Medicine and Health Sciences Commons^™

Individuals’ Lived Experiences With Pharmaceutical Patient Assistant Programs, Marcia Clarke-Burke

Walden Dissertations and Doctoral Studies

AbstractPharmaceutical patient assistance programs (PAPs) were introduced as an alternative to address patients’ inability to obtain necessary prescription drugs. However, individuals were not fully exploring the beneficial nature of PAPs due to a poor understanding of the programs. Additional research is needed to understand how PAPs impact patients’ outcomes and costs of care. Grounded in Andersen and Newman’s model of health care utilization, this qualitative research was guided by the hermeneutic phenomenological research design. Data were collected during interviews with 11 participants located in various states regarding their participation in PAPs and their lived experiences in using PAPs. Collected data …

An Educational Intervention For Perioperative Nurses On Venous Thromboembolism Prophylaxis, Joann Mcghee-Evans

Walden Dissertations and Doctoral Studies

AbstractResearch has demonstrated that enhancing a nurse’s knowledge and awareness may result in positive patient, provider, and organizational outcomes. In a local organization, there had been a 25% increase of postoperative venous thromboembolisms (VTEs) within the last 12 months. The purpose of this doctor of nursing practice (DNP) project was to determine whether an educational intervention focused on VTE and the standards of care for VTE prevention increased knowledge and awareness among perioperative nurses working in the local organization. Benner’s novice to expert theory and King’s goal attainment theory provided the framework for the DNP project. Thirty-eight nurses were invited …

Reducing Same-Day Procedure Cancellations At An Interventional Spine And Pain Management Center, Adriene Smith

Walden Dissertations and Doctoral Studies

AbstractReducing Same-Day Procedure Cancellations at an Interventional Spine and Pain Management Center by Adriene Smith

Walden UniversityOctober 2023   Abstract The practice problem at a local interventional spine and pain management center was that the nurses lacked sufficient knowledge of the facility’s preoperative screening tool. The problem resulted in inadequate patient preparation for surgical procedures that led to a 33% same-day surgery cancellation rate. A staff education project was conducted to educate the nurses on how to properly use the facility’s preoperative screening tool and assess their knowledge of common blood thinner medications included in the preoperative screening process. Failure to …

Improving Nurse-Patient Communication Through Motivational Interviewing In A Step-Down Unit, Ana G. Becker

Walden Dissertations and Doctoral Studies

AbstractPatient satisfaction is an essential component in assessing the quality of nursing care. Often monitored through patient satisfaction surveys, this doctorate in nursing practice project (DNP) was developed to improve the problem of low Press Ganey nurse-patient communication scores for a medical-surgical step-down unit. The aim of the project was to develop a staff education program for the purpose of introducing motivational interviewing as an intervention to improve nurse-patient satisfaction scores. Lewin’s change model, Knowles’ adult learning theory, and the analysis, design, develop, implement, and evaluate (ADDIE) model were used to guide the development of the DNP project. Conducted over …

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …

Maternal-Early-Warning-System Education To Improve Registered Nurse Knowledge Of And Appropriate Responses To Triggers, Dawn Marie Moore

Walden Dissertations and Doctoral Studies

The maternal early warning system (MEWS) is the single most reliable response tool to improve maternal outcomes in obstetrics. Recognition and response by nurses to the MEWS triggers was worrisome at the project site as the MEWS trigger to detect changes in the clinical conditions in obstetric patients was not applied consistently at the bedside. This project was developed to evaluate whether providing an education program on the application of MEWS to nurses in obstetrics at the practicum site would improve registered nurses’ knowledge of and appropriate responses to the MEWS trigger alarms. A literature search targeting the key words …

Help-Seeking Behavior Of African American And Non-African American Victims Of Elderly Abuse, Tesfaye Yigletu Wosene

Walden Dissertations and Doctoral Studies

Elderly abuse is a pervasive public health problem in the United States. Most abuse and neglect go unreported due to barriers including fear for safety, concerns about the consequences, culture, lack of knowledge about elder abuse, shame, and self-blame. However, there is limited research on how race and ethnicity impact help-seeking behaviors of the elderly. This cross-sectional quantitative study examined the difference in reporting and help-seeking behavior between African American and non-African American victims of elderly abuse. Applying the behavioral model of health services use, this study involved a secondary data analysis using the Nation Elderly Mistreatment Study Wave II …

The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar

Walden Dissertations and Doctoral Studies

AbstractCompassion fatigue (CF) has been described as the “cost of caring” for traumatized individuals, which may lead to missed workdays, diminished work satisfaction, increased turnover, and decreased client care. CF has long been studied in other caring professionals, but occupational therapy practitioners (OTPs) have been largely overlooked. The purpose of this quantitative correlation study was to determine the relationship between secondary traumatic stress (STS) and resilience (RES) on burnout (BO) and compassion satisfaction (CS; i.e., indicators of CF) in OTPs. In this study, the moderation effect that RES has on STS and BO as related to CF in 68 completed …

The Essence Of Therapeutic Relationships In Equine-Assisted Psychotherapy, Joy Clark Akin

Walden Dissertations and Doctoral Studies

AbstractTraditional psychotherapeutic approaches are not always effective in alleviating psychological symptoms and improving functioning in young adults. Equine-assisted psychotherapy (EAP) has been shown as a beneficial alternative therapeutic method developed for clients not helped by traditional methods. However, the essence of the therapeutic relationship that develops between the client, horse, therapist, and equine specialist has not been explored. The purpose of this phenomenological study was to explore the lived experience of the therapeutic relationship in young adults who participated in EAP. The frameworks of person-centered theory and self psychology guided the development of interview questions, data analysis, and interpretation. Four …

Closing The Knowledge Gap For Advanced Practice Nurses On Medical Cannabis, Regina Bernice Askew-Gibbs

Walden Dissertations and Doctoral Studies

AbstractSince cannabis, also called marijuana, has been decriminalized or legalized as a prescription for medical purposes, more patients are using cannabis recreationally for medical purposes or as a holistic therapeutic approach in contrast to Western medicine. With increased use among patients, it has become important for the advanced practice nurse (APN) to have a basic knowledge of the therapeutic benefits of marijuana. The goal of this DNP project was to supply APNs with education on marijuana and cannabis to prevent poor patient assessment and education. Pre-and posttest data from 6 participants who work at a medical, ambulatory clinical site, were …

Mental Health In Black Women With Endometriosis-Related Symptoms During Covid-19, Anjanette Jaye Blunt

Walden Dissertations and Doctoral Studies

Endometriosis is an incurable chronic illness impacting 190 million women worldwide. Despite the prevalence of this painful disease, research addressing how it affects Black women in the United States was limited. Research addressing this phenomenon during the COVID-19 pandemic was further limited. The purpose of this qualitative study employing an interpretative phenomenological analysis was to understand the mental health of Black women with endometriosis-related symptoms during the COVID-19 pandemic and how having the illness during the pandemic might have impacted individuals in this population. The strong Black woman schema and biopsychosocial model were the theoretical foundations for the study. Data …

Teach-Back As An Evidence-Based Tool In Patient Education, Andrea Clyne

Walden Dissertations and Doctoral Studies

AbstractDischarge instructions are a valuable component of patient education as they can influence outcomes post-discharge, leading to positive social change through improved morbidity and mortality. The use of teach-back education by registered nurses is a best practice that assures understanding of discharge instructions. However, consistent use of this method relies on the staff’s conviction and confidence in this manner of education. The purpose of this project was to develop, deliver, and evaluate a program to educate staff on the best practice of teach-back to effectively deliver patient education. The logic model helped guide and develop the stages of the project …

Adverse Childhood/Adolescent Experiences And Risk Of Recruitment Into Sex Trafficking, Shwana Coleman

