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Articles 781 - 810 of 6102

Full-Text Articles in Medicine and Health Sciences

Do Minorities Attend Culturally Competent Hospitals? The Case Of Minority-Serving And Safety-Net Hospitals, Rumel Mahmood Jun 2025

Do Minorities Attend Culturally Competent Hospitals? The Case Of Minority-Serving And Safety-Net Hospitals, Rumel Mahmood

Journal of Social, Behavioral, and Health Sciences

Minorities disproportionately attend minority-serving hospitals (MSHs) and safety-net hospitals (SNHs). This study examines whether MSHs or SNHs are more culturally competent than their counterparts. No research to date has examined the cultural competency of MSHs and SNHs with hospitals outside of these categories. The literature on the determinants of hospital-level cultural competence is sparse, with limited measures used nationally and a robust measure used in a single U.S. state. I calculated a 100-point score of hospital cultural competence from a nationally representative survey of hospitals (N = 849 respondents). Using multilevel regression models, I found that MSHs are culturally …

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Associations Between Daytime Sleepiness, Obesity, And Sleep Apnea Severity Among Caribbean Women, Melaine F. Mcleod Jun 2025

Associations Between Daytime Sleepiness, Obesity, And Sleep Apnea Severity Among Caribbean Women, Melaine F. Mcleod

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea is the most common type of sleep-disordered breathing. Obstructive sleep apnea (OSA) is a global health epidemic that is associated with the obesity pandemic and daytime sleepiness. This quantitative cross-sectional descriptive study aimed to examine associations between daytime sleepiness measured by the Epworth Sleepiness Scale, obesity measured by body mass index (BMI), and severity of OSA measured by the apnea-hypopnea index among Caribbean women residing in the Cayman Islands. The health belief model served as the theoretical framework to guide this research. Daytime sleepiness and obesity were independent variables; the dependent variable was the severity of OSA, …

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Provision Of Transportation To Psychiatric Follow-Up Appointments, Eliane Sandrine Tueche Fankam Jun 2025

Provision Of Transportation To Psychiatric Follow-Up Appointments, Eliane Sandrine Tueche Fankam

Walden Dissertations and Doctoral Studies

This quality improvement initiative is focused on the lack of transportation as a significant barrier to obtaining health care services for patients with severe psychiatric disorders. Transportation issues remain an important factor that hinders the attainment of health care services by the members of this population. Transportation challenges should be addressed as much as possible for improving healthcare accessibility and providing timely care. Prior to the implementation of the transportation service, only 30% of patients with severe mental illness (SMI) attended their scheduled appointments, demonstrating the need for intervention. This project focused on whether providing transportation services would improve compliance …

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Cultural And Structural Barriers Influencing The Mental-Health-Seeking Behaviors Of South Asians In Dallas, Texas, Judith Jose Jun 2025

Cultural And Structural Barriers Influencing The Mental-Health-Seeking Behaviors Of South Asians In Dallas, Texas, Judith Jose

Walden Dissertations and Doctoral Studies

Despite being one of the fastest growing immigrant populations in the United States, South Asians experience disproportionately high rates of untreated mental health conditions while reporting low utilization of professional mental health services. This qualitative phenomenological study explored the cultural and structural barriers that influence mental-health-seeking behaviors among South Asians residing in Dallas, Texas. Guided by the health belief model and principles of cultural competency, this research investigated how perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy intersect with cultural stigma, religious beliefs, generational dynamics, and systemic obstacles. Semistructured interviews with 12 South Asian adults revealed seven major …

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Staff Education To Educate Healthcare Providers On Effective Communication And Support Strategies For Child Sexual Abuse Victims, Njideka Ajemba Jun 2025

Staff Education To Educate Healthcare Providers On Effective Communication And Support Strategies For Child Sexual Abuse Victims, Njideka Ajemba

Walden Dissertations and Doctoral Studies

With this project, I sought to enhance the quality of care provided to child sexual abuse (CSA) survivors by improving healthcare providers’ skills in trauma-informed communication and support strategies. The project was undertaken at a large, private behavioral health facility located in the mid-Atlantic region of the United States, where an assessment of the practice environment revealed a critical gap in provider training. This gap often resulted in missed indicators of abuse, limited emotional support, and poor therapeutic outcomes for children affected by sexual abuse-related trauma. To address this, the project implemented a targeted educational intervention grounded in current evidence …

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Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity Jun 2025

Hypotension-Specific Rapid Response Team Nurse-Geared Protocol, Quennie Xserenity

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was conducted to develop a clinical practice guideline (CPG) to address a gap at a southeastern hospital where frontline nurses often call rapid response teams for severe hypotension without a standard guideline for necessary interventions. Therefore, the practice gap identified at the project site was the lack of a CPG geared for rapid response nurses (RRNs) to use when responding to a call to intervene on a patient with hypotension. RRNs are nurses with advanced clinical training who provide immediate medical care to rapidly hemodynamically declining patients. The guiding question for this DNP …

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Identifying And Exploring Successful Leadership Strategies To Improve Nurse Retention, Jennifer Triggs Rickerson Jun 2025

Identifying And Exploring Successful Leadership Strategies To Improve Nurse Retention, Jennifer Triggs Rickerson

Walden Dissertations and Doctoral Studies

Nurse turnover has become a critical concern in healthcare, as low retention rates lead to decreased patient care quality and increased operational costs. A critical issue for hospital stakeholders is that many nursing leaders lack strategies to improve nursing retention. Grounded in the leader-member exchange theory, the purpose of this qualitative pragmatic inquiry was to identify and explore successful leadership strategies used by nurse managers in the Pacific South region of the United States to improve nurse retention. The study included interviews with six nurse managers who successfully implemented retention strategies. Data were collected through semistructured interviews and publicly available …

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Gender Differences In Regretted Consensual Sexual Experiences And Problematic Alcohol Use Among First-Year College Students, Shannon Shen, Soyoung Kwon, Sukho Lee Jun 2025

Gender Differences In Regretted Consensual Sexual Experiences And Problematic Alcohol Use Among First-Year College Students, Shannon Shen, Soyoung Kwon, Sukho Lee

Journal of Social, Behavioral, and Health Sciences

Regretted sexual behaviors and alcohol use often occur in tandem for college students; however, few studies have examined their interrelationships or the variance across gender. This study tested gender differences in how regretting a consensual sexual experience is related to college students’ alcohol use. One hundred and forty first-year students (63% women, 69% Hispanic) surveyed in 2018 and 2019 reported their sexual behavior and alcohol use (following the Rutgers Alcohol Problem Index [RAPI]). Twenty-one percent of men and 16% of women reported a regretted sexual encounter. Interaction effects from regression models revealed that men with sexual regret had a significantly …

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Staff Education Project On Genetic Testing In A Psychiatric Facility, Chinenye Vivian Akpuaka Jun 2025

Staff Education Project On Genetic Testing In A Psychiatric Facility, Chinenye Vivian Akpuaka

Walden Dissertations and Doctoral Studies

The project was an educational DNP project that aimed to improve staff knowledge on genetic testing. The practice focused question was “Will an education module on best practices for genetic testing increase self-reported knowledge among health care professionals in a mental health clinic?” The purposes of genetic testing in psychiatry are to improve pharmacological therapy through better prescription of the right medications (Pinzón-Espinosa et al., 2022). The implementation of genetic testing at the project site is limited due to gaps in knowledge and attitudes as well as efficacy of this intervention. The leaders at the practicum site supported the potential …

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Impact Of Military-Related Moves On Spousal Perinatal Depression Screening And Mental Health Services, Chambraia Jones Jun 2025

Impact Of Military-Related Moves On Spousal Perinatal Depression Screening And Mental Health Services, Chambraia Jones

Walden Dissertations and Doctoral Studies

Maternal depression, including perinatal depression (PND), poses significant public health risks to women, infants, and families. Although routine PND screening is recommended, limited research has examined screening and referrals among military spouses, an underserved population affected by frequent relocations and deployments. This study examined how permanent change of station (PCS) frequency affects PND screening and referrals to mental health services. Grounded in Bronfenbrenner’s socioecological model and the CDC’s social ecological model of health, eight research questions explored associations between PCS frequency, PND screening, referrals, and the moderating roles of military branch and deployment status. A quantitative cross-sectional design was used …

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Clinical Practice Guideline: Appropriate Selection Of Mental Health Conditions For Telepsychiatry Visits, Oluwatoyin Sowunmi Jun 2025

Clinical Practice Guideline: Appropriate Selection Of Mental Health Conditions For Telepsychiatry Visits, Oluwatoyin Sowunmi

Walden Dissertations and Doctoral Studies

This doctoral project was a clinical practice guideline (CPG) aimed at addressing the practice problem of inappropriate selection of patients for telepsychiatry visits. The issue is significant in nursing practice, as the misalignment between patient needs and telehealth capabilities often results in appointment cancellations. The practice focus question guiding this project was “Does the evidence support development and expert panel validation via the Appraisal of Guideline for Research and Evaluation II (AGREE II) of a CPG for appropriate selection of mental health conditions for telepsychiatry visits that is also approved for use in practice by end users?” The project successfully …

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Reducing Readmission Rates In A Mental Health Hospital, Zamzam Mohamed Jun 2025

Reducing Readmission Rates In A Mental Health Hospital, Zamzam Mohamed

Walden Dissertations and Doctoral Studies

Summary I designed this clinical practice guideline (CPG) doctoral project to address the critical practice problem of high readmission rates in a mental health unit at a large academic medical center. This quality improvement initiative focused on developing and evaluating CPG to improve discharge planning. I aimed to address gaps in continuity of care, inadequate discharge education, and limited post discharge follow-up, which had been identified as contributing factors to early psychiatric readmissions. The practice-focused question guiding this project was: What evidence supports the development of a discharge planning CPG designed to reduce readmission rates in a mental health unit? …

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Educating Staff On Using Medication-Assisted Treatment (Mat) In Opioid Use Disorder (Oud), Demie Alaekwe Jun 2025

Educating Staff On Using Medication-Assisted Treatment (Mat) In Opioid Use Disorder (Oud), Demie Alaekwe

Walden Dissertations and Doctoral Studies

Medication-assisted treatment (MAT) programs, especially those led by providers, can expand access to care for persons with opioid use disorder (OUD). The gap in practice at the site was the insufficient knowledge among nurses on how to effectively use MAT in treating OUD. The purpose of this staff educational project was to design and implement a training module to educate mental health providers on the principles and interventions of MAT. The practice-focused question was: Does educating nurses on MAT principles while incorporating evidence from the literature improve their knowledge as measured by pre- and post-test? The ADDIE pedagogy model was …

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Clinical Practice Guideline For Intentional Rounding, Julia Griggs Jun 2025

Clinical Practice Guideline For Intentional Rounding, Julia Griggs

Walden Dissertations and Doctoral Studies

This is a quality improvement clinical practice guideline (CPG) to address the inconsistent staff rounding practices, developed following recognition of a fall rate of 3.2 per 1000 patient days and declining patient satisfaction in the project facility. I developed the CPG using current evidence-based practices to establish standardized procedures for purposeful rounding to enhance patient safety, satisfaction, and care quality. Three experts, including an educator, clinician, and administrator, evaluated the CPG using the Appraisal of Guidelines for Research and Evaluation II (AGREE II), a tool consisting of seven domains used for measuring the methodological rigor and transparency in which a …

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Staff Education To Addressing Medication Nonadherence Amongst Patients With Mental Health Challenges, Euphemia Mah Jun 2025

Staff Education To Addressing Medication Nonadherence Amongst Patients With Mental Health Challenges, Euphemia Mah

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Euphemia Mah has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Corinne Wheeler, Committee Chairperson, Nursing Faculty Dr. Robert McWhirt, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Summary Poor adherence to medication regimens among patients who have a mental illness leads to multiple adverse outcomes, which include symptom exacerbation, decreased quality of life, and repeated hospitalizations. To address this …

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Lived Experiences Of Nurses Caring For Patients With Opioid Use Disorder, Oneatha Alexander Jun 2025

Lived Experiences Of Nurses Caring For Patients With Opioid Use Disorder, Oneatha Alexander

Walden Dissertations and Doctoral Studies

Opioid abuse is a significant problem in the United States. People with opioid use disorder (OUD) visit the emergency room (ER) for pain management. OUD is the overuse and abuse of opioids, which can result in dependence, relapses, and death. Nurses in the ER and medical-surgical units face challenges in distinguishing OUD from chronic pain. The purpose of this qualitative interpretive phenomenological study, guided by Benner’s novice-to-expert framework, was to explore the lived experiences of ER and medical-surgical nurses who provide care to OUD patients. Eight ER and medical-surgical nurses were interviewed using semi-structured interviews. The main themes from coding …

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Staff Education On Strategies To Eliminate Medication Errors And Promote Medication Compliance In The Community And Healthcare Settings, Rita Nyongkah Yeba Jun 2025

Staff Education On Strategies To Eliminate Medication Errors And Promote Medication Compliance In The Community And Healthcare Settings, Rita Nyongkah Yeba

Walden Dissertations and Doctoral Studies

Patient health is highly influenced by non-adherence to medications and faults in them. Longer diseases, unneeded hospital visits, and growing healthcare expenses are the effects of these problems. Medication errors can arise from incorrect prescriptions, too low or too high doses, poor administration, or inconsistent provider communication. Patients may also neglect their prescriptions for several reasons, including lack of motivation, forgetfulness, or worries about side effects. This initiative aimed to provide medical staff members with techniques meant to help lower errors in the healthcare environment and enhance medication adherence. The aim of this initiative was to instruct the staff members …

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A Clinical Practice Guideline For Enhanced Rehabilitation Assessment In Poststroke Patients, Chanda Honeywood Jun 2025

A Clinical Practice Guideline For Enhanced Rehabilitation Assessment In Poststroke Patients, Chanda Honeywood

Walden Dissertations and Doctoral Studies

This doctoral project aimed to develop clinical practice guidelines (CPG) to strengthen the assessment of poststroke patients for rehabilitation. The project sought to adopt an evidence-based approach to develop standardized recommendations that can help in the timely and appropriate rehabilitation of stroke survivors, thereby reducing the risk of long-term disability and readmissions. Stroke is a significant cause of disability and poor functional recovery, increased healthcare costs, and lower quality of life for patients occur because of poor rehabilitation assessment. While rehabilitation protocols already exist, discrepancies in patient evaluations result in intervention delays and ineffective uptake of rehabilitation programs, limiting the …

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Using The Token Economy To Improve Show Rates In An Outpatient/Community Mental Health Clinic, Gertrude Nabila Ndansi Jun 2025

Using The Token Economy To Improve Show Rates In An Outpatient/Community Mental Health Clinic, Gertrude Nabila Ndansi

Walden Dissertations and Doctoral Studies

The type of project was a quality improvement intervention. The identified practice problem was limited appointment shows among patients with appointments. Outpatient clinics often struggle with patients not showing up for appointments. Addressing this gap was critical for improving patient outcomes and resource efficiency. The practice problem must be addressed within the context of nursing practice by enhancing access to consistent mental health care and giving patients more timely support, leading to better outcomes and overall wellbeing.

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Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha Jun 2025

Staff Education Program On Care Transitions For The Elderly, Emmanoela Mugha

Walden Dissertations and Doctoral Studies

This project was developed as a staff education program using the analyze, design, develop, implement, and evaluate (ADDIE) model with a focus on discharge planning in a medical clinic in northern Maryland. There is a gap in discharge planning for older adults due to shortage of providers and inadequate education related to care transitions among the elderly. The care transition process can be improved through education. The practice focused question was: “Does an educational project for nurses on care transitions for the elderly increase knowledge as compared pre-to post education?” The Johns Hopkins evidence-based practice model (Appendix A) was the …

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Nurses’ Role In Reducing Mental Health Stigma In Healthcare, Olufunmilayo Elizabeth Adeloye Jun 2025

Nurses’ Role In Reducing Mental Health Stigma In Healthcare, Olufunmilayo Elizabeth Adeloye

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a targeted educational intervention to reduce mental health stigma among healthcare providers. Mental health stigma, often resulting in misdiagnosis, delayed treatment, and decreased patient engagement, represents a significant barrier to effective nursing practice. The project’s practice-focused question examined whether an educational program could improve provider knowledge and attitudes toward mental illness. Using the ADDIE model (analysis, design, development, implementation, and evaluation), a needs assessment at a family practice and behavioral healthcare clinic identified gaps such as judgmental perceptions, avoidance behaviors, and lack of empathy among providers. An extensive literature review supported the …

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Preoperative Clinical Practice Guidelines For Patients Undergoing Coronary Artery Bypass Graft Surgery, Marjorie Badong Yumul Jun 2025

Preoperative Clinical Practice Guidelines For Patients Undergoing Coronary Artery Bypass Graft Surgery, Marjorie Badong Yumul

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Marjorie B. Yumul has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Patricia Schweickert, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Executive Summary: Clinical Practice Guideline Preoperative Clinical Practice Guidelines for Patients Undergoing Coronary Artery Bypass Graft Surgery by Marjorie B. Yumul MS, University of the Philippines Manila, 2003 BS, La Concordia, …

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Registered Nurses’ Perceptions Of Patient Safety In Critical Care Units, Martha Benghie Hyacinthe Jun 2025

Registered Nurses’ Perceptions Of Patient Safety In Critical Care Units, Martha Benghie Hyacinthe

Walden Dissertations and Doctoral Studies

Patient safety is a cornerstone of effective healthcare delivery, particularly in critical care units (CCUs) where patients are at heightened risk of complications due to their complex medical conditions. The purpose of this study, guided by Watson’s theory of human caring, was to explore RNs’ perceptions of patient safety in CCUs. Data on eight RNs working in CCUs were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Data were collected through semi-structured interviews, allowing for an in-depth exploration of nurses’ perspectives. Using Saldana’s method of thematic analysis, three overarching themes emerged: patient safety, resource allocation, and …

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Nafld Surveillance In The Alaska Native/American Indian Population, Wileina Saumara Rhodes Jun 2025

Nafld Surveillance In The Alaska Native/American Indian Population, Wileina Saumara Rhodes

Walden Dissertations and Doctoral Studies

In the United States, the prevalence of NAFLD is estimated at 24% of the population, and by 2030, the incidence of NAFLD will increase to 100.9 million cases. This study aimed to determine the prevalence and rate of non-alcoholic fatty liver disease (NAFLD) progression in the Alaska Native/ American Indian population (AN/AI) with and without elevated liver function tests. Two research questions guided the study: Do outcomes (abnormal/normal) of LFTs, A1C, lipids, BMI, and inflammatory markers predict or have a relationship with NAFLD progression? Does NAFLD surveillance have a relationship with the patient’s outcome as measured by the NAFLD Fibrosis …

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Staff Education On Uti Screening, Antimicrobial And Antibiotic Resistance, And Poor Regimen Adherence, Shereen Robinson Jun 2025

Staff Education On Uti Screening, Antimicrobial And Antibiotic Resistance, And Poor Regimen Adherence, Shereen Robinson

Walden Dissertations and Doctoral Studies

This staff education project focused on enhancing nurses’ knowledge of urinary tract infections (UTIs) and antibiotic and antimicrobial resistance intended to promote screening for UTIs. The practice problem addressed was lack nurses’ knowledge of UTI screening and antibiotic resistance. Inadequate screening contributed to increased UTI rates, re-occurrences, and complications such as delirium. It was essential to address the issue because nurses are at the frontline regarding educating, screening, and providing care to patients with UTIs. Knowledgeable nurses can implement standard practices to ensure adequate screening for UTIs. Effective screening would enhance early treatment and minimize misuse and unnecessary antibiotic prescriptions. …

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Staff Education To Registered Nurses On An Inpatient Pediatric Unit Regarding Pediatric Burn Principles, Qwinnetta Janae Stokes Jun 2025

Staff Education To Registered Nurses On An Inpatient Pediatric Unit Regarding Pediatric Burn Principles, Qwinnetta Janae Stokes

Walden Dissertations and Doctoral Studies

The purpose of this staff education project was to improve nurses’ knowledge on burn care using an educational intervention. The project site became the children's hospital designated burn unit. Children with burns were a new patient population that the project unit had never cared for, and there was no formal training or competencies for nurses caring for these patients. Nurses requested formal education before being expected to care for these patients. This project utilized a single group, pre-post design comparing knowledge of bedside surgical nurses about pediatric burn care management principles before and after the educational intervention. The intervention was …

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Staff Education On Substance Use Screening In An Outpatient Mental Health Clinic, Kelvin Okwudiogor Jun 2025

Staff Education On Substance Use Screening In An Outpatient Mental Health Clinic, Kelvin Okwudiogor

Walden Dissertations and Doctoral Studies

This DNP project aimed to enhance the quality of care by improving healthcare providers’ knowledge and fostering confidence in the utilization of screening, brief intervention, and referral to treatment (SBIRT). At the practice site, patients were not screened for substance use due to the lack of provider knowledge on evidence-based screening tools. The practice-focused question for this project was, Among healthcare providers in outpatient mental health clinics, does education on the use of the SBIRT screening tool increase their knowledge and skill after educational intervention? The project used a sample of 12 healthcare professionals, including four mental health practitioners and …

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Clinical Practice Guideline For Systemic Lupus Erythromatosus And Lupus Nephritis, Seleaina A. Thomas Jun 2025

Clinical Practice Guideline For Systemic Lupus Erythromatosus And Lupus Nephritis, Seleaina A. Thomas

Walden Dissertations and Doctoral Studies

Summary This project addressed the critical practice problem of delayed and inaccurate diagnosis of systemic lupus erythematosus (SLE), which has been linked to increased morbidity and mortality, particularly among marginalized populations. These diagnostic challenges have been recognized globally, with international research highlighting inconsistencies in care and the absence of standardized guidelines. Implementing inclusive and equitable clinical practice guidelines (CPGs) that consider social determinants of health, political determinants of health and actively involve diverse populations in research can play a crucial role in reducing racial disparities and improve outcomes for all lupus patients. Thus, the development of a CPG focused on …

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Standardizing Discharge Planning To Reduce Readmission Rates In Outpatient Mental Health Clinics, Navasha Martin Jun 2025

Standardizing Discharge Planning To Reduce Readmission Rates In Outpatient Mental Health Clinics, Navasha Martin

Walden Dissertations and Doctoral Studies

Psychiatric readmission rates remain a major concern in outpatient mental health clinics, often resulting from inconsistent discharge practices and limited patient education. This Doctor of Nursing Practice (DNP) project aimed to develop and evaluate a clinical practice guideline (CPG) to standardize discharge planning and reduce psychiatric readmission rates. Guided by the question: Does evidence support the quality of an evidence-based standardized discharge planning protocol to reduce readmissions?, this project integrated findings from a structured literature review and expert panel evaluation. The CPG was developed using evidence-based strategies and evaluated using the AGREE II instrument, a validated tool for assessing the …

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The Relationship Between Food Label Comprehension And Consumer Dietary Choices, Marline Denis Jun 2025

The Relationship Between Food Label Comprehension And Consumer Dietary Choices, Marline Denis

Walden Dissertations and Doctoral Studies

Poor dietary choices and limited understanding of nutritional information are ongoing public health concerns that contribute to the rise of chronic illnesses such as obesity, diabetes, and heart disease. This quantitative, cross-sectional, correlational study investigated the associations between health literacy and food label comprehension with consumer dietary choices and adherence to dietary guidelines among individuals aged 16 and older in the United States. Guided by the Nutrition Label Literacy (NLL) framework, this study explored whether components such as basic nutritional knowledge, numeracy skills, health motivation, and label usage predict healthier food choices. Age, education, and gender were included as covariates. …

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