Medicine and Health Sciences Commons^™

Nonpharmacological Behavioral Interventions For Patients With Dementia: An Integrative Literature Review, Michelle Monique Spears

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in older adults with dementia increases risk of

mortality; therefore, it is critical that nurses use nonpharmacological interventions in dementia care. The nurses' role is integral to implementation of treatment strategies to dementia patients and efforts to improve care in patients with dementia using a nonpharmacological approach are necessary. Therefore, guidelines outlining nonpharmacologic dementia care management will enable nurses to provide a wider spectrum of care to dementia patients. The purpose of this project was to make recommendations for the development and implementation of interdisciplinary practice guidelines to standardize care in the organizational setting. An …

Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu

Walden Dissertations and Doctoral Studies

Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were …

Development Of A Sexual Assault Support Group For Female Rape Victims, Ann Marie Nichole Willoughby

Walden Dissertations and Doctoral Studies

Survivors of sexual assault struggle to cope with subsequent psychological disturbances. The project facility was a rural hospital in the southwestern United States in which postasault care was initially provided, but survivors later returned to the emergency department. Support groups can be a powerful tool to alleviate long-term consequences of assault by helping individuals cope and improving socialization. This project used the social-ecological theory to explore whether a sexual assault support group would impact the progress of survivors toward improved social interaction, improved socialization, and decreased psychological disturbance. The purpose of the quality improvement (QI) project was the development of …

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach

Walden Dissertations and Doctoral Studies

Inadequate interprofessional collaboration (IPC) and communication among health care professionals are associated with medical errors and mortality. Guided by the theory of goal attainment and the chronic care model, a systematic review was conducted to explore the evidence related to whether interprofessional collaborative primary care can have a positive effect on health outcomes for patients living with diabetes (PLWD). The systematic review followed the Joanna Briggs Institute method for systematic reviews and results were complied with the PRISMA evidence-based minimum set for reporting. Data were analyzed to identify if IPC positively impacted the health outcomes of PLWD, as evidenced by …

Understanding Parenting Styles Of Second-Generation Parents Of Residential School Survivors Within Treaty 8 Reserves, Judy Kim-Meneen

Walden Dissertations and Doctoral Studies

Approximately 150,000 First Nation, Metis, and Inuit children attended Canadian residential schools from the 1840s to 1996. Most residential school children had negative experiences of physical, verbal, and sexual abuse that led to parenting repercussions once these children became parents. These repercussions of residential schools led to a rate of neglect for First Nation children 12 times higher than non-First Nation children. The purpose of this qualitative phenomenological descriptive study was to explore the lived experiences of second generation parents, who were schooled in residential schools as children and their current parenting styles. The conceptual frameworks of trauma theory and …

Emotional Self-Management Experiences Of Practical Nursing Students, Cindy Ko

Walden Dissertations and Doctoral Studies

In Ontario, Canada, practical nurses (PN) are educated through a 2-year diploma program. A review of PN program curricula in Ontario suggested that emotional intelligence (EI) and the core concept of emotional self-management are not specified in curriculum outcomes or courses. The study explored PN students' lived experiences with emotional self-management in the clinical settings where they are exposed to stress related situations using van Manen's orientation to hermeneutic phenomenology. The original four-branch ability model of EI by Mayer and Salovey was used as the theoretical framework to guide the explorative and interpretative processes of the study. Face-to-face interviews were …

Predictors Of Blood Pressure And Lipids Levels Among African Americans, Frank Lanor

Walden Dissertations and Doctoral Studies

African Americans disproportionately develop cardiovascular disease risk factors including high blood pressure and high cholesterol levels in comparison to European Americans. The purpose of this study was to examine the associations of diet quality and physical activity with blood pressure levels and cholesterol levels among African Americans. The social ecological model was the theoretical foundation for the study. Research questions were designed to examine the extent to which diet quality and physical activity predict blood pressure levels and cholesterol levels. The research design was quantitative cross-sectional secondary analysis of 959 participants. After controlling for demographic factors, body mass index, and …

Dissertation: Sociodemographics And Pancreatic Cancer Survival Rate, Sylvester Lewis

Walden Dissertations and Doctoral Studies

Pancreatic carcinoma or pancreatic cancer (PaCa) is an insidious disease with a prognosis of 6- to 12-month survival time for a late stage diagnosis. This problem has become crucial given that no study to date had been able to establish a definitive association between independent factors (other than a few diseases) and the survival rate of pancreatic cancer. The purpose of this quantitative, cross-sectional study was to determine whether an association exists between the independent, sociodemographic variables (marital status, age, education, income, and employment) and the outcome variable of survival rate. The social cognitive theory was the framework that provided …

Effectiveness Of Guardrails At Reducing Medication Errors Indrug Administration, Teresa Mosley

Walden Dissertations and Doctoral Studies

Medication errors during drug administration are an issue in the nursing profession. The errors that occur due to intravenous vein infusions pose threats to patients due to the mode of administration and the risk of occurrence. Strategies such as guardrails have been implemented to reduce the rate of such errors. Despite these guardrails, facilities record mixed results on the effectiveness of infusion pumps in reducing medication errors. The project was designed as a quantitative study to evaluate the effectiveness of guardrails in reducing medication errors at the facility. Data analysis included error reports from the facility before and after the …

Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip

Walden Dissertations and Doctoral Studies

Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …

Maternal Characteristics And The Risk Of Cleft Lip And Palate In The United States, Letha Thomas

Walden Dissertations and Doctoral Studies

Cleft lip with or without cleft palate (CLP) is an ongoing public health issue across the globe, and in the United States. The estimated number of babies born each year in the United States with cleft palate (CP) is about 2,650, while CLP affects approximately 4,440 babies. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between CLP and maternal characteristics such as reproductive history (advanced maternal age, maternal obesity, prenatal visits, month prenatal care began, number of pregnancies, gestational age at birth, assisted reproductive technology used, gestational diabetes, and hypertension), socioeconomic status of …

Effect Of Socioeconomic And Neighborhood Factors On Stroke Hospitalization Rate In Virginia, Esther Musu Stephens

Walden Dissertations and Doctoral Studies

The stroke rate in Virginia is above the national rate. Stroke results in poor quality health, morbidity, and mortality. This quantitative epidemiological study was conducted to investigate whether a significant association exists between stroke and (a) socioeconomic and (b) neighborhood factors among people who were admitted to Virginia hospitals between 2010 and 2015. An ecological design, including ecosocial theory, was used to examine associations between environmental factors and stroke. Data (746 census output areas) were acquired using patients' billing zip codes from the Virginia Health Information System in combination with socioeconomic and neighborhood data by Zip Code Tabulation Area from …

Organizational Strategies To Reduce Hospital Readmissions, Steven Warchol

Walden Dissertations and Doctoral Studies

Reducing hospital readmissions is critical to the success and sustainability of both hospitals and the communities in which they reside. The purpose of this multiple case study was to explore organizational strategies hospital leaders use to reduce hospital readmissions. The study was limited to hospitals in Southwest Missouri with readmission rates below the state average. Complex adaptive systems was the conceptual framework for the study because of the complex nature and numerous stakeholders of the healthcare system. Data were collected from a purposive sample of 15 hospital leaders via semistructured interviews and an analysis of organizational artifacts. Member checking was …

Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe

Walden Dissertations and Doctoral Studies

This DNP project focused on the spiritual aspects of care that are often neglected in the outpatient setting. Most patients value their spiritual health and believe that it is just as important as their mental and physical health. The purpose of this project was to improve the overall spiritual care provided to patients, their families, and/or caregivers in times when they were experiencing spiritual distress. This quality improvement (QI) project was designed to determine whether embedding a chaplain in an outpatient clinic instead of providing a pamphlet about chaplain services increases patient satisfaction. Secondary analysis of the data in this …

Impact Of Social Support On Malaria Management By Burundian Community Health Workers, Bonaventure Bazirutwabo

Walden Dissertations and Doctoral Studies

Malaria is the main cause of mortality for children under the age of 5 in Burundi. The access to malaria diagnostics and treatment is hampered not only because of logistical issues, but also due to the lack of qualified human resources and their inequitable distribution across the country. To mitigate the lack of human resources for health, the government of Burundi, along with its partners, shifted some tasks to community health workers (CHWs) to cover unmet healthcare needs for selected diseases such as malaria, diarrhea, and pneumonia. The purpose of this study was to determine whether the social support provided …

Factors Associated With Menthol Cigarettes Smoking Among Youths Ages 12 To 19, Eniye Emmanuel Eguae

Walden Dissertations and Doctoral Studies

Menthol is added to cigarettes to make smoking more convenient. Menthol is considered a contributing factor that makes smoking appealing to youths and their continuous smoking initiation, which progresses to regular cigarette smoking and addiction, especially among youths ages 12 to 19. Menthol encourages approximately 4,000 youths to experiment with smoking daily in the United States, of which approximately 1,000 become active smokers. Not enough is known regarding the influence of menthol on youth smoking initiation/smoking behavior. A quantitative analysis of data from the 2014 National Youth Tobacco Survey (NYTS) was used to explore the association between age, race/ethnicity, gender, …

Leisure Time Physical Activities Of Older Adults In Senior Housing, Tamiera S. Harris

Walden Dissertations and Doctoral Studies

Increasing physical activity levels of older adults is a public health priority given the associated risks with sedentary lifestyles. Exercise such as walking may positively affect older adults as they age decreasing the risk of heart disease, stroke, or death. The purpose of this study was to examine physical activities of older adults in senior housing and to determine if age correlates with the amount of physical activity. Physical activity studies on older adults are limited due to time and resources. The health belief model and transtheoretical model frames this study theorizing that older adults will take positive steps towards …

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …

Understanding Quality Of Care In A Hospice Setting, Sarah Fese Taylor

Walden Dissertations and Doctoral Studies

Assuring quality of care for patients who face the end of life has been a major concern for those in hospice settings. Limited research is available that has a focus on understanding what quality of care in a hospice setting looks like. This research is important to provide insight into hospice health care providers' perceptions of the quality of care in the hospice setting and on the indicators that influence care quality. A qualitative phenomenological approach was used to answer the research questions on the perspectives of the health care providers in the hospice care setting regarding the quality of …

Use Of Hpv Vaccination For Cervical Cancer Prevention In African American Women, Diamond Diane Hanson

Walden Dissertations and Doctoral Studies

Despite the availability of the human papillomavirus (HPV) vaccine, African American women are still at risk for contracting HPV. This is significant because HPV is one of the main risk factors for cervical cancer. The purpose of this quantitative study was to explore the relationship between the use of HPV vaccination for cervical cancer prevention and personal history of HPV, reduced access to healthcare, and risky sexual behaviors in African American women. The theoretical framework used for this study was the health belief model (HBM). Two hundred twenty-nine (n=229) African American women living in the United States, ages 18-49, who …

The Effects Of Cultural Dissimilarity On Employee Job Attitudes And Productivity, Sherrice Olithia Lyons

Walden Dissertations and Doctoral Studies

Organizations in Jamaica have been impacted by globalization and the opportunities and challenges of cultural incompatibilities. Most previous studies on cultural incompatibilities have focused on the impact on expatriates leaving a gap in the literature with respect to the implications for host country nationals, and specifically Jamaicans. This quantitative study focused on employees of 2 companies in Jamaica, an energy company and a hospitality company. It examined cultural dissimilarity with respect to host country nationals and expatriates, and its effect on the productivity, job satisfaction, affective commitment, and normative commitment of these employees (N = 110). In addition to the …

Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck

Walden Dissertations and Doctoral Studies

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to …

Depression Management In Outpatient Settings: A Systematic Review Of The Literature, Modupe Mary Okonofua

Walden Dissertations and Doctoral Studies

Depression is a mental illness that requires prompt identification and treatment due to grave consequences if untreated. Depression can affect a person's level of functioning, lead to worsening health conditions, comorbid substance abuse, and suicide. Despite these facts, the current state of nursing practice includes an inadequate diagnosis of patients with depression, lack of guidelines for the use of assessment tools and diagnostic tests to identify depression, and insufficient information concerning the accuracy of depression assessment tools. This systematic literature review examined 6 depression assessment tools in regard to their accuracy as identified by specificity, sensitivity, reliability, and validity. This …

Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker

Walden Dissertations and Doctoral Studies

The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than …

Bleach-It-Away Clostridium Difficile, Kim Ione Hecker

Walden Dissertations and Doctoral Studies

Hospital-associated infections (HAIs) are infections patients contract as a result of being hospitalized. HAI rates decreased for almost all pathogens in the past few years, with the exception of Clostridium difficile infections (CDIs), which have been steadily climbing, placing hospital-acquired CDI at the top of the HAI list. The Center for Disease Control and Prevention reported in 2010 almost a half a million people were infected with CDIs yearly in the United States, and CDIs claimed the lives of approximately 29,000 people, representing a 4-fold increase from 1993. To address the problem in the local hospital, a quality improvement initiative …

Evidence-Based Education Program To Reduce Nurse Manager Burnout, David Howe

Walden Dissertations and Doctoral Studies

Nurse managers face numerous challenges and stressors in their daily practice. The support services offered to managers to facilitate coping in stressful situations vary among employers and may be ineffective depending on the stressors faced. Implementation of evidence-based best practices may positively impact nurse managers' ability to manage stress. The purpose of this project was to develop an evidence-based stress reduction education program to empower nurse managers to handle work-related stressors and reduce burnout. The primary theory used to inform this project was the job demands-resource model, which explains how job demands and resources have multiple effects on job stress, …

Chronic Low Back Pain- A Needs Assessment For Practice Change, Chukwudi Oduah

Walden Dissertations and Doctoral Studies

There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for …

Educational Program For Parents Of Neonates On Nasal Continuous Positive Airway Pressure, Irina Sher

Walden Dissertations and Doctoral Studies

Parents in the neonatal intensive care unit (NICU) whose term or preterm infants are receiving nasal continuous positive airway pressure (NCPAP) experience stress. They often worry about being able to hold their child and possible complications of NCPAP, such as nasal deformities and compromised organ function. Lacking standard educational programming to provide parents information that they need to understand the care their infant is receiving, parents experience unnecessary stress that affects their capacity to care for their infants. A review of the literature suggested family-centered educational programs are able to decrease stress and increase parental confidence. The purpose of this …

A Nutrition Education Program For Advanced Practice Registered Nurses Caring For Obese Patients, Kathy Lynn Wilson

Walden Dissertations and Doctoral Studies

Obesity is a major U.S. public health epidemic. A review of the current literature identified a lack of obesity counseling with individuals. The gap in practice was a lack of understanding of nutrition, nutrition labeling, and how foods affect health. The objective of this project was to identify the community assessment need related to obesity and then educate APRNs on ways to better communicate with obese patients. This project focused on an education program for advanced practice registered nurses (APRNs) on using the 5 A's framework for obesity counseling to improve their knowledge and skill in counseling their overweight and …