Walden Dissertations and Doctoral Studies

Human trafficking victims are negatively impacted by the process of coercion, kidnapping, and forced sexual interactions. Previous research studies showed that sex trafficking impacts victims’ mental health. The purpose of this quantitative study was to investigate whether adverse childhood/adolescent experiences (i.e., substance abuse, psychological abuse, and physical abuse) influence recruitment to sex trafficking in the United States and whether age acts as a moderator. The health belief model provided the theoretical framework for the study that includes data from 2010–2015 collected by the Polaris Project, a global sex trafficking database. Convenience sampling was done to delineate the study variables and …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

Improving Staff Knowledge Of The Value Of Hourly Rounding, Dr. Melissa Gagliano, Dnp, Nea-Bc

Walden Dissertations and Doctoral Studies

Research has shown that consistent hourly rounds improve patient satisfaction and quality of care. Successful implementation and maintenance of this patient-centered practice hinges on nursing knowledge and proper training in the processes and procedures that support timely, purposeful, and effective hourly rounds. The purpose of this doctoral project was to implement a staff education project to improve staff perception of the value of hourly rounding on an inpatient orthopaedic unit. Project materials supplemented the hourly rounding program already in place at the facility. Following an in-depth literature search, pre-intervention multiple-choice knowledge assessment questionnaires were distributed to staff who volunteered to …

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …

Relationship Between Maternal Language And Use Of Electronic Cigarettes In Pregnancy, Tara Halpern

Walden Dissertations and Doctoral Studies

Tobacco use has been a long-standing known modifiable risk factor to maternal health. Although there have been many efforts to encourage smoking cessation, use of electronic cigarettes in pregnancy has been increasing over the years. Understanding potential factors that may play a role in the increased use of electronic cigarettes is important to improve maternal and fetal health outcomes. The social ecological model provides the theoretical framework for this study. The purpose of this study is to determine whether a woman’s primary language and pregnancy health care factors (i.e., access to health care 12 months prior to pregnancy, access to …

Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi

Walden Dissertations and Doctoral Studies

AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) …

Survival Rates And Clinical Trial Participation Among Rural Cancer Patients, Tatiana Kurilo

Walden Dissertations and Doctoral Studies

The literature indicates that cancer patients in rural areas lack adequate access to clinical trials and may experience more harmful consequences than patients residing in urban areas. The purpose of the study was to compare cancer survival rates among patients living in rural and urban counties in a southeastern U.S. state with breast cancer and lung cancer. Analysis was conducted using secondary data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program tumor registry, Comprehensive Cancer Center (CCC) tumor registry, and CCC OnCore Subject Accrual Data. A series of independent samples t-tests and factorial ANOVA were conducted …

Registered Nurses’ Perceptions Regarding Postoperative Pain Management And Opioids For Adolescents, Susan Miller

Walden Dissertations and Doctoral Studies

More than 2.4 million children undergo surgery annually in the United States and many experience postoperative pain. Poor pain management causes negative outcomes to both the individual and society. Increased rates of prescription drug misuse and rising death rates for adolescents from drug overdoses underscore the need for improvements in pain management. However, there is a lack of research, limited guidelines, and significant provider variability in managing adolescents’ acute postoperative pain. The purpose of this qualitative study was to explore the topic of acute postoperative pain management for adolescents through the lens of registered nurses (RNs). Nurses play an essential …

Hiv Testing And Counseling Uptake Predictors Among University Students In Southwest Cameroon., Lilian Belole Motia Pencille

Walden Dissertations and Doctoral Studies

AbstractDespite public health efforts to increase human immuno-deficiency virus testing and counseling (HTC) uptake, screening among college students remains low and understudied. The purpose of this cross-sectional correlational quantitative study was to explore the relationship between the constructs of the health belief model (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy) and HTC uptake while controlling for age, sex settlement type, relationship status, area of residence, religious affiliation, and level of education. Four hundred and eighty-seven (N = 487) university students in Southwest Cameroon were recruited using a convenience sampling method. Data were collected using …

Exploring Relationships Between Psychological Capital And Perceived Stress Among Newly Graduated Nurses, Rita June Jarvis-Isaac

Walden Dissertations and Doctoral Studies

Stress among the newly graduated nurses has been linked to physical and emotional distress, high turnover rates, and the quality of patient care. Psychological capital is a positive state of mind that consists of four components (hope, efficacy, resilience, and optimism). Higher levels of psychological capital have been linked to improvements in the work environment and the psychological and emotional state of nurses. Despite the extensive work of researchers exploring psychological capital among nurses, its relationship to stress among new graduate nurses has not been well studied. The purpose of this quantitative, correlational study was to explore the relationship between …

Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons

Walden Dissertations and Doctoral Studies

Insurance based discrimination is a bias that has the potential to harm patients by limiting their access to care and widen health disparities between patients with private and public insurance. The purpose of this study was to examine whether there is a relationship between type of health insurance (private and public) and access to care factors (acceptability and availability) among African American males ages 25–64 with chronic conditions. The Andersen healthcare utilization model framework supported this research in focusing on the determinants that influences a patient’s ability to access to health care. The research questions examined whether a relationship existed …

Sub-Saharan African Immigrants’ Experiences In Utilizing Mental Health Services In Baltimore, Helen Tanwani

Walden Dissertations and Doctoral Studies

AbstractMental illness is associated with poor quality of life evidenced by unemployment, homelessness, and substance abuse. Despite the adverse effects of mental illness, research has indicated that mental health-seeking behaviors and experiences in accessing mental health services among immigrants from sub-Saharan Africa are under-researched. The purpose of this qualitative study was to explore the experiences of sub-Saharan African immigrants in accessing mental health services in Baltimore, Maryland. To achieve the objective of this study, a descriptive research study was conducted utilizing semistructured one-on-one in-depth interviews with eight sub-Saharan African immigrants in Baltimore. Braun and Clarke’s six-step thematic data analysis approach …

The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco

Walden Dissertations and Doctoral Studies

The clinical laboratory plays a crucial role in aiding physicians to diagnose disease. With numerous studies on “Speak Up” culture well-documented among providers and nurses surrounding patient safety, gaps in literature exist concerning “Speak Up” culture that address team effectiveness and organizational performance within the clinical lab setting. The purpose of this quantitative correlation study was to investigate the relationship between “Speak Up” culture level, team effectiveness, and organizational performance among health care workers employed in the clinical lab. The high-performance work practices model was utilized as the conceptual framework to ground this study. Research questions assessed the link between …

Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …

Health Literacy, Race, And Understanding Health Information Among Women, Adrienne Clark

Walden Dissertations and Doctoral Studies

Health literacy is a topic often referred to by public health professionals to help improve the health of a population. This study used a quantitative approach to understanding health information among women of different races, income levels, household sizes, and education levels within a specific age range. This study used the socio-ecological model for its framework. The overall goal of this study was to improve health disparities and improve health communication one population at a time. Women tend to be the pillar of communities. Having a better understanding of how women understand health information could improve public health outreach. The …

The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire

Walden Dissertations and Doctoral Studies

AbstractHospital readmissions have continuously been a concern to healthcare providers and policymakers because of their negative impacts on the economy and the well-being of patients. A gap in knowledge exists in the understanding of the factors that have led to increased readmissions due to chronic cardiovascular diseases (Heart Failure) and respiratory diseases (chronic obstructive pulmonary disease [COPD] and Asthma). The aim of this study was to examine the relationship between poverty rate and hospital readmission rates for patients with COPD, Heart Failure, and Asthma in the United States using secondary data from the Healthcare Cost and Utilization Project’s (HCUP’s) Nationwide …

The Lived Experiences Of Black Women With Hysterectomy For Benign Fibroids, Clarise M. Jackson-Hall

Walden Dissertations and Doctoral Studies

Black women are more likely than women of any other race in the United States to undergo an abdominal hysterectomy instead of a less invasive and less damaging laparoscopic or robotic procedure for benign fibroids. Although Black women are the population most disparately affected by benign fibroids, as evidenced by higher morbidity and mortality rates due to complications, they are often excluded in clinical research. The purpose of this qualitative phenomenological study was to explore the lived experiences of Black women who decided to undergo an invasive abdominal hysterectomy for benign fibroids. Semistructured interviews were conducted with 14 Black women, …