Medicine and Health Sciences Commons^™

Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper

Walden Dissertations and Doctoral Studies

The introduction of federal initiatives and incentives regarding health information technology fostered a movement towards the adoption of electronic health records (EHR). Implementation of EHRs sparked discussions among healthcare providers, patients, and others about the benefits or challenges of the move from the traditional paper method to the electronic version in healthcare settings. A knowledge gap in research involving the usefulness of EHRs and their impact to the delivery of care in other settings exists. The purpose of this qualitative study was to explore public health providers' perceptions of the meaningful use of EHRs in a disaster setting. Study participants …

Maternal Socioeconomic Status And Human Papilloma Virus Vaccine Uptake, Shawn Lockett

Walden Dissertations and Doctoral Studies

There are more than 79 million people in the U.S. currently infected with human papillomavirus (HPV), with an estimated 14 million new infections annually. There is a lack of knowledge about the maternal socioeconomic influences and uptake of the HPV vaccine series. Infection with HPV can cause cervical cancer in women, and there are over 11,000 cervical cancer diagnoses in the U.S. responsible for 4000 deaths annually. Vaccination coverage to prevent HPV infection does not meet the Healthy People 2020 goals of an 80% vaccination rate in the U.S. In this study, associations were tested between maternal SES variables and …

Diabetes Management Protocol In The Rehabilitation Setting, Hannah Mottel

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a growing healthcare problem in the United States. Diabetes affects 1.4 million Americans yearly, impacting the lives of individuals of all ages. One of the most challenging aspects about diabetes is that many individuals are not aware of the impact of the disease on multiple organs until the progression of the disease has reached latter stages. Prevention and early detection of diabetes is a key component of lifesaving interventions including proper nutrition counseling, exercise regimens, management, and patient compliance with a treatment plan. The purpose of this doctoral project was to create a standardized diabetes management protocol …

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …

Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha

Walden Dissertations and Doctoral Studies

Although it is known that the prevalence of type 2 diabetes is on the rise in Canada, more information is needed on how well type 2 diabetes patients living in Cambridge, Ontario self-manage their diabetes and what factors influence their adherence to diabetes medication regimens. The objective of this cross-sectional study based on the theory of planned behavior was to determine if there are predictors of adherence to diabetes medications among patients living with type 2 diabetes in Cambridge. The World Health Organization STEPwise Approach to Surveillance was used to collect demographic data. Adherence and diabetes knowledge were assessed with …

Awareness And Attitudes Of Young Nigerian Immigrants In The United States To Sickle Cell Screening And Premarital Genetic Testing, Timothy Atolagbe

Walden Dissertations and Doctoral Studies

The carrier frequency for sickle cell anemia among Nigerians, who account for a high percentage of African immigrants in the United States, is high, according to the World Health Organization. Even though sickle cell disease contributes $2.4 billion annually to U.S. health care expenditures, ascertaining the number of affected individuals in the U.S. is difficult because sickle cell is not a reportable genetic disease. However, according to the Census Bureau, the number of African immigrants continues to grow at a steady pace among the foreign-born immigrant population in the U.S. There is a lack of research on the contribution of …

Exploring The Role Of Religious Leaders In Preventing Sickle Cell Disease In Nigeria, Grace Awe

Walden Dissertations and Doctoral Studies

Nigeria has high rates of sickle cell disease (SCD), which is attributed to the lack of awareness of the disease among the reproductive age in the country. The purpose of this cross-sectional study was to explore the role of religious leaders in contributing to awareness and prevention of SCD in Nigeria. Religious leaders' knowledge, attitude, and prevention and awareness practices of SCD, and how they translated to the prevention of SCD through improved counseling of premarital couples, were explored. A stratified random sampling was employed in selecting a sample of 150 religious leaders from different religious affiliations. Data were collected …

Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie

Walden Dissertations and Doctoral Studies

Children exposed to secondhand smoke (SHS) are at risk of developing ear infections, asthma, wheezing, bronchitis, as well as retarded lung growth. Indoor smoking is the main source of children's exposure to SHS. Despite a downward trend in smoking, children from low income families, especially African American and Hispanic children, continue to be exposed to SHS at a higher rate than their wealthier counterparts. This multiple case study explored the perceptions of 15 parents of 3- to 5-year-old children currently enrolled in Head Start regarding children's exposure to SHS. This study relied on the social ecological model, the theory of …

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …

Systematic Review Of Sedation Management In The Pediatric Critical Care Unit, Myrlene Madelon

Walden Dissertations and Doctoral Studies

Nurse-driven guidelines existed for the management of sedation in adult population; however, there is a lack of guidelines for the critically ill children. Nurses play significant roles in the management of sedation for mechanically ventilated patients in the Pediatric Intensive Care Unit (PICU), nonetheless, comprehensive guidelines for the management of sedation does not exist. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to adapt a pediatric clinical guideline for sedation management. The ACE star model and the evidence-based practice model were used as a framework to guide this review. The …

Pain Management, Gender, And Quality Of Life In Cancer Patients, John Robert Buhmeyer

Walden Dissertations and Doctoral Studies

The type of cancer pain management used may have an effect on the quality of life (QOL) of cancer patients. Researchers have determined that cancer patients are inadequately treated for pain and pain management is an essential determinant of patient survivability and QOL. Numerous clinical studies have been accomplished concerning opioid administration and noncancer and cancer pain management exist. Previous studies have examined the relationship between cannabinoid products, noncancer pain, cancer pain, and related QOL for patients but have not focused on the QOL of cancer patients while also moderating for gender. These relationships were investigated using the health belief …

Alzheimer's Disease Dementia: Stress, Female Caregiver Burden, And Older Caregiver Health Outcomes, Nadia Muhammad

Walden Dissertations and Doctoral Studies

Alzheimer's disease dementia caregivers are heavily engaged in providing daily assistance to individuals encumbered with Alzheimer's disease, but these caregiving duties can have a devastating effect on caregivers' self-reported health and mental outcomes. The purpose of this study was to evaluate older female caregivers' background and contextual stressors and care stressors on caregivers' self-reported harm to health resulting from the stress of caregiving, health status and emotional stress. The stress process model for Alzheimer's caregivers served as the theoretical foundation for this study. Correlation and logistic and linear regression analysis were used to evaluate if a relationship exists between the …

Practice Guidelines For Continuous Pulse Oximetry Monitoring For Obstructive Sleep Apnea Patients, Bridgette Smart

Walden Dissertations and Doctoral Studies

As the rate of obesity has increased in the United States to include approximately 40% of the adult population, there has been a corresponding rise in the number of patients with obstructive sleep apnea (OSA). The OSA population is at risk for adverse perioperative respiratory depression. Continuous pulse oximetry monitoring is indicated for these patients upon discharge from the recovery room into other treatment settings and when cared for by telemetry or by trained hospital staff in the patient's room. The practice question was whether an evidence-based practice guideline could be developed to help ensure safe postoperative monitoring of patients …

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …

Influence Of Psychological Capital And Thinking Perspectives On Construction Safety Climate And Performance, Anne-Perrine Pascale Cades

Walden Dissertations and Doctoral Studies

Understanding safety factors in construction is critical to reducing accident frequency and severity. Grounded in the safety performance model, this study was conducted to examine the impact of psychological capital (PsyCap), which consists of the shared variance of hope, efficacy, resilience and optimism, and Past, Present, and Future thinking perspectives, on safety climate and performance. A nonexperimental quantitative design was used to determine whether PsyCap and thinking perspectives of construction project employees predicted safety performance and/or moderated the relationship between safety climate and performance across construction sites in different countries. 411 construction employees were recruited via a multistage and clustering …

Improving Human Papillomavirus Vaccination Rates Through Evidence-Based Interventions, Deidra Thompson

Walden Dissertations and Doctoral Studies

Cervical cancer is the most common human papilloma virus (HPV) -associated cancer and is the second leading cause of death in the world. Vaccination against HPV is essential to reduce the incidence of HPV and subsequent morbidity and mortality. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million Americans are currently infected with HPV. The site for this DNP project was a 163-bed facility with inpatient and outpatient services in the southern United States. The vaccination rate at the site was 48%. The facility lacked educational interventions to prepare and remind providers to offer HPV vaccine. …

Poverty Rate And Occurrence Of Foodborne Illness Risk Factors In Retail Facilities, Margolite Joseph Cesar

Walden Dissertations and Doctoral Studies

Despite the efforts of food safety regulations and rules, food contamination remains a public health concern and prevalent vehicle of pathogens. This study identifies the predictors of food risk in different types of food establishments in Miami Dade County, Florida during the period November 2014 - November 2016. Guided by the epidemiologic triangle model, this correlational study analyzed the log number of risk factor violations and failure rates controlling for US Census sociodemographic data (2010 to 2014) for the food establishment neighborhoods by using linear and logistic regression. Results indicated that most of food entity types are significant predictors of …

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Walden Dissertations and Doctoral Studies

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

Physical Activity And Veteran Status In Obesity And Chronic Obstructive Pulmonary Disease, Erin Mcguire Kren

Walden Dissertations and Doctoral Studies

There are few data available regarding the relationship between physical activity and veteran status in those with combined chronic obstructive pulmonary disease (COPD) and obesity. COPD is a common illness and a leading cause of death in the United States. Veterans represent a distinct subpopulation in the United States and are more likely to have COPD, which is a disease with a high rate of comorbidities such as obesity. Physical activity can improve outcomes for those with COPD and obesity. However, recommendations for physical activity for those with COPD and obesity are vague. This study, based on the self-determination theory, …

Collaborative Treatment Plan Development, Sally Kangas

Walden Dissertations and Doctoral Studies

The practice problem for this quality improvement project was the lack of engagement of chronic back pain patients at a Midwest clinic in evidence-based risk/benefit discussions regarding treatment options. The project was designed to explore whether practice guidelines increase patient engagement as measured by the Patient Activation Measure (PAM). Practice guidelines for interactive patient/nurse practitioner discussions regarding treatment options were developed, implemented, and evaluated. The concepts of chronic pain, chronic pain treatment options, and patient engagement were researched, and the evidence was evaluated using the Grades of Recommendation Assessment, Development, and Evaluation system. The clinical practice guideline was developed following …

Association Between Age Of Women When Diagnosed With Endometriosis And Infertility, Whitney Kennedy

Walden Dissertations and Doctoral Studies

Abstract

Because endometriosis is considered to be the primary cause of infertility in women and

the diagnosis is known to be delayed by many years, it is important to understand the

association between endometriosis and infertility. The purpose of this cross-sectional,

secondary data analysis study was to determine whether there was an association between

the age of women when diagnosed with endometriosis and infertility. Using the general

model of total patient delay (i.e., the Andersen model) as a theoretical foundation, data

for this study was collected by assessing patient medical records of women with

endometriosis at multiple OB-GYN clinics in …

Workplace Violence Among Nurses And Nursing Assistants In Texas, Tamala Norris

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) is ranked as one of the leading causes of occupational injury in the United States and is common in health settings. Nurses have the highest rate of violent victimization reported in the U.S., thus presenting a significant issue for healthcare leaders. Various researchers focus on prevalence rates of WPV among nurses discussing types of violence, location, and the setting where the WPV occurred. Less information exists regarding time taken off work and factors associated with WPV among nurses versus nursing assistants (NAs). This information is important due to the impact on safe work environments for nursing employees. …

Time Banks As Aging-In-Place Initiatives, Calli Sajnani

Walden Dissertations and Doctoral Studies

There has been growing concern over how state and federal governments can support the increasing population of aging Americans and their need for long-term care. Current insurance funding models cover acute hospitalization and skilled care only, leaving unskilled care needs and homemaker services at the full expense of those in need. Time banking allows individuals to exchange or barter time for goods or services without monetary payment. There is insufficient evidence to determine if members believe time banks to be a viable alternative to support aging-in-place care needs. This phenomenological study explored time banking as a potential vehicle for nonskilled …

Integration Of Learning Activities For Improved Performance On The Nclex-Rn Exam, Erika Wilkinson

