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Articles 5131 - 5160 of 6102

Full-Text Articles in Medicine and Health Sciences

Fostering An Environment Of Magnet Recognition By Using Internet Technology, Shyneka Montgomery Jan 2016

Fostering An Environment Of Magnet Recognition By Using Internet Technology, Shyneka Montgomery

Walden Dissertations and Doctoral Studies

Magnet Recognition, a nurse-driven certification, is an acknowledgement of nursing excellence within a hospital. Magnetic Recognition supports the highest quality of patient outcomes and is the standard for nursing care and professionalism in nursing practice. The site for this project has engaged in the process of seeking Magnet Recognition but lacked a method of communicating their progress to staff, prompting the need for the institutional intranet Magnet webpage. Guided by Roger's diffusion of innovation theory and Lewin's change management model, the purpose of this quality improvement project was to develop an evaluation plan for this webpage on the institutional intranet. …

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Prescribing Hiv Prep And The Need For Education Among Care Providers, Martin Kokou Logo Jan 2016

Prescribing Hiv Prep And The Need For Education Among Care Providers, Martin Kokou Logo

Walden Dissertations and Doctoral Studies

Preexposure prophylaxis (PrEP) is an innovative biomedical approach that has been used over the past 6 years to avert the spread of human immunodeficiency virus (HIV). Under-prescribing of PrEP could increase the probability of HIV exposure among serodiscordant couples/partners and those who do not practice safe sex. Previous PrEP research has not assessed the association between awareness of PrEP, years of experience of providers, provider types, and the frequency of PrEP prescription among physicians. Precaution adoption model framed this study, which aimed to evaluate the bond between the independent variables relating to awareness of PrEP, years of experience, and provider …

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Return To Full Duty Work: Determining The Ideal Time To Refer Occupationally Isolated Acute Low Back Pain Patients To Physical Therapy, Aletha Mae Stephenson Jan 2016

Return To Full Duty Work: Determining The Ideal Time To Refer Occupationally Isolated Acute Low Back Pain Patients To Physical Therapy, Aletha Mae Stephenson

Walden Dissertations and Doctoral Studies

Employees who develop and report nontraumatic acute low back pain that occurs while performing work duties, or shortly thereafter, are classified as having occupational isolated acute low back pain (OIALBP). The purpose of this project was to identify and implement an evidence- based time frame to refer occupational isolated acute low back pain patients (OIALBPPs) to physical therapy (PT) that returns them to full duty work (FDW) more quickly. The diffusion of innovation theory aided the project leader and health care providers to develop strategies to overcome barriers in implementing the project's results into the practice. A total of 932 …

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Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett Jan 2016

Using Sbar To Decrease Transfers From The Long-Term Care To The Emergency Room, Phyllis Marie Bowers Garrett

Walden Dissertations and Doctoral Studies

Care of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementation of a standardized process of assessment that would have decreased avoidable transfer of the resident. The project would have involved training …

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Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna Jan 2016

Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna

Walden Dissertations and Doctoral Studies

Military stigma is a heavy burden of social stigma internalized by veterans who are diagnosed with posttraumatic stress disorder (PTSD) during post-deployment psychological screening. PTSD is classified as a mental disorder associated with widespread reluctance to seek medical assistance. Among military veterans who suffer from combat-related posttraumatic stress (PTS), military stigma is considered a widespread problem. The purpose of this phenomenological study was to explore veterans' perceptions of various aspects of military stigma, including post-deployment psychological screening, the diagnosis of PTSD, and factors associated with reluctance to seek medical assistance for PTS. In-depth interviews were conducted with a convenience sample …

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Orientation Of Nurses Transitioning Into Hospital Specialty Units, Mary Laly Chacko Jan 2016

Orientation Of Nurses Transitioning Into Hospital Specialty Units, Mary Laly Chacko

Walden Dissertations and Doctoral Studies

Competency-based nurse orientation programs focus on the new nursing graduate and experienced nurse employees' ability to perform skills necessary in a new work setting. The purpose of this project was to develop a learner-focused and competency-based orientation program for new nursing employees at a large urban hospital to enhance patient safety and nurse retention. The Johns Hopkins nursing evidence-based practice model and guideline were used in the selection of articles with higher levels of evidence and research quality for the critical appraisal of literature in support of the program development. The best practices for nursing orientation content and delivery for …

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Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson Jan 2016

Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …

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African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard Jan 2016

African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard

Walden Dissertations and Doctoral Studies

Insufficient physical activity detracts from healthy living and has a disparate impact on African American women and their female children. The extensive body of prior research addressing preventable chronic disease and other consequences of insufficient physical activity includes limited information specific to African American single mothers. The purpose of this descriptive phenomenological study was to gain an understanding of African American single mothers' perceptions of physical activity. Specifically investigated were African American women's familial influences and potential effects of these influences on their children's health behaviors. The health belief model served as the theoretical framework for this study and provided …

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Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling Jan 2016

Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling

Walden Dissertations and Doctoral Studies

The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease …

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Supervisor Perceptions Of Entry-Level Doctorate And Master's Of Occupational Therapy Degrees, Sherry Lynne Muir Jan 2016

Supervisor Perceptions Of Entry-Level Doctorate And Master's Of Occupational Therapy Degrees, Sherry Lynne Muir

Walden Dissertations and Doctoral Studies

In occupational therapy (OT), there is a push to encourage the entry-level doctorate (eOTD) over the master's of OT (MOT), without having identified which degree develops therapists who can best meet the needs of clients, while providing the fewest negative consequences for stakeholders. This collective case study assessed whether there are differences between OTs with MOT and with eOTD. Each supervisor's experiences with the two degree groups represented a separate case, then all were collectively considered. The central research question was whether OT supervisors, who have observational knowledge of clinical performance, perceived differences between MOTs and eOTDs in factors that …

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The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark Jan 2016

The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark

Walden Dissertations and Doctoral Studies

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …

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Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton Jan 2016

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …

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Tools That Measure Caring: A Systematic Literature Review Of The Impact Of Caring, Jennifer Drake Jan 2016

Tools That Measure Caring: A Systematic Literature Review Of The Impact Of Caring, Jennifer Drake

Walden Dissertations and Doctoral Studies

Technology and the complexity of the patient care can take the nurse's attention away from caring for the patient to caring for the technology. The purpose of this systematic review was to gather evidence from the literature on tools for measuring caring and the outcomes in order to make that body of knowledge easily accessible to the direct care nurse for implementation. Jean Watson's theory of human caring 'the theoretical framework that guided and informed this DNP project' focuses on human caring processes and experiences. It assumes that effective caring promotes health and outcomes of the nurse and patient. By …

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The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari Jan 2016

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

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Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik Jan 2016

Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik

Walden Dissertations and Doctoral Studies

Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement …

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Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr Jan 2016

Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr

Walden Dissertations and Doctoral Studies

Physical activity is associated with many health benefits to include weight management, lower risk for chronic diseases, and improved mental health and self esteem. The built environment has been linked to lower physical activity levels and overweight and obesity in children living in low income communities but the exact causes need further investigation. The purpose of this quantitative, cross sectional study was to examine the association between parents' perception of safety and body mass index (BMI) percentile and children's physical activity/ inactivity levels and children's BMI as measured by the National Survey of Children's Health (2011/12 NSCH). The sample consisted …

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Health Care Leaders' Experiences Of Electronic Medical Record Adoption And Use, Joseph B. Weagraff Jan 2016

Health Care Leaders' Experiences Of Electronic Medical Record Adoption And Use, Joseph B. Weagraff

Walden Dissertations and Doctoral Studies

Adoption of electronic medical record (EMR) technology systems of meaningful use has been slow despite the mandate by the U.S. government. The purpose of this single case study was to explore strategies used by health care leaders to implement EMR technology systems of meaningful use to take advantage of federal incentive payments. Diffusion of innovation theory provided the conceptual framework for the study. Semistructured interviews were conducted with 6 health care leaders from a military installation in the Southeast United States. Data were analyzed using software, coding, and inductive analyses. The 3 prominent themes were patient, provider, and champion. Alerts …

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Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls Jan 2016

Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls

Walden Dissertations and Doctoral Studies

Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …

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Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre Jan 2016

Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre

Walden Dissertations and Doctoral Studies

While epidemiological research has generated new knowledge about the treatment and prevention of chronic obstructive pulmonary disease (COPD) through smoking secession, the socioeconomic status (SES) of people with the disease has been under investigated. Thus, the purpose of this study was to determine the predictability of association between SES and COPD. This study was based on the ecological theory, which states that health and disease may have multiple underlying factors. This study was a secondary analysis of archived data from the Inter-University Consortium for Political and Social Research (ICPSR). The dataset was collected for the National Survey of Midlife Development …

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An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore Jan 2016

An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore

Walden Dissertations and Doctoral Studies

Seasonal influenza, or the flu, impacts over 3 million people each year. Within the health sector, nosocomial infection and absenteeism are frequently associated with the flu. The Centers for Disease Control and Prevention (CDC) recommend flu vaccination for all eligible individuals, especially health care workers (HCWs). Interventions associated with increased HCW vaccination include educational programs and occupational health campaigns to address misconceptions regarding vaccine safety and efficacy. This project evaluated the impact of a voluntary, web-based education module to encourage registered nurse (RN) vaccination. The logic and health belief models served as the theoretical frameworks. In a nonequivalent group design, …

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The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green Jan 2016

The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green

Walden Dissertations and Doctoral Studies

Back pain is a chronic disease epidemic and the most common chronic painful condition in Americans. It is associated with human suffering and enormous financial and social burdens. Smoking is a prevalent and harmful health behavior and is the greatest modifiable risk factor for many chronic diseases. Cigarette smoking is associated with back pain, but there is little research on this relationship among adults in the United States. Using biopsychosocial theory, this study examined (a) the prevalence of back pain (dependent variable) among smokers, former smokers, and never smokers (independent variable), and (b) the influence of age, sex, race, body …

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Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader Jan 2016

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …

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Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh Jan 2016

Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh

Walden Dissertations and Doctoral Studies

Malaria is a vector-borne disease that presents the most persistent and serious public health burden in Liberia. Numerous studies have examined the relationship between ITN use and malaria prevalence. However, little research has explored the effectiveness of ITNs in controlling malaria among children in postwar Liberia. The aim of this study was to examine the association between ITN ownership, parental economic status, ITN installation support, and malaria prevalence among children. This was a quantitative cross-sectional study guided by the health belief model. The study used secondary data from the 2011 Liberia Malaria Indicator Survey. Chi-square for association and Logistic regression …

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Nurse Practitioner Residency Programs: An Educational Journey, Gregory Paul Rys Jan 2016

Nurse Practitioner Residency Programs: An Educational Journey, Gregory Paul Rys

Walden Dissertations and Doctoral Studies

Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with minimal leadership and clinical experiences directly into practice. One resolution to mitigate this concern would be an NP residency program. Evaluating the knowledge and attitudes of stakeholders prior to the implementation of a NP residency program is an important first step to this implementation plan. The …

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Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston Jan 2016

Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston

Walden Dissertations and Doctoral Studies

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in …

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The Pharmaceutical Industry's Effect On Rheumatologists' Patterns Of Care, Frank Bailey Jan 2016

The Pharmaceutical Industry's Effect On Rheumatologists' Patterns Of Care, Frank Bailey

Walden Dissertations and Doctoral Studies

Drug makers have developed numerous techniques to influence treatment choices. Almost no information exists regarding the pharmaceutical industry's influence on rheumatologists and how these pressures could affect patient care. This phenomenological research, conducted within the framework of social exchange theory, explored the lived experiences of rheumatologists regarding their interactions with agents of the pharmaceutical industry. A researcher-designed interview protocol was used to gather feedback from 10 rheumatologists regarding how interactions with agents of the pharmaceutical industry made them feel. Using horizonalization, meaningful statements made by rheumatologists were condensed into specific themes and patterns, which provided a composite summary of their …

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The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran Jan 2016

The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran

Walden Dissertations and Doctoral Studies

Lack of accessibility to healthy foods is a factor associated with the increase in obesity, diabetes, and other negative health consequences. While programs such as WIC (Women, Infants, and Children) provide supplemental nutritional access to healthy foods, few organic food items are included in the WIC authorized food list. Government programs and policy makers that provide to the most vulnerable populations are concerned about equal availability of healthy foods. The purpose of this study was to compare variability and cost of organic food items in 24 large chain grocery stores located in high- and low-income areas. The theoretical concepts of …

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Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink Jan 2016

Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink

Walden Dissertations and Doctoral Studies

Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided …

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Assessing Knowledge Of Evidence-Basedpractice Among Nurses, Suja Merin John Jan 2016

Assessing Knowledge Of Evidence-Basedpractice Among Nurses, Suja Merin John

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is used worldwide to improve the quality of patient care to provide cost-effective care. EBP is a mandate for nursing practice combining individual clinical judgment with available expertise to generate a positive outcome for the patient. Investigators have documented that nurses have varying degrees of confidence and knowledge about EBP. The purpose of this project was to improve knowledge of EBP among registered nurses (RNs). The ACE Star Model of Knowledge transformation was used as the conceptual model. The key project question was to assess the level of knowledge and confidence about EBP among RNs in a …

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Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass Jan 2016

Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass

Walden Dissertations and Doctoral Studies

The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and …

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