Medicine and Health Sciences Commons^™

Knowledge And Barriers To Safe Disposal Of Pharmaceutical Products Entering The Environment, Aldo Francesco Fidora

Walden Dissertations and Doctoral Studies

The use of pharmaceutical products has steadily increased in the United States from 2 billion prescriptions in 1999 to 3.9 billion in 2009. Half of patients do not comply with the recommended prescription regimen and dispose of unused drugs in the environment. The U.S. Environmental Protection Agency and many researchers have highlighted the human-health risks associated with improperly disposing of pharmaceutical products. This quantitative cross-sectional study examined the potential correlations between people's actual disposal practices and their knowledge of the impact of disposal practices on the environment and human health, and availability of disposal options. The conceptual framework selected for …

Strategies To Overcome The Nursing Shortage, Edward A. Mehdaova

Walden Dissertations and Doctoral Studies

Nursing shortage is a growing problem in the healthcare industry as hospital leaders are experiencing difficulties recruiting and retaining nurses. Guided by the PESTEL framework theory, the purpose of this case study was to explore strategies healthcare leaders use to overcome a nursing shortage. Participants were 5 healthcare leaders who have the knowledge and experience in recruitment and retention of registered nurses in a healthcare facility in Seattle, Washington. Data were collected through audio-recorded semistructured interviews and document review of the Hospital Employee Education and Training Program. Data analysis consisted of documenting the data, organizing and categorizing the data, connecting …

The Impact Of Engagement Strategies On The Reduction Of Patient Falls, Rosemary Martin

Walden Dissertations and Doctoral Studies

Despite the availability of many fall prevention measures, many patients fall in U.S. hospitals each year. Experts view patient fall rates as the measure that can be most affected by a nurse-led, evidence-based intervention. The purpose of this quality improvement project was to implement and evaluate the impact of patient engagement strategies on patient compliance to fall prevention education and the reduction of falls. The quality improvement framework used for this project was the Iowa Model. Interventions for this project included patient engagement strategies including the teach-back (TB) method and video-based fall prevention education paired with the project site's existing …

Prevention And Management Of Postpartum Hemorrhage, Lisa N. Medoh

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage (PPH) remains a major traumatic event that can occur after delivery. All expectant women are considered to be at risk of PPH and its effects. PPH is a preventable condition and primary interventions including active management of the 3rd stage of labor, use of uterotonics, and uterine massage. Analysis of the project site showed that PPH affected approximately 15% of all deliveries that occurred between 2014 and 2015. The overarching aim of the project was to determine how a nursing-focused educational intervention would affect staff nurse knowledge regarding PPH to decrease the incidence rate. The goal of the …

Perceptions Of Women Receiving Services From Domestic Violence Advocacy And Counseling Programs, Lisa Yvette Proby

Walden Dissertations and Doctoral Studies

Abstract

The purpose of this qualitative study was to examine domestic violence victims' perceptions of advocacy and counseling programs that provide women with safe refuge, prevention education, mental health treatment, and other services. Many women in the United States are victims of intimate partner violence. Review of existing literature found that little is known about the extent to which the needs of these victims are met from available advocacy and counseling services. The health belief model was used to theorize victims' perceptions of services and risk factors for re-abuse. A phenomenological design was used to answer research questions, and in-depth …

Possible Risk Factors For Multidrug-Resistant Tuberculosis Infection In The Philippines, Molovon Jr Pasagui Azores

Walden Dissertations and Doctoral Studies

Multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is a leading cause of morbidity and mortality in the Philippines. The purpose of this study was to gain knowledge about the relationship between potential risk factors and MDR-TB. Risk factors (the independent variables) for MDR-TB (the dependent variable) include previous TB treatment, infection with HIV, exposure to patients with drug-susceptible TB/MDR-TB, delays in diagnosis and treatment, employment status, smoking, imprisonment, alcohol abuse, and poor compliance with TB treatment regimens. The study was based on the epidemiological approach to causal inference work. A case-control study design was used wherein a quantitative method was applied in data …

An Rn Sepsis Training Program That Supports Registered Nurses In The Emergency Room Setting, Daphne Marjorie Davis-Patrick

Walden Dissertations and Doctoral Studies

Sepsis is a severe blood stream infection that claim the lives of almost 220,000 Americans annually. Delayed patient treatment results in multi-organ failure, morbidity, mortality, and increased hospital length of stay. Timely sepsis management enables hospitals to have decreased expenses, increased patient survival, and judicious interventions. The problem addressed in this project was the lack of sepsis- training for registered nurses (RNs) working in the emergency department (ED) of a 628-bed hospital in the southeastern United States. Under the direction of the director of the ED, 269 patient charts were reviewed during 2014 to February 2015 for data related to …

Faculty Perspectives On Effective Integration Of Simulation Into A Baccalaureate Nursing Curriculum, Linda Jane Howell

Walden Dissertations and Doctoral Studies

Research shows that use of high fidelity simulation (HFS) as a teaching strategy requires extensive amounts of faculty time and financial resources for faculty development and equipment. This project study addressed the challenges encountered in the integration of HFS into a Midwestern metropolitan baccalaureate nursing program. The purpose of this qualitative case study was to explore perceptions of nursing faculty about best practice elements for successful integration of HFS into undergraduate nursing programs. Guiding questions were developed using Donabedian's structure-process-outcome model and focused on faculty perceptions related to successful implementation of simulation in their programs. Purposeful sampling was used to …

The Effects Of Structured Health Policy Education On Connecticut Registered Nurses' Clinical Documentation, Rosale Lobo

Walden Dissertations and Doctoral Studies

Registered Nurses use clinical documentation to describe care planning processes, measure quality outcomes, support reimbursement, and defend litigation. The Connecticut Department of Health, guided by federal Conditions of Participation, defines state-level healthcare policy to include required care planning processes. Nurses are educated in care planning process standards, however no policy-required competency verification processes in academia or employers exists. Guided by the advocacy coalition framework, the purpose of this quasi-experimental study was to determine if the quality of nurse coalition actors’ clinical documentation, a relatively stable parameter, would increase after attending policy-centered structured education. Data were extracted from 272 electronic medical …

Investigating Funding Policies For New Clinics In Rural Northwest Region, Cameroon., Chenwi Mbuoko Ngwa

Walden Dissertations and Doctoral Studies

Abstract

Healthcare policies are complex health promotion strategies used by healthcare policy

designers to create awareness, educate, and develop the capacity of sustainable health

promotion practices in rural communities. The purpose of this phenomenological study

was to investigate an occurrence being experience by rural residents in the NWR of

Cameroon where residents lacked nearby healthcare clinics where they can seek medical

treatment and to determine if there were any funding policy requirements for the

construction of new rural community clinics at the NW Regional Delegation of Public

Health. Using Wright's conceptual framework on policy analysis and evaluation and

Coleman's rational …

Design And Development Of An Educational Intervention On Nurse Perceptions Of Caring, John S. Norris Iii

Walden Dissertations and Doctoral Studies

Caring is central to the nursing profession and important to patients and family members who expect nurses to display caring attributes. The acute care hospital in this study did not have an education program on caring practices for nursing staff although the organization acknowledged the importance of and need for a culture of caring practices in the organization. The purpose of this project was to design an educational program based on Watsons' theory of caring for registered nurses at the acute care hospital where the project took place. Rosswurm and Larrabee's model for change and Watson's theory of caring were …

Factors Associated With Provider Utilization Of The Heath Information Exchange In The State Of Hawaii, Kris K. Wilson

Walden Dissertations and Doctoral Studies

In a context where technology is increasingly being incorporated into health care practice, many U.S. health care providers and organizations are finding it challenging to connect disparate electronic documentation systems to retrieve patient information when coordinating care across providers and heath care entities. Local and regional health information exchange (HIE) systems were created to facilitate collecting information into one integrated patient record to address information transfer between heath care providers. Yet, adoption and use of HIEs have been low. The purpose of this study was to review the predictive factors accounting for physicians' use of a HIE in the U.S. …

Development Of An Educational Program To Obtain And Maintain Healthy Weights Among 4th And 5th Grade Students, Stephanie Dean Black

Walden Dissertations and Doctoral Studies

Development of an Educational Program to Obtain and Maintain Healthy Weights Among 4th and 5th Grade Students

By

Stephanie D. Black

MSN, University of Phoenix, 2008

BSN, Southwest Baptist University, 2006

ASN, Southwest Baptist University, 2003

Capstone Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

October 2017

Obesity is prevalent in schoolchildren and increases risk of chronic diseases throughout the lifespan. Strategies are needed to address this growing health problem. Education in elementary schools targeting the topics of nutritional choices and prevention of obesity, particularly in 4th-5th grade population, is …

