Medicine and Health Sciences Commons^™

Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González

Walden Dissertations and Doctoral Studies

Business executives risk higher healthcare costs and absenteeism rates without implementing cost-effective strategies to support wellness within the organization. To offset rising healthcare costs and absenteeism, executives should implement wellness programs as a component of the benefits package provided to their employees and families. Grounded in the theory of planned behavior, the purpose of this qualitative multiple case study was to explore the cost-effective strategies that executives in the private and not-for-profit sectors implemented to encourage employees to adopt healthy habits for increasing productivity and decreasing organizations’ healthcare costs. Six executives from the healthcare sector within the southern region of …

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …

A Self-Guided Educational Program Based On Informatics Competency Self-Assessment, Brenda J. Kulhanek

Walden Dissertations and Doctoral Studies

The informatics competency gap for nurses has existed since the first use of technology in healthcare. Although numerous informatics competencies for nurses have been identified over the past 20 years, there is a lack of standardized educational content to help address the informatics competency gap. In a digital healthcare environment, the ability for nurses to understand and use informatics competencies is essential and the lack of informatics competency has a far-reaching impact. Based on the identified gaps, an informatics competency self-assessment tool with associated microeducation was developed to provide a standardized learning approach that would be supported by stakeholders in …

Hand Hygiene Education For Nursing Homes, David La Rosa-Presume

Walden Dissertations and Doctoral Studies

In the health care sector, hand hygiene has been identified as one of the most appropriate approaches to preventing health-associated infections or nosocomial infections. A nursing home in the western United States had repeated survey findings showed that their hand hygiene compliance rates did not meet the expectations of the Long-Term Care Institute. This project was aimed to develop and implement an education program to improve hand hygiene compliance in a nursing home setting. The project practice question asked whether an education program would increase staff’s knowledge of hand hygiene methods within a skilled nursing facility. The Joint Commission’s Targeted …

Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed

Walden Dissertations and Doctoral Studies

AbstractThe National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …

Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey

Walden Dissertations and Doctoral Studies

Retail health care clinics (RHCCs) were designed to ease the shortage of access to primary care by having nurse practitioners (NPs) provide quality care to patients on a walk-in approach. RHCCs can be stressful work environments and when NPs become dissatisfied, they may leave RHCCs which creates a shortage of primary care access. The purpose of this descriptive study, guided by Herzberg’s dual-factor theory, was to determine if there was a relationship between: (a) challenge/autonomy, and professional growth and job satisfaction among NPs who work at RHCCs and (b) intrapractice partnership/collegiality, professional, social and community interaction, time and benefits and …

Factors Of Experience And Training And Physician Intention To Adopt Telemedicine, Tina Mozhayski

Walden Dissertations and Doctoral Studies

Despite the increased role of telemedicine services, physicians’ intention to adopt telemedicine for the long term remains disproportionately low; further, little research has focused on the factors behind these intentions. The purpose of this study was to determine and compare the effects of two causal factors: previous experience of physicians in telemedicine and company telemedicine training, on physicians’ intention to adopt telemedicine. The Davis’s technology acceptance model was used as a theoretical framework for this study, which included analytical data of health care regulatory organizations, medical professional alliances, and secondary statistical data of a marketing company with experience in conducting …

Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu

Walden Dissertations and Doctoral Studies

AbstractPolydipsia is found in 20% of inpatients with chronic severe mental disorders. Of this, 80% are diagnosed with chronic schizophrenia, hence polydipsia is strongly associated with chronic schizophrenia. Despite the prevalence and serious health complications of coexisting polydipsia in this population, its current method of detection is flawed. The purpose of this quantitative study was to accurately identify comorbid polydipsia in schizophrenia using periodic weight change and hyponatremia. The Wilson’s complexity theory and primary data were used to attempt to explain the relationship between weight change and hyponatremia and polydipsia, in a cross-sectional study design. The dependent variable was polydipsia, …

Examining Clinical Behaviors That Demonstrate Intersectionality And Cultural Humility In Mental Health Treatment, Loretta Kosi Okeke

Walden Dissertations and Doctoral Studies

AbstractCultural humility is an ethical standard within the social work profession. As the United States becomes more diverse, there are increasing rates of failure to implement cultural humility in social work practice in mental health settings. The purpose of this generic qualitative study was to examine how clinical social workers demonstrate cultural humility and intersectionality in mental health settings. The theoretical basis on which the research was conducted includes the person-centered theory and the feminist theories, which provided a strong framework for understanding the influences of cultural dynamics and intersectionality on the quality of patient outcomes in mental health care. …

Relationship Between Information System Success Model Dimensions And Electronic Health Records Use, Gloria Oshegbo

Walden Dissertations and Doctoral Studies

The rise in the use of electronic health records (EHRs) in health care facilities necessitates a standardized tool for evaluating their effectiveness. Delone and McLean’s information system success model (ISSM) was the theoretical foundation, which consists of seven dimensions namely system, information, service qualities, user satisfaction, use, system usefulness, and net benefits. The purpose of this study was to examine EHRs’ efficiency and identify ISSM dimensions that influenced net benefits, the dependent variable. The research questions examined the relationship between dimensions of ISSM and the dimensions that affect net benefits. Participants were recruited using purposeful sampling via social media and …

Staff Education Program: Increasing Nursing Knowledge Of Exclusive Breastfeeding, Leigh Anne Panek

Walden Dissertations and Doctoral Studies

AbstractIn the initial postpartum period, exclusive breastfeeding (EBF) improves women's and children's health status and outcomes. Gaps in nursing practice that decrease the rate of EBF during hospitalization at this site were identified by the lactation consultant using a standard chart audit during the last two years. The purpose of this Doctor of Nursing Practice education project was to provide a comprehensive education program that included the purpose, philosophy, nursing practice, and evaluation tools for increasing the EBF rates to meet the Joint Commission’s standard of improvement for perinatal care core measures. A formal educational program that included didactic and …

Risk Factors Associated With Access To Intermittent Preventive Treatment For Malaria Among Pregnant Women In Uganda, Mayanja Simon Peter

Walden Dissertations and Doctoral Studies

Intermittent preventive treatment of malaria in pregnancy (IPTp) is an intervention consisting of the full course of therapeutic antimalarial medicine administered to pregnant women during routine antenatal visits regardless of whether the woman is infected with malaria. The use of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) has been reportedly low in most of the malaria endemic areas, including Uganda. The coverage of IPTp in Uganda has been estimated to be as low as 17%. An in-depth secondary data analysis using the 2016 Uganda Department of Health Services survey was conducted to understand the causal relationships between …

Depression, Drug Use, And Hsv-2 Among Women Who Have Sex With Women, Viani Picchetti

Walden Dissertations and Doctoral Studies

Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, is an incurable sexually transmitted infection responsible in 2018 for 18.6 million infections in the United States. HSV-2 is twice as frequent in women than in men. Women who have sex with women (WSW) have a higher prevalence of depression and drug use than women who have sex exclusively with men (WSM), which are each related to HSV-2 as they increase the likelihood of engaging in risky sexual behaviors. The purpose of this study was to assess the predictive relationship between depression status, nonprescription drug use status, and …

Grief Experiences Of Mothers After A Child’S Death From A Drug Overdose, Shonetesha L. Quail

Walden Dissertations and Doctoral Studies

AbstractResearch on young adult deaths primarily focuses on other causes of death such as homicide, suicide, and accidents. There is very little research surrounding maternal bereavement when the cause of death is from a drug overdose. The purpose of this phenomenological study was to explore the perceptions, attitudes, and lived experiences of grieving mothers who had a biological, adopted, or stepchild die from a drug overdose when the decease’s age was between 18 and 25. Guided by Le Poi Devin’s multidimensional grief theory, the study sought a better understanding to assist mental health and other healthcare providers in developing individualized …

Situation-Background-Assessment-Recommendation During Hand-Off In A Mental Health Nursing Unit, Renel Ramos

Walden Dissertations and Doctoral Studies

AbstractCommunication failures, especially inadequate hand-off communication, in U.S. hospitals has accounted for 30% of malpractice claims, resulting in 1,744 deaths over 5 years. This prompted the Joint Commission to recommend utilizing standardized communication tools to reduce the number of medical errors related to miscommunication. The Situation-Background-Assessment-Recommendation (SBAR) Communication Tool has been used to improve the effectiveness of communication among health care providers. The partner organization noted failures to communicate patient-care-related information between psychiatric mental health nurses (PMHN) during hand-off, given the absence of standardized communication. This project aimed to develop a program to educate PMHNs on the SBAR Communication Tool. …

Improving Pediatric Nurses Knowledge About Palliative Care Services, Marilia M. Rivera Camacho

Walden Dissertations and Doctoral Studies

Palliative care knowledge is important for nursing staff caring for children with life-threatening and debilitating illness because it can provide comfort-based interventions to optimize their quality of life. Nurses in pediatric settings can support the patient and family by providing education and evaluate patients who can benefit from palliative care services. If nurses do not have the palliative care education to support this comfort care process, the quality of life for children with life-threatening and debilitating illness may be affected. The purpose of this DNP project was to educate pediatric nurses about pediatric palliative care standards. The educational program resulted …

Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw

Walden Dissertations and Doctoral Studies

In the United States, the total cost for vaccine preventable diseases was $8.95 billion in 2015. The unvaccinated accounted for 80% of the total costs. This quantitative study was conducted to investigate the success and/or gaps in the implementation of the measles, mumps, and rubella (MMR) vaccine through the Vaccine for Children (VFC) Program by the Ohio Department of Health. General systems theory was chosen as a theoretical framework due to the complicated nature of the healthcare system. Healthcare is a complex system composed of multidisciplinary units that have their own structure and purpose that interact to accomplish the mission …

Clinical Practice Guidelines For Type 2 Diabetes Patients, Rajeena Varghese

Walden Dissertations and Doctoral Studies

In the United States, Type 2 diabetes mellitus (T2DM) is a public health concern and a primary cause of readmissions to hospitals. Many patient readmissions may be avoided if quality, evidence-based clinical practice guidelines (CPGs) are developed and followed using a comprehensive approach. The project site’s retrospective analysis of electronic health records indicated a lack of consistency in following best practice recommendations, as shown by higher readmission rates. The purpose of this project study was to create a current evidence-based CPG that nurses can use to educate T2DM patients before being discharged from the hospital. The practice-focused question addressed whether …

Factors Associated With The Uptake Of Hiv Testing Among African American Male College Students, Brittney Sade Washington-Ball,Drph

Walden Dissertations and Doctoral Studies

HIV testing rates are much lower among African American male college students than male college students of other racial groups. Routine HIV testing on college campuses can decrease HIV rates among African Americans and increase students' awareness of their HIV status. This study was an investigation of factors associated with HIV testing among a sample of 140 African American male college students. The health belief model guided the research study and served as the theoretical framework to examine the influence of factors such as the location of testing, STD status, number of sexual partners, insurance coverage, health information, and alcohol …

Nurse Staffing And Leadership Support On In-Patient Hospital Safety, Kearia Deresa Watson-Orr

Walden Dissertations and Doctoral Studies

In-patient hospital safety relates to healthcare facilities protecting patients from medical errors. The “problem of many hands” exists, where there is a gap in understanding who is responsible for in-patient hospital safety, nurse staffing, or leadership support. The purpose of this quantitative study was to determine the association between nurse staffing (nurse-to-patient ratios and hours worked) and in-patient safety (perception of in-patient safety by nurses) as well as the association between leadership support (work climate promotes patient safety and actions of hospital management to show that patient safety is a top priority) and in-patient safety (perception of in-patient safety) based …

Sustainability Strategies Of Small Nigerian Restaurants, Omotayo A. Adeniyi

Walden Dissertations and Doctoral Studies

Fewer than half of small restaurants remain in the market after the first 5 years of operation. Small business leaders and policymakers are concerned with business failure due to the negative economic impacts on their employees and the local community. Grounded in the entrepreneurship theory, the purpose of this qualitative multiple case study was to explore strategies small restaurant owners use to sustain their operations beyond at least 5 years. Participants included four owners of small Nigerian restaurants who successfully operated their restaurants for more than 5 years. Data were collected using semistructured interviews and a review of internal documents. …

Understanding How Healthcare Social Workers Respond To Adult Medical Trauma, Sonya Anthony

Walden Dissertations and Doctoral Studies

Medical trauma in the hospital is a growing health disparity often accompanied by social determinants. Assisting in alleviating disparities and social determinants is a standard of care embedded in social work practice. This research was conducted to examine healthcare social workers’ experiences responding to and managing the psychosocial impacts of adult medical trauma in an acute inpatient environment. The goal of the research was to identify if a need exists for trauma-informed training among healthcare social workers. The research question examined how healthcare social workers respond to medical trauma. The model of case management, trauma-informed care, and systems theory were …

Adverse Childhood Experiences And Hiv Risk Behaviors Among Transgender Populations, Linda Baggio

