Medicine and Health Sciences Commons^™

Website Accessibility Strategies, Gary W. Hrezo

Walden Dissertations and Doctoral Studies

Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …

An Educational Program For Standardization Of Care For The Acute Opioid Withdrawal, Jessica Ann Larson

Walden Dissertations and Doctoral Studies

Opioid addiction is a widespread chronic disease affecting millions of Americans each year, resulting in medical, social, financial, and societal detriments. Patients experiencing opioid withdrawal benefit from a standardized and evidence-based approach to care. The purpose of this doctoral nursing project was to provide inpatient nursing education for a standardized clinical practice approach to optimize patient outcomes. The research question examined the impact of an educational program for nurses presenting a new standardized opioid withdrawal clinical practice guideline inclusive of assessment, nursing interventions, a symptom triggered order set, and follow up plan of care in terms of knowledge gained and …

Prediabetes, Implementation Of Ada Practice Guidelines And Provider Perspective, Kimberlee May Manguiat-Lang

Walden Dissertations and Doctoral Studies

AbstractPrediabetes occurs before the development of diabetes in some people. Practitioners who educate people about prediabetes are not consistently using the latest evidence-based practice guidelines. The purpose of this mixed-method study was to fill a gap in the literature by providing evidence of the provider practices, attitudes and barriers when implementing American Diabetes Association (ADA) practice guidelines for the prediabetic patient. The Theory of Planned Behavior applies to evidence-based practice and the implementation of evidence-based practice guidelines. Research questions for this study focused on determining rate of compliance with ADA clinical practice guidelines from health care professionals to include providers …

Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro

Walden Dissertations and Doctoral Studies

Moral distress in nursing has been an issue for decades and has consequences on nurses’ physical, emotional, and psychological well-being. Nurses in different settings experience a high intensity and frequency of moral distress particularly in intensive care units (ICU), but few studies have examined the moral distress of non-ICU nurses. The purpose of this 3-manuscript dissertation was to assess the frequency and level of moral distress, ethical climate, and psychological empowerment among new registered nurses (NRNs) who work in non-ICU settings. The conceptual framework of Jameson's moral distress guided this study. Twenty-three NRNs with fewer than 3 years of experience …

Exploring Implementation Strategies Of Iot Technology In Organizations: Technology, Organization, And Environment, Khanhhung Hoang Pham

Walden Dissertations and Doctoral Studies

AbstractAfter organizations successfully adopt the internet of things (IoT) technology, many corporate information technology (IT) leaders face challenges during the implementation phase. Corporate IT leaders' potential failures in implementing IoT devices may impede organizations from integrating IoT solutions and promoting business benefits. Grounded in technology-organization-environment (TOE) theory, the purpose of this qualitative, pragmatic inquiry study was to explore strategies that corporate IT leaders use to implement IoT technology in their organizations. The participants were six corporate healthcare IT leaders who successfully used implementation strategies for implementing IoT solutions for their organizations. Data were collected using semistructured interviews and industry security …

Emergency Department Operational Strategies, Joyce W. Davis

Walden Dissertations and Doctoral Studies

AbstractEmergency Department Operational Strategies by Joyce W. Davis MBA/MHA, Pfeiffer University, 2011 BS, North Carolina A&T State University, 1980

Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration

Walden University December 2022

The Correlation Between Staffing Hours And Nursing Home Resident Fall Rate, Nduka Ikpo Eke

Walden Dissertations and Doctoral Studies

AbstractHealthcare administrators and researchers have had the burden of determining best practice protocols that minimize falls among older adults living in nursing homes for several years. Several studies have investigated, and identified intrinsic and extrinsic factors that lead to falls among other adults and made recommendations along the lines of their findings. However, researchers are yet to establish the impact of staffing hours on nursing home resident fall rate. The purpose of this study was to determine the correlation if any, between nursing home residents fall rate and the staffing hours they receive daily from certified nursing assistants (CNAs), licensed …

Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards

Walden Dissertations and Doctoral Studies

This study was focused on organizational barriers to effective university student mental health services access in the department of student resources (DSR) at a for-profit university in the northeastern United States. Once such barriers are addressed, faculty may be more successful in reaching out to students needing mental health services who are not self-identifying as needing these services. The Baldrige excellence framework guided this descriptive case study to examine the organizational barriers that prevent university leadership from creating clear policies and procedures for faculty to refer students to mental health services. Data sources included interviews with the behavioral health leader …

Effects Of Indoor Air Pollutants On Childhood Asthma: African American Parents’ Perspective, Marcia Maureen Haughton Lewis

Walden Dissertations and Doctoral Studies

AbstractIndoor air pollution has been implicated in many chronic health conditions, including childhood asthma, which is more prevalent among African American children. Children are more susceptible than adults to the effects of exposure to indoor air pollution; however, many parents may not be aware of the polluting impacts of products in their homes and are inadvertently placing their families at risk for adverse health outcomes. Understanding parents’ perceptions and experiences is essential for planning and developing educational programs and interventions for improving indoor environment management as part of asthma management in children. This descriptive phenomenological study aimed to explore parents’ …

Moral Distress Among Master’S Counseling Students Attending A Cacrep Accredited Counselor Training Program, Matthew Stevens

Walden Dissertations and Doctoral Studies

Moral distress, an understudied phenomenon among the counseling profession, has been defined as an experience of knowing the right thing to do but being institutionally prevented from doing what is believed to be right. This phenomenon often occurs in hierarchical relationships, such as those between student and teacher or supervisor and supervisee, and may lead to psychological impairment, deviation from ethical standards, and professional burnout, which threatens the ability of professional counselors to initiate and maintain healthy professional relationships. The purpose of this descriptive, phenomenological study was to explore the lived experiences of six master’s level students attending counselor training …

Mentorship And The Transition From Registered Nurse To Advanced Nurse Practitioner, Arcelia Kiss

Walden Dissertations and Doctoral Studies

The transition from registered nurse to nurse practitioner (NP) can be challenging and stressful. This problem is particularly true for the novice NP who must adapt to a new scope of practice coupled with increased demands. Recognizing that mentorship can contribute to competency development, employee satisfaction, higher retention rates, and improved patient care outcomes, the goal of this project was to develop a staff education program and manual on mentorship. Knowles’ adult learning theory; Benner’s novice-to-expert framework; and the analysis, design, development, implementation, and evaluation model guided development of the staff education program and mentorship manual. Practice-focused questions guiding the …

Factors Associated With Accidental Drug Exposure In U.S. Adults Over 65 Years Of Age, Edwin Raj

Walden Dissertations and Doctoral Studies

Medication errors are a major public health issue and a leading cause of fatalities in the United States and globally. Older adults who rely on medications to address age-related health issues are at higher risk of medication errors. Accidental exposure to drugs is a major type of medication error that impacts older people more than other age groups. The purpose of this quantitative correlational study was to examine the association between patient gender, age group, and reporter type and accidental exposure to drugs in older people. The ecological model was used to guide the study. Logistic regression analysis was used …

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …

Strategies To Implement Effective Succession Planning, Michelle Chapple

Walden Dissertations and Doctoral Studies

Most U.S. hospitals do not engage in succession planning at the executive level to account for retirees aging out of the workforce. The potential loss of institutional knowledge transfer threatens leadership development and organization stability. Guided by the leadership model succession theory, the purpose of this qualitative program evaluation was to offer a formative assessment to understand better strategies needed for effective succession planning by healthcare leaders. Five healthcare leaders from a single healthcare facility in Oklahoma City, Oklahoma, in the United States participated in semistructured, face-to-face interviews and provided company documents for review. Data were analyzed using descriptive and …

Educating Providers About Integrated Treatment For Individuals With Co-Occurring Disorders, Ihuarulam Chidiebere Okoroji

Walden Dissertations and Doctoral Studies

AbstractThe problem identified by this staff education project was the providers’ lack of knowledge on integrated treatment for individuals with co-occurring disorders (CODs). Integrated treatment is the gold standard for working with individuals with CODs. Providers knowledge gap and barriers were addressed by educating them on integrated treatments. This project used the analysis, design, development, implementation, and evaluation (ADDIE) model in planning, implementation, and evaluation. The participants were 20 providers in a residential addiction treatment facility which include one physician, three nurse practitioners, eight counselors, one registered nurse, and seven licensed practical nurses. This project used a pretest to determine …

Impact Of Healthcare Providers’ Perception On Telehealth Implementation, Misty Leann Cantrell

Walden Dissertations and Doctoral Studies

Telehealth has been proven to have a significant impact on patient outcomes; however, the use of telehealth in both rural and urban areas is sporadic and inconsistent. Although researchers have investigated this issue, there is little literature on the understanding of the impact healthcare provider (HCP) perception plays in this sporadic usage. The purpose of this quantitative research study was to understand how perception and behavioral intention of HCPs impacted the use of telehealth in rural and urban areas. The unified theory of acceptance and technology (UTAUT) was used to structure this research to facilitate determining the correlation between perception …

Experiences Of Maritally Satisfied Black American Couples Serving In Law Enforcement, Amanda Davis-Buie

Walden Dissertations and Doctoral Studies

The purpose of this hermeneutic phenomenological study was to explore the lived experiences of maritally satisfied Black American couples when at least one partner is serving in law enforcement. Members of law enforcement, Black American couples, and members of the counseling profession can gain knowledge from the answering of the research question. A family strengths perspective was used to provide a framework to study the phenomenon of marital satisfaction from a positive perspective. Six Black American couples, who are satisfied in their marriage and employed in law enforcement for a period of a least 6 months during their marriage, participated …

Comparison Between Hospital Ownerships In The Prevention Of Surgical Site Infections, Kameha Johnson

Walden Dissertations and Doctoral Studies

AbstractMillions of Americans seek health care for surgical interventions throughout the United States. Despite the 2010 Affordable Health Reform Act, hospital-acquired infections (HAIs) are still rising. Specifically, surgical site infections (SSIs) are a national problem in both non-profit and for-profit hospitals. SSIs are the third most commonly reported HAIs and account for 14%-16% of HAIs among U.S. patients. The purpose of this quantitative study was to determine an association between the independent variable of the type of hospital ownership (i.e., non-profit and for-profit), and SSI rates, health care utilization cost (i.e., readmission rates and LOS), and patient outcome measures (i.e., …

Mental Health-Medical Crisis Team Impact On First Responder Outcomes On Persons With Mental Illness, Mary Josephine Lakey

Walden Dissertations and Doctoral Studies

Persons with mental illness (PMIs) are 16 times more likely to experience harm when interacting with police than individuals without mental illness. This inequity has recently become prominent in American discourse due to the ubiquitous use of cell phones and social media, where videos of incidents between police and PMIs circulate. In this generic qualitative research, members of a collaborative mental health and emergency medical service professionals (EMSPs) team in an urban area were interviewed to assess the team members’ perceptions of the impact of the program on frequency of adverse outcomes during interactions with PMIs. The theoretical framework for …

The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman

Walden Dissertations and Doctoral Studies

The practice problem addressed in this Doctor of Nursing Practice project was safe medication administration in the emergency department (ED). Paper-based delivery of medication administration is prone to errors and multiple points of failure affecting patients’ safety. The gap in nursing practice was the lack of analysis regarding the efficacy of the barcoded medication administration (BCMA) process in the ED. The practice-focused question for this project addressed whether the implementation of BCMA in the ED effectively reduced medication administration errors as compared to the previously used paper-based, non-BCMA process. The aim of this doctoral project was to review the efficacy …

Improving Advance Care Planning Among Native Americans, Jasjit Kaur Pataria

Walden Dissertations and Doctoral Studies

A staff education project was created in a tribal health system of primary care clinics to improve advance care planning (ACP) conversations between care providers and Native American tribal patients. ACP conversations and advance directive documentation occurrences were found to be low or negligible in the project site despite primary care clinics being an ideal place to start these conversations. The purpose of the staff education project was to improve the knowledge and attitudes of providers toward initiating ACP conversations in a rural underserved community of Native Americans. The knowledge-to-action model was used to frame the project. Pretests and posttests …

How Being Aware Of Military Culture Influences Social Work Practice With Female Military Personnel, John Raymond Gonzalez

Walden Dissertations and Doctoral Studies

Active-duty women in the military seek help through the Family Advocacy Program (FAP) on military bases from social workers with a master’s degree in social work (MSW) who are hired by the federal government or by firms that contract with social workers to serve military personnel. Most of those social workers have no military background per se, which brings into question how being aware of the military culture might influence their practice with female military personnel. Grounded in self-awareness theory, which places focus on one's awareness relative to one's culture and environment at any time, the purpose of this action …

Staff Education On Self-Care Management For Bipolar Patients To Prevent Readmission, Dorthy Igbonagwam

Walden Dissertations and Doctoral Studies

Bipolar disorder is a chronic mental disorder that can negatively affect an individual’sreadmission to bipolar patients. The purpose of the doctor of nursing practice project was to develop a staff education program to empower the staff to educate the patients by increasing the staff’s knowledge about evidence-based, self-care management strategies. The focus of the educational content was on the approaches to improving patients’ adherence to their medications, promote follow-up care and prevent suicide. The theory that informed this project was Knowles’s theory of adult learning. One source of evidence generated during the project was the evaluation conducted by four content …

Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu

Walden Dissertations and Doctoral Studies

An investigation into the upstream determinants of mental disorders could provide insight into pathways by which these risk factors could relate to different groups of mental illness. The study was a quantitative inquiry using constructs within the Rothman’s sufficient and component cause framework to examine the pathways existing between upstream risk factors for schizophrenic and mood disorders. The study population was drawn from a convenience sample of clients accessing services at the psychiatry departments of a secondary mental health institution in North-Central Nigeria. The mean age of the participants in this study was 35.5years. The majority were males (53.4%), single …

Perceptions Of Instructor Caring Behaviors Between English As A Second Language And Non-English As A Second Language Nursing Students, John Chukwuemeka Dike

Walden Dissertations and Doctoral Studies

AbstractEnglish as a second language (ESL) nursing students have a significantly higher attrition rate and lower National Council Licensure Examination (NCLEX) pass rate than their non-ESL counterparts. Instructor caring behaviors (ICBs) are the ways nursing instructors treat students with respect, taking care to avoid prejudices, stereotyping, and judgments in the teaching-learning process which present prelicensure faculty to grapple with the challenge of effectively meeting the learning needs of both ESL and non-ESL students. The purpose of this cross-sectional, comparative study, guided by Watson’s theory of human caring, was to explore the differences in perceptions of ICBs between ESL and non-ESL …

Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze

Walden Dissertations and Doctoral Studies

AbstractObesity is one of the Healthy People 2020 high-priority public health issue. Obesity is of importance due to the troubling higher prevalence in women because of the close link that exists between body weight and reproductive health in females from menarche to menopause and beyond. The identification of guidelines to improve or manage the care of female patients can alleviate the burden and complications from being overweight or obese. This project guided by the ADDIE (analyze, design, develop, implement, and evaluate) model was conducted in a family primary care clinic to address a gap in practice, the lack of knowledge …

Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon

Walden Dissertations and Doctoral Studies

AbstractSome organizational leaders of home healthcare agencies (HHA) experience financial pressures to sustain within the changing regulatory landscape. Organization healthcare leaders who develop sustainability strategies remain competitive and employ the community. Grounded in the balanced scorecard framework, the purpose of this descriptive, qualitative multiple case study was to identify strategies home healthcare agency (HHA) leaders used to maintain sustainability. The participants were five organizational leaders of three HHA and two home health industry consultants in the Northeast United States who implemented sustainability. Data collected came from semistructured interviews, archival records, and organizational documentation. Three themes emerged from the thematic analysis: …

Risk Factors Associated With Community-Onset Sepsis In Latino/Hispanic Adults, Joan Ivaska

Walden Dissertations and Doctoral Studies

Sepsis results in a significant public health burden globally, causing 20% of adult mortality worldwide and accounting for more than one third of deaths in hospitalized adults in the United States, making it one of the top 15 leading causes of death in the United States. Community-onset sepsis (COS) comprises nearly 80% of all sepsis cases occurring in the United States each year. Despite the widespread prevalence of COS, significant gaps in knowledge exist regarding the risk factors that lead to COS and sepsis mortality in Latino/Hispanic adults in the United States. The purpose of this secondary data study was …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

Medication Reconciliation Education To Promote Patient Safety In A Family Practice Setting, Oghaleoghene Kolo

Walden Dissertations and Doctoral Studies

AbstractMedication reconciliation is a process in which the medications a patient is taking (or should be taking) are compared with newly ordered medications to identify and resolve discrepancies. Morbidity and mortality associated with the use of medication have become a public health concern. It was identified in this family practice setting that medication reconciliation guidelines were not being followed. This prompted the practice focused question if educating providers about medication reconciliation will improve their knowledge and intent to use guidelines about medication reconciliation. Peplau’s theory of interpersonal relationships provided the framework for the study. Data were collected from nine participants …