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Articles 2551 - 2580 of 5875
Full-Text Articles in Medicine and Health Sciences
Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah
Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah
Walden Dissertations and Doctoral Studies
In the United States, the registered nurse turnover rate was 17.2% in 2018, a 0.4% increase from 2017. The nursing turnover rate at a small out-patient clinic in the northeast United States was 19.1% in 2019 and has not improved to date. The administrator at the out-patient clinic further indicated that the turnover rate has been approximately two nurses per month for the last 6 months and that the facility did not have a formalized nurse orientation program. Nursing orientation is one of the strategies for increasing the confidence levels and retention of newly hired nurses. The purpose of this …
Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead
Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead
Walden Dissertations and Doctoral Studies
In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …
An Orientation Program For Neonatal Nurse Practitioners In A Level Iii Nicu, Lu-Ann Campagnola
An Orientation Program For Neonatal Nurse Practitioners In A Level Iii Nicu, Lu-Ann Campagnola
Walden Dissertations and Doctoral Studies
Due to a nationwide shortage of neonatal nurse practitioners (NNPs), chronic short staffing shifted priority away from hiring novice and newly graduated NNPs in favor of recruiting experienced NNPs and contracting temporary locum tenens to expeditiously fill gaps in NNP staffing. Provision of formal orientation and an infrastructure that supported successful role transition became devalued and inconsistency in clinical approach and decision-making amongst providers raised concerns for patient safety. The goal of this Doctor of Nursing Practice (DNP) project was to develop a formal orientation program for NNPs in a Level III Neonatal Intensive Care Unit. The purpose was to …
Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho
Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho
Walden Dissertations and Doctoral Studies
In the United States, many patients cannot speak English well enough to communicate with their medical providers. Many of these patients use professional interpreter services offered by their medical organizations to help with communication, which can lead to miscommunication due to the translation process between patients, interpreters, and physicians, and to incorrect diagnosis and poor health outcomes for the patient. The purpose of this study was to explore the experiences of Spanish-speaking patients who used interpreter services with their physicians. The transmission model was the theoretical framework used to explore the experiences and outcomes for the participants. In this study, …
Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum
Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum
Walden Dissertations and Doctoral Studies
This study addressed whether race and ethnicity, birthing location, the month the mother begins prenatal care, and pregnancy risk level impact fetal/infant mortality. Infant mortality is a gauge by which the efficacy of the healthcare system and the overall health of the country is measured. The United States falls behind most other developed countries in terms of infant mortality rates. The ecological perspective was used as the theoretical framework. The study design was a cross-sectional cohort design using a sample of births and infant deaths from U.S. Vital Statistics data. Binomial logistic regression analyses were carried out to calculate odds …
Adult Day Care Staff Education To Improve Communication And Behavioral Management Skills, Kathy Davis
Adult Day Care Staff Education To Improve Communication And Behavioral Management Skills, Kathy Davis
Walden Dissertations and Doctoral Studies
AbstractIneffective communication and behavioral management skills are quality and safety issues that were identified at a local adult day care facility in the Southwest United States. Administrators at the facility identified a knowledge gap in communication and behavior management techniques for patients with cognitive impairment. An educational program, with a PowerPoint presentation and verbal feedback as key components, was developed and used to address the identified gap in practice related to individuals with cognitive impairments at the facility. The adult learning theory and the plan-do-study-act model provided supportive frameworks for program development and staff education. The project question explored whether …
Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo
Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo
Walden Dissertations and Doctoral Studies
Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …
The Association Between Teen Pregnancy And Academic Performance Among Schoolgirls In The Ivory Coast, Moussokoura Ouattara Epse Assoumou
The Association Between Teen Pregnancy And Academic Performance Among Schoolgirls In The Ivory Coast, Moussokoura Ouattara Epse Assoumou
Walden Dissertations and Doctoral Studies
AbstractTeen pregnancy (TP) is a social and public health problem around the world. In developed nations, approximately 16 million girls from aged 15 to 19 years become pregnant each year, presenting health problems for the mother and fetus in addition to economic and social consequences for the communities in which they live. The purpose of this quantitative causal-comparative study, based on the theory of planned behavior, was to explore the association of academic performance and self-efficacy with TP. The research questions examined the association between the TP and the academic performance and self-efficacy while controlling for two covariates (socioeconomic status …
Increasing Nurse Manager Knowledge Of Authentic Leadership, Patricia Ann Stone
Increasing Nurse Manager Knowledge Of Authentic Leadership, Patricia Ann Stone
Walden Dissertations and Doctoral Studies
AbstractResearch has demonstrated a positive correlation between authentic leadership and positive patient and organizational outcomes. Given that nurses can be educated in authentic leadership, providing nurse leaders with training opportunities will help them develop authentic leadership skills which will benefit patients and the organization. At the project site, there is little opportunity for leadership development among nurse leaders. Thus, the purpose of this DNP project was to determine if an educational intervention focused on authentic leadership increase knowledge and awareness among nurse managers. Authentic leadership theory grounded the DNP project. Twenty-three nurse managers were invited to participate in an educational …
Staff Education Program For Chlamydia And Gonorrhea Self-Collected Vaginal Swabbing, Cheryl Marie Tugman
Staff Education Program For Chlamydia And Gonorrhea Self-Collected Vaginal Swabbing, Cheryl Marie Tugman
Walden Dissertations and Doctoral Studies
Girls and women carry the burden of negative consequences of untreated sexually transmitted diseases (STDs), such as chlamydia and gonorrhea. Screening for chlamydia and gonorrhea by increasing self-collected vaginal swabbing (SCVS) can improve access of care and prevent delayed treatment. Nurses may support their patients if they receive training in how to teach screening for sexual self-healthcare. The purpose of this project was to develop and conduct a staff education program in an urban primary care clinic. The project addressed whether the education program would increase nurses’ knowledge of SCVS. The goal is to ultimately increase female patients’ access to …
Using Social Cognitive Theory To Explain Cannabidiol Usage For Generalized Anxiety Disorder, Margaret Wenzel
Using Social Cognitive Theory To Explain Cannabidiol Usage For Generalized Anxiety Disorder, Margaret Wenzel
Walden Dissertations and Doctoral Studies
AbstractIn the United States, over 40 million adults suffer from a generalized anxiety disorder (GAD), with a 67% increase in overdose-related deaths. Research substantiates the efficacy and safety of cannabidiol (CBD) for GAD. Findings show that CBD, sourced from industrial hemp, may reduce anxiety symptoms. However, a problem exists for individuals deciding to subscribe to CBD’s oral administration because of the inability to remain compliant with the regimen. The measured steps that occur when a medication is prescribed are lacking when an individual accesses CBD independently. This quantitative cross-sectional study was designed to examine whether social cognitive theory explained the …
Emotional Reactions In First-Time African American Fathers During The Postnatal Period, Aisha Wilkins
Emotional Reactions In First-Time African American Fathers During The Postnatal Period, Aisha Wilkins
Walden Dissertations and Doctoral Studies
AbstractIndividuals who have recently become first-time parents can find the experience to be both rewarding and challenging. While research has mainly focused on the challenging experiences of first-time mothers after giving birth, recent studies have begun to find that first-time fathers may have just as difficult a time adjusting to their new role. Most research studies conducted in this area have primarily focused on the experience of European American and Asian American first-time fathers and not specifically on African American fathers. Social exchange theory was used in this interpretive phenomenological analysis study to explore how first-time African American fathers handled …
Experiences In An Online Learning Community, Michelle Potthoff Wylie
Experiences In An Online Learning Community, Michelle Potthoff Wylie
Walden Dissertations and Doctoral Studies
Master of public health online programs have been experiencing issues with retention and problems related to inconsistent implementation of online learning communities. This basic qualitative study aimed to understand the efficacy of online programs and the perceived impact of the implantation of online learning communities. The conceptual framework for this study is Siemens’s connectivism theory supporting different types of learning in the online environment. Two research questions guided the study: (a) How do graduate students in an online Master of Public Health program perceive the efficacy of online learning communities and (b) Which components of online learning communities do graduate …
Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose
Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose
Walden Dissertations and Doctoral Studies
Malaria is one of the leading causes of death among children under 5 years old in sub-Saharan Africa (SSA). Also, public health efforts on malaria prevention have been successful in many regions but remains an issue in SSA. Malaria-induced anemia (MA) is associated with health complications among children. The impact of several sociodemographic factors (age, gender, residential type, and parent’s educational level) and malaria preventive/intervention measures such as mosquito net use and malaria medication use among children under 5 years old in Nigeria were assessed to inform malaria best practices and strategies, prioritize resource allocation, and support existing literature on …
Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski
Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski
Walden Dissertations and Doctoral Studies
There is growing interest in trauma-informed nursing methods to better respond to the needs of patients with histories of adverse childhood experiences and other traumatic events. Recent advances in the understanding of how trauma can negatively affect long-term health outcomes have fostered a shift towards trauma-informed care as a method to decrease patient retraumatization in nursing practice. With the implementation of trauma-informed care in many areas of healthcare and public health, several challenges have been exposed. The purpose of this study was to examine nurses’ lived experience of implementing trauma-informed care into nursing practice for the care of patients with …
Staff Education And Depression Screening In Pulmonology And Sleep Medicine, Christina Boyle
Staff Education And Depression Screening In Pulmonology And Sleep Medicine, Christina Boyle
Walden Dissertations and Doctoral Studies
AbstractDespite recommendations that all adults be screened for depression, providers at the project site struggled to consistently assess for depression. Identification of depression is an essential step in depression management, which is a concern for patients with sleep disorders and other pulmonary disease served at the site. The purpose of this project was to develop an education training program for clinicians regarding depression screening. The theory of cognitive development using the Iowa model of evidence-based practice (EBP) guided the project, which sought to determine if an EBP education program regarding depression screening would be an effective means for staff education, …
The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns
The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns
Walden Dissertations and Doctoral Studies
AbstractThe current literature on self-esteem (SE), body dissatisfaction (BD) and internalized weight stigma (IWS) was limited, albeit evolving. The variables were well established across multiple domains of study: IWS was consistently noted to be a contributing factor for the development of obesity, but no studies explored the relationship between SE and BD on IWS. Therefore, the purpose of this correlational study was to explore the relationship between SE and BD and their effect on IWS in 30–44-year-old, obese, Hispanic women who are 20% more likely to be overweight or obese than non-Hispanic women. The study was guided by symbolic interactionism …
Antenatal And Postnatal Care Services And Maternal Mortality In Nigeria, Lucy Evans
Antenatal And Postnatal Care Services And Maternal Mortality In Nigeria, Lucy Evans
Walden Dissertations and Doctoral Studies
Nigeria has had a high maternal mortality rate per 100,000 live births since the 1990s. A possible contributing factor is that many Nigerian women are not aware of prenatal and postpartum pregnancy care-related services. The purpose of this study was to investigate the association between pregnancy-related care (access to antenatal services, maternal health education, and knowledge of prenatal and postpartum care) and maternal mortality in Nigeria. The theory of planned behavior forms the basis of this study. A cross-sectional quantitative study design was used to determine whether maternal mortality is influenced by pregnancy-related care. Secondary data collected by the Demographic …
Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold
Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold
Walden Dissertations and Doctoral Studies
There is a shortage of registered nurses (RNs) who work in the specialty of psychiatric nursing. Attrition among psychiatric RNs is partly due to lack of leadership empowerment which includes autonomy and access to professional development opportunities. The purposes of this study, guided by Kanter’s theory of structural empowerment, were to determine (a) if there was a relationship between leadership empowerment behavior and psychiatric RNs’ intent to leave within the first 2 years of practice in inpatient psychiatric settings and (b) if there was a relationship between leadership empowerment behavior and intent to leave among psychiatric registered nurses who are …
Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield
Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield
Walden Dissertations and Doctoral Studies
Culturally competent care is widely accepted as a strategy to address healthcare disparities based on the perceptions of the individual provider, yet this approach lacks the voice of the African American (AA) communities intended to benefit from the strategy. Individuals in AA communities have been shown to suffer higher incidence of disease, disproportionately poorer health outcomes, and inequitable healthcare treatment. Framed by Leininger’s culture care theory, the purpose of this interpretive phenomenological study was to explore the lived cultural experiences of AA recipients of care when interacting with the healthcare system in an effort to contribute evidence to improve the …
Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu
Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu
Walden Dissertations and Doctoral Studies
AbstractThis study explored the lack of formalized managerial education and training for nurses new to leadership. This quantitative study specifically explored the knowledge gap of beginner nurse managers based on a lack of formalized education, a universal approach is supported by the research. Currently, there is no standard or formal nurse manager education program through the Department of Nursing or the Department of Learning and Development. The focus of the evidence-based project was to evaluate pre- and post-data assessing the impact of instituting a formal education program for beginner level nurse managers in collaboration with the human resources department of …
Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan
Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan
Walden Dissertations and Doctoral Studies
Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers …
Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas
Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas
Walden Dissertations and Doctoral Studies
AbstractHeart failure (HF) is a progressive and life -threatening disease that places a large burden on the health care systems worldwide with increased rates of re-hospitalization, readmissions, and outpatient visits. With the use of telehealth monitoring and support from nursing case managers, HF patients are able to manage this disease at home. The focus of this project was to evaluate a home health agency (HHA) telehealth program, exploring if there was an improvement in 30-day readmission rates, and patient satisfaction scores for the HHA telehealth program one year after revising the program incorporating nursing virtual case managers. This project used …
Sociodemographic Factors Associated With Childhood Vaccination Status In Sokoto State, Nigeria, Dauda Milgwe Madubu
Sociodemographic Factors Associated With Childhood Vaccination Status In Sokoto State, Nigeria, Dauda Milgwe Madubu
Walden Dissertations and Doctoral Studies
Immunization remains one of the most successful and cost-effective public health interventions worldwide. Despite the critical role of vaccines in improving childhood and maternal health, Sokoto state recorded the lowest childhood vaccination completion rate among the 37 states in Nigeria with only 5% of children aged 12-23 months having had full childhood vaccination based on data from the 2018 demographic and health survey. The factors associated with the state’s low childhood vaccination status have not been explored. The study examined the relationship between the sociodemographic factors including parents’ socioeconomic and ethnoreligious factors, place of residence, and children’s biological characteristics and …
Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga
Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga
Walden Dissertations and Doctoral Studies
AbstractFamily care practitioners (FCPs) are important players in the treatment of childhood obesity. However, the evidence-based literature shows that practitioners lack both knowledge of how to diagnose the condition as well as the confidence and education to care for patients with obesity. The primary care setting for this project has a 77% obesity rate among the clinic pediatric population compared to a national average of 19%; the FCPs at the target clinic lacked sufficient knowledge on the diagnosis and treatment of obesity, limiting their ability and confidence to counsel families on weight control measures. Following the Walden University Clinical Practice …
Factors Associated With Help-Seeking Behaviors Among Persons With Serious Psychological Distress, Minn A. Oh
Factors Associated With Help-Seeking Behaviors Among Persons With Serious Psychological Distress, Minn A. Oh
Walden Dissertations and Doctoral Studies
Serious psychological distress (SPD) is an important individual and public health concern, but inconsistent results exist in the literature in terms of help-seeking behaviors and health-related outcomes among persons with SPD. The purpose of this study was to address this issue and understand clinical factors, access and quality of care factors, and sociodemographic factors associated with help-seeking behaviors among adults with SPD using the California Health Interview Survey (CHIS). CHIS data were collected in 2015 as a part of a two-year cycle (2015-2016) and surveyed 42,089 adults. For multivariable analyses, logistic regression analyses were performed. Participants with chronic health conditions …
Association Of Surgical Site Infections With Hospital Size And Urban And Rural Locations In California, Jim Edjerore Omaraye
Association Of Surgical Site Infections With Hospital Size And Urban And Rural Locations In California, Jim Edjerore Omaraye
Walden Dissertations and Doctoral Studies
Approximately 20% of health care-associated infections (HAIs) result from surgical site infections (SSIs), increasing health costs, morbidity, and mortality. The mandates of public reporting of HAIs through the Centers of Medicare and Medicaid Services can have consequential effects on hospitals’ reimbursement, a significant concern to health care administrators. The primary purpose of this quantitative study was to determine if urban and rural locations and the size of hospitals affect the rate of SSIs in California. The two research questions addressed whether there is an association between the rate of SSIs in urban and rural locations and the size of hospitals …
Employee Retention Strategies In The Fast Food Industry, Patrick C. Umezurike
Employee Retention Strategies In The Fast Food Industry, Patrick C. Umezurike
Walden Dissertations and Doctoral Studies
AbstractThe annual employee turnover rate in the fast-food industry is 73%, resulting in significant financial losses to the fast-food industry across the United States. The fast-food managers who lack strategies to improve employee retention; risk reduced organizational performance and effectiveness. Grounded in the eight motivational forces of voluntary employee turnover, the purpose of this qualitative multiple case study was to identify strategies managers in the fast-food industry used to improve employee retention. The participants were five senior fast-food managers in Baltimore, Maryland, who successfully improved restaurant employee retention. Data were collected through semistructured interviews; and documents (e.g., employee handbook, training …
Impact Of Case Management On Childhood Lead Exposure In Marion County, Indiana, Maliki Yacouba
Impact Of Case Management On Childhood Lead Exposure In Marion County, Indiana, Maliki Yacouba
Walden Dissertations and Doctoral Studies
The Centers for Disease Control and Prevention recently declared that no amount of childhood blood lead level (BLL) is safe. The purpose of this quantitative study with a retrospective cohort design was to evaluate the effectiveness of case management intervention on children diagnosed with elevated BLL (EBLL; ≥ 5 μg/dL) in Marion, County, Indiana. The health belief model was used as the theoretical foundation for the study. A data set of 160 lead exposure case management records was analyzed to find whether: (a) BLL at post-case-management time significantly differ from BLL at baseline (b) BLL at post-case-management time is affected …
Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze
Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze
Walden Dissertations and Doctoral Studies
Obesity is one of the Healthy People 2020 high-priority public health issue. Obesity is of importance due to the troubling higher prevalence in women because of the close link that exists between body weight and reproductive health in females from menarche to menopause and beyond. The identification of guidelines to improve or manage the care of female patients can alleviate the burden and complications from being overweight or obese. This project guided by the ADDIE (analyze, design, develop, implement, and evaluate) model was conducted in a family primary care clinic to address a gap in practice, the lack of knowledge …