Medicine and Health Sciences Commons^™

Educating Oncology Nurses On Identifying And Managing Cancer-Related Distress, Rosemary Vivella Irish

Walden Dissertations and Doctoral Studies

AbstractUp to 50% of patients diagnosed with cancer will experience significant levels of distress. Cancer is related to psychological distress and can negatively impact recovery from surgery, increase treatment side effects, and decrease overall quality of life. The National Comprehensive Cancer Network recommended screening for distress as part of comprehensive cancer care. In the practice setting, there was a need for better assessment of distress in cancer patients. The purpose of this staff education project was to address a gap in practice regarding the lack of knowledge of screening for distress by providing education to oncology nurses on how to …

Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo

Walden Dissertations and Doctoral Studies

AbstractOne of the most frequent medical errors in contemporary medicine is incorrect prescriptions, and the profits from retail pharmacy operations are adversely impacted by the costs associated with prescription errors. Independent pharmacy managers are interested in finding workable strategies to mitigate the cost of prescription errors and increase profit. Using the resource-based theory of competitive advantage (RBTCA), the purpose of this qualitative multiple-case study was to explore strategies some independent pharmacy managers in Texas use to mitigate the cost of pharmacy employee prescription errors and increase profitability. The participants were five independent pharmacy managers who implemented strategies to mitigate the …

Impacts Of Mobile Health Technology On The African American Millennial Health Care Experience, Antoine J. Campbell

Walden Dissertations and Doctoral Studies

African Americans are underrepresented and have limited access to health care in the United States due to systemic disparities. The purpose of this qualitative phenomenological study was to develop a better understanding of the relationship that African Americans have with the health care system and the way they interact with it as well as to examine the impacts of mobile health (mHealth) patient engagement applications and their impact on shaping health experiences amongst millennial African Americans. Research questions addressed African American millennials’ perspectives on potential barriers to utilizing health care in the U.S. health care system as well as consideration …

Education On Protective Measures For Primary Care Staff During Covid Outbreaks, Lenina Ochioza Ukeju Chi-Ukpai

Walden Dissertations and Doctoral Studies

Since the emergence of COVID-19, healthcare workers have been in continuous risk of infection because of the way the disease is transmitted. Hence, the proper use of personal protective equipment (PPE) is important during the pandemic. The aim of this project was to increase healthcare workers’ and patients’ disease protection and prevention. This staff education project assessed the knowledge of proper PPE practice among healthcare workers who were in close contact with COVID-19 patients and provided lectures and practice in proper donning and doffing of PPE. Guided by the Lewin theory of change, the knowledge of the 9 health care …

Effect Of Drug Medi-Cal Organized Delivery System Access To Substance Use Disorder Treatment, Ana Y. Davies

Walden Dissertations and Doctoral Studies

Drug addiction, mental health disorders, and homelessness has impacted communities nationwide increasing mortality and morbidity and is a public health threat. But access to substance use treatment has been a problem due to the lack of the ability by many to pay for services. This observational quantitative research design utilized administrative secondary data collected between July 2017 and June 2022. The key variables are Insurance Status, Number of Admissions, and Successful Discharges in outpatient substance use treatment. The purpose of the study and research questions involved evaluating the effects Drug Medi-Cal (DMC) Organized Delivery System program by analyzing program admissions …

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Improving Staff Knowledge Of The Value Of Hourly Rounding, Dr. Melissa Gagliano, Dnp, Nea-Bc

Walden Dissertations and Doctoral Studies

Research has shown that consistent hourly rounds improve patient satisfaction and quality of care. Successful implementation and maintenance of this patient-centered practice hinges on nursing knowledge and proper training in the processes and procedures that support timely, purposeful, and effective hourly rounds. The purpose of this doctoral project was to implement a staff education project to improve staff perception of the value of hourly rounding on an inpatient orthopaedic unit. Project materials supplemented the hourly rounding program already in place at the facility. Following an in-depth literature search, pre-intervention multiple-choice knowledge assessment questionnaires were distributed to staff who volunteered to …

Lived Experiences Of Stress And Burnout Among Pediatric Home Care Nurses, Johane Garcon-Paul

Walden Dissertations and Doctoral Studies

Abstract

Research shows that healthcare providers encounter stress in their workplaces whether in a home or a healthcare facility that results in reduced job satisfaction, burnout, and inadequate care of patients. There is a gap in the literature regarding the lived experiences of nurses caring for children in all work settings, including the home care setting, regarding stress and burnout. The lived experiences of pediatric nurses working in home care settings were explored to discover conditions that contribute to their occupational stress and burnout. The occupational stress model with a major focus on the job demands-resources occupational stress model was …

Clinicians' Perceptions Of Telehealth Services During The Covid-19 Pandemic In Virginia, Johnetta Hill Guishard

Walden Dissertations and Doctoral Studies

The onset of COVID-19 introduced unprecedented changes to how U.S. public health services were delivered. Many public and private agencies faced mandatory closures, social distancing mandates, and rapid transitions to telehealth interventions and treatment. Mental health clinicians witnessed disruptions in continuity of care and an increase in mental health risks overall. Although some studies have been conducted to survey clinicians’ perceptions of the usefulness and ease of use of technology-based interventions, knowledge about mental health clinicians’ experiences and perceptions in Virginia was sparse. The purpose of this generic qualitative study was to explore how mental health clinicians in Virginia described …

Practice Size And Geographical Location And Annual Merit-Based Incentive Payment System Scores In Dermatology, Issam H. Harmouch

Walden Dissertations and Doctoral Studies

Despite the transition to value-based care in the healthcare industry using the Merit-Based Incentive Payment Systems (MIPS), small and rural physician practices still score in the poor category annually. These poor performances negatively impact funding for staffing and service availability; further, little research has focused on the factors behind these poor performance scores. The purpose of this study was to examine the relationship between practice size and organization geographical location on annual MIPS scores among dermatologists in the South-Central United States. The Donabedian model was used as the theoretical framework for this study that focused on the three qualities of …

Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris

Walden Dissertations and Doctoral Studies

Inaccurate patient information resulting from duplicate record data entry errors can compromise patient safety. Emergency room (ER) visits in the United States have increased by 15% over the last decade, and the increase has prompted hospitals to implement fast-track admissions in the ER to mitigate overcrowding and expedite the admission process for patients with low-acuity symptoms. Although duplicate record data entry errors occur frequently in ER admissions, there is a lack of information about fast-track ER admissions and the predictors of different types of confirmed duplicate record data entry errors. This correlational quantitative study examined the associations between work shift …

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 …

Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd

Walden Dissertations and Doctoral Studies

AbstractHealthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in …

Staff Education On Workplace Violence And Prevention Measures, Fatu Koroma

Walden Dissertations and Doctoral Studies

Forensic nurses are essential in helping forensic mental health patients at an inpatient/outpatient forensic psychiatric health care facility. The practice gap that the forensic psychiatric health care facility experienced was a deficit in knowledge among forensic nurses on the importance of workplace violence and prevention. The practice-focused question guiding the project was to determine if education on the American Nurses Association’s workplace violence and prevention measures would increase forensic nurses’ and staff’s education scores. The purpose of the project was to close the gap by educating nurses and staff on measures to increase a safer environment. The instructional design was …

Using Multi-Theory Model To Explain Hiv Screening Behaviors Among College-Aged People, Joshua David Kamimoto

Walden Dissertations and Doctoral Studies

There is a need to examine novel approaches that explain the association between the initiation and sustenance of HIV screening behavior. This quantitative, cross-sectional study was used to examine if the components of the multi-theory model (MTM) of health behavior change can explain the initiation and sustenance of HIV screening behavior among college-aged people. A convenience sample of 151 consenting college-aged people between the ages of 18 and 34 in a western US state completed a self-administered 44-item instrument. Multiple regression analysis was used to assess the correlation between the constructs of the multi-theory model of health behavior change (independent …

Perioperative Nurse Education For Undiagnosed Obstructive Sleep Apnea Screening, Juanita Turnipseed

Walden Dissertations and Doctoral Studies

AbstractApproximately one third of surgical patients have undiagnosed obstructive sleep apnea (OSA), the most common form of sleep disordered breathing, which presents a risk in the perioperative setting. OSA is underdiagnosed and undertreated in the adult population and has an economic impact on limited healthcare resources. The need existed for nurses in the perioperative setting to be educated on OSA, including the introduction of the STOP-BANG screening questionnaire. The analysis, design, development, implementation, and evaluation model of instructional design informed this project. The purpose of this Doctor of Nursing Practice project was to plan, implement, and evaluate a perioperative nurse …

Staff Education: Improving Hypertension Management Among African American Adults, Marie Survie Tunis-Blanc

Walden Dissertations and Doctoral Studies

AbstractHypertension (HTN) is a frequent diagnosis in primary care settings and is disproportionately higher among African Americans. Observed in the clinic were frequent office visits by patients with uncontrolled blood pressure and nonadherence to medication in an outpatient cardiology clinic in Northeast New Jersey. Also, a knowledge gap was noticed among clinical staff on current HTN guidelines. An awareness of evidence-based guidelines was necessary to combat poorly controlled BP in the clinic. The purpose of this Doctor of Nursing Practice project was to create an education program on current HTN guidelines to bridge the knowledge gap among clinic staff. The …

Impact Of Family Health Outcomes And Work Balance On Health Services Organizations’ Workplace Attendance, Marcus Levinsky Wade

Walden Dissertations and Doctoral Studies

Work-life balance (WLB) is employees’ ability to effectively manage between job obligations and everyday life activities involving family, health, and social life. Successful WLB has become increasingly important to healthcare administrators due to staff shortages and essentials of job performance, attendance, and satisfaction. The purpose of this quantitative study was to determine if there was a correlation between WLB, workplace stress, and employee workplace attendance. The two research questions were correlational; the dependent variable was workplace attendance, and the independent variables were workplace stress and WLB. The compensation theory served as the foundation for the study, in which both family …

Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn

Walden Dissertations and Doctoral Studies

In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …

Predictive Effects Of Length Of Treatment And Type Of Dialysis On African Americans’ Quality Of Life, Latoya Benjamin

Walden Dissertations and Doctoral Studies

Individuals on dialysis often face challenges with the management of their health, resulting in low health-related quality of life (HRQOL), but the extent of this impact has not been fully examined. The purpose of this quantitative cross-sectional study was, having accounted for relevant demographic variables such as age, gender, family history, employment status, to examine the effects of length of time for treatment and type of dialysis on HRQOL in African American end-stage renal disease (ESRD) patients. This study was guided by the socioecological model. Secondary data from 2016 to 2021 was obtained from the Chronic Renal Insufficiency Cohort (CRIC) …

The Perceived Effectiveness And Evolution Of First-Semester Nursing Students’ Studying Methods, Elizabeth Brown

Walden Dissertations and Doctoral Studies

Little research has been done to identify the study strategies used by nursing students during their first nursing classes despite studies indicating they have poor study skills, making the nursing program challenging and causing many of the students to decide to leave after their first semester. The purpose of this qualitative study was to improve the understanding of registered nursing students’ study strategies during their first semester of nursing classes. Winne and Hadwin’s self-regulated learning model was used as the conceptual framework to answer the research questions about students’ study strategies during their first semester of nursing classes, how they …

Staff Education Project: The Emergency Severity Index, Jo Crabtree

Walden Dissertations and Doctoral Studies

AbstractThe triage process is an important precursor to ensuring expeditious and appropriate medical care in the Emergency Department (ED). There is a positive correlation between proper triage technique and improved patient outcomes, making triage an essential issue for nursing practice. The purpose of this project addressed the results of a staff education program directed at teaching the Emergency Severity Index (ESI) Triage System to 42 triage nurses working in an ED in a critical access facility in the rural Midwest. The practice-focused problem for this project was as follows: Will a staff educational program improve understanding of the ESI triage …

Strategies For Clinical Managers To Reduce Nosocomial Infections, Samisha Lynn Davis

Walden Dissertations and Doctoral Studies

Increasing nosocomial infection rates threaten patient safety when approximately 100 million patients annually acquire at least one nosocomial infection during their hospital stay. Some clinical managers lack strategies to reduce the incidence and costs of nosocomial infections. Clinical managers need training in proactive infection control guidelines that may reduce infection rates and increase profitability. Grounded in adaptive leadership theory, the purpose of this qualitative multiple case study was to explore successful strategies that clinical managers used to reduce incidence and costs associated with nosocomial infections. The participants were four clinical managers employed by health care organizations in the Southeast Texas …

Local Anesthetic Systemic Toxicity Education For Perianesthesia Nurses, Rachelle Lynn Dix

Walden Dissertations and Doctoral Studies

Local anesthetic systemic toxicity (LAST) is a potentially life-threatening event following a local anesthetic bolus into the circulatory system. Because LAST is a low-volume, high-risk event, clinical exposure is lacking, creating a knowledge gap among perianesthesia nurses. A knowledge gap regarding LAST among perianesthesia nurses was identified at the project site, an ambulatory surgery center in south Mississippi. The practice-focused question was: Whether a web-based education intervention would increase perianesthesia nurses’ knowledge about LAST. The doctoral project aimed to provide perianesthesia nurses with the clinical knowledge essential for early detection of LAST symptoms. A LAST education module was developed using …

Help Seeking Behavior For Mental Health Issues Among College Students At A Southern University, Amanda Brooke Espinoza

Walden Dissertations and Doctoral Studies

The mental health of college students continues to decline, leading to increased suicide rates among young adults. College campuses provide mental health resources; however, many college students do not effectively utilize the resources. This quantitative research study allowed for a deeper understanding of why college students are not using mental health resources on their campus. A non-probability convenience sample was used. This sample of convenience was comprised of students who volunteered to complete the study survey sent via a university email. The survey was created for the purposes of this study using social cognitive theory constructs. The instrument contained four …

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 …

Strategies To Mitigate Foreign Trade Costs And Regulations That Reduce Revenues, Allan Dithan Mugisa

Walden Dissertations and Doctoral Studies

Foreign trade costs and regulations can lead to unfavorable business outcomes. Business leaders in firms engaged in global trade express concerns about the potential negative impact of foreign trade costs and regulations on revenues. Grounded in the resource-based theory of firms, the purpose of this qualitative multiple case study was to explore strategies some small medical devices and supplies business leaders use to mitigate foreign trade costs and regulations that reduce revenues. Participants were four business leaders of medical device and supply firms who reversed declining revenues. Data were collected using in-person semi-structured interviews. Through thematic analysis, four themes were …

Ambiguous Loss Feelings Amongst Caregivers Of Operation Enduring Freedom Veterans, Stephanie T. Spann

Walden Dissertations and Doctoral Studies

This quantitative study compares the possible relationship between ambiguous loss and the stress level of caregivers of Operation Enduring Freedom (OEF) veterans who served in combat. Injured servicemembers need caregivers to assist them in caring for their physical and mental health needs. This study examined whether there is a relationship between the perceived ambiguous loss among caregivers of OEF injured veterans and the stress level experienced by caregivers. The theoretical framework for this study is the ambiguous loss theory. The methodology used to test the hypothesis is a quantitative correlational design to compare ambiguous loss variables amongst caregivers of injured …

Lived Experiences Of Non-Licensed African American Pastors Providing Counseling For Race-Related Mental Health Issues To Their Parishioners, Brian Sutton

Walden Dissertations and Doctoral Studies

It is important to understand treatment practices of clergy members due to their influence on the treatment seeking behavior for professional counseling services among African American parishioners. The purpose of this qualitative study was to explore and describe African American pastors’ experiences of providing counseling for race-related mental health issues to their parishioners. The conceptual framework for this study was critical race theory. The research design included a descriptive phenomenological study with semi structured interviews with five non-licensed pastors and clergy members. The results of data analysis revealed three main themes and nine subthemes related to the participants’ experiences. The …