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Articles 2341 - 2370 of 5875
Full-Text Articles in Medicine and Health Sciences
Behavioral Health Audit Tool Implementation And Health Care Documentation, Stephanie Lou Weatherly
Behavioral Health Audit Tool Implementation And Health Care Documentation, Stephanie Lou Weatherly
Walden Dissertations and Doctoral Studies
Quality documentation is a foundational element in healthcare. This QI project was conducted to examine the extent to which the implementation of a standardized behavioral health audit tool influenced compliance with required documentation elements. The context, input, process, product evaluation model was used to support the need for documentation compliance in behavioral health. A new audit tool was developed and implemented. Retrospective audit data were gathered from 86 locations over a period of 3 years, reflecting quarterly corporate audits and monthly program self-audit results. The first five quarters exhibited the widest variation in scoring; 28 locations required action plans for …
Perceived Learning Needs Of High School Teachers Regarding Suicide Prevention, Miranda Lynne Bevilacqua
Perceived Learning Needs Of High School Teachers Regarding Suicide Prevention, Miranda Lynne Bevilacqua
Walden Dissertations and Doctoral Studies
Suicide is the second leading cause of death among youth in Canada. Though school-aged youth are surrounded by teachers, mentors, and school mental health nurses (SMHN), little is known about what teachers want to know regarding suicide and whether the teachers have the knowledge to recognize youth at risk. The purpose of this generic exploratory qualitative study, guided by the health belief model, was to explore the perceived learning needs of high school teachers in northwestern Ontario (NWO) regarding suicide prevention. The data collection process involved semistructured virtual interviews with 14 high school teachers in NWO recruited via social media. …
Nurse Executives’ Intuitive Decision Making And Leadership Personality Styles During Organizational Change, Chaudron Carter Carter Short
Nurse Executives’ Intuitive Decision Making And Leadership Personality Styles During Organizational Change, Chaudron Carter Carter Short
Walden Dissertations and Doctoral Studies
Within the complex and multifaceted health care environment, nurse executives are challenged to effectively make decisions and lead organizations through change. How nurse executives make those decisions is determined in a variety of ways, one being through intuitive decision making. The purpose of this quantitative correlational study, guided by the dual process theory, was to examine nurse executives’ intuitive decision making and leadership personality styles during organizational change. The Agor Intuitive Management Survey and the Multifactorial Leadership Questionnaire were administered to 70 nurse executives recruited by direct email obtained from public hospital organizations’ websites and social media platforms. Regression analysis …
Relationship Between Social Media Screen Time, Sedentariness, And Bmi Among Young Adults, Helen Golod
Relationship Between Social Media Screen Time, Sedentariness, And Bmi Among Young Adults, Helen Golod
Walden Dissertations and Doctoral Studies
Obesity has quickly become an epidemic that affects adults and youth not only in the United States, but also increasingly elsewhere in the global community. Research suggests that most children and adolescents spend a significant amount of time indulging in screen-based leisure, especially on social media. Such behavior may also be linked to sedentary lifestyle, which can impact an individual’s body mass index (BMI). There is a lack of understanding concerning how sedentary behavior moderates the relationship between screen time spent on different types of social media and BMI among young adults in the United States. To address this research …
Noncompetitive Subordinate Employees’ Descriptions Of Adaptive Performance Following An Internal Promotion, Yemisi Milledge
Noncompetitive Subordinate Employees’ Descriptions Of Adaptive Performance Following An Internal Promotion, Yemisi Milledge
Walden Dissertations and Doctoral Studies
Employees’ views on internal promotions tend to influence outcomes such as support given to the promoted employee, employee organizational commitment, and employee job satisfaction. Research on the influence of internal promotions has focused primarily on the reactions of competitive non-promoted internal candidates and those of the promoted individuals. This qualitative study investigated how employees who did not compete for a promotion adapted to a coworker being promoted to become their supervisor and how the employees described the coworker’s adaptation to the promotion. A taxonomy of adaptive performance and generic qualitative research formed the conceptual frameworks, and the leader-member exchange theory …
Healthcare Leader Strategies For Leveraging Electronic Heath Records, Danessa Thomas
Healthcare Leader Strategies For Leveraging Electronic Heath Records, Danessa Thomas
Walden Dissertations and Doctoral Studies
AbstractHealthcare organizations may incur significant losses of productivity and profit because of the absence or incomplete implementation of Electronic Health Records (EHRs). EHRs are important to healthcare leaders because they enhance communication between providers and patients, reduce unnecessary costs, and increase adherence to clinical guidelines. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies that some successful healthcare leaders used to leverage EHRs in their organization to increase profit and productivity. The participants were nurse managers from four healthcare organizations that successfully implemented an EHR system in Georgia. Thematic analysis was …
Educating Pediatric Emergency Department Nurses On Autism Spectrum Disorder, Melanie Lynn Cardona
Educating Pediatric Emergency Department Nurses On Autism Spectrum Disorder, Melanie Lynn Cardona
Walden Dissertations and Doctoral Studies
Caring for patients with autism spectrum disorder (ASD) that present to a pediatric emergency department (ED) poses many challenges for nurses. The multifaceted characteristics and needs exhibited by a child with ASD presenting to an ED has the potential to lead to poor patient outcomes. The purpose of this doctoral project was to increase registered nurses’ knowledge and confidence level for caring for patients with ASD in a pediatric ED. The practice-focused question for this doctoral project explored whether the implementation of an ASD educational intervention increase registered nurses’ knowledge and confidence level for caring for patients with ASD in …
Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham
Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham
Walden Dissertations and Doctoral Studies
AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …
Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton
Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton
Walden Dissertations and Doctoral Studies
Falls among hospitalized, geriatric patients are a leading cause of injury. Geriatric patients with psychiatric illnesses are at an even greater risk of falls. The project site was experiencing an increase in the number of patient falls and identified a need for staff education on fall risk assessment and implementation of interventions specific to the hospitalized, geriatric, psychiatric patient. Thus, the practice-focused question for this project was whether an educational program on evidence-based assessment and fall prevention strategies would improve nurses’ knowledge and skills to assess risk for falls and implement appropriate interventions for inpatient, geriatric, psychiatric patients. Knowles’s adult …
The Impact Of Telehealth Services Offered By Home Care Agencies On Patient Safety, Moyna Temple
The Impact Of Telehealth Services Offered By Home Care Agencies On Patient Safety, Moyna Temple
Walden Dissertations and Doctoral Studies
There is little available research about how home care agencies attempt to address patient safety during the nurse virtual healthcare visit. The purpose of this quantitative correlational study was to determine, during the delivery of telehealth care by a home care agency, to what extent the level of education of the registered nurse, the level of education of the director of the home care agency, and the clinical decision support system (CDSS) impact patient safety. The framework for the study was the complex sociotechnological systems model. Data from the 2007 National Home and Hospice Care Survey were analyzed using logistic …
Clinical Practice Guideline For Early Identification Of Sepsis In The Emergency, Delta Williams
Clinical Practice Guideline For Early Identification Of Sepsis In The Emergency, Delta Williams
Walden Dissertations and Doctoral Studies
Sepsis, a life-threatening condition caused by infection, is a leading cause of mortality and morbidity globally. Researchers suggest that early identification of sepsis upon admission to the emergency department (ED) can help mitigate the consequences of sepsis. The emergency department of a hospital in a large urban U.S. city has participated in the Centers for Medicare & Medicaid Services’ sepsis reporting system (SEP-1) since 2015; however, recent reports indicated below benchmark scores. As more than half of patients diagnosed with sepsis were admitted or readmitted through the ED, the purpose of this project was to develop a clinical practice guideline, …
Education Of Staff On Promoting Yoga Activities In Women With Depression, Ahaoma Roselima Nnebedum
Education Of Staff On Promoting Yoga Activities In Women With Depression, Ahaoma Roselima Nnebedum
Walden Dissertations and Doctoral Studies
Major depression is a serious global health issue and one of the most common mental health problems women face in the United States. The problem in this DNP project, Education of Staff on Promoting Yoga Activities in Women with Depression, was the lack of staff knowledge in using yoga activity to treat women with depression resulting in suboptimal care of women with depression. The DNP project questions were addressed by collecting evidence-based information from the literature to develop the education and to explore if the DNP project would improve the staff knowledge of yoga allowing for the application of the …
Change Fatigue, Job Satisfaction, And Organizational Commitment Among Nurses, Melissa Kapping
