' And Faculty Members' Perceptions Of Supports And Barriers To Success, Amy J. Randall-Mcsorley

Walden Dissertations and Doctoral Studies

Practical nursing program students at a rural vocational school (RCC) in the midwestern United States were graduating at a low rate that was putting the school at risk to not meet accreditation standards set by the Council on Occupational Education. The purpose of this study was to explore the perceptions of practical nursing program students and faculty at RCC about institutional, situational, and dispositional supports and barriers students faced toward graduation. The conceptual framework, Cross’s model of barriers to adult learning, was used to identify institutional, situational, and dispositional supports and barriers. A bounded case study design was employed to …

Systematic Review: Barriers To Primary Care For The Transgender Individual, Charles David Mccormick

Walden Dissertations and Doctoral Studies

Representing a diverse group, the transgender community defies conventional norms expected by society resulting in discrimination and denial of essential goods and services necessary to maintain personal health, safety, and well being. The identification of the barriers to primary care faced by the transgender individual has the potential to reduce healthcare disparities and improve the compliance with national screening and treatment guidelines. The purpose of this project was to examine available literature incorporating the systematic review method to determine the barriers to primary care faced by the transgender individual. Using Leininger’s transcultural nursing theory to guide the process to determine …

Perceptions Of Academic Success Of English As A Second Language Nursing Students, Jean Lansang

Walden Dissertations and Doctoral Studies

Hispanic or Latino and Asian communities represent two of the rapid-growing ethnicities who seek healthcare in the United States. However, the U.S. nursing workforce does not reflect the ethnic or cultural makeup of the patient population. The purpose of this study was to examine the lived experiences of Asian and Hispanic or Latino English as a second language (ESL) nursing students and learn the barriers and facilitators they experienced in their nursing program. A qualitative phenomenological approach underpinned by the social-ecological model and the Cummins language acquisition model was used for the study. Face-to-face interviews were conducted with 7 Asian …

Nursing Administration And Faculty Perceptions Of Their Self-Efficacy With Active Learning Methods, Lindsey Ann Helm

Walden Dissertations and Doctoral Studies

A lack of active teaching was identified in a small, rural college in a midwestern state, resulting in negative course evaluations that referenced students’ learning preferences as not being met. This qualitative case study was aligned with Bandura’s theory of self-efficacy to explore the perceptions of nursing administrators and nursing faculty about their teaching methods and self-efficacy regarding the implementation of active learning strategies. A purposeful sampling method was used to select a total of 8 participants: 6 nursing faculty and 2 nursing administrators. Selection criteria included nurse educators and administrators who had worked at the college within the last …

Nurse Educator Perceptions Of Using Simulation For Evaluation Of Nursing Competencies, Angela Elizabeth Horton

Walden Dissertations and Doctoral Studies

Over the past 10 years, simulation technology has been increasingly used in clinical settings to evaluate nursing competencies and ensure safe patient care. However, not all simulation laboratories are used consistently by hospital nursing education departments to support learning. The purpose of this qualitative case study, framed by constructivist theory, was to identify nurse educators’ perceptions of the value of using simulation to evaluate nurse competence. Research questions addressed how nurse educators decided what teaching methods to use when evaluating nursing competencies. The participant sample included 8 nurse educators responsible for the education of new and practicing nurses in the …

Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston

Walden Dissertations and Doctoral Studies

Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …

Mental Health Professional Perceptions Of Barriers To Fidelity For Empirically- Supported Treatments, Chris Streidl

Walden Dissertations and Doctoral Studies

It is estimated that one in five adults in the United State of America experience mental illness in a given year. When mental health organizations implement empirically-supported treatments but fail to maintain them, it can result in individuals not being provided the services that they need. The purpose of this study was to identify perceived barriers to maintaining fidelity for empirically-supported mental health treatments. The study utilized a quantitative cross-sectional correlational research design (N = 154) and the Perception of Barriers Scale (PBS) was developed to measure perceived barriers to maintaining fidelity for empirically-supported treatments. Bandura’s social cognitive theory as …

Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann

Walden Dissertations and Doctoral Studies

Tobacco use among people with mental illness remain a significant problem in the western United States. At the project site, there is widespread tobacco use among patients with mental illness and lack of training for nurses to address the issue. The purpose of this project was to educate nurses working in the acute psychiatric setting about evidence-based tobacco treatment interventions. The practice-focused question addressed whether a tobacco education program would increase nurses' knowledge, confidence, and skills to provide tobacco treatment interventions to patients with a mental illness. Self-determination theory and the transtheoretical model of change provided the theoretical framework for …

Barriers To Implementation And Strategies To Improve Adherence To The Sepsis Bundles, Rowena Amistad

Walden Dissertations and Doctoral Studies

Sepsis is associated with high mortality and morbidity. Immediate recognition and treatment is crucial to prevent complications that can be highly detrimental and cause a significant impact on the U.S. healthcare economy. Numerous studies have been conducted to improve patient outcomes and lower healthcare costs from sepsis and septic shock. Many of these studies were focused on exploring healthcare providers' knowledge and compliance to the Surviving Sepsis Campaign (SSC) guidelines. This study aimed to explore and identify barriers to the implementation of the sepsis bundles and strategies to enhance healthcare providers' adherence to these bundles. A systematic review of articles …

Assessment Of Tuberculosis Underreporting By Level Of Reporting System In Lagos, Nigeria, Mustapha Gidado

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is the leading cause of death from a single infectious disease. Unfortunately, 4.1 million cases were missed in 2017 globally, and Nigeria contributes 9% of the missing TB cases. At least 73% of the estimated TB cases in Nigeria were not reported in 2017 to the National TB Program (NTP); therefore, the true burden of TB was not certain, and this affected planning for prevention and control of TB. This quantitative secondary data analysis (NTP Lagos TB Inventory study database) guided by the integrated behavioral model assessed TB underreporting based on the TB reporting process in Nigeria. …

Barriers To Oral Care Among African American Adolescents In Prince George's County, Maryland, Nkiruka Soribe Mcginnis

Walden Dissertations and Doctoral Studies

When adolescents forgo oral health treatment, factors that hinder them from obtaining these services put them at risk of detrimental consequences in their oral and overall health. The purpose of this qualitative phenomenological study was to identify the various barriers that adolescents encounter causing them to defer oral treatment. Through this study, public health officials, school health care providers, the state, and parents could be made aware of these factors and work together to implement programs and supplemental aid to help adolescents become more knowledgeable of the importance of oral care and encourage them to desire and seek treatment. The …

Counselors' Perceptions On Adolescent Access And Use Of School-Based Mental Health Services, Samuel C Godwin Okeorji

Walden Dissertations and Doctoral Studies

The role of school-based mental health counselors (SBMHCs) is essential in addressing the mental health needs of U.S. adolescents. The purpose of this phenomenological study was to examine SBMHCs' perceptions about factors that affect the use of SBMH services by adolescents from a school district in Connecticut. SBMHCs were chosen for this study because they provide direct mental health services to adolescents. Mechanic's general theory of help-seeking provided the framework to interpret research findings using the 10 interrelated constructs. Fifteen SBMHCs participated in face-to-face semistructured interviews. Colaizzi's 6-steps-guide was used to organize, code, and identify common themes. The following themes …

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 …

Barriers Cardiac Nurses Face In Addressing Psychosocial Issues Of Heart Failure Patients, Debra Kay Disbrow

Walden Dissertations and Doctoral Studies

Heart failure is a chronic disease and a common cause of hospitalizations and readmissions within 30-days of discharge. To decrease the cost of care for patients with heart failure, the Centers for Medicare and Medicaid Services initiated the Readmissions Reduction Program that reduces payment to hospitals with preventable readmissions. Among the causes for readmissions of patients with heart failure are concurrent behavioral health issues that can lead to decreased medication compliance and increased risk for disease progression. The prevalence of comorbid depression is as high as 77% among patients with heart failure and may be an important factor in readmissions. …

Patients, Preferences, And Portals: Barriers Identified To Accessing Personal Health Information Through A Secure Online Website, Helen Patricia Fox-Mccloy

Walden Dissertations and Doctoral Studies

Patient engagement is one of the 6 quality directives issued by the Institute of Medicine for patient-centered care. Federal meaningful use regulations require health care organizations to offer patients a secure online website, or patient portal, to access their health information. Although the patient portal offers patients the opportunity to be more involved in their care, the portal has not been widely used. However, barriers to utilization are best understood from the perspective of the patient. Any barriers to patients accessing the portal are also barriers to patient engagement. The purpose of this project was to understand from the patient …

Barriers To Transition Of Care For Heart Failure Patients, Catherine Mary Murray

Walden Dissertations and Doctoral Studies

Heart failure (HF) is an escalating chronic disorder that impacts patients, families, and society. HF necessitates efficient transition of care and complex self-care knowledge in a population often burdened with low health literacy and high readmission rates. The purpose of this project was to improve transition of discharged HF patients from a Level 1 trauma system in a mostly rural area of South Carolina to its affiliated nurse-led HF clinic. The no-show rate for initial visits to the health care system's outpatient HF clinic by postdischarge patients was 59%. Using Henderson's need theory and Stevens's knowledge transformation model for theoretical …

Access To Care: Assessment Of Barriers In Two Rural Iowa Communities, Jean M. Osgood

Walden Dissertations and Doctoral Studies

The ability to access primary care services within the local community has a direct impact on the health and wellness of the community. Individuals living in rural settings face multiple challenges when attempting to access care. The purpose of this retrospective project was to identify barriers in 2 rural, underserved communities and make recommendations for process changes that could reduce these barriers. Data were gathered from 2 critical access hospitals and 2 rural health clinics located in rural, underserved areas in Iowa. Both hospitals identified access to health services as an issue within their communities. Administrative data were gathered on …

Barriers To Membership In A Professional Organization For Advanced Practice Nurses, Kesha Renee Walton

Walden Dissertations and Doctoral Studies

Professional organizations offer nurses services and resources for professional growth throughout their careers; yet, membership has declined over the past 10 years. Accordingly, this study was to understand the barriers in membership and identify positive changes that will increase membership and retain members. A quantitative descriptive design was employed within a convenience sample of 150 advanced practice registered nurses (APRNs) who were past or nonmembers of a professional organization. Exchange theory was applied and the Professional Association Membership Questionnaire (PAMQ) was administered to assess the barriers to APRNs participating in a specific professional organization. Statistical analysis included mean scores for …

Adherence Barriers To Healthcare For African Americans With Hiv/Aids On Antiretroviral Medications, Angela Bumphus Corbin

Walden Dissertations and Doctoral Studies

The purpose of this mixed methods research study was to examine the role of adherence barriers to healthcare and the impact that such barriers have on highly active antiretroviral therapy (HAART) compliance for African Americans living with HIV/AIDS. HAART helps reduce HIV/AIDS morbidity and mortality. Of the 49% of study participants who had been out of medical care for more than 12 months, financial concerns were listed as the most common barrier (22.8%). Not having the support from family and friends (17.5%), being tired of going to doctor appointments (15.8%), health challenges (12.3%), lack of transportation (12.3%), and incarceration (12.3%) …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …