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Articles 4261 - 4290 of 6102

Full-Text Articles in Medicine and Health Sciences

A Comparative Analysis Of Family Therapies On Youth With A Co-Occurring Disorder, Rochelle Henderson-Clark Jan 2018

A Comparative Analysis Of Family Therapies On Youth With A Co-Occurring Disorder, Rochelle Henderson-Clark

Walden Dissertations and Doctoral Studies

There are approximately 1.3 million youth who have been diagnosed with a co-occurring disorder. The purpose of this study was to analyze the relationship between the type of therapy (brief strategic family therapy or family functional therapy), demographic factors (age, race, type of drug used), and therapy discharge status (successful or unsuccessful) in male youth with a co-occurring disorder of attention-deficit hyperactivity disorder and substance use disorder. A correlational research design of a cross-sectional nature was used for this study and secondary data were obtained from a mental health agency located in Hampton Roads Virginia. The theoretical basis for this …

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Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton Jan 2018

Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton

Walden Dissertations and Doctoral Studies

Inadequate discharge planning for individuals with chronic illnesses or injuries is associated with increased readmissions to the hospital or rehabilitation facility where the original treatments were administered. To help ensure the recovery of discharged patients and avoid readmissions, discharge planners guide medication and care processes. The rate of readmissions was high in a stand-alone rehabilitation center due to ineffective discharge plans. Patients, family members, and caregivers lacked knowledge about medications, treatments, and self-care guidelines after the patient left the facility. The purpose of this project was to ascertain the impact of improved discharge processes using the (a) IDEAL Discharge Planning …

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Motivation And Sociodemographic Factors In Organized Physical Activity Events, Katy Gozalka Jan 2018

Motivation And Sociodemographic Factors In Organized Physical Activity Events, Katy Gozalka

Walden Dissertations and Doctoral Studies

Adult physical activity is important for prevention of chronic diseases and to minimize health issues; therefore, the motivational influences of sociodemographic variables on participation in organized physical activity events warrant an investigation. The purpose of this quantitative study was to investigate differences in motivational influences between various sociodemographic variables as related to physical activity events in organized settings. The theoretical framework that guided this research study consisted of the theory of reasoned action (TRA), and the health belief model (HBM). The TRA was applied to study the intention of health behavior, while the HBM was used to investigate individuals' motivation …

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Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal Jan 2018

Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal

Walden Dissertations and Doctoral Studies

Anxiety, depression, and substance use disorders are some of the frequently occurring mental illnesses among Canadian children and adolescents that can result in debilitating short and long terms outcomes. The rise in readmission rates for recipients of mental illness in Saskatchewan, coupled with the high incidences of suicide-related deaths, necessitates a patient outcome evaluation for predictors of readmission to youth counseling services among adolescents. The purpose of this secondary data analysis study was to explore the associations between anxiety, depression, substance use disorder, individual counseling, family counseling, group counseling, and the outcome of readmission within 1 year following discharge from …

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Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander Jan 2018

Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander

Walden Dissertations and Doctoral Studies

This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the …

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Development And Validation Of The Body Knowledge Questionnaire (Phase 2), David A. Hernandez, Cheri Ann Hernandez Jan 2018

Development And Validation Of The Body Knowledge Questionnaire (Phase 2), David A. Hernandez, Cheri Ann Hernandez

Journal of Social, Behavioral, and Health Sciences

This study evaluated the psychometric properties of the Body Knowledge Questionnaire (BKQ), an instrument that measures weight management integration: an individual’s attitudes, preferences, and behaviors associated with weight self-management. The BKQ was revised following a pilot study demonstrating its validity and reliability, and new items were added based on data gathered through four focus groups of obese and normal-weight survey completers. Additional items were derived from the extant literature on weight management and integration. A panel of 30 health professionals who work in the area of weight management, bariatrics, and nutrition science reviewed the revised BKQ for content validity. Two …

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Do Adverse Pregnancy Outcomes Predict Under-Five Mortality In Nigeria?, Henry Chukwunonso Debem, Amany H. Refaat, Tolulope A. Osoba Jan 2018

Do Adverse Pregnancy Outcomes Predict Under-Five Mortality In Nigeria?, Henry Chukwunonso Debem, Amany H. Refaat, Tolulope A. Osoba

Journal of Social, Behavioral, and Health Sciences

Nigerian children under 5 years of age are over 15 times more at risk of death than their counterparts in developed regions of the world; the prevalence of miscarriage, an adverse pregnancy outcome (APO), was estimated at 49%. In the present study, the relationship between APO and under-5 mortality (U5M) in Nigeria was examined to determine if APO could be used as a reliable early warning indicator for U5M. We used a cross-sectional secondary data analysis of datasets from three Nigeria demographic and health surveys: 2003, 2008, and 2013. The study population was women of reproductive age (15–49). Cochran–Mantel–Haenzel chi-square …

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Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer Jan 2018

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer

Journal of Social, Behavioral, and Health Sciences

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, no studies were located about hypertension in the Armenian American population, despite evidence of health disparities in this population. The purpose of the present study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. A quantitative approach was used to examine the relationship between hypertensive status and health promotion behavior. With a sample size of n = 204, this …

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Perceptions Of Nursing As A Career By African American College Students Attending Historically Black Colleges And Universities, Brenda Marie Owens Jan 2018

Perceptions Of Nursing As A Career By African American College Students Attending Historically Black Colleges And Universities, Brenda Marie Owens

Walden Dissertations and Doctoral Studies

Previous studies and official organizations have indicated that African Americans are underrepresented in the healthcare workforce and that patients belonging to minority groups feel they are treated slightly differently in healthcare settings. Limited research examines perceptions of the nursing profession among a variety of demographic groups, and exploratory investigations into the perceptions of nursing as a career by African Americans are limited. The purpose of this quantitative descriptive study was to explore perceptions of nursing as a career by African American students who attend an undergraduate program at a historically black college or university (HBCU) in an attempt to further …

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Strategies For Sustaining Small Businesses In The U.S. Health Care Sector, James Utobunwa Nwachukwu Jan 2018

Strategies For Sustaining Small Businesses In The U.S. Health Care Sector, James Utobunwa Nwachukwu

Walden Dissertations and Doctoral Studies

In the United States, many small businesses fail within the first 5 years due to poor implementation of sustainability strategies. Researchers and business practitioners have indicated that small business owners face challenges on how to maintain their businesses beyond 5 years due to lack of sustainability strategies. The purpose of this qualitative multiple case study was to explore the strategies that health care small business owners and managers in New York State use to maintain their businesses beyond 5 years. Sustainability development theory was used for the study's conceptual framework. Semistructured face-to-face interviews were conducted with 6 purposively-selected participants who …

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Evaluating Nursing Pain Assessment Documentation With The Pediatric Client, Aziza Alexander Jan 2018

Evaluating Nursing Pain Assessment Documentation With The Pediatric Client, Aziza Alexander

Walden Dissertations and Doctoral Studies

Pain is often seen as a primary complaint in the pediatric emergency department (ED). Assessment and documentation of pain are integral to effective pain management, and nurses are responsible for documenting pain assessment. Nursing documentation is essential for ensuring continuous, safe, high-quality care. Evidence shows nurses are inadequately documenting pain assessment and reassessment and not always using appropriate pain scales in a busy, cosmopolitan children's hospital ED. The practice-focused question that guided this project was: How does an educational module and change in electronic health record pain assessment flowsheet increase the nurses' compliance with initial documentation of pain? An educational …

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Patient Navigation Program In Oncolgy Clinical Practice, Mercy George Jan 2018

Patient Navigation Program In Oncolgy Clinical Practice, Mercy George

Walden Dissertations and Doctoral Studies

Cancer diagnoses affect millions of people in the United States each year. Today, cancer patients face many challenges when trying to navigate the complex healthcare system. Patient navigation programs were developed to address and overcome barriers patients may face as they make their way through the healthcare system. The purpose of this project was to provide an analysis and discussion of the current published literature to provide evidence for improving care coordination and patient satisfaction in the oncology clinical setting with a patient navigator program. The practice-focused question for this project asked if a patient navigator program for adult cancer …

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Implementation Of The Crafft Cannabis Screening Tool, Barbara Loeprich Jan 2018

Implementation Of The Crafft Cannabis Screening Tool, Barbara Loeprich

Walden Dissertations and Doctoral Studies

Cannabis use among teenagers in Canada is a concern because of the long-term and irreversible effects cannabis has on the developing body and mind. Nurses can be instrumental in screening for cannabis abuse by implementing a tool to assess for substance use disorder (SUD) and triage drug users to appropriate treatment. This project focused on how to implement the CRAFFT screening tool while gaining insight of the practitioner's knowledge base about the tool and how SUD is being screened for, currently. The CRAFFT screening tool aligns with the DSM-IV's SUD diagnosis criteria, allowing for efficient identification of those at risk …

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Advanced Cancer Patients' Medical Decision-Making While Experiencing Financial Toxicity, Heather L. Morel Jan 2018

Advanced Cancer Patients' Medical Decision-Making While Experiencing Financial Toxicity, Heather L. Morel

Walden Dissertations and Doctoral Studies

Financial toxicity (FT) is the impact that out of pocket (OOP) costs of cancer care have on patients' well-being, leading to lower quality of life, less compliance with prescribed therapy, and poorer outcomes, including increased mortality. The purpose of this study was to understand the impact of FT on advanced cancer patients' lives and their health care decision-making. Fuzzy trace theory provided the framework for examining how patients use gist and verbatim when making health care decisions while experiencing FT. Gist refers to main ideas that are often infused with emotional overlays that people use to make risky decisions, while …

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The Role Of Family Structure In The Abuse Of Children, Ramona Okonya Jan 2018

The Role Of Family Structure In The Abuse Of Children, Ramona Okonya

Walden Dissertations and Doctoral Studies

Every year, about 1 million children are abused in the United States and an average of 4.5 of those children die daily at the hands of caretakers, parents, relatives, or friends. Using the ecological model as a guide, the purpose of this study was to investigate the relationship between family structure and specific types of child maltreatment utilizing cases from an agency in Montgomery, Alabama, in 2012-2013. Approximately 727 cases of child maltreatment were reviewed. Logistic regression results indicate married and common law families' children are 1.83 times more likely to experience sexual abuse than the reference category (single) (OR= …

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The Novice Licensed Professional Counselor's Perceived Preparedness To Use Self-Disclosure, Nicole Pfaff Jan 2018

The Novice Licensed Professional Counselor's Perceived Preparedness To Use Self-Disclosure, Nicole Pfaff

Walden Dissertations and Doctoral Studies

Self-disclosure is used by feminist, humanistic, client-centered, and a variety of other counselors to build therapeutic alliances with clients. However, little research has been conducted on counselors' perceptions of their preparedness to use self-disclosure. This exploratory multiple-case study used attachment theory as a framework to explore the perceptions of novice licensed professional counselors' preparedness to use self-disclosure. The 12 participants who participated in face-to-face interviews practiced as licensed professional counselors in Delaware, New Jersey, or Pennsylvania. The participants described how they learned, practiced, and used self-disclosure. After analyzing interview data through cycle coding and peer review, themes emerged showing participants' …

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Incorporating Technology To Decrease Heart Failure Readmission Rates, Vernell Thames Jan 2018

Incorporating Technology To Decrease Heart Failure Readmission Rates, Vernell Thames

Walden Dissertations and Doctoral Studies

The rate of hospital readmissions within 30 days of discharge of heart failure (HF) patients affects patient outcomes, the financial stability of the health care facility, and the economy. Hospitals focus on strategies that will decrease the HF readmission rates by cultivating evidence-based interventions that improve patients' transition from the hospital to the community, including promoting self-management of their condition. The purpose of this quality improvement project was to develop, implement, and evaluate the use of health information technology along with written forms of plans of care to assist HF patients in managing their care, divert the HF patients to …

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Child Sexual Abuse And Prenatal Care: Understanding Screening, Modifications, And Proper Care, Wendy Abbott-Egnor Jan 2018

Child Sexual Abuse And Prenatal Care: Understanding Screening, Modifications, And Proper Care, Wendy Abbott-Egnor

Walden Dissertations and Doctoral Studies

Research has shown that 1 in 9 women in prenatal care have a history of childhood sexual abuse. Pregnant women with a history of childhood sexual abuse are at increased risk of depression, somatization, preterm contractions, posttraumatic stress symptomology, and re-traumatization. The purpose of this study was to bridge the gap in literature between research and practice. Data was collected from practitioners regarding the care and treatment of pregnant women with a childhood sexual abuse history. It was hypothesized that screening practices and modification to care and treatment based on practitioner knowledge of prior sex abuse history will vary by …

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Transition Of Care Guideline For Reducing Heart Failure Hospital Readmission, Geeti Farrahi Jan 2018

Transition Of Care Guideline For Reducing Heart Failure Hospital Readmission, Geeti Farrahi

Walden Dissertations and Doctoral Studies

Heart failure (HF) patients are among the populations with the highest rates of hospital readmission within 30 days of discharge. Because of the 2010 Health Care Reform legislation, healthcare organizations are subject to financial penalty when a patient population exhibits excess readmissions. A significant reason for readmission of HF patients is a gap in the transition of care from hospital to home. The purpose of this doctoral project was to develop a practice guideline of best practices for transitioning HF patients from hospital to home. The transitional care model and care transitions intervention provided the theoretical underpinnings for developing this …

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Predicting Certification Success For The Family Nurse Practitioner, Tammy Lee Gravel Jan 2018

Predicting Certification Success For The Family Nurse Practitioner, Tammy Lee Gravel

Walden Dissertations and Doctoral Studies

High-stakes licensure or certification examinations are required for many health professions disciplines to ensure safe entry-level practice. Accrediting agencies set a benchmark for graduates' first-time licensure or certification success as a measure of program effectiveness. Failures of graduates on licensure or certification examinations may directly affect the school's recruitment and retention of qualified students and faculty, as well as institutional financial viability. A health science university has added Health Education System, Inc. (HESI) standardized examinations using computer adaptive testing into the family nurse practitioner (FNP) master's program to support certification success, although research on these advanced practice examinations as related …

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Assessing Nurses' Safety Attitudes In Preventing Clabsi, Seraphine Ikwueme Jan 2018

Assessing Nurses' Safety Attitudes In Preventing Clabsi, Seraphine Ikwueme

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infection (CLABSI) has been widely studied because of its impact on patient morbidity, mortality, and overall health care costs. Research has shown that nurses' attitudes and perceptions regarding safety are critical to developing and maintaining clinical environments that are safe, prevent CLABSI, and assure better health outcomes. The practice-focused question for this project sought to determine the safety attitudes exhibited by registered nurses on a medical-surgical unit at the practice site. The Stetler model was used as a framework to guide the study. The Safety Attitude Questionnaire (SAQ) measured attitudes and perceptions regarding teamwork, safety, job satisfaction, …

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Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson Jan 2018

Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson

Walden Dissertations and Doctoral Studies

Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …

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Strategies To Sustain A Physician-Led Primary Care Practice, Ashley Polidori Jan 2018

Strategies To Sustain A Physician-Led Primary Care Practice, Ashley Polidori

Walden Dissertations and Doctoral Studies

Since 2008, physician-led primary care practices have decreased as physician's encounter sustainability challenges because of government regulations and the requirements of the Affordable Care Act. The problem is that some physician-led primary care practice leaders lack strategies to sustain a medical practice longer than 5 years. The purpose of this study was to explore strategies primary-care practice leaders use to sustain a practice longer than 5 years. This study followed a case study design, including a purposeful sampling of 3 physician-led primary care practice leaders in southern Indiana. Open-ended semistructured interviews were conducted and triangulated with company policies and procedures …

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Changes In Beliefs About Aggression In Baton Rouge Youth Peace Olympics Participants, Shonta Manuel Jan 2018

Changes In Beliefs About Aggression In Baton Rouge Youth Peace Olympics Participants, Shonta Manuel

Walden Dissertations and Doctoral Studies

Youth violence in the Baton Rouge inner-city area continues to create heightened concerns for the communities as well as the financial and healthcare systems. Even though violence prevention programs are in place in the area, no decline has been recorded in those who are being affected by violence. Due to lack of research in this field, a need for a sound research study exists to understand how Youth Peace Olympics (YPO) community-based program may be related to changes in attitudes about aggression and violence. A correlational cross-sectional research design was used to evaluate participants' beliefs about aggression, measured using the …

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Increasing Patients' Understanding Of Prescribed Medication Adherence, Valarie Finley Thomas Jan 2018

Increasing Patients' Understanding Of Prescribed Medication Adherence, Valarie Finley Thomas

Walden Dissertations and Doctoral Studies

The cost of healthcare in the United States has increased due to growing numbers of patients who live with chronic health problems, such as heart disease. The cost of healthcare is compounded by the cost in terms of complications of cardiovascular disease secondary to medication non-adherence. Education about medication use and adherence, safety, and side effects was needed for patients in a cardiovascular unit to improve adherence to medications as prescribed. Results of a health care provider (HCP) and nursing staff needs assessment provided by the site showed the need for improved cardiovascular medication education. The project focused question asked …

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Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright Jan 2018

Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright

Walden Dissertations and Doctoral Studies

Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …

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Progression Of Clinical Self-Efficacy Among Baccalaureate Nursing Students, Christine Lee Hamilton Jan 2018

Progression Of Clinical Self-Efficacy Among Baccalaureate Nursing Students, Christine Lee Hamilton

Walden Dissertations and Doctoral Studies

Clinical self-efficacy, or the confidence that nursing students have in their ability to successfully perform nursing clinical skills, is imperative for the safe and effective practice of nursing. A gap in knowledge exists about the change in clinical self-efficacy as baccalaureate nursing (BSN) students move through a nursing program, in which they learn and practice clinical skills in laboratory and clinical settings. Guided by Bandura's social cognitive theory, the purpose of this quantitative study was to determine the relationship between clinical experience within a nursing program and the reported clinical self-efficacy of BSN students in the sophomore, junior, and senior …

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Perceptions Of Collaboration And Mutual Respect Among Members Of Interprofessional Teams, Brenda Lankhof Jan 2018

Perceptions Of Collaboration And Mutual Respect Among Members Of Interprofessional Teams, Brenda Lankhof

Walden Dissertations and Doctoral Studies

Government agencies are encouraging healthcare practitioners to work in interprofessional teams to address the complex needs of an aging population, to improve client outcomes, and to increase the cost-effectiveness of health care. However, a clearer understanding of the elements required for an effective interprofessional collaborative practice is needed. The purpose of this online, descriptive study was to focus on one component, mutual respect, and determine its relationship to collaboration among members of interprofessional teams working in family health teams (FHTs) and community health centers (CHCs) across Ontario. D'Amour's four-dimensional model of collaboration was used as the theoretical basis. This model …

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Evaluation Of The Bedside Swallow Screen, Ruby Ben Jan 2018

Evaluation Of The Bedside Swallow Screen, Ruby Ben

Walden Dissertations and Doctoral Studies

Dysphagia is a leading complication of a stroke. A nurse-driven bedside swallow screen can identify dysphagia and decrease the risk for complications such as aspiration pneumonia. At the project site, the use of the bedside swallow screen was at 33%; there was noncompliance with the use of the bedside swallow screen by the emergency department nurses. The purpose of the doctoral project was to increase the use of the bedside swallow screen. Published outcomes, research, and reports generated from archived data were the sources of evidence. The six sigma methodology was used to inform the quality improvement doctoral project. At …

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Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty Jan 2018

Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty

Walden Dissertations and Doctoral Studies

Incidents of falls among the elderly increase with age. About $31 million is spent annually in the United States on medical costs related to fall injuries in the elderly. This project evaluated the outcomes of a fall reduction program implemented in an assisted living facility (ALF). The Stop Elderly Accidents, Death & Injury program developed by the Centers for Disease Control and Prevention was implemented by the ALF for 60 days prior to the outcome evaluation project. The program included a convenience sample of 62 residents and involved medication evaluation, exercises, assistive devices, environmental risk reduction, and evaluation of blood …

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