Change Fatigue, Job Satisfaction, And Organizational Commitment Among Nurses, Melissa Kapping
Walden Dissertations and Doctoral Studies
The healthcare environment is complex and ever-changing, which has a direct impact on the nurse. The effects of the constant change to the nurse may result in the development of change fatigue, which causes the loss of trust in the organization, a feeling of resentment, and a sense of apprehension while depleting the individual’s reserves. The purpose of this correlational study guided by Lazarus and Folkman’s stress and coping theory was to determine if there is a relationship between (a) job satisfaction and change fatigue and (b) organizational commitment and change fatigue in nurses who work in an outpatient clinical …
Relationship Between Employee Satisfaction And Patient Satisfaction Within The Veterans Affairs Health Care System, Krista Penn
Relationship Between Employee Satisfaction And Patient Satisfaction Within The Veterans Affairs Health Care System, Krista Penn
Walden Dissertations and Doctoral Studies
Within health care organizations, the experience of care is a critical measure of the quality of a health care system and is an important measure of success. Over the past several years, the quality and experience of care have been criticized within the Veterans Health Administration. Veterans Health Administration hospitals suffer from low patient satisfaction scores and high nurse turnover rates. Research shows a correlation between patient satisfaction and employee satisfaction within other health care organizations, yet there has been limited research on whether this type of relationship exists within facilities across the Veterans Health Administration. Using Donabedian’s quality health …
Perceived Health And Preventative Care In The Transgender Population, Gregory Page Carpenter
Perceived Health And Preventative Care In The Transgender Population, Gregory Page Carpenter
Walden Dissertations and Doctoral Studies
Historically, the transgender community has been treated and studied myopically, using the lens of psychological illness. As treatment and research efforts have expanded in the past decade, the transgender population is becoming better understood. The purpose of the study was to examine the relationship between perceived health and preventative care in the transgender community. The health belief model was the theoretical framework for this cross-sectional study, which included data from the 2014–2018 Behavioral Risk Factor Surveillance System Survey. Chi-square tests and binomial logistic regressions were performed to investigate associations between perceived health and preventative care in the transgender community. The …
The Social Work Perspective Regarding The Underutilization Of Mental Health Services Among African American Families, Carissma Tempest Hughes
The Social Work Perspective Regarding The Underutilization Of Mental Health Services Among African American Families, Carissma Tempest Hughes
Walden Dissertations and Doctoral Studies
The underutilization of mental health services amongst African American families has been a long-standing concern in the African American community within large metropolitan cities in Texas. The metropolitan cities are Austin, Dallas/Fort Worth, Houston, San Antonio and McAllen. There remain experiences that impede families’ ability to engage in mental health services. These experiences involve the conflict between prayer and therapy, stigma, lack of awareness of local mental health services, and cultural competency. The purpose of this qualitative research study was to explore experiences of African American families and how those experiences affect mental health engagement, as well as how practicing …
Hospital Emergency Room Visits For Heavy Menstrual Bleeding, Henry John Mead
Hospital Emergency Room Visits For Heavy Menstrual Bleeding, Henry John Mead
Walden Dissertations and Doctoral Studies
Heavy menstrual bleeding (HMB) is a well-recognized health issue among women of reproductive age. The characteristics and demographics of women in the community with HMB who present at the emergency department (ED) are not well described. This research aimed to describe the cohort of women who seek treatment at the ED. The Healthcare Cost and Utilization Project 2016 National Emergency Department Sample was examined. The theory of reasoned action predicts that women who present at the ED are exhibiting health seeking behavior. From 32 million records, the inception cohort identified N = 111,555 cases. Using national estimation weights, this translates …
Relationship Between Faculty Age, Stress, And Intent To Leave Academic Medical Institutions, Susan Christian Atterton
Relationship Between Faculty Age, Stress, And Intent To Leave Academic Medical Institutions, Susan Christian Atterton
Walden Dissertations and Doctoral Studies
Faculty intent to leave academic medicine affects clinical productivity, patient and teaching service quality, and institutions' profitability. Understanding factors associated with faculty intent to leave is critical for healthcare and human resources leadership within academic medical institutions in efforts to reduce faculty intent to leave. Grounded in Graves’ spiral dynamics theory, the purpose of this correlational study was to examine the relationship between faculty age, faculty stress, and faculty intent to leave academic medical institutions. The data were collected and analyzed for 125 faculty physicians with an M.D., Ph.D., D.O., or M.B.B.S. degree in an academic medical institution in the …
Comparison Of The Therapeutic Efficacy Of Rheumatoid Arthritis Treatments, Kacy Smith Davis
Comparison Of The Therapeutic Efficacy Of Rheumatoid Arthritis Treatments, Kacy Smith Davis
Walden Dissertations and Doctoral Studies
Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint pain and destruction. The current standard regimen of monotherapy disease modifying anti-rheumatic drug (DMARD) treatments may not be as effective as that of combination therapy of a DMARD and a biologic agent in treating RA. The purpose of this study was to answer the question, is there a difference in the therapeutic efficacy of combination DMARD treatments with a biologic, compared to monotherapy DMARDs without a biologic, in U.S. Caucasian women between the ages of 30 and 60 that have been diagnosed with RA? Guided by the theoretical framework …
A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad
A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad
Walden Dissertations and Doctoral Studies
Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff’s minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …
The Relationship Between Health Insurance And Dialysis Utilization For Chronic Kidney Disease Patients In Saint Lucia, Anita Lilian Sydney
The Relationship Between Health Insurance And Dialysis Utilization For Chronic Kidney Disease Patients In Saint Lucia, Anita Lilian Sydney
Walden Dissertations and Doctoral Studies
AbstractChronic kidney disease (CKD) is a significant cause of disability and death in Saint Lucia. The incidence of CKD is disproportionately higher among individuals who are socially and financially disadvantaged. New evidence suggests that in resource-poor countries, government subsidization programs for dialysis treatment aid in the delay of disease progression and its associated costs. The purpose of this study was to examine the relationship between health insurance, government subsidization, employment, and dialysis utilization for CKD patients and the efficacy of subsidization for dialysis in Saint Lucia. The study included a retrospective cohort of 979 moderate-to-severe CKD patients from secondary data …
Chronic Obstructive Pulmonary Disease Readmissions And Mortality In Veterans Administration Hospitals, Carolyne S. Davis
Chronic Obstructive Pulmonary Disease Readmissions And Mortality In Veterans Administration Hospitals, Carolyne S. Davis
Walden Dissertations and Doctoral Studies
AbstractRates for chronic obstructive pulmonary disease (COPD) have continued to increase, resulting in readmission tracking by the Centers for Medicare and Medicaid for community hospitals and Veterans Health Administration (VHA) hospitals. By using the Andersen healthcare utilization model as the theoretical framework, the purpose of this quantitative correlational research was to examine differences in 4,879 COPD readmission and mortality rates in VHA hospitals for the four Veteran Administration (VA) regional districts—Northeast, Southeast, Continental, and Pacific—as well as and between rural and urban VA hospitals. Secondary data was acquired from an open website through the Centers for Medicare & Medicaid Services. …
Introduction Of Simulation To A Rural Health Care Facility, Jaime Lynn Duke
Introduction Of Simulation To A Rural Health Care Facility, Jaime Lynn Duke
Walden Dissertations and Doctoral Studies
AbstractDisparities exist between the quality and safety of care provided to patients seen in rural critical access hospitals and patients seen in metropolitan and suburban hospitals. These disparities result from lack of education opportunities and the infrequent exposure of staff to high-risk patient situations. The project addressed the lack of continuing education opportunities by introducing the hospital’s nurse leaders to simulation-based education to improve staff competence. The practice-focused questions asked if providing the nurse leaders of the hospital with information about the benefits of simulation-based staff education would lead to increased knowledge about and support for this type of education. …
Relationship Between Nursing And Nurse Practitioner Instructors’ Online Teaching Self-Efficacy And Their Students’ Online Academic Self-Efficacy, Pauline C. Stoltzner
Relationship Between Nursing And Nurse Practitioner Instructors’ Online Teaching Self-Efficacy And Their Students’ Online Academic Self-Efficacy, Pauline C. Stoltzner
Walden Dissertations and Doctoral Studies
AbstractTo meet the high demand for nurses and nurse practitioners (NPs) and address the national shortage of these professionals, nursing and NP schools are rapidly moving courses online. With this trend, and with the COVID-19 pandemic, many universities across the United States have been conducting classes in the online environment. The rapid transition from brick-and-mortar classes to online education has been a challenge for underprepared educators. The purpose of this correlational study was to investigate whether a relationship existed between potentially underprepared instructors’ online teaching self-efficacy and their students’ online academic self-efficacy. Bandura’s self-efficacy theory served as the theoretical framework. …
Barriers To Effective Personal Protective Equipment Use In Public Health Workers, Sheila Storr-Mathis
Barriers To Effective Personal Protective Equipment Use In Public Health Workers, Sheila Storr-Mathis
Walden Dissertations and Doctoral Studies
Exposure to infections continues to be a significant concern for nursing practice and for other health care professionals. Personal protective equipment (PPE) minimizes occupational exposure; however, their use is subject to variability. This quality improvement project addressed the impact of an educational intervention on attitudes and barriers to proper use of PPE for public health workers at the study site. The health belief model and the literature review provided theoretical support for the project and evidence of current trends in PPE use. There were 44 employees who completed the preintervention survey and 22 who completed the postintervention survey to gauge …
Clinical Guideline To Support Diabetes Education For Adult Nursing Home Residents, Adediwura Ajadi
Clinical Guideline To Support Diabetes Education For Adult Nursing Home Residents, Adediwura Ajadi
Walden Dissertations and Doctoral Studies
AbstractDiabetes is a major cause of increased disease burden and cost of care for patients in long-term care (LTC) settings. Of common diabetes-related complications, hypoglycemia has the most catastrophic implications for this population. Poor understanding, reporting, and management of hypoglycemia by LTC staff can cause increased diabetes-related hospitalizations, disability, deaths, and financial burden for LTC patients and nursing homes. This DNP project focuses on developing a clinical guideline to address the recognition and management of hypoglycemia in LTC settings. It will advance the skills and knowledge of LTC staff regarding hypoglycemia management. The project is grounded in nursing theoretical models …
Development Of A Clinical Guideline For An Emergency Department Fast Track Protocol, Cyrus C-Max Doe
Development Of A Clinical Guideline For An Emergency Department Fast Track Protocol, Cyrus C-Max Doe
Walden Dissertations and Doctoral Studies
AbstractDue to the large influx of patients, emergency departments (ED) across the United States strive to efficiently manage and improve workflow to increase the quality of care and reduce wait times for patients who present at the ED for care. Well-organized workflow is critical to providing efficient and time-sensitive care, beginning with the Fast Track (FT) area. The FT is a designated area of the ED where lower acuity or noncritical patients are seen and treated. Improving workflow in the FT area of the ED can help lessen wait times and overall length of patient visit and improve the delivery …
Increasing Provider Awareness About The Use Of Cbt In Treating Insomnia In Adults, Ayorinde Oluwagbemiga Oyeneyin
Increasing Provider Awareness About The Use Of Cbt In Treating Insomnia In Adults, Ayorinde Oluwagbemiga Oyeneyin
Walden Dissertations and Doctoral Studies
AbstractThis doctoral project addressed the issue of prescribing cognitive-behavioral therapy (CBT) as the first-line treatment for insomnia. Despite being less efficacious, medications are the most preferred form of treatment for insomnia among most psychiatric clinicians. Providers at the clinical site where the project took place were foregoing CBT in preference to medications. Providers preferred the pharmacotherapeutic approach due to its ease of prescription compared to the psychotherapeutic intervention. An educational program was provided for the providers regarding the advantages of prescribing CBT over medications, for the treatment of insomnia. The program was in the form of a PowerPoint presentation, which …
Increasing Staff Knowledge Regarding The Use Of Nonpharmacological Interventions With Long-Term Care Residents Diagnosed With Dementia, Larissa Latrice Anderson
Increasing Staff Knowledge Regarding The Use Of Nonpharmacological Interventions With Long-Term Care Residents Diagnosed With Dementia, Larissa Latrice Anderson
Walden Dissertations and Doctoral Studies
Dementia is an umbrella term that describes a clinical syndrome of progressive cognitive decline. The prevalence of a dementia diagnosis increases with age, making it a common occurrence within the older population. In long-term care facilities, where 5% of the older population reside, antipsychotic medications are the first line of defense and the choice of treatment among patients diagnosed with dementia. Recently, the Center for Medicare and Medicaid Services (CMS) announced a new goal of decreasing antipsychotic medication usage by 15% by the end of 2019. Guided by Watson’s Theory of Caring, this project was conducted to determine if an …
The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe
The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe
Walden Dissertations and Doctoral Studies
Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …