Medicine and Health Sciences Commons^™

Educating Acute Care And Emergency Nurses On Infant Safe Sleep Practices, Kimberly Catherine Mackeil-White

Walden Dissertations and Doctoral Studies

Rates of infant deaths due to sudden infant death syndrome, asphyxia, and sudden unexplained infant death dropped significantly during the original marketing and education push for infant safe sleep practices during the 1990s following the recommendations from the Center for Disease Control and the American Academy of Pediatrics, but a plateau has occurred with no further recent decreases. Safe sleep practices are inconsistent in the practicum site and guidelines for safe sleep practices do not exist. Although aware of the concepts, staff do not consistently educate families about maintaining the practices within the hospital environment, as evidenced by non-compliance with …

Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed

Walden Dissertations and Doctoral Studies

Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care …

Integrating Palliative Care In The Cardiac Surgery Icu, Katherine Rodman

Walden Dissertations and Doctoral Studies

Over the last decade, patients who remain critically ill but in the chronic stage have become a subset of patients who often remain in the cardiac intensive care unit (CICU) for many months. Palliative care in the ICU has an important role and is well recognized by various studies to alleviate physical symptoms due to invasive treatments, to set patient-centered goals of care, and to provide end-of-life care. This acute care facility does not have guidelines for clinicians to use when introducing and managing palliative care for terminal heart failure patients during long term stays in the ICU. The clinical …

Religiosity, Daily Rosary, And Well-Being Of Catholics In College During The Pandemic, Michael Raul Rios

Walden Dissertations and Doctoral Studies

Before and since the Coronavirus pandemic, college students suffered from increasing rates of mental health conditions affecting their well-being. Researchers have requested more studies on prayer as a strategy to address well-being issues. The purpose of this anonymous online survey study (N = 59) was to discover if there were any associations between religiosity and well-being, daily Rosary frequency and well-being, and if daily Rosary frequency mediated an association between religiosity and well-being of Catholic students in college in the United States during the pandemic in 2021. Participants were recruited via social media, listservs, email, one nationwide organization, the Walden …

Diabetes Self-Management Education, Jean David Thomas

Walden Dissertations and Doctoral Studies

AbstractAccording to the World Health Organization, Type 2 diabetes mellitus (T2DM) is a chronic, metabolic disease that can lead to damage throughout the body and development complications if self-care management is not implemented. Studies have demonstrated a lack of preparedness of nursing staff on T2DM self-care. At the federally qualified health clinic where this Doctor of Nursing Practice project occurred, a gap in practice existed related to the use of outdated American Diabetes Association (ADA) guidelines and lack of patient education documentation on self-care management of T2DM. The purpose of this staff education project was to plan, implement, and evaluate …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Relationship Of Acetaminophen And Alcohol To Incipient Renal Insufficiency: The Role Of Race In Estimating Glomerular Filtration Rate, Preston Eledu

Walden Dissertations and Doctoral Studies

There are increasing concerns about the incorporation of race in the estimated glomerular filtration rate (eGFR) prediction equation. which has been used to measure renal function in studies that have shown a relationship between therapeutic dose of acetaminophen and light-moderate alcohol use to incipient renal insufficiency. The purpose of this study was to assess the same relationship, using a redefinition of renal insufficiency based on the chronic kidney disease–epidemiology collaboration creatinine-based eGFR, with and without race, and exploring the potential impact of race in the hypothesized relationship. Data from the 2003-2004 National Health and Nutrition Examination Survey were analyzed using …

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

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 …

Impacts Of White Privilege And Implicit Bias On Treatment Implementation With Black Pediatric Patients, Tara Geer-Leiker

Walden Dissertations and Doctoral Studies

White privilege and implicit bias are known contributing factors to the racial health inequities that exist in the treatment of Black children in U.S. hospitals. There is limited research, however, on the potential for White nurses to engage in self-examination related to either concept. The purpose of this basic qualitative inquiry was to understand how White privilege and/or implicit bias shapes the lived experiences of White nurses as they treat and interact with Black pediatric patients. The conceptual framework included a modified model comprised of Hobbs’s concept of White privilege and Blair et al.’s model of influences of implicit bias …

Nurse Perceptions Of Nonacademic Factors That Influence Undergraduate Nursing Student Retention And Persistence To Graduation, Marianne Gray

Walden Dissertations and Doctoral Studies

Having an adequate supply of nurses is critical to maintaining the health care system. The problem for this study was that undergraduate nursing students were leaving a local Midwest community college’s nursing program before obtaining a degree. The purpose of this qualitative study was to explore the perceptions of the program’s recent graduates, regarding nonacademic factors that they believe helped to facilitate their success. Jeffreys’s nursing universal retention and success model served as the conceptual framework. The research question was focused on identifying nurse graduate perceptions of nonacademic factors that contributed to their success. A basic qualitative research design was …

Managing Nurse Leader Stress To Promote Leader Retention, Rebecca Sue Hawkins

Walden Dissertations and Doctoral Studies

Nurse leaders are a health care group that has been provided limited support to managestress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. The purpose of this staff education project was to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A combination of Watson’s theory of caring and Ray’s …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins

Walden Dissertations and Doctoral Studies

Patient satisfaction has been utilized to measure healthcare quality and outcomes, which affects reimbursement. Some claim such measures could be biased as they do not consider the patient’s socioeconomic status. Measuring the quality of care, Area Deprivation Index (ADI), and patient experience has been captured and publicly reported; and the measuring indicator Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS), however, hospitals serving patients in low ADI areas generally score poorly. Grounded in the theory of Donabedian, the purpose of this quantitative correlational study was to examine the relationship between patient experience associated with socioeconomic disparities and how patients …

Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this study was to explore respiratory therapists’ (RTs') perceived roles and responsibilities in a COPD multidisciplinary care team, and how those roles and responsibilities were affected when RTs were monitored and evaluated by a team member. Accountability theory was used to guide the development of this study. The study’s goal was to provide needed information on the specific roles and responsibilities of RTs in a COPD multidisciplinary care team because RTs knowing their roles and responsibilities could improve the quality of care and enhance the delivery of healthcare services for patients with COPD. The study’s research method …

Associations Between Substance Use And Obesity Among Native American Adolescents, Joseph Jude Janosky

Walden Dissertations and Doctoral Studies

Obesity and substance use are two significant public health issues among Native American adolescents. Despite much evidence linking obesity and substance use during adolescence to several long-term health conditions and increased morbidity and mortality, evidence describing the relationship between current substance use and obesity among Native American adolescents is lacking. The purpose of this quantitative study was to investigate associations between current substance use – specifically alcohol, marijuana, and tobacco products – and obesity among Native American high school students, when adjusted for sex, soda consumption, and physical activity. Rosenstock’s health belief model served as the theoretical foundation for this …

Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones

Walden Dissertations and Doctoral Studies

The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …

Association Of Socioeconomic Status And Marital Status With Genuine Halitosis Among Dental Patients In Sudan, Eiman Abd Almonim Khidir

Walden Dissertations and Doctoral Studies

AbstractThe prevalence of halitosis has been rising in recent years and has become a social and public health problem worldwide. People’s concerns about halitosis can influence their psychological, social, and professional lives and lead to social isolation and anxiety. The purpose of this quantitative cross-sectional study was to examine the association of socioeconomic status and marital status with genuine halitosis after adjusting for age, gender, and smoking among patients attending dental clinics in Khartoum, Sudan. The social-ecological model grounded the study. Secondary data from dental clinics in Khartoum, Sudan, were used with a sample size of 340. Data analysis included …

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

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 …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …

Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor

Walden Dissertations and Doctoral Studies

Diabetes education is a principal component of optimal diabetes care that is often underutilized despite the known benefits that include reductions in complications as well as improved glycemic control and self-management knowledge. The purpose of this quantitative study was to examine the association between the completion of diabetes education, referral source, and visit modality. Because the completion of diabetes education is multifaceted, Levesque’s theoretical framework of health access, which incorporates dimensions of the accessibility of services and the abilities of potential users in the utilization of health services, was used to ground the study. A retrospective chart review was conducted …

Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza

Walden Dissertations and Doctoral Studies

Reporting mortality information is the primary data source from which evidence can be drawn to monitor disease trends and inform public health policy to improve population health. Still, only two-thirds of expected annual deaths are reported globally. Health education and promotion play a significant role in empowering communities to uptake public health services such as mortality surveillance. This qualitative descriptive study aimed to understand health workers’ (HWs’) perspectives regarding the need for health education to support mortality surveillance in Machakos County, Kenya. The capabilities, opportunities, and motivation for the behavior change model guided the study. Semi-structured interviews were used to …

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

Factors Associated With Intent To Quit Smoking Among U.S. Adult Smokers, Patrese Ann Nesbitt

Walden Dissertations and Doctoral Studies

Smoking and tobacco use continue to be a public health issue for over 40 million Americans, which explains the appropriateness and abundance of smoking cessation programs throughout the United States. The purpose of this quantitative correlational study was to examine the associations between independent variables of marital status, advice from a medical clinician, and use of community smoking cessation resources and the dependent variable of intent to quit smoking, controlling for race, ethnicity, gender, and age. The theory of reasoned action was used to guide the study. Data from the National Adult Tobacco Survey (N = 12,357) were analyzed using …

Staff Education Of Diabetic Foot Care In An Ambulatory Setting, Riza Grace Nielsen

Walden Dissertations and Doctoral Studies

One of the most important factors affecting the quality of diabetes care is the association between a patient’s knowledge and their practices. The practice gap in this primary care clinic was a lack of standardized diabetic foot care. The purpose of this DNP project was to provide nursing staff with an evidence- based, culturally congruent diabetic footcare curriculum that could help decrease inconsistencies in care. The practice-focused question for this project addressed whether an educational program for nursing staff on diabetic footcare would increase their knowledge and translate this knowledge into practice to prevent diabetic foot infections and its complications. …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …