Medicine and Health Sciences Commons^™

Leadership Strategies For Retaining Healthcare Professionals, Kimberly Hulett

Walden Dissertations and Doctoral Studies

Obtaining information about employee engagement and retention practices is vital for organizations. Affective organizational commitment reflects the extent to which organizational members are loyal and willing to work toward organizational objectives. In particular, affective organizational commitment holds important implications at all organizational levels (e.g., turnover rates, performance, and citizenship behavior). Using general systems theory and transformational leadership theory, the purpose of this single case study was to explore strategies used to improve employee engagement and retention from 5 senior leaders with hiring responsibilities from a midsize hospital in Austin, Texas that have been successful with employee engagement and retention strategies. …

Crafting A System Of Profound Knowledge Management In Long-Term Care, Charlotte Johnston

Walden Dissertations and Doctoral Studies

The paradigm shift to a knowledge economy, predicted by Drucker, is currently reflected in a knowing-to-doing gap in healthcare, potentially threatening the lives of long-term care (LTC) residents and sustainability of LTC organizations. The purpose of this grounded theory study was to seek a substantive conceptual theory to explain how LTC uses knowledge management (KM) to improve performance by probing the a priori views and lived experiences of 11 LTC knowledge creators, managers, and users. Data were collected via semi structured interviews that were transcribed and coded. The research questions guided by the conceptual concentrated on how KM is used …

Attitudes And Beliefs Towards Prostate Cancer Screenings And Diagnosis Among Zimbabwean Physicians, Adoniah Mavura Mukona

Walden Dissertations and Doctoral Studies

Zimbabwean men at risk of developing prostate cancer (PC) are diagnosed late or not at all. A cross sectional, quantitative study was done in Zimbabwe to establish physicians' attitudes and beliefs towards PC screening and diagnosis. Descriptive statistics were obtained to determine physicians' beliefs and attitudes using the Physician Attitudes and Beliefs Questionnaire Survey. The instrument incorporated validated instruments, the Burns' Cancer Belief Scale and Physician Survey on Prostate Cancer Screening, and demographic questions to measure specific independent variables, potentially influencing attitudes and beliefs. Means and standard deviations were conducted for continuous variables for beliefs and attitudes, and frequencies and …

Risk Factors And Outcomes For Bloodstream Infections Among Patients With Skin Infections, Michael Rybak Rybak

Walden Dissertations and Doctoral Studies

Acute bacterial skin and skin structure infections (ABSSSI) are common infections within the local community, and they result in higher morbidity and health care costs. While risk factors for skin and soft tissue infections have been previously evaluated, risk factors associated with secondary bloodstream infections (BSI) has not been investigated, especially in an intercity patient population with limited health care resources. In this case control investigation, 392 patients consisting of 196 cases (ABSSSI + BSI) and 196 controls (ABSSSI) were investigated to determine risk for BSI. Both sociodemographic and underlying conditions were evaluated. According to bivariate analysis of cases and …

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …

Attitudes Of Nigerian Mothers Toward Children With Autism Spectrum Disorder, Valentine Ntoo Chukwueloka

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) is a form of developmental disability that affects many children in the U.S. and abroad. The Center for Disease Control (CDC) has indicated that 1 out of every 68 children is diagnosed with ASD in the United States. However, there was limited literature about the attitudinal dispositions of Nigerian mothers toward children with ASD and their lived experiences with a child with autism. The purpose of this qualitative study was to explore the attitudes of Nigerian mothers toward their children with autism. The theoretical foundation of this study was the variation of the social relational understanding …

Improving Quality Of Care For Mechanically Ventilated Patients In Long Term Care Through Full Compliance With The Ventilator Bundle Protocol, Tedgardo Pacal Mercene

Walden Dissertations and Doctoral Studies

One of the most common methods used by healthcare professionals in the ventilator unit to reduce morbidity and mortality due to ventilator-associated pneumonia (VAP) is a group of best practices known as the ventilator bundle. However, evidence from the literature shows that all its components must be in compliance if the bundle is to be effective. The purpose of this quality improvement project was to investigate the level of compliance with the different components of the ventilator bundle protocol at the study site's nursing home and rehabilitation center, as well as to improve compliance with the bundle protocol at the …

Influence Of Teacher Participation On Student Fitness And Student Participation In Physical Education, Whitney Morris

Walden Dissertations and Doctoral Studies

Physical activity plays a key role in the health of children. Childhood obesity is increasing in the United States, and children are spending less time being physically active. Active participation by a physical education (PE) teacher in physical activities has been suggested as a means of promoting student fitness. The purpose of this quasi-experimental quantitative study was to determine whether modeling of physical activity by a PE teacher would increase student participation and physical fitness. Bandura's social learning theory provided the theoretical framework for the study. Participants included 311 4th and 5th grade elementary students enrolled in physical education classes. …

Developing A Guideline For Care Of Students With Diabetes, Rita Ozioma Onwenna-Aninyei

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is one of the most common chronic diseases affecting children under the age of 20, and it often leads to serious complications. In recent decades, there has been an increase in incidence of both types of DM among U.S. children. Having this chronic condition not only negatively impacts the health of these children but also their academic achievements. School health nurses struggle to manage these children appropriately and safely. The purpose of this project was to develop an evidence- based guideline for a standardized process in which school nurses coordinate the school and student health care teams …

Meeting Meaningful-Use Requirements With Electronic Medical Records In A Community Health Clinic, Tony Andrew Richardson

Walden Dissertations and Doctoral Studies

Small nonprofit medical practices lack the technical expertise to implement electronic medical records (EMRs) that are consistent with federal meaningful-use requirements. Failure to comply with meaningful-use EMR requirements affects nonprofit community health care leaders' ability to receive reimbursement for care. Complexity theory was the conceptual framework used in this exploratory single case study. The purpose of the study was to explore the strategies nonprofit community health care leaders in Washington, DC used to implement EMRs in order to comply with the meaningful-use requirements. Data were collected via in-depth interviews with 7 purposively-selected health care leaders in a nonprofit clinic and …

Evaluation Of Intervention To Increase Exercise Among A Group Of Hispanic Patients In South Florida, Rene Beltran Rodriguez Elias

Walden Dissertations and Doctoral Studies

Despite knowledge regarding the need for regular physical exercise, little is known about the most effective ways to encourage and maintain regular physical activity among primary care patients. New approaches to education about and support of physical activity are needed for everyone, but especially for groups susceptible to diseases related to sedentary lifestyles. This project evaluated a web-based educational intervention guided by the health belief model to address the lack of regular physical activity among 25 Hispanic patients in a South Florida clinical practice. The physically inactive patients were identified through the clinic's electronic medical records and consented to participate. …

Developmental Evaluation Of A Centralized Denials Management Program, Lisa Schiener

Walden Dissertations and Doctoral Studies

Health care reimbursement is changing, and hospitals are finding it difficult to receive payment due to insurers' denial of services already rendered to patients. A denial can be considered an underpayment by the insurer to the hospital. Using a Six Sigma approach, a large hospital system in the southeast United States found that individual hospitals were not focused strictly on denials, but other tasks as well. Hospital administrators conducted a literature review and found that centralizing denials management team has improved reimbursement outcomes elsewhere. Therefore, the hospital system implemented a centralized denials unit to focus on overturning insurer denials while …

Improving Bedside Swallow Screening In Acute Stroke Patients: An Evaluation Plan, Juliette Segree

Walden Dissertations and Doctoral Studies

A stroke is a life-changing event for a patient and his or her family. The acute stroke patient is at risk for developing aspiration pneumonia, whether silent or overt. Prevention of pneumonia in this population requires timely completion and documentation of the bedside swallow screen to identify those patients at risk for aspiration pneumonia; however, anecdotal data from the emergency department at the site of this project suggested that completion and documentation of the screening were inconsistent. Guided by the quality caring model adopted by the project site as well as the logic model, the aim of this project was …

An Exploration Of Bullied Nurses, Witnesses, And A Hospital's Bottom Lline, Brenda Kay Williams

Walden Dissertations and Doctoral Studies

Nurses experiencing bullying or witnessing other nurses bullied may choose to vacate their hospital positions. Nurse attrition negatively impacts a hospital's bottom line, which can lead to insolvency and a lack of access to healthcare by patients. The purpose of this phenomenological study was to understand the choices nurses made regarding their careers after experiencing or witnessing bullying and to calculate a hospital's cost of loss. Freire's oppressed group theory provided the conceptual framework for the study. The basis of the research questions was to understand how the nurse felt when bullied or observing a coworker bullied, the actions taken, …

Reducing The Use Of Indwelling Urinary Catheters During Cesarean Deliveries, Michelle Renee Borland

Walden Dissertations and Doctoral Studies

One concern for medical professionals and women experiencing cesarean deliveries is the use of indwelling urinary catheters, which is associated with a delay in first void time, slower ambulation time, increased discomfort, longer hospital stays, and an increased risk for urinary tract infections. The purpose of this project was to determine if a practice change regarding the use of urinary catheters among pregnant women decreases the number of women receiving a catheter prior to having a cesarean section in a small community hospital. The knowledge to action and Rosswurm and Larabee's models were used to guide this project, which was …

Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo

Walden Dissertations and Doctoral Studies

Abstract

Type 2 diabetes mellitus (T2DM) is a long term metabolic disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. T2DM is a leading cause of cardiovascular disease, blindness, kidney failure, lower-limb amputation, and other complications that are costly to patients and the U.S. health care system. Lack of knowledge and underdeveloped skills for self-management of diabetes continues to be the biggest problem for patients with T2DM. Using a team approach and Rosswurm and Larrabee's (1999) conceptual model as a framework, the purpose of this doctorate of nursing practice quality improvement project was to develop an …

Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization, John K. Amoh

Walden Dissertations and Doctoral Studies

Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) are conditions that represent significant and ongoing medical costs, including frequent emergency department (ED) visits, hospitalizations, work absences, and disability. This retrospective cross-sectional study, examined the effects of the frequent ED visits due to COPD and CHF on the beneficiaries of Medicare and Medicaid in Maryland. The goal was to identify the factors that led these patients to visit the ED, the impact of these visits on Medicare utilization and costs across Maryland, and preventative intervention strategies to control this population's costs of care. Secondary data were analyzed from 2010-2012 …

Effect Of Reduced-Fee Dental Hygiene Treatment And Oral Health Perceptions Among Socioeconomically Deprived Persons, Janeime Necole Asbury

Walden Dissertations and Doctoral Studies

Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges …

Gestational Age, Birth Weight, And Incidence Of Adult Type 2 Diabetes Among Southeast Alaska Natives, Renee Elaine Crawford

Walden Dissertations and Doctoral Studies

American Indian and Alaska Native adults are 2.6 times more likely to have adult onset diabetes resulting from higher weight at birth. Pregnant women, providers, and Indian Health Service administrators may benefit from timely information during pregnancy to intervene and prevent Type 2 diabetes. The purpose of this study was to examine the role of birth weight in the development of Type 2 diabetes among Southeast Alaska (SEA) Natives. Guided by the socioecological model, this study examined the extent to which birth weight and gestational age predict the incidence of Type 2 diabetes. The study used a quantitative research design …

Self-Efficacy And Self-Management Assessments On Hispanic Patients With Diabetes, Yesenia Dejesus

Walden Dissertations and Doctoral Studies

Hispanics are at increased risk for diabetes and are 40% more likely to die from the condition than are non-Hispanic Caucasians. The purpose of this project was to determine the effects of diabetes education conducted in Spanish by bilingual staff on the self-management and self-efficacy of a sample of 50 volunteer adult Hispanic clinic patients with diabetes. The education intervention incorporated the American Diabetes Association's Diabetes Self-Management Education program materials. Bandura's self-efficacy theory was selected as the theoretical support for the project that relied on self-management education of the patients to improve their self-efficacy to undertake the interventions necessary to …

Wellness Intervention As A Quality Of Life Predictor In Mentally Ill Veterans, Tosha Lashon Ellis

Walden Dissertations and Doctoral Studies

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical …

The Lived Experiences Of Hiv+ Community Health Workers Serving Hiv+ Clients, Phronie Lynn Jackson

Walden Dissertations and Doctoral Studies

Numerous studies have focused on the effectiveness of community health worker (CHW) programs in producing positive health behaviors and health outcomes for the clients CHWs serve; however, there has been a gap in the literature regarding how the health of HIV + CHWs is impacted by their jobs. A phenomenological design was used to gain insight into the lived experiences of HIV+ CHWs (HIVCHW) who provided services to HIV positive clients. Fifteen HIVCHW were recruited using criteria and snowball techniques. Data were collected via audio recorded personal interviews regarding respondents' perceptions of their work and how it impacted their own …

Effects Of Education On Pressure Ulcer Prevention In Developmentally Disabled Individuals, Jasneth M. James

Walden Dissertations and Doctoral Studies

Pressure ulcers were a continuing concern among the nonverbal developmentally disabled population of a state institution. The lengthy use of wheelchairs, the inability to body shift, and physical and mental impairment were attributes of the target population that have been cited in the literature as contributing to pressure ulcer. The purpose of this quasi-experimental pretest/posttest project was to evaluate the effectiveness of an education intervention for direct care staff on the prevention treatment, and eradication of pressure ulcers among patients with developmental disabilities. Orem's self-care deficit theory, particularly the emphasis on the need for nursing staff to perform self-care activities …

The Relationship Between Hospital Leadership Activities And Clinical Quality Outcomes In Iowa, Sarah Pavelka

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services have been working with hospital networks across the United States to improve health care through education and training on clinical best practices and leadership frameworks. Some organizations have failed to reach the high-quality standards of care expected and have adverse patient care outcomes. The purpose of the study was to determine the relationship between leadership actions, funding type, and clinical care outcomes in participating Partners for Patients hospital programs in Iowa. The secondary variable data were provided from a Partnership for Patients contractor, through the Centers for Medicare and Medicaid Services Organizational Assessment …

Heroes Or Victims: The Lived Experiences Of Women On Female Genital Mutilation/Cutting In Northwestern Nigeria, Sarah Kasham Philips

Walden Dissertations and Doctoral Studies

The custom of female genital mutilation/cutting (FGM/C) is a traditional practice inimical to women's health with profound implications. There is a gap in the literature on the lived experiences of women who have undergone FGM/C and their statuses within their communities. Guided by the social cognitive theory and the ecological model, this qualitative study aimed at explicating the attitudes and perceptions of women in the northwest region of Nigeria towards the practice of FGM/C, to illuminate how the women view themselves in their society and the inspiration for the continued practice of FGM/C. Interview and observation data were gathered from …

Dementia Caregive Module And Pamphlet, Shawen Denise Ransby

Walden Dissertations and Doctoral Studies

Dementia care is an immediate and growing issue that affects everyone. People are living longer increasing the likelihood that they may be diagnosed with dementia. Friends and family are become caregivers but are often unprepared for the role. The purpose of this project was to develop a 15-minute dementia care module to assist caregivers with the home care of dementia patients. A pamphlet was created to reinforce the module information and to provide a quick reference for dementia support. The self-efficacy theory, along with the review of best practice guidelines and evidence from literature, informed the development of the module. …

The Influence Of Nursing Academic Leadership On Faculty Retention, Carol Turrin Turrin

Walden Dissertations and Doctoral Studies

The critical nursing faculty shortage in the United States affects the ability of nursing schools to train an adequate number of nurses to meet increasing health care demands. Researchers have focused on the nursing faculty shortage; however, insufficient information exists on the relational influence leadership has on faculty retention. The research problem addressed in this study was the lack of information identifying how and in what ways leadership influences retention and intent to stay in academia. The purpose of this phenomenological study was to explore the perceptual views of current faculty, using the leader-member exchange theory. Focusing on baccalaureate nursing …

Health Care Provider Perceptions Of High Blood Pressure Screening For Asymptomatic African American Teens, Juanita Braxton

Walden Dissertations and Doctoral Studies

Health care provider perceptions of typical practices play a significant role in evaluating the efficacy of screening and diagnosis of teen high blood pressure in African Americans. African American adults are more likely to develop high blood pressure than are any other ethnic group; however, there is a gap in the literature concerning high blood pressure in teens. Approximately 1 to 5 of every 100 children has high blood pressure. This purpose of this phenomenological study was to explore the perspectives of health care providers on high blood pressure screening and diagnosis of African American asymptomatic teens. The health belief …

The Relationship Between Health Risk And Workplace Productivity In Saudi Arabia, Sarah Lorraine Hayman

Walden Dissertations and Doctoral Studies

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto …

Increased Risk Factors For Substance Abuse And Attitudes Regarding Substance Use Among Nursing And Non-Nursing Students, Carolyn Sue Britt

Walden Dissertations and Doctoral Studies

Nonmedical prescription drug (NMPD) use is a well-documented problem among college students, but few studies have examined nursing students' attitudes regarding NMPD. The purpose of this study was to compare nursing and non-nursing students' attitudes, risk factors, and current substance use. This descriptive, comparative design utilized a convenience sampling and social media to reach students over 18 years of age and enrolled in a Midwestern university. Twenty-nine students, 14 non-nursing and 15 nursing students, participated in this online survey. Substance use attitudes were measured using the Drug Attitude Scale (DAS). Risk factors for substance use were used as demographic questions …