Medicine and Health Sciences Commons^™

Racial Differences In Hospital Readmission And Reimbursement Rates For Patients With Congestive Heart Failure, Catherine Talongwa

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a …

The Perception Of Men's Preferred Female Body Size And Weight Control Behaviors Of Afro-Caribbean Women In The United States Virgin Islands, Alice Victoria Henry

Walden Dissertations and Doctoral Studies

The prevalence of obesity among Afro-Caribbean women living in the United States Virgin Islands (USVI) is a health care issue that can have detrimental effects on society. To reverse the spread of this disease, factors contributing to its prevalence must be understood so that they can be addressed. The purpose of this cross-sectional study was to examine Afro-Caribbean women's perception of the female body size preferred by Afro-Caribbean men and the influence of that perception on the women's weight control behaviors of diet and physical activity. The reasoned action approach was the basis for the theoretical foundation. The research problem …

The Dietary Decision-Making Process Of Women In Nigeria, Gachomo Joanne Mapis

Walden Dissertations and Doctoral Studies

Nigerians have been opting for a more processed Western diet. These changes in dietary choices have aligned with obesity and undernutrition, attributable to micronutrient deficiencies or malnutrition. Many scholars have presented varying intervention strategies ranging from consumption of a variety of foods containing the necessary micronutrients to food fortification. The purpose of this grounded theory study was to explore the perceptions of women in an urban city in Nigeria on indigenous foods and Western dietary influences to determine social interactions, the consequence of the interactions, and the women’s current perceptions of food choices. The social-ecological model was used to explore …

Mothers With Diabetes And The Effects Of The Disease To Their Offspring, Rachel Smart-Fadairo

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological was to understand the lived experiences of mothers who were diagnosed with gestational diabetes mellitus and had a child who had been diagnosed with a speech disorder. Despite educational and medical interventions having increased to reduce gestational diabetes, the growing incidence of gestational diabetes signals a disconnect between education, intervention, and prevention. Previous studies have shown that mothers with gestational diabetes mellitus can experience high- risk pregnancies. The long-term effects of the disease on the mother and her newborn child in terms of soaring healthcare cost, loss of work productivity, education, and the emotional health …

Flipped Classroom Approach To A Critical Care Educational Program For New Graduates, Deborah Ann Smithers

Walden Dissertations and Doctoral Studies

Of the new graduate registered nurses hired to work in critical care areas, a few percent do not receive a formal critical care orientation. Furthermore, there is a high attrition rate of new graduates hired to work in high acuity patient care units. Many resign before their first work anniversary due to a lack of education and training. An initiative was put forth by critical care administration, at the study site, to critical care clinical leadership to significantly revise a critical care educational offering known as critical care core. The revision would allow for the satisfaction of the novice nurses …

Exploring The Lived Experiences Of The Prelicensure Hispanic Nursing Student, Mary Valerie Santos

Walden Dissertations and Doctoral Studies

AbstractNursing constitutes the largest group of healthcare professionals in the United States. Despite decades of discussion about the need to diversify the nursing profession, there continues to be a significant lack of diversity, particularly in the number of Hispanic nurses. The purpose of this qualitative study was to explore the lived experiences of Hispanic nursing students who have enrolled in a pre-licensure nursing program using Leininger’s culture care theory as the theoretical framework for this phenomenological study. This study sought to explore the lived experiences of the prelicensure Hispanic nursing student attempting to complete nursing school successfully and what factors …

Factors Affecting Cervical Cancer Screening Among Dominican Women Living In The United States, Cybil Bonhomme

Walden Dissertations and Doctoral Studies

The highest incidence and mortality rates of cervical cancer are seen among minority women groups in the United States. Hispanic women have the highest rate of cervical cancer, contributing to the 2nd highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared with other groups of U.S. women, but researchers have not examined cervical cancer screening practices, specifically for U.S. Dominican women. The purpose of this study was to examine the correlation between compliance with cervical cancer screening and major influences including acculturation, socioeconomic status, immigration status, and usual …

Promotion Of Lifestyle Changes By Community Pharmacists Among Adults With Hypertension In Nigeria, Olanike Olawunmi Kehinde

Walden Dissertations and Doctoral Studies

The growing prevalence of hypertension is a global public health problem. Lifestyle modification is the first-line best practice for the management of hypertension, however there is not enough focus on healthcare professionals’ competencies in managing hypertension in Nigeria. The perspectives of Community Pharmacists (CPs) about promotion of lifestyle modification (PLM) among adults with hypertension have not been explored in Nigeria though they play an essential role in healthcare in the community. This phenomenological study was conducted to document the experiences of CPs about PLM by using in-depth interviews. Social cognitive theory and the health promotion model were used as frameworks …

Evaluation Of The Tuberculosis Management Program In Ghana, Boampong Akese

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major health issue estimated to be affecting about 1/3 of the world’s population. TB is a major health problem in Ghana primarily because of weak health infrastructure and poor TB case detection and management practices. Measuring and evaluating the performance of health programs is an important aspect of health care services in any country. The purpose of this quantitative study was to evaluate the TB management program in Ghana. A cross-sectional research design was used to answer the research questions. Secondary data were obtained from the Ghana District Health Information Management System database. The theoretical foundation …

An Educational Activity For Primary Care Providers Treating Older Veterans With Sexually Transmitted Infections, Beatrice Fannie Grant

Walden Dissertations and Doctoral Studies

AbstractComprehensive sex education is an effective method of promoting sexual health. Because primary care providers conduct the initial health need assessment of veterans, it is important that providers understand how to approach the subject of sexual health and the prevention of sexually transmitted infections. The purpose of this evidence-based project was to implement and evaluate an educational activity for primary care providers. The health belief model was used as theoretical framework. This project was introduced to a federal primary care clinic in the Mid-Atlantic United States. Twenty-five participants completed a pretest prior to the start of the educational activity that …

Public Stigma, Familiarity With Mental Illness, And Attitudes Toward Seeking Mental Health Services, Eugenia Combie-Knowles

Walden Dissertations and Doctoral Studies

Public stigma and adverse beliefs and attitudes toward individuals with mental illness can negatively influence help seeking. The purpose of this quantitative cross-sectional study was to assess associations and the effect of stigmatized attitudes toward mental illness and familiarity with mental illness on help-seeking attitudes in three community health clinics in the Bahamas. Attribution theory and theory of planned behavior provided the framework for the study. Data were collected from a convenience sample of 366 individuals who completed a self-administered questionnaire consisting of sociodemographic questions, the Attribution Questionnaire that assessed stigmatizing attitudes and beliefs toward individuals with mental illness, and …

Structural Predictors Of Lights And Sirens Use By Emergency Medical Services, Justin Alex Sleffel

Walden Dissertations and Doctoral Studies

Ambulances regularly respond to scenes and transport patients while using lights and sirens (L&S), which are associated with an increased risk of vehicle crashes. The use of L&S persists, despite the risks, which impact emergency medical service (EMS) workers, patients, and other drivers and pedestrians on U.S. roadways. To understand the factors associated with ambulance crashes while using L&S, this study applied the Donabedian model to the problem. The purpose of this study was to investigate the association between 3 organizational structural factors—organizational type, organizational status (staffing model), and level of service—and ambulance crash rates while using L&S. This study …

Implementing A Diabetes Optimization Protocol For Elective Surgery Patients, Barbie Denise Harbaugh

Walden Dissertations and Doctoral Studies

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

Disparities In The Qulaity Of Bariatric Care Among African American Women, Tracey S. White

Walden Dissertations and Doctoral Studies

Improving the quality of health care in the United States has been an ongoing challenge for decades. As health care providers seek to provide unsurpassed levels of health care, disparities continue to exist among races. Racial and ethnic disparities in the quality of health care persist that affect African American women disproportionally. The purpose of this study was to explore the lived experiences of African American women with regard to quality health care following bariatric surgery. Using a phenomenological approach, semistructured interviews were conducted with 10 African American women who had suboptimal weight loss outcomes following bariatric surgery. Data from …

Homelessness And Hiv Risk: Experiences, Perceptions, And Beliefs Of Transgender Youth, Darcia Bryden-Currie

Walden Dissertations and Doctoral Studies

Human ImmunodeficiencyVirus (HIV) continues to be a public health concern in the United States, with increased rates of infection among transgender youth. The phenomenon of homelessness is also a significant challenge for transgender youth. Gender expression often results in stigma, and discrimination, many trans youth experience poverty, rejection, and low self-esteem, which are precursors to homelessness. The purpose of this qualitative phenomenological study was to explore the influence that homelessness has on sexual risk associated behaviors in transgender youth. The theoretical framework that guided this study was Bandura’s social cognitive theory. The research questions sought to explore how this population …

Cannabis As A Safer Alternative To Opioid Management Of Chronic Pain, Loren Nedelman

Walden Dissertations and Doctoral Studies

Chronic pain affects approximately 100 million American adults and costs the United States upwards of $635 billion each year in medical treatments and lost productivity. Opioid prescription for pain has increased exponentially over the past several years, with the CDC estimating 20% of prescriptions lasting longer than 3 months for patients with noncancerous pain. Opioid addiction has become a national public health crisis with mortality surpassing 100,000 deaths annually due to overdose. As States have begun to deregulate the use of cannabis and cannabis derivatives for medical purposes; oversight and regulation by the federal government on its use as a …

Food Advertisements And Access To Primary Care And The Impact On Family Food Decisions Made By Women, Linda Soriano-Copelin

Walden Dissertations and Doctoral Studies

Women are responsible for preparing family meals in 71% of American households. The meal choices that women make has an impact on lifestyle choices for themselves and their family. The purpose of this research was to evaluate the extent to which food advertisements and access to primary care influence a woman’s food-making choices. The first question focused on how exposure to food advertisements on television may impact the food choices of women. The second question asked how food advertisements affect women’s eating habits. The third question asked how access to primary care impacts food decisions. The theoretical framework integrated the …

Improving The Ethical Use Of E-Health And Emr, Josephine Tafie

Walden Dissertations and Doctoral Studies

Improving the Ethical Use of E-health and EMR

by

Josephine Tafie

MS, Walden University

BS, Washington Adventist University

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2020

Abstract

The healthcare industry is experiencing ethical problems with the integration of new technological applications, such as e-health and electronic medical records (EMRs) in service delivery. Thus, the purpose of this capstone project was to conduct a systematic literature review to determine the best practices that are well suited to a large urban hospital, to ensure patients’ privacy with the continued use …

Family Members’ Lived Experiences Of Chronic Migraine, Elizabeth Biddle

Walden Dissertations and Doctoral Studies

Chronic migraine (CM) is a growing phenomenon in the United States and has been recognized as a disabling headache disorder. CM negatively affects the quality of life not only of CM sufferers but also their family members. The lived experiences of the family member of CM sufferers has not been sufficiently investigated. The purpose of this study was to gain in-depth insight into the lived experiences of family members who lived with CM sufferers. The phenomenological approach, guided by the social support theory, was used to investigate the lived experiences of family members who live with CM sufferers through open-ended …

Strengthening Mental Health Awareness Of University Students Using An Online Training Module, Lavern Rosemarie Bourne

Walden Dissertations and Doctoral Studies

Canadian youth pursuing postsecondary education are facing a major mental health crisis. There are substantial gaps between the diagnosis and treatment of mental illnesses. The purpose of this study was to evaluate whether a web-based mental health educational intervention was an effective tool with which to increase mental health awareness and help-seeking behaviors of university students. The theory of planned behavior, the help-seeking model, and the technology acceptance model were the theories that guided this study. Using a quantitative quasi-experimental research design, data were collected from 329 undergraduate students in the Faculty of Health Sciences at a university in Eastern …

Nurses’ Aesthetic Responses And Emotional Judgements To Senior Leaders’ Symbolism, Lucinda A. Easler

Walden Dissertations and Doctoral Studies

Stress can be heightened during a merger; understanding how acute care nurses who work in a hospital undergoing a merger, experience senior leaders’ use of symbolism may help to promote hospital and leader sustainability. Executive symbolism unfolds into aesthetic experience, normally considered a response to art, with few studies of its existence and benefit to organizational life. The purpose of this phenomenological-hermeneutic study guided by Parker’s aesthetic theory was to examine acute care nurses’ emotional responses and experiences with senior leaders’ use of executive symbolism in the midst of the organizational change. Interviews with 11 acute care registered nurses were …

Effects Of Government Regulations And Reimbursement Policies On Home Health Administration In Illinois., Sally Nwafor

Walden Dissertations and Doctoral Studies

Recent changes in government regulations and reimbursement policies threaten the financial viability and the ability of home health agencies to provide the necessary services. There is a gap in knowledge about the effect of the changes in healthcare policies on the administration of home health businesses in Illinois. The purpose of this study was to bridge the knowledge gap by investigating the effect of the regulatory and policy changes on home health administration in Illinois. The research question focused on the challenges that home health administrators face due to the changes in government regulation and reimbursement policies, and the strategies …

Evaluating The Impact Of Nurse Leader Professional Development, Celeste Rogers Romp

Walden Dissertations and Doctoral Studies

A health care organization’s success is impacted by its leaders’ knowledge, confidence, and training. A quality improvement (QI) project was undertaken by a 300-bed acute care medical center to determine the impact of providing nurse leaders with education and training in increasing the leader’s knowledge and confidence in their role and in improving nursing satisfaction, catheter-associated urinary tract infection (CAUTI) rates, and fall rates. The FOCUS-PDSA QI model and the nurse manager leadership collaborative learning domain framework were used to guide the QI project and its evaluation. There were four primary sources of evidence. A nurse leader professional development pre- …

Evaluation Of A Shared Governance Model, Gorda Peters-Joseph

Walden Dissertations and Doctoral Studies

AbstractShared governance (SG) has been defined as a style of management in which frontline staff and managers work together to improve clinical practice. Guided by the PLAN-DO-STUDY-ACT cycle, the purpose of this project was to evaluate the implementation of the SG model for pediatric services in a US acute care hospital. The practice question explored whether the implementation of the SG model would demonstrate improvements in nurse satisfaction using the culture of safety survey, a change in nurse staff turnover reported as numbers hired, retired, resigned, or transferred, and changes in patient satisfaction measured by survey scores from the Hospital …

African Americans Beliefs Regarding Skin Cancer And Prevention, Tamara Wesley

Walden Dissertations and Doctoral Studies

Skin cancer is becoming more prevalent in African Americans. African Americans' mortality rate is significantly higher than any other race due to lack of awareness. The purpose of this qualitative study, guided by Rosenstock's health belief model, was to gain an understanding of African Americans' beliefs and perceptions regarding skin cancer. Ten telephone interviews were conducted with African Americans who were 18 years old or older, no history of cancer, and who were members of a church in a rural town in the southeastern United States. The interview transcripts were manually transcribed verbatim. The data were analyzed by using codes …

Effects Of Full Practice Authority On Chronic Disease Outcomes And Costs, Nichole Marie Alegria

Walden Dissertations and Doctoral Studies

Rising medical costs and increasing shortage of qualified primary care providers has left hundreds of thousands of Texans with limited or no access to primary care services. One way to bridge the gap is to use advanced practice registered nurses who function as nurse practitioners (NPs). Current evidence indicates that by expanding the scope of practice (SOP) of NPs, access to care and patient outcomes improve. The aim of this DNP project was to analyze the current health care policy and examine the relationship and impact SOP has on patient outcomes and health care costs associated with hypertension and diabetes. …

A Comparative Analysis Of Job Satisfaction, Burnout, And Intent To Leave Among Nurses, Randall Lee Mcelreath

Walden Dissertations and Doctoral Studies

There is a significant shortage of qualified registered nurses in the United States which, in part, is due to a lack of job satisfaction and burnout with an intent to leave nursing, especially among nurses who work in specialty areas such as intensive care. There is limited research as to how job satisfaction and burnout contribute to intent to leave among the specialty areas of nursing working at the bedside in an acute care environment. The purpose, guided by the modeling and role modeling theory, was to determine the relationship that exists between burnout, job satisfaction, and intent to leave …

Information Security Ambassadors’ Perceptions Of Peer-Led Motivation In Phishing Detection, Kingkane Malmquist

Walden Dissertations and Doctoral Studies

Phishing rates are increasing yearly and continue to compromise data integrity. The need to guard business information is vital for organizations to meet their business objectives and legal obligations. The purpose of this phenomenological study was to explore security ambassadors’ perceptions of motivating their peers to adopt safe internet behaviors in a large medical campus in Minnesota. Hackman and Oldham’s job characteristic motivation theory was used to frame the study. Data were collected from semistructured interviews with 20 security ambassadors. Data coding and analysis yielded 7 themes: rewarding, value, personal interest, limited information security knowledge, increased interest, communication, and topics …

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

Lived Experiences Of African Americans 65 And Older After Rural Hospital Closures, Derrick Mike

Walden Dissertations and Doctoral Studies

African Americans 65 and older have had varied experiences due to losing immediate access to nearby hospitals for urgent treatment for emergency medical conditions. This phenomenological study was conducted to explore the lived experiences of those residing in areas after a rural hospital closure occurred. The hospital was the primary and nearest facility for receiving immediate access to urgent treatment. The research questions focused on the encounters experienced by the participants after the hospital closure. The Health Belief Model was the conceptual framework used for this study. The method and data analysis procedures included interviews, field notes, a life-course chart, …