Walden Dissertations and Doctoral Studies

An institute of higher education located in the United States was unable to maintain the required first-time pass rate, on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, by nursing graduates, as defined by their State Board of Nursing and accreditation body. Failure to meet these requirements resulted in a corrective action plan and fewer licensed nurses able to enter practice. The purpose of this study was to identify curricular changes to the associate nursing program to improve the first time pass rate by their nursing graduates. Benner's theory of skill acquisition was used as the conceptual framework …

Spiritual Wellness As A Predictor For Moral Injury In Combat Veterans, Steve Zappalla

Walden Dissertations and Doctoral Studies

Many combat veterans face difficulties coping with their personal lives, relationships, and families when they leave the service and return to civilian life. Most studies examining the effects of combat on veterans focus on posttraumatic stress disorder (PTSD) as well as a collection of related consequences. Interest in the term moral injury of military veterans as a related mental health construct has grown. Researchers have investigated the effects of spiritual wellness of combat veterans. However, there is a paucity of counseling literature on the relationship between spiritual wellness and moral injury when combat veterans return to civilian life. Investigating the …

Evidence-Based Practice Guideline For Peripheral Artery Disease, Jenny Ann Salve Managbanag

Walden Dissertations and Doctoral Studies

The absence of a practice guideline for peripheral artery disease (PAD) in the cardiology department creates differing practice preferences among providers, leading to deviations in practice among staff. Variations in practice can affect the quality of care that is provided to patients. This project was guided by research statements indicating that there was a difference in the screening approach for PAD among health practitioners at preimplementation and postimplementation and that an 85% compliance with the guideline would signify consistency in the provision of care. Rogers' theory of diffusion of innovations was used to facilitate the adoption of the guideline. This …

Early Detection Of Neonatal Abstinence Syndrome By Neonatal Intensive Care Unit Nurses, Ebele Oraka

Walden Dissertations and Doctoral Studies

Neonatal abstinence syndrome (NAS) is a public health concern that is increasing in the United States due to the use of illicit drugs by pregnant women, which exposes the fetus to these substances. NAS results in increased infant morbidity and prolonged stay in the hospital, which can lead to increased cost of care. The inability of the nurses to care for at-risk infants can lead to inconsistent NAS scores, which can affect the infant's care treatment. The project examined the effectiveness of educating the neonatal intensive care unit (NICU) nurses on the correct use of the modified Finnegan Neonatal Abstinence …

Factors That Influence Whether Mexican Americans With Depression Seek Treatment, Irene Rodriguez

Walden Dissertations and Doctoral Studies

Mexican Americans, the largest Hispanic subgroup in the United States, tend to underuse mental health services. Grounded in Andersen's behavioral model of health services use, the purpose of this nonexperimental study was to examine the likelihood of birth country, education, income, and insurance predicting which respondents would report seeking mental health services to treat depression. The Mini International Neuropsychiatric Interview was used to diagnose depression in 203 Mexican Americans whose data was archived from the primary study. This archived data was analyzed within this study. The results of the 2 x 2 chi-square tests of independence indicated a significant association …

An Educational Program For Using The Distress Themometer, Mabel M. Che-Tuma

Walden Dissertations and Doctoral Studies

The distress thermometer (DT) is a screening tool designed to measure the level of stress in oncology patients. Clinical oncology nurses (CONs) at the local site lacked knowledge and training on how to administer and apply the DT. Because of this practice gap, patients were not receiving referrals to the necessary support services. The purpose of this project was to design and validate a CON staff education program on the use of the DT. The diffusion of innovation theory along with the theory of interpersonal relations served as the conceptual framework for the project. The project was organized into a …

Strategies To Reduce Occupational Injuries And Illnesses In Government Agencies, Sandra Montgomery

Walden Dissertations and Doctoral Studies

Despite regulatory efforts of the Occupational Safety and Health Administration (OSHA), 104 cases of nonfatal occupational illnesses and injuries (OIIs) per 10,000 full-time workers required time away from work in 2015. Although OII rates in private and public sectors are high, the rates among state and local government agencies were over 50% higher than private sector rates in 2015, especially in the healthcare industry. OIIs can lead to reduced organizational productivity and performance. Guided by the leader member exchange theory (LMXT) and risk homeostasis theory (RHT), the purpose of this single case study was to explore effective strategies that supervisors …