Adherence Barriers To Healthcare For African Americans With Hiv/Aids On Antiretroviral Medications, Angela Bumphus Corbin

Walden Dissertations and Doctoral Studies

The purpose of this mixed methods research study was to examine the role of adherence barriers to healthcare and the impact that such barriers have on highly active antiretroviral therapy (HAART) compliance for African Americans living with HIV/AIDS. HAART helps reduce HIV/AIDS morbidity and mortality. Of the 49% of study participants who had been out of medical care for more than 12 months, financial concerns were listed as the most common barrier (22.8%). Not having the support from family and friends (17.5%), being tired of going to doctor appointments (15.8%), health challenges (12.3%), lack of transportation (12.3%), and incarceration (12.3%) …

Race, Age, Gender, Income, And The Experience Of Adult Intimate Partner Violence, Jacquelynn Melnita Hairston

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a significant public health problem that affects approximately 2.4 million individuals in the United States each year. Race, age, gender, and household income are established correlates of criminal victimization and diverge across various victimization experiences for these individuals. The purpose of this study was to investigate relationships between IPV victimization and the demographic variables of race, age, gender, and household income using race, class, and gender theory as a framework. Logistic regression analyses on data from 3,492 adult male and 3,637 adult female IPV victims obtained from the 2013 National Crime Victimization Survey showed that …

Differences In Survival Times, By Gender, Among Those Diagnosed With Necrotizing Fasciitis, Ashley Elizabeth Hill

Walden Dissertations and Doctoral Studies

Necrotizing fasciitis infections have high mortality rates especially when treatment is delayed. Despite the abundance of research in many areas of necrotizing fasciitis infection, there are limited and conflicting studies focusing on gender-related outcomes for those diagnosed and died with necrotizing fasciitis infection. The purpose of this study was to determine the association that gender plays on survival time of patients who have been diagnosed with necrotizing fasciitis using a cross-sectional study design. Succeeding the conceptual design of the life course model, the research question tested whether there was a significant difference in survival time between the genders while in …

The Effectiveness Of Course-Based Health Education Interventions Towards Increased Physical Activity Among College Students, Jay Morris Martin

Walden Dissertations and Doctoral Studies

Despite the many health benefits, physical activity participation among those between 18 to 24 years is in significant decline during the college-age years. Postsecondary education has been identified as an ideal environment where young adults should be targeted for physical activity participation. However, a limited number of studies have assessed the effectiveness of college-level health education and physical education program interventions to increase physical activity levels among college students. The purpose of this study was to examine current physical activity levels of college age students who have completed a college-level health education course and laboratory to gain a better understanding …

Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor

Walden Dissertations and Doctoral Studies

The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by …

New Graduate Nurses' Perceptions Of Their Delay To Professional Practice, Ruth Ann Obregon

Walden Dissertations and Doctoral Studies

This project study addressed the problem of knowledge and skills lost by new graduate RNs while delayed in transitioning to professional nursing practice. There is a paucity of knowledge about how new RNs experience their delay and how a delay may affect their future clinical performance. Mezirow's transformation learning theory was the conceptual framework for this qualitative case study. Research questions addressed new RNs' understanding of their experiences during a delay to professional practice. A purposeful sample included 8 new RNs who had completed a New Graduate Residency Transition Program (NGRTP) after a delay to practice of 6 months to …

Retired, Unmarried, Male Baby Boomer Attitudes And Behaviors Toward Disease Prevention, Irene Nyawira Ruminjo

Walden Dissertations and Doctoral Studies

Preventive health care is effective in reducing both infectious diseases and chronic conditions among the elderly. Despite efforts to prevent or decrease the risk of illness, unmarried men are less likely to receive selected preventive services compared to married men. The purpose of this cross-sectional survey was to describe disease prevention attitudes and behaviors of retired, unmarried, male baby boomers residing in Harlingen, Texas. Further, the study examined the effects of socioeconomic status on disease prevention attitudes and behaviors. The health belief theory framed the study. A validated questionnaire collected disease prevention attitudes, behaviors, and sociodemographic characteristics data. Data inquiry …

Lived Experiences Of Pre-Menopausal African American Women With Advanced Breast Cancer, Carmelita Whitfield

Walden Dissertations and Doctoral Studies

This qualitative study examined the phenomenology of advanced breast cancer (ABC) among 7 female participants between the ages of 20 and 45. Oral data were collected to extract participants' interpretations of their spiritual and psychosocial experiences of living with ABC. Findings suggest that these women experienced a dichotomous relationship with regard to their bodies and their relationships with others; this served as a means of making sense of their experiences and as a coping mechanism. Positive psychology and the theory of reasoned action and planned behavior provided the theoretical framework for examining the role of social reinforcements, beliefs, and attitudes …

Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson

Walden Dissertations and Doctoral Studies

Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …

Sugar Intake And The Five Personality Traits Of Millennials, Flora Gashi

Walden Dissertations and Doctoral Studies

Sugar intake continues to be connected to an increased risk of heart diseases, diabetes, arthritis, and certain forms of cancers, depression, and schizophrenia. The purpose of the study was to examine if sugar intake is related to personality traits in the Millennial population. The health belief model was used as the theoretical framework for conducting the study. The research questions addressed in the current study were in regards to the relationships between Millennials daily sugar intake and openness, conscientiousness, extraversion, agreeableness, and neuroticism. This study was a cross-sectional design in which a panel of randomly selected United States Millennials (N …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

Attitudes Of Women Offenders Towards Medicaid Enrollment And Coverage Under The Affordable Care Act, Morrisa Barbara Rice

Walden Dissertations and Doctoral Studies

Although women offenders face barriers to successful reentry into their communities, as yet, no research has explored their experiences in accessing health care reentry services. Medicaid enrollment, the process of applying for Medicaid coverage, can be offered as a health care reentry service. Women offenders in jails have shorter sentencing times compared to those in prison, which presents Medicaid enrollment opportunities before release. The Second Chance Act provides the opportunity for reentry services, and the Affordable Care Act provides the opportunity for Medicaid coverage for women offenders. This phenomenological study explored the attitudes of women offenders about Medicaid enrollment and …

Re-Educating Healthcare Providers On Hand Hygiene Practice, Veronica Ihuoma Ubah

Walden Dissertations and Doctoral Studies

The Centers for Disease Control (CDC) and the World Health Organization (WHO) estimate that there are approximately 1.4 million cases of hospital acquired infections (HAIs) at any given time worldwide. Recent reports indicate that 722,000 patients acquire HAIs, with 75,000 or more succumbing to the infections and dying. This quality improvement project focused on the value of re-educating practicing nurses on hand hygiene practices as an approach to reduce the incidence of HAIs. Pre-intervention rates of HAIs were compared with post-intervention rates of HAIs across 2 units (Unit A and Unit B) in an acute care setting to determine if …

Advanced Triage Protocols In The Emergency Department, Lijuan Zhao

Walden Dissertations and Doctoral Studies

Overcrowded emergency departments (EDs) are a major problem in the United States resulting in inefficiency in operation and performance. A Southern California hospital ED was the site for this project because it had operated over its maximum capacity during the last decade. Advanced triage protocols integrating standard order sets were implemented to improve quality of care; however, no evaluation of the protocols had been done. The purpose of this project was to evaluate the effect of the advanced triage protocols. Two project questions determined whether advanced triage protocols reduced ED length of stay (LOS), number of patients who left without …

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan

Walden Dissertations and Doctoral Studies

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, few studies have examined hypertension in the Armenian American population in the Los Angeles area, one of the most concentrated Armenian American communities in the United States. The purpose of this study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. The theoretical basis for this study was Pender's health promotion model and the health promoting lifestyle profile (HPLP-II), …

Perceived Job Stress And Life Style Behaviors' Effects On The Quality Of Life Of Registered Nurses, Jennifer Rose Limongiello

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine to what extent work demands as measured by perceived job stress affected the health-related quality of life (HRQOL) as determined by the number of unhealthy days of registered nurses in the United States. This study was also an investigation of the extent to which other variables such as body-mass index (BMI) and certain lifestyle behaviors affected the HRQOL (number of unhealthy days). The independent variables were perceived job stress, weight (BMI), and lifestyle factors such as tobacco and alcohol use, physical inactivity, and the mindful eating score, and the dependent variable …

Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller

Walden Dissertations and Doctoral Studies

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining …