Medicine and Health Sciences Commons^™

Development Of Couplet-Care Education, Annette L. Backus

Walden Dissertations and Doctoral Studies

The facility under study has had a traditional postpartum and nursery, with different nurses for the mother and baby. A decision was made to change the care model to couplet-care (CC). CC is an evidence-based care model that promotes newborn care at the mother's bedside. Establishing an education and implementation plan is important to the success of the transition. The purpose of this project was to develop an evidence-based education and implementation plan for CC implementation and to provide for staff barriers and pushback to change. The goals of the study were to identify an approach to implement evidence-based practice …

Relationship Between Medicare Alternative Payment Methodology And Hospital Program Service Revenue, Sandra J. Gubbine

Walden Dissertations and Doctoral Studies

Medicare paid $388.7 billion to acute care hospitals in 2014 representing the largest portion of the health care sector in the United States. Medicare implemented an innovative reimbursement model called Value Based Purchasing (VBP) to ensure hospitals provide quality care for the dollars spent. This correlation study used the VBP theoretical framework developed by Dudley as the foundation for the reimbursement model implemented by Medicare in 2013. The data used for this study came from the Centers of Medicare and Medicaid, as well as from Guidestar. The data focused on acute care, nonprofit hospitals located in New Jersey, New York, …

Bedside Reporting: Improving Practice, Lori Wichman

Walden Dissertations and Doctoral Studies

Bedside reporting is one way to improve communication among the health care team. At the study site, at least 50% of bedside reporting was being conducted at the door of the patient's room instead of at the patient's bedside. The project question addressed whether a computer-based education and training video on bedside reporting and a standardized bedside reporting checklist would increase the rate of bedside shift-to-shift reporting among a medical surgical unit (MSU) to 100%. The project addressed the implementation of standardizing bedside reporting through education and training using Agency for Health Care Research and Quality's (AHRQ) Guide to patient …

Comparing The Effectiveness Of Masters-Prepared And Non-Masters-Prepared Nurse Leaders, Subha Narasimha Chari

Walden Dissertations and Doctoral Studies

The complex nature of healthcare requires nurse leaders to be skilled in professional practice, communication, teamwork, and problem solving to improve staff satisfaction and patient outcomes. The American Association of Colleges of Nursing and Institute of Medicine promotes graduate education for nurse leaders to enhance the delivery of quality care to the nation's diverse patient populations. Guided by the diffusion of innovation theory, this project explored the differences in nursing care hours, staff turnover, nurse quality indicators, as well as leadership characteristics on units lead by masters-prepared and non-masters-prepared nurses. Forty-eight nurse leaders completed the impact of graduate education among …

Motivating Allied Health Students To Successfully Complete Core Courses, Lisa Renee Trusclair

Walden Dissertations and Doctoral Studies

This project study addressed the problem of a decline in retention of students at a local allied health college. The need for allied health professionals is projected to exceed the availability by 2020, so it is important to identify strategies to help allied health students succeed. The purpose of this case study was to explore perceptions of students and faculty about motivating factors and learning strategies that foster successful progression in allied health programs. Ryan and Deci's self-determination theory, focused on the relationship between motivation and success, served as the framework for the study. Research questions addressed intrinsic and extrinsic …

Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe

Walden Dissertations and Doctoral Studies

Obesity is a national health problem with serious medical, psychological, and economic outcomes. Nurses and nurse practitioners (NPs) are frequently the first point of patient contact and play an essential role in the management of obesity. The current literature noted that practitioners working in primary care settings demonstrate inadequate knowledge related to evidence based practice (EBP) strategies to treat obesity, including diet modification and physical activity. The purpose of this DNP project was to develop and validate an EBP provider educational module related to diet modification and physical activity education for adult patients diagnosed with obesity in a primary care …

Colorectal Cancer Screening For The Vietnamese American Population In Iowa, Michael H. Le

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a primary cause of cancer-related mortality in the United States. Asian Americans have the highest CRC mortality rates. CRC screening tests can reduce CRC incidence, yet Asian Americans, specifically the subgroup of Vietnamese Americans, underuse CRC screening. The purpose of this phenomenological study was to understand why Vietnamese Americans, ages 50 to 75, underuse CRC screening. The health belief model constructs of susceptibility, severity, benefits, barriers, and self-efficacy were the framework for understanding this population's health-related behaviors. Three research questions focused on how knowledge, language, and cultural beliefs and perceptions affect Vietnamese Americans' CRC screening decisions. …

Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch

Walden Dissertations and Doctoral Studies

While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …

Health, Wellness, And Ecological Impacts Of Horse Therapy For Special Needs Children, Jennifer Suzanne Sulkowski

Walden Dissertations and Doctoral Studies

The benefits of horse therapy for special needs children have been documented for centuries, but direct experience and perspective from special needs children and their families involved in horse therapy are missing from the literature. The purpose of this study was to enhance understanding on the health, well-being, and ecological impacts of horse therapy for special needs children, and to demonstrate how horse therapy aligns with public health, by interviewing 8 special needs families who utilize the therapy, 8 adults who underwent horse therapy as children, and 12 ecological experts in local communities. Data were hand-coded and organized based on …

Performance Outcomes Of Nurses Based Upon Nursing Students'classroom Expereinces, Beatrice Obiageli Eweni

Walden Dissertations and Doctoral Studies

Schools of nursing educators are faced with redesigning nursing education to meet the complexity of implementing communication and patient- centered care to improve patient safety. This qualitative case study addressed the problem that teaching communication and patient- centered care were not threaded throughout curriculum, which left many new graduates nurses unprepared. The purpose of this study was to understand classroom experiences of new graduate nurses to meet performance outcomes. The research questions focused on understanding the classroom experiences of new graduates' of a nursing program by assessing the two concepts and how to address preparatory practices. The target populations were …

Examining Venous Thromboembolism Post-Operative Orthopedic Care Using Electronic Order Sets, Kelly Remancus

Walden Dissertations and Doctoral Studies

Venous thromboembolism (VTE) is a serious health concern of patients undergoing orthopedic surgery. Analysis of the study site semiannual reports from January 2014 through March 2015 indicated 10 VTE events in 546 orthopedic cases. The community hospital was classed as an outlier performing in the bottom 10th percentile when compared to other hospitals. To standardize the ordering of VTE prophylaxis, the hospital developed a postoperative electronic VTE order set. The purpose of this project was to assess the difference in orthopedic VTE occurrences in the postoperative total hip arthroplasty (THA) patients before and after the implementation of the electronic VTE …

Relationships Between Early Academic Indicators And Accelerated-Baccalaureate Student Nurse Success, Bonnie J. White

Walden Dissertations and Doctoral Studies

In 2013, the National Council Licensure Examination for Registered Nurses' (NCLEX-RN) passing standard was increased, leading to a decrease in NCLEX-RN pass rates. The passing standard increase was prompted by an advisory panel's determination that a gap in safe, competent practice existed among new graduate nurses. New graduates' success on NCLEX-RN is critical to meet workplace demand for new nurses. The purpose of this study was to examine whether cumulative grade point average at completion of 200-level nursing courses and scores on the standardized final exam in the 200-level fundamentals course were related to on-time nursing program completion and a …

A Case Study Exploration Of Teachers' Perspectives On Children's Mental Health Service Needs In Title I Elementary Schools, Natalie Denise Yates

Walden Dissertations and Doctoral Studies

Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to …

Exposure To Hiv Prevention Messages On Social Media And Behavior Change Intent, Yoshika Shajuan Eason

Walden Dissertations and Doctoral Studies

African Americans living in the Southeastern region of the United States disproportionately contract sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Facebook and other social media sites are becoming a way to deliver health-related messaging to targeted populations. The purpose of this quantitative, cross-sectional study was to examine the association between selected demographic factors and impact of social media on intent to change sexual behaviors among 112 African Americans between the ages of 18 and 49 in the Southeastern United States who viewed STI/HIV prevention materials on Facebook within 1 year prior to the study. The theory of planned …

Screening For Opioid Misuse And Abuse In Chronic Pain Patients, Gloria Jean Farris

Walden Dissertations and Doctoral Studies

Abstract

In 2012, opioid prescriptions exceeded 250 million, which is equivalent to providing a prescription to every adult in the United States. Prescription opioids have contributed to over 100,000 deaths since the late 1990s with the greatest impact among adults 35 through 54 years of age. The purpose of this doctoral project was to introduce an evidence-based screening tool that will identify patients who are at risk of opioid misuse and aid in the development of the most effective treatment plan to manage chronic pain and avoid abuse. The Screener and Opioid Assessments for Patients with Pain (SOAPP), a screening …

Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell

Walden Dissertations and Doctoral Studies

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to …

The Effect Of Two Modes Of Aerobic Assessment On Fifth Grade Students' Self Efficacy, Debra Roth

Walden Dissertations and Doctoral Studies

Declining youth physical activity levels and lack of aerobic fitness have been well documented with a corresponding rise in obesity levels and health issues. Based on Bandura's social cognitive theory, healthy physical activity levels and aerobic fitness are strongly connected to positive physical activity self-efficacy beliefs. This study examined whether student physical activity self-efficacy, motivation, and effort were different for the FitnessGram-® (FG) 1-Mile Run when compared to the 15-minute Aerobic Assessment Based on Improvement (AABI). A concurrent mixed method quasi-experimental approach measured 5th grade students' physical activity self-efficacy beliefs through a pretest and posttest survey while aerobic assessment scores …

Vitamin D And Age-Related Macular Degeneration, Mandy Hemphill

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is the leading cause of vision loss in individuals aged 50 years and older and is estimated to affect as many as 11 million individuals in the United States. The purpose of this study was to examine the association between vitamin D and AMD disease progression. The life course epidemiology framework model was used to explore how vitamin D level as a risk factor may have an association to AMD disease through time. Data in the 2005-2008 National Health and Nutrition Examination Survey (NHANES) database were collected on vitamin D levels and identified stages of AMD …

Effects Of Temperature And Precipitation On Giardiasis In Missouri, Lori Michelle Calderas

Walden Dissertations and Doctoral Studies

Global Climate Change has empirical evidence to support the idea that CO2 levels may be affecting weather and health, including rates of infectious diseases. The Midwest region of the United States of America has had the highest increase in giardiasis rates in recent years, and Missouri was chosen for this study as a representative state in the Midwest. There is no definitive answer as to why the rates of giardiasis have changed from 2003 - 2013. The Theory of Climate Change was used as the theoretical framework for this study. The purpose of this research was to determine whether temperature, …

Consequences Of Community Water Fluoridation Cessation For Medicaid Eligible Children And Adolescents, Jennifer Meyer

Walden Dissertations and Doctoral Studies

Oral health impacts general health and well-being throughout the lifespan. Recent trends in the United States towards cessation of community water fluoridation (CWF) may increase disparities in oral health. The purpose of this quantitative retrospective cohort study was to analyze Medicaid dental claims records for caries related procedures among 0 to18-year-old patients during an optimal CWF year 2003 (n = 854) and compare them to claims records from 2012 (n = 1,053), 5 years after CWF was ceased. The theoretical framework of this study was the diffusion of innovations theory. Statistically significant results included higher mean number of caries related …

Nurses' Reflection, Compassion Fatigue, And Work Burnout - A Correlational Analysis, Sarah Urban

Walden Dissertations and Doctoral Studies

Compassion fatigue and work-related burnout are harmful reactions to patient situations and work environments that negatively affect nurses' well-being and ability to provide safe, effective patient care. However, research is needed to understand how reflection as a self-care response to patient situations is related to nurses' development of work burnout, compassion fatigue, and secondary traumatic stress, a type of compassion fatigue. The purpose of this correlational, cross-sectional quantitative study was to determine the relationship between hospital-based acute care nurses' levels of reflection and their levels of compassion fatigue, secondary traumatic stress, and work burnout. The study was based on Hentz …

Development Of A Graduate Nurse Residency Program In Women's Services, Dinez Diamond Esmail

Walden Dissertations and Doctoral Studies

Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical …

Knowledge, Perceptions, And Facilitators To Colorectal Cancer Screening Among African American Men In Mobile, Alabama, Ruben Franklin

Walden Dissertations and Doctoral Studies

African American (AA) men in the state of Alabama are affected by colorectal cancer (CRC) more than all other races. The purpose of this phenomenological study was to gain understanding of colorectal cancer screening health benefits in AA men in Mobile, Alabama. The health beliefs model (HBM) developed by Hochum, Rosemstock, and Kegels was used to to explore the barriers and facilitators to CRC screening in AA men with health insurance in Mobile, Alabama. The research questions explored knowledge, perceptions, and facilitators to CRC screening among AA men age 40 to 75. Participants were selected using purposive sampling and data …

Assessing Effective Interventions In Pregnant And Postpartum American Indian And Alaska Native Women, Hope Thompson

Walden Dissertations and Doctoral Studies

Through the creation of the Indian Health Service in 1955, the health status of American Indian and Alaska Native (AI/AN) has improved; however, AI/AN women of reproductive age still have some of the poorest health outcomes of all populations. This study aimed to examine effective interventions that seek to improve the health of AI/AN women during pregnancy, and immediately postpartum (up to 12 months post delivery). This study addressed the research question: What effect does parental competence have on early parenting and/or infant/toddler outcomes? The life course conceptual framework was used to demonstrate how life experiences impact current health. The …

Relationships Between Interprofessional Teamwork And Clinical Management Of, Jacqueline G. Stephens

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a highly prevalent chronic disease that affects 29 million people in the United States including over 2 million veterans who receive care through the Veterans Administration. Patient-aligned care teams (PACTs) are an interprofessional teamwork system designed to improve outcomes of chronic illness, but empirical explorations of the efficacy of the PACTs have been insufficient. Utilizing the chronic care model, the purpose of this retrospective study was to determine if PACTs have been efficient in the diabetic management of veterans receiving care through a Southeastern VA. Medical records for 114 veterans with type 2 DM were randomly …

Neighborhood And Community Influence On Adolescent Obesity, Peggie Arnzellique Harrison

Walden Dissertations and Doctoral Studies

In the United States, over two-thirds of adults are overweight or obese, and the number of children and adolescents who are overweight is increasing. Obesity is a significant issue as obesity-related chronic diseases can result in diminished quality or life, high morbidity and mortality, and substantial healthcare costs. The purpose of this study was to examine neighborhood social capital and how it relates to adolescent obesity. The socio-ecological model was used as the theoretical framework of this study to examine how the environment and social contexts influence health behaviors. Utilizing a quantitative cross-sectional research design, bivariate and multivariate analyses were …

Exploring Security, Privacy, And Reliability Strategies To Enable The Adoption Of Iot, Daud Alyas Kamin

Walden Dissertations and Doctoral Studies

The Internet of things (IoT) is a technology that will enable machine-to-machine communication and eventually set the stage for self-driving cars, smart cities, and remote care for patients. However, some barriers that organizations face prevent them from the adoption of IoT. The purpose of this qualitative exploratory case study was to explore strategies that organization information technology (IT) leaders use for security, privacy, and reliability to enable the adoption of IoT devices. The study population included organization IT leaders who had knowledge or perceptions of security, privacy, and reliability strategies to adopt IoT at an organization in the eastern region …

Standardized Critical Thinking Tests As A Predictor Of Success In Nursing Programs, Jaimee Kastler Kastler

Walden Dissertations and Doctoral Studies

High attrition rates and a nursing shortage across the nation have led schools of nursing to seek out ways to better identify which applicants will be most successful in graduating from the nursing program and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Nursing programs have historically included standardized entrance exam scores and prerequisite scores among their admission criteria but have not used standardized critical thinking assessments (CTA), even though critical thinking is an integral part of being a successful nursing professional. Using Astin's input-environment-output (I-E-O) model, the purpose of this retrospective correlational study was to determine whether …

The Relationship Between Pre-Licensure Employment And Student Nurse Self-Efficacy, Khristina Lee Grimm

Walden Dissertations and Doctoral Studies

Student nurses transitioning to acute care practice often feel unprepared to accept the responsibilities associated with their new role. Lack of self-efficacy in nursing practice contributes to high levels of stress and anxiety as the new nurse enters the workforce which causes turnover during the first year of practice. Little is known about how the type and amount of pre-licensure employment affects the self-efficacy in nursing practice of the student nurse. Using Bandura's social cognitive theory, the purpose of this quantitative study was to examine the relationship between type and amount of pre-licensure employment and self-efficacy in nursing practice of …

Educational Intervention For Engaging Adolescents And Their Parents In Hpv Vaccination, Alvin Mena Cantero

Walden Dissertations and Doctoral Studies

In the United States, 79 million people are currently infected with Human Papilloma Virus (HPV) and it is estimated that an additional 14 to 20 million people will be infected with HPV every year. Infection with HPV increased to 52.7 % of preventable infections within the United States in 2012, and 39.6% of the infected population are adolescents engaged in sexual activities. The practice-focused question that this project addressed was: To what extent can an educational program influence the HPV vaccination rate in a small family practice clinic located in Texas? The main purpose of this project was to increase …