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have a negative impact on health and have created a social challenge in managing HIV risk behavior in the transgender population. The aim of this study was to determine the association between ACEs and HIV risk behavior among the transgender population and identify the association between ACE score (1, 2, 3, 4, or more) and HIV risk behavior among the transgender population. This involved a quantitative methodology using a Behavioral Risk Factor Surveillance System (BRFSS) questionnaire to obtain data from 323 transgender participants. Multivariable regression analyses were conducted to determine the association between ACEs and HIV …

Faculty Perception: Developing Critical Thinking In New Graduate Associate Degree Nurses, Joyet Belcher

Walden Dissertations and Doctoral Studies

Despite national nursing exams that assess critical thinking, new nurses do not fully develop the skills to think critically. The literature review revealed that the lack of critical thinking endangers patients' lives. This study's purpose was to investigate how students are supported by college faculty in their knowledge of critical thinking to ensure they are prepared to care for patients. Participants were a purposeful sample of full-time nursing educators with doctoral or master's degrees in nursing, familiar with critical thinking, who have taken nursing students to clinical settings. The study had a basic qualitative design with 8 semistructured interviews. The …

Perceptions Of Human Interactions In Adult Patients After Using Digital Therapeutic Mobile Applications, Traci Brakefield

Walden Dissertations and Doctoral Studies

AbstractWhile the use of technology in healthcare has been present for many years, the recent rise of digital therapeutics in healthcare has been understudied, specifically regarding the perceptions and experiences of patients using mobile applications. Traditional healthcare involves face-to-face human interactions, requiring scheduled check-ins and provides structured interventions. Conversely, Digital therapeutics is primarily comprised of human to machine interactions. Digital therapeutics allows the user to access intervention in their time of individual need. The decrease of human-to-human interaction and the rise of human-to-machine interaction was explored in this qualitative descriptive phenomenological study from the patient perspective. Watson’s theory of human …

Factors Causing Commercial Leaders In U.S. Multinational Pharmaceutical Businesses To Change Companies, Robert J. Britting Jr

Walden Dissertations and Doctoral Studies

Employee turnover in U.S. multinational pharmaceutical companies remains high, even though U.S. multinational pharmaceutical companies offer competitive salaries and benefits compared to other large industries. A recent survey found that 67% of 2,400 pharmaceutical leaders would be looking for a new job within 12 months and that general employee turnover costs organizations 70% to 300% of each employee's salary. The purpose of this case study was to explore the factors that cause commercial leaders from mid- to large-size U.S. pharmaceutical companies to seek employment outside of their organization. Lewin’s three-stage model of unfreezing, moving, and refreezing, along with the psychology …

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …

Child Sexual Abuse And Its Effects On A Young Adult Relationship With A Sexual Partner, Friends, And Community, Miriam Cires

Walden Dissertations and Doctoral Studies

AbstractIn the United States, child sexual abuse is a significant public health issue, but society lacks awareness and its consequences. Therefore, little is known about the influence of sociodemographic factors on a sexually abused child and the quality of relationships as a young adult. A quantitative cross-sectional study based on the social-ecological model was carried out to assess whether the presence of sexual abuse, age of abuse, frequency of abuse, abusive kindship, race, and sex predict in a sexually abused child inappropriate relationships as a young adult. Logistic regression analyses were conducted using secondary data collected from 1300 children and …

Therapists’ And Teachers’ Experiences Of Children With Aggression: A Children’S Partial Hospitalization Program, Kimberlee Joy Dunlap

Walden Dissertations and Doctoral Studies

Aggression is an indicator of future criminal behavior. It can be a result of trauma, substance-abusing parents, or executive functioning. Research has shown that aggression in childhood often creates criminal behavior later in life, thus researchers suggest that more studies are conducted on programs that help children with aggression. The purpose of this qualitative study was to examine the experiences of therapists who work with aggressive children in a children’s partial hospitalization program, and those teachers who have had these children in class before entering the program and upon discharge from the program. The qualitative study was done using semi-structured …

Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant

Walden Dissertations and Doctoral Studies

The United States lacks postdischarge services, which can negatively impact hospital readmissions within 30 days. It is important for case managers to effectively leverage outpatient services to enhance patient care and reduce readmission rates. Grounded in the practice change model framework, this qualitative single case study explores the perspectives of case managers involved with postdischarge services for patients diagnosed with coronary artery disease (CAD). Participants included 13 case managers from two metropolitan hospitals in Atlanta, Georgia. To address the research problem and study purpose, data collection techniques included semi-structured interviews, case management discharge summaries, and reflective journal notes. The thematic …