Medicine and Health Sciences Commons^™

Baby's Skin, Deborah Weatherspoon, Debra Henline Sullivan

Walden Faculty and Staff Publications

A neonate's skin serves many important roles, is fragile, and requires special care. The childbirth educator may be called on to give sound, evidence based advice to caregivers who have concerns about their baby's skin. This article reviews the basics in newborn skin care with qualified recommendations on skin imperfections. Neonatal skin alterations are reviewed and include erythema toxicum neonatorum, milia, sebaceous glands, baby acne, and cradle cap. Babies are also affected by too much moisture which can result in drool rashes, heat rashes, and diaper rashes. These rashes are common and treatable with proficient guidance. Other skin concerns are …

Leadership In Community Public-Private Partnership Health And Social Care Initiatives, Hawa Yatera Mshana, Magdeline Aagard, Cheryl Cullen, Patrick A. Tschida

Journal of Sustainable Social Impact

Although the public–private partnerships in health have been adopted as the best pathway to improving health outcomes in many developing nations, implementation lacks collaborative leadership. The purpose of this empirical qualitative case study was to determine key factors that promote leadership synergy (LS) between partners that enhance ownership and accountability of community health and social initiatives in Tanzania. The diffusion of innovation theory and public–private integrated partnership module were the theoretical framework guided this study. Diffusion of innovation theory is based on the importance of effective communication to spread new ideas and foster change in behavior in a social group …

Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione

Walden Dissertations and Doctoral Studies

The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected …

A Nursing In-Service For Diabetes Education, Heidi Steiner

Walden Dissertations and Doctoral Studies

Nurses play a central role in preparing patients for discharge. Diabetes affects one-third of all hospitalized patients, with readmission rates 20% higher for patients with diabetes. Low health literacy affects patients' ability to understand education provided during a hospitalization, especially in diabetic patients who are required to perform complex self-care activities. The rehabilitation nurses within the practicum site struggled to provide adequate diabetes education, leading to patients' readmissions and frequent calls to the nursing unit post discharge. The purpose of this project was to educate nurses on an inpatient unit about survival skills and teach-back approaches to improve inpatient diabetes …

Direct Supervisor Influence On Nurse Engagement, Kelly Elaine Tapp

Walden Dissertations and Doctoral Studies

Nurse engagement is essential for organizational success. If organizations can engage nurses, they may be able to improve organization and patient outcomes. The purpose of the evidence-based practice project was to use current evidence of direct supervisor influence on nurse engagement to create an educational program for clinical leads to use in their interactions with direct reports. The relationship-based care model was used as a framework for the project, and concepts included work engagement, nurse engagement, recognition versus meaningful recognition, professional development, communication, transformational leadership, and authentic leadership. Before and after attending the education program, clinical leads were given a …

Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner

Walden Dissertations and Doctoral Studies

The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …

The Efficacy Of Neurofeedback In The Treatment Of Autism., Rosemary Akhavan

Walden Dissertations and Doctoral Studies

Autism is a disorder that impairs the development of a person's ability to interact with other people and to relate productively with the outside world. There are many types of interventions being used to treat autism, but there are no cures or definitive treatments for this disorder. A biological theoretical foundation was the basis of this study, as recent neuroimaging techniques have demonstrated that autism is a neurological disorder that reveals distinct abnormalities in the brain. The purpose of this study was to examine the efficacy of neurofeedback (NFB) in the treatment of autism. NFB has shown promise of improving …

Effect Of Augmented Reality On Anxiety In Prelicensure Nursing Students, Sarah Ball

Walden Dissertations and Doctoral Studies

Prelicensure nursing students experience high anxiety as they enter the clinical setting, which can have a negative impact on learning care performance and critical thinking. Nursing faculty are faced with the challenges of limited time for clinical experiences, meeting the needs of learners who are technologically astute, and engaging students in the clinical environment to meet learning outcomes. The purpose of this pretest posttest quasi-experimental study, guided by the discovery learning theory, was to determine the effect of augmented reality (AR) 360 photosphere on prelicensure nursing students' level of anxiety as they entered a new clinical environment as compared to …

A Nursing Education Program To Decrease Use Of Psychotropics Among Dementia Patients, Tami Felicia Blackmon

Walden Dissertations and Doctoral Studies

Dementia, a clinical condition that affects the psychological ability of patients, is distinguished by a significant overall decline in cognitive function that results in distorted perception. Guiding nursing practice in the long-term care (LTC) setting to decrease the unnecessary use of psychotropics is critical because doing so relates to the patients' quality of life and safety. In the LTC facility that served as the practicum site for this study, there was an observed overuse of psychotropic medications in the care of patients with dementia. The practice-focused question guiding this project asked whether a nursing staff development program would decrease the …

Intimate Partner Violence And Posttraumatic Stress Disorder Symptoms Among College Women, Crystal Bowler

Walden Dissertations and Doctoral Studies

Approximately 35% of women in the United States experience intimate partner violence (IPV). IPV could be linked to symptoms of posttraumatic stress disorder (PTSD) that result in long-term mental health issues. Public health professionals, college counselors, and educators require information to assist in identifying college-age women who may be affected by IPV. The purpose of the study was to explore the association between the occurrence of symptoms of PTSD and IPV among college-aged women. The socioecological model was the theoretical framework for the study. A total of 199 cases were selected from National Intimate Partner & Sexual Violence Survey dataset …

Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock

Walden Dissertations and Doctoral Studies

Glycemic control of the perioperative patient improves patient outcomes, specifically prevention of surgical-site infections. The prevention of surgical-site infections helps to reduce complications that can increase length of stay and readmissions, thereby increasing healthcare costs. The purpose of this project was to provide an educational module to the same-day surgery nurses on a clinical guideline to maintain glycemic control of the perioperative patient to prevent surgical-site infections. Lewin's change theory guided the development of a clinical practice guideline (CPG) for nurses to standardize the glycemic management of the perioperative patient. This project was conducted to determine whether educating nurses through …

Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha

Walden Dissertations and Doctoral Studies

Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer …

Sickle Cell Disease Pain Burden And Quality Of Life Among Black Children In Mississippi, Laquita Nichelle Cooper

Walden Dissertations and Doctoral Studies

Acute and chronic pain is a common hallmark of sickle cell disease (SCD) in children and adolescents, which can have a profound effect on their quality of life (QOL). However, this relationship is not well quantified. The purpose of this quantitative study was to examine the relationship between SCD pain burden and QOL among Black children ages 8-17 in Mississippi with SCD. The secondary aim was to compare children and caregiver reports of SCD pain burden and QOL with SCD. The social ecological model was used to identify personal factors that influence SCD pain burden and QOL of children with …

The Evaluation Of The Relationship Between Racial Health Disparities And The Patient-Provider Relationship, Andrea Nicole Curry

Walden Dissertations and Doctoral Studies

African Americans are adversely affected by health disparities due to the complexities of the patient-provider relationship. The behavioral model of health services was used as the theoretical framework to understand how individuals make healthcare utilization decisions. The purpose of the research was to evaluate how the patient-provider relationship influences inconsistent doctor visits by African American patients despite the prevalence of chronic conditions. 45 African Americans located in Shelby County, Tennessee were included in this study. A cross-sectional quantitative design was used to collect the data via an online survey. The 45 collected responses were analyzed by performing multiple linear regression, …

Effectiveness Of Pressure Ulcer Protocols With The Braden Scale For Elderly Patients In The Intensive Care Unit: A Systematic Review, Natalie A. Floyd

Walden Dissertations and Doctoral Studies

Each year, approximately 3 million people in the United States develop a pressure ulcer. Although a preventable complication, pressure ulcers are among the top 5 adverse outcomes in the acute care setting with the prevalence as high as 42% in the intensive care unit (ICU). The purpose of this systematic review was to evaluate the inclusion of the Braden Scale as part of a multicomponent pressure ulcer intervention protocol, or care bundle, to identify geriatric patients hospitalized in the ICU who were at risk for pressure ulcers. The Cochrane protocol guided this review; findings were reported according to the Preferred …

Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker

Walden Dissertations and Doctoral Studies

Tobacco use among veterans is significantly higher than among members of the general population. The purpose of this quality-improvement project was to increase acute care staff members' knowledge and confidence in using tobacco cessation interventions to increase quit rates among the inpatients of a veterans' hospital in the midwestern region of the United States. An evidence-based, standardized Tobacco Tactics Toolkit was developed and implemented, and a 6 sigma method guided the quality improvement process to define, measure, analyze, improve, and control the tobacco-cessation education initiative. The reach, effectiveness, adoption, implementation, and maintenance framework was used to ensure that evidence-based interventions …

Using Social Cognitive Theory To Predict Counseling Behaviors In Registered Dietitians, Marianela Guerrero

Walden Dissertations and Doctoral Studies

Obesity and morbid obesity affect more than 30% of Americans, which emulates the rate of smoking as the leading preventable cause of disease and death in the United States. The prevalence of obesity among adults in the United States increased dramatically between 1980 and 2010 (16% to 36%). The integration of the social cognitive theory (SCT) constructs such as self-efficacy, self-control, environment and expectations in the study instrument allowed identifying the impact of personal, social and economic factors on Registered Dietitians (RDs) counseling behaviors with obese clients. The goal of this quantitative cross sectional study was to investigate the association …

Preparing Novice Nurses For Early Recognition Acute Deterioration, Norma Patricia Harris

Walden Dissertations and Doctoral Studies

Hospitalized patients increasingly present with complex health issues that place them at risk for acute patient deterioration (APD). Novice nurses are ill-equipped with the critical clinical skills to function competently in recognizing APD, placing patients at risk for negative health outcomes. This project addressed the need to educate novice nurses to recognize APD and answered the project focused questions that asked if an educational intervention with high-fidelity simulation (HFS) would improve nurse knowledge and clinical confidence in recognizing APD. Benner's novice-to-expert and the constructivism theory were used to guide the project. Based upon a review of the literature, the HFS …

Strategies For Increasing Volunteer Engagement In Nonprofit Healthcare Organizations, Sanja Katina Hudson

Walden Dissertations and Doctoral Studies

Implementing effective strategies to address the challenges of volunteer engagement is critical for helping ensure the sustainability of nonprofit healthcare organizations. Nonprofit healthcare leaders seek strategies to increase the volunteer workforce and enhance volunteer engagement. Through the conceptual lens of Deci and Ryan's self-determination theory, the strategies nonprofit healthcare leaders used to reduce volunteer turnover were explored in this single-case study. Data were collected using semistructured interviews with 5 nonprofit healthcare leaders from a single organization in the southwestern United States. Analysis of internal and external organizational documents and publicly available data were manually coded and thematically organized. The use …

Country Girls Fight, Too: The Relationship Between Social Support And Rural Female Youth Violence, Redhonda Vanessa Malone

Walden Dissertations and Doctoral Studies

This study was conducted to explore the relationship between social support and youth violence by testing the relationships between violence victimization, violence exposure, violence perpetration, delinquency, and the moderating variable of social support for rural female adolescents in the United States. This research, guided by the social disorganization theory, involved analyses of data from Wave 3 of the National Survey for Children's Exposure to Violence. The logistic regression analyses (n = 278; female; rural area; mean age 13.5) showed no moderating effect of social support on youth violence perpetration. However, there was a positive association between delinquency and violence perpetration, …

Educating Psychiatric Nurses To Improve Medication Adherence Among Schizophrenic Patients, Chandrika Mcqueen

Walden Dissertations and Doctoral Studies

The purpose of this project was to implement an educational program that provided psychiatric nurses with the knowledge and skills to engage patients with a diagnosis of schizophrenia in self-care management regarding medication and treatment adherence. The theory employed in the project was the educational theory. Evidence of effectiveness came from a pre- and postintervention assessment of nurses' knowledge and confidence in teaching about medication, along with a pre- and postassessment of knowledge gained as a result of the educational intervention. Pre- and posteducational rates of patient rehospitalization for medication nonadherence were compared. The results indicated a 15% rate of …

Young Women's Perceptions Of Factors Influencing Eating Disorders, Francisca Masawi

Walden Dissertations and Doctoral Studies

Eating disorders (EDs) cause irreversible physical damage, including organ failure and death. Although EDs receive considerable attention, the number of affected young women who seek help remains low. The purpose of this phenomenological study was to understand the sociocultural and socioenvironmental factors influencing ED development from the perspective of young women, and to explore why the rate of EDs continues to rise in this population. The sociocultural model served as a guide for the study. Ten young women 18-24 years old from Southwest Ohio participated in in-depth, semi structured, face-to-face interviews. Data coding and analysis revealed recurring themes, with findings …

Achieving Glycemic Control In Rural Clinics, Gayla Diane Mclaughlin

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States and is the main cause of chronic kidney failure, nontraumatic limb amputations, blindness, myocardial infarction, and stroke. Many patients with diabetes do not meet goals for at least 1 control measure of blood sugar, blood pressure, or cholesterol. The purpose of the project was to implement a template for documentation--a toolkit for patient care management-to improve blood glucose and blood pressure levels in a rural health clinic in central Texas for 33 patients with diabetes during a 6- to 8-week timeframe. The practice-focused question asked whether management of …

Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer Lynn Mullen

Walden Dissertations and Doctoral Studies

Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual's ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest-posttest quasi-experimental study, guided by Lazarus's theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R …

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

Education Protocol For Type Ii Diabetes Mellitus, Raegan Elizabeth Quandt

Walden Dissertations and Doctoral Studies

Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health …

Counselors' Knowledge And Attitudes Of The Recovery Paradigm, Kathleen Ruscitto

Walden Dissertations and Doctoral Studies

As of 2014, an estimated 18.1% or approximately 43.6 million adults, 18 years of age or older in the United States experienced a form of mental illness. Professional counselors subscribe to a wellness or holistic paradigm; however the recovery paradigm, using collaborative strategies and unique treatment planning is the directed approach of mental health services in the United Stated. The purpose of this quantitative study was to understand what factors contribute to counselors' knowledge and attitudes of the recovery paradigm. Survey methodology was used to examine whether, among professional counselors, years of experience, gender, professional setting, and licensure status, as …

Dementia-Spcific Education In An Assisted Living Facility, Sharon Dianne Samarin

Walden Dissertations and Doctoral Studies

Providing competent, high-quality, and person-centered care is important in the healthcare environment, including the care for the aging and training of those who provide care. A knowledge gap in dementia-specific training was identified at an assisted living facility. The purpose of this project was to answer the question whether a dementia-specific educational staff training program would improve staff members' knowledge and application of dementia-specific competencies as well as caring behaviors. Watson's theory of human caring, the theory of planned behavior, and Leininger's framework of culture care were used to inform this project. The educational project evaluated the success of implementing …

Educational Outcomes Of Online Registered Nursing To Bachelor Of Science In Nursing Students, Shuba Samuel

Walden Dissertations and Doctoral Studies

The projected nurse workforce shortage and the need for nurses with bachelor's degree has increased the number of accelerated and online programs in nursing education. The evolving healthcare system demands registered nurses (RNs) to demonstrate critical thinking skills and evidence-based practice in varied healthcare settings. The purpose of this quantitative study was to analyze if academic variables, such as preadmission grade point average (GPA), predicted evidence-based skills and research utilization skills among students enrolled in the online RN to Bachelor of Science in nursing program. The theoretical foundations of this study was comprised of Knowles's adult learning theory, Benner's stages …

Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …