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Walden Dissertations and Doctoral Studies

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Full-Text Articles in Medicine and Health Sciences

Association Between Metabolic Syndrome And Second Primary Cancer Among Colorectal Cancer Patients, Olukayode Ayodeji Agbeyomi Jan 2020

Association Between Metabolic Syndrome And Second Primary Cancer Among Colorectal Cancer Patients, Olukayode Ayodeji Agbeyomi

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third most common diagnosed cancer in both women and men in the United States. The gradual increase of incidence of second primary cancer (SPC) among CRC individuals has been a concern in recent times. Many CRC survivals have been forced back to be hospitalized for life-threatening cancers that are nonmetastatic cancers of CRC. Literature has suggested that there may be a relationship between metabolic syndrome (MetS) and CRC cases. The importance of early surveillance, detection, and treatment of SPC in CRC patients is significant to achieve better survival rates. The aim of this retrospective quantitative …

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Obesity And Overweightness Among African-American Adolescent Population And Health-Related Quality Of Life, Emmanuel Anene Jan 2020

Obesity And Overweightness Among African-American Adolescent Population And Health-Related Quality Of Life, Emmanuel Anene

Walden Dissertations and Doctoral Studies

Obesity and overweightness are a significant public health problem and a risk factor for many chronic diseases. The purpose of this study was to find the associations between gender, race, physical activity, and health-related quality of life (HRQOL) among obese and overweight African American adolescents aged 12 to 19 years. An improved understanding of the health issues could help this population live a longer quality life and prevent serious health implications in adulthood. A quantitative approach with a sample size of 331 was used. The control variables were age and household income, the dependent variable was HRQOL, and the independent …

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Leadership And End-Of-Life Planning Among Elderly Patients With End-Stage Renal Disease, Elizabeth R. Armstrong-Fears Jan 2020

Leadership And End-Of-Life Planning Among Elderly Patients With End-Stage Renal Disease, Elizabeth R. Armstrong-Fears

Walden Dissertations and Doctoral Studies

More than 8-million people in the United States possess no kidney function. The purpose of this quantitative casual-comparative research study is to examine the relationship between ethnicity status of African American and European American patients suffering from end-stage renal disease, and advanced care planning and end-of-life decision-making among patients who are 55 years of age and older. The health belief model is the selected explanatory framework used to examine (a) whether ethnicity status is a significant predictor of whether decedents had written end-of-life care instructions, (b) whether ethnicity status is a significant predictor of whether treatment decisions were made, and …

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The Lived Experience Of Child Marriage And Its Health Effects Among Young Mothers In Nigeria, Anastasia Iliwo Ashi Jan 2020

The Lived Experience Of Child Marriage And Its Health Effects Among Young Mothers In Nigeria, Anastasia Iliwo Ashi

Walden Dissertations and Doctoral Studies

Child marriage has life-threatening implications for the mental, physical, and psychological development of the girl-child. In Sub-Saharan Africa, and other resource poor settings, child brides and very young mothers undergo various negative experiences including economic hardship and health challenges such as obstetric fistulas, birth complications, and even death. The purpose of this phenomenological study was to describe the lived experiences of child marriage and its effect on maternal health among young mothers in Nigeria. The social ecological model provided the conceptual framework for this study. Ten young women ages 18-24 years who had been child brides when age 12-16 years …

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Faculty Evaluation Of Underperforming Nursing Students In Clinical Settings, Melody Lynn Bethards Jan 2020

Faculty Evaluation Of Underperforming Nursing Students In Clinical Settings, Melody Lynn Bethards

Walden Dissertations and Doctoral Studies

Difficulty in evaluating underperforming nursing students in clinical settings is a problem for many nursing programs. The subjective nature of evaluations and faculty reluctance to provide negative evaluations have implications for subsequent patient care. A descriptive single case study research design was used to explore the experiences of clinical faculty evaluating underperforming nursing students in clinical settings at a U.S. Midwest community college. Gagné's learning outcomes and the National League for Nursing (NLN) Clinical Nurse Educator Core Competency: Implements Effective Clinical Assessment and Evaluation Strategies provided the conceptual framework for the study. The research questions focused on how nursing faculty …

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Leadership Strategies To Achieve Organizational Excellence, Cherron Lakisha Blakely Jan 2020

Leadership Strategies To Achieve Organizational Excellence, Cherron Lakisha Blakely

Walden Dissertations and Doctoral Studies

Inadequate quality management tools and processes can lead to inefficient hospital operations and poor organizational performance. Community hospital leaders who fail to improve operations and organizational performance risk negatively impacting patient care and profitability. Grounded in the theory of high-performance work systems (HPWS), the purpose of this qualitative single case study was to explore strategies community healthcare leaders use to effectively employ quality management approaches to improve operations and achieve organizational excellence. The participants comprised 5 community healthcare leaders in the northeast United States who effectively used quality management approaches to improve operations and achieve organizational excellence. Data were collected …

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Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown Jan 2020

Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and …

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Managing Energy As Experienced By Female Federal Senior Managers, Gwendolyn Jones Crimiel Jan 2020

Managing Energy As Experienced By Female Federal Senior Managers, Gwendolyn Jones Crimiel

Walden Dissertations and Doctoral Studies

Senior managers experience a drain on personal energy while trying to meet the demands of work. The purpose of this hermeneutic phenomenological study was to explore how female senior managers describe lived experiences of managing and renewing personal energy while at work. The theoretical framework included conservation of resources theory and effort recovery theory. Data were collected from semi-structured interviews with 14 female senior managers who experienced managing and renewing their personal energy at work. Data analysis involved coding to capture the essence of the experiences and to identify common themes. Findings indicated that insufficient energy affected participants’ mental and …

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Strategies For Automating Pharmacovigilance Adverse Event Case Processing, Mythily Easwar Jan 2020

Strategies For Automating Pharmacovigilance Adverse Event Case Processing, Mythily Easwar

Walden Dissertations and Doctoral Studies

Business leaders who fail to implement innovative technology solutions in their companies face economic distress in these organizations. Guided by the task technology fit model as the conceptual framework, the purpose of this qualitative single case study was to explore strategies used by pharmacovigilance (PV) systems leaders to implement innovative technology solutions. The participants were 4 PV systems managers working in a pharmaceutical company in the Boston area of Massachusetts, United States, who used successful strategies to implement innovative technology solutions to automate adverse events case processing. Data were collected using semistructured interviews and company documents. The collected data were …

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Prevention Of Care Of Catheter-Associated Infections In Long Term Care, Maureen Edozie Jan 2020

Prevention Of Care Of Catheter-Associated Infections In Long Term Care, Maureen Edozie

Walden Dissertations and Doctoral Studies

The incidence of catheter-associated urinary tract infections (CAUTI) in long-term care settings ranges from 1.5 to 3.3 per 1,000 catheter days for adult. Over 380,000 nursing home residents are hospitalized due to infections each year. Staff education using Agency for Healthcare Research and Quality (AHRQ) practice guidelines showed knowledge gained. The use of an evidence-based practice guideline developed AHRQ has been shown to significantly reduce the rate of CAUTI in the long-term care residents. The clinical practice problem was a CAUTI rate higher than the national average in the long-term care facility of interest due, in part to inconsistent nursing …

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Group Education Program To Increase Obesity Knowledge In Cardiac Care Nurses, Ethel Emenogu Jan 2020

Group Education Program To Increase Obesity Knowledge In Cardiac Care Nurses, Ethel Emenogu

Walden Dissertations and Doctoral Studies

Obesity increases the severity of cardiac disease, leading to increased mortality and morbidity. The need to address obesity is critical in reducing obesity-associated complications such as heart failure, strokes, heart attacks, and even death. Obesity is also a risk factor for many chronic diseases such as heart disease, cancer, diabetes, hypertension, and depression. Evidence has shown that obese individuals with cardiac disease are at increased risk of developing complications. The practice-focused question for this doctoral project asked whether a group educational program could increase obesity knowledge among cardiac care clinic nurses. The purpose of this DNP project was to provide …

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An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane Jan 2020

An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane

Walden Dissertations and Doctoral Studies

Medical laboratory professionals have faced more than 20 years of workforce shortages. The causes of these workforce shortages include poor retention of new professionals and an insufficient number of new graduates who enter the workforce. The purpose of this qualitative case study was to explore the strategies that are used by managers in hospitals for the retention of laboratory professionals. The theoretical framework comprised Mobley’s theory of turnover and Porter’s organizational commitment theory. The research questions for this study addressed what managers perceived as the biggest challenges for the retention of laboratory professionals and what effective strategies they thought could …

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Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins Jan 2020

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

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Instructor Perspectives On Case-Based Learning And Student Engagement In Occupational Therapy Curriculums, Pamela Lewis-Kipkulei Jan 2020

Instructor Perspectives On Case-Based Learning And Student Engagement In Occupational Therapy Curriculums, Pamela Lewis-Kipkulei

Walden Dissertations and Doctoral Studies

Students who are not engaged in the classroom become clinicians who are not successful in clinicals and entry-level work. This prompted occupational therapy (OT) educators to explore active teaching and learning strategies that have proven successful in various professional programs. This study explored OT instructors’ perceptions and experiences of case-based learning (CBL). This single case, qualitative study utilized content and thematic analysis to analyze interviews, brainstorming activities, and reflective journals from eight participants. Participants were OT professors who utilized CBL strategies. First and second cycle coding was used to categorize data then codes were reviewed for emerging themes. Content analysis …

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Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee Jan 2020

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

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Systematic Review: Barriers To Primary Care For The Transgender Individual, Charles David Mccormick Jan 2020

Systematic Review: Barriers To Primary Care For The Transgender Individual, Charles David Mccormick

Walden Dissertations and Doctoral Studies

Representing a diverse group, the transgender community defies conventional norms expected by society resulting in discrimination and denial of essential goods and services necessary to maintain personal health, safety, and well being. The identification of the barriers to primary care faced by the transgender individual has the potential to reduce healthcare disparities and improve the compliance with national screening and treatment guidelines. The purpose of this project was to examine available literature incorporating the systematic review method to determine the barriers to primary care faced by the transgender individual. Using Leininger’s transcultural nursing theory to guide the process to determine …

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Healthcare Providers Perception Of Their Ability To Recognize Boys As Victims Of Human Sex Trafficking In A Pediatric Emergency Room, Deborah Susan Mican Jan 2020

Healthcare Providers Perception Of Their Ability To Recognize Boys As Victims Of Human Sex Trafficking In A Pediatric Emergency Room, Deborah Susan Mican

Walden Dissertations and Doctoral Studies

The purpose of this dissertation was to explore the perceived barriers to pediatric emergency room (ER) providers’ identifying boys as victims of child sex trafficking (CST), to understand how providers working in a pediatric ER compared to a general ER believe they are better able to identify boys as CST victims, and to understand how the New Jersey-mandated human trafficking training affected the confidence of the healthcare providers’ to identify boys as CST victims using a grounded theory approach. In-depth interviews were conducted using a sample of 10 healthcare providers, including physicians, nurse practitioners, and physician assistants at a suburban …

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Staff Education On Heart Failure Guidelines And Self-Care Management Practices, Mary Mitcheltree Jan 2020

Staff Education On Heart Failure Guidelines And Self-Care Management Practices, Mary Mitcheltree

Walden Dissertations and Doctoral Studies

Heart disease is the leading cause of death in the United States with heart failure (HF) being one of the more prevalent diseases associated with heart disease. HF is reported to have a high mortality rate and presents an economic burden to the U.S. healthcare system. To improve patient outcomes and reduce the costs of treatment for HF-related symptoms, infusion nurses need adequate education and training. The purpose of this project was to train home infusion nurses on self-care management practices based on current HF guidelines. The Donabedian model, known for quality assurance, provided the framework to support the educational …

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Accuracy Of Death Certificate Data In Reporting Suicide In The United States, Miland Ned Palmer Jan 2020

Accuracy Of Death Certificate Data In Reporting Suicide In The United States, Miland Ned Palmer

Walden Dissertations and Doctoral Studies

Suicide is one of the leading causes of death in the United States. Death certificates are currently being used by public health professionals and policy makers as a main source of public health surveillance data on suicide. The accuracy of death certificates in tracking and reporting suicides has not been well quantified or evaluated in the United States. Death certificates from other countries have been found to under-report suicide. The purpose of this study was to evaluate the accuracy of death certificates in reporting suicides in the United States. The National Violence Death Reporting System (NVDRS) collects information on all …

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Case Analysis Of Acute Care Guidelines For The Prevention Of Pressure Ulcers, Carle Ray Jan 2020

Case Analysis Of Acute Care Guidelines For The Prevention Of Pressure Ulcers, Carle Ray

Walden Dissertations and Doctoral Studies

Prevention of pressure ulcers (PUs) in acute care settings is an attempt to avoid adverse events (AE). Literature shows that wounds such as PUs are the most prevalent complication for spinal cord injury patients (SCI) including quadriplegic individuals (QI). SCI and QI bring important pressure ulcer (PU) prevention knowledge to the hospital which involves teamwork and participation by nurses, organizations, and patients. The purpose of this qualitative study was to examine the effectiveness of acute care guidelines for PUs by drawing insights from multiple sources including interviews with QI, healthcare clinicians, care providers, family members, and an online search of …

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Development And Validation Of A Sepsis Course For Burn Intensive Care Unit Nurses, Colleen Melisa Reid Jan 2020

Development And Validation Of A Sepsis Course For Burn Intensive Care Unit Nurses, Colleen Melisa Reid

Walden Dissertations and Doctoral Studies

Sepsis is the most common cause of death in burn patients. Optimal recovery from sepsis requires early recognition and prompt treatment. When sepsis is suspected or detected, the 2016 Surviving Sepsis Campaign guidelines endorse immediate initiation of the Hour-1 Sepsis Bundle. Unfortunately, a random audit of hospital system compliance with the Centers for Medicare and Medicaid Services sepsis core measure was less than 50%. A 2019 performance improvement project uncovered delays in antibiotic administration, and a search of scientific and burn center literature did not elucidate a course that educated burn intensive care nurses about sepsis. The purpose of this …

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Promoting New Graduate Registered Nurse Retention Through A Staff Preceptorship Program, Sheba Saelee Jan 2020

Promoting New Graduate Registered Nurse Retention Through A Staff Preceptorship Program, Sheba Saelee

Walden Dissertations and Doctoral Studies

The transition from classroom to the clinical setting is challenging for most new graduate nurses (NGRNs). They often report being unprepared and lack confidence in their skills. Preceptors play a significant role in the success of the NGRNs and overall quality of care provided on the floor. However, the training they are provided is lacking. Preceptors tend to view their role as a daunting task and an assigned burden. The purpose of this project was to implement a NGRN preceptor training program. The practice focused question explored if a preceptor education program in a long-term acute care hospital increased the …

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Managerial Competencies Driving Successful Change Initiatives: A Multiple Case Study Of Healthcare Administrators, William King Selsor Jan 2020

Managerial Competencies Driving Successful Change Initiatives: A Multiple Case Study Of Healthcare Administrators, William King Selsor

Walden Dissertations and Doctoral Studies

Healthcare administrators’ competencies for driving successful strategic change initiatives in healthcare organizations remain outdated and limited in the management literature. The purpose of this qualitative, multiple case study was to explore the perceptions of healthcare administrators on the specific nature of management competencies needed to drive successful strategic change initiatives within healthcare organizations. To address the research problem and purpose of the study, qualitative data were collected from multiple sources of evidence, including semi-structured interviews with seven healthcare administrators, archival data, and reflective journaling notes. This study was framed by Kash, Spaulding, Johnson, and Gamm’s conceptual framework, the comparison of …

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Clinical Practice Guideline For Transitions Of Patients With Chronic Obstructive Pulmonary Disease, Thomas Stewart Jan 2020

Clinical Practice Guideline For Transitions Of Patients With Chronic Obstructive Pulmonary Disease, Thomas Stewart

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a public health challenge and a leading cause of readmissions in the United States. Research suggests that many patient readmissions could be prevented by using a multidisciplinary approach to develop quality, evidence-informed clinical practice guidelines. A retrospective review of the electronic health record by the project site’s quality committee revealed a lack of consistency in adhering to best practice recommendations, as evidenced by increased readmission rates. The purpose of this project was to develop a clinical practice guideline with input from a collaborative expert advisory committee for the discharge care of COPD patients. The …

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Competition And Services Offered Among General Hospitals In The Deep South, Vanessa Stone Jan 2020

Competition And Services Offered Among General Hospitals In The Deep South, Vanessa Stone

Walden Dissertations and Doctoral Studies

Hospitals, along with other health care providers, are a central part of every health care system and responsible for a great share of healthcare expenditure. In the United States, the cost of health care is much higher than it is anywhere else. High expenditures for hospital services could reduce the resources available for primary care and other services that could do more for population health. The purpose of this study was to explore the competition among general medical and surgical hospitals in the Deep Southern states of Mississippi, Alabama, Georgia, South Carolina, and Louisiana to determine if increasing the level …

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Job Satisfaction, Engagement, And Motivation For Nursing Leadership Among Millennial Registered Nurses, Oluwaseyi Stover Jan 2020

Job Satisfaction, Engagement, And Motivation For Nursing Leadership Among Millennial Registered Nurses, Oluwaseyi Stover

Walden Dissertations and Doctoral Studies

There is a shortage of nursing leaders because current nursing leaders who are in the baby boomer generation are retiring. Millennial RNs are needed to fill vacant nursing leadership positions, but millennial RNs are not satisfied in their jobs and lack motivation and engagement, which impedes their interest in nursing leadership positions. The purposes of this quantitative, descriptive, correlational study, guided by King’s theory of goal attainment, were to examine the relationship between job satisfaction, motivation, engagement, and the aspiration of millennial RNs for nursing leadership positions in the acute care hospital setting, and the combined effects of job satisfaction, …

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Optimizing The Use Of Antibiotics:Evaluation Of A Quality Improvement Project, Elaine Marie Summers Jan 2020

Optimizing The Use Of Antibiotics:Evaluation Of A Quality Improvement Project, Elaine Marie Summers

Walden Dissertations and Doctoral Studies

The overuse and inappropriate use of antibiotics for residents in long-term care facilities (LTCFs) is associated with significant unintended treatment harm with 50% to 70% of residents prescribed an antibiotic at least once in 12 months. The purpose of this project was to evaluate data from a quality improvement quality improvement initiative conducted at a 168-bed LTCF to implement a protocol of an antibiotic stewardship program (ASP) to reduce the overuse of antibiotics. The John Hopkins nursing evidence-based practice model guided this project to analyze health care provider compliance with implementation of protocol guidelines before and after the ASP program …

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Mental Health Professional Perceptions Of Barriers To Fidelity For Empirically- Supported Treatments, Chris Streidl Jan 2020

Mental Health Professional Perceptions Of Barriers To Fidelity For Empirically- Supported Treatments, Chris Streidl

Walden Dissertations and Doctoral Studies

It is estimated that one in five adults in the United State of America experience mental illness in a given year. When mental health organizations implement empirically-supported treatments but fail to maintain them, it can result in individuals not being provided the services that they need. The purpose of this study was to identify perceived barriers to maintaining fidelity for empirically-supported mental health treatments. The study utilized a quantitative cross-sectional correlational research design (N = 154) and the Perception of Barriers Scale (PBS) was developed to measure perceived barriers to maintaining fidelity for empirically-supported treatments. Bandura’s social cognitive theory as …

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Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende Jan 2020

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

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Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones Jan 2020

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

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