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Articles 3241 - 3270 of 5875
Full-Text Articles in Medicine and Health Sciences
Identifying Strategies That Address Race-Based Traumatic Stress Of African Americans In Rural Mississippi, Syrenia Johnson
Identifying Strategies That Address Race-Based Traumatic Stress Of African Americans In Rural Mississippi, Syrenia Johnson
Walden Dissertations and Doctoral Studies
There has been a dramatic increase of race-based encounters that have had an extensive health impact on African Americans. Social workers and other mental health professionals play a crucial role in working with African American adults who experience race-based traumatic stress. The purpose of this qualitative study was to identify strategies to address race-based traumatic stress from a mental health perspective. Racial encounter coping appraisal and socialization theory (RECAST) guided this study where eight social workers from the local community mental health center in rural Mississippi completed an open-ended questionnaire to identify and determine culturally competent treatment strategies for African …
Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch
Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch
Walden Dissertations and Doctoral Studies
AbstractElectronic health record system implementations have a high failure rate when properly developed strategies are not used. These implementation failures affect healthcare workers and practitioners core roles through a lack of documentation practices, which decreases the quality of the care of the patients. Grounded in the technology acceptance model, the purpose of this qualitative multiple case study was to explore the strategies information technology systems engineers use for the implementation of Health Information Management Systems. The participants were 10 information technology systems engineers from three healthcare organizations in the greater Tennessee area. The data were collected through recorded participant interviews …
Exploring Staff Nurse Interactions In Their Role As Student Nurse Educators, Jennifer Nafarrete
Exploring Staff Nurse Interactions In Their Role As Student Nurse Educators, Jennifer Nafarrete
Walden Dissertations and Doctoral Studies
The majority of nurse education occurs in academic settings, but up to 40% can occur in hospital settings. Nurse education programs rely on the staff nurses who work in the hospitals to serve as student nurse educators and fulfill the clinical education requirement of their academic programs. The problem for this study is that staff nurses in their role as student nurse educators often have negative interactions with student nurses that do not promote learning in the clinical setting. The purpose of this qualitative study was to better understand how student nurse educator interactions with student nurses are positively influenced …
Implementing A Cauti Bundle In The Adult Hospitalized Trauma Population, Sabrina Marcella Braun
Implementing A Cauti Bundle In The Adult Hospitalized Trauma Population, Sabrina Marcella Braun
Walden Dissertations and Doctoral Studies
The use of an indwelling catheter is a common occurrence in the hospital setting. Careful evaluation of the initial indication for catheterization and need for continued catheterization is necessary to mitigate the complications of catheter insertion, which includes urinary tract infection. Catheter associated urinary tract infections (CAUTI) are the most common healthcare-associated infection in the United States, with > 30% of these infections reported. More than 560,000 hospital acquired urinary tract infections occur annually. CAUTI and its complications increase morbidity and mortality, hospital length of stay, readmission rates, cost, and the use of antimicrobial medication. CAUTI was identified as an outlier …
Understanding Characteristics Of Chronic Obstructive Pulmonary Disease Readmissions In An Acute Care Hospital, Jordan Danyale Brautigam
Understanding Characteristics Of Chronic Obstructive Pulmonary Disease Readmissions In An Acute Care Hospital, Jordan Danyale Brautigam
Walden Dissertations and Doctoral Studies
Patients suffering from chronic obstructive pulmonary disease (COPD) not only face difficulties managing their disease but are also faced with a higher risk of being readmitted to a hospital after an initial visit for acute exacerbation of their condition. Despite hospitals’ many attempts to offset this burden, readmission reduction programs are not effective. The purpose of this quantitative study was to further research an organization’s specific population surrounding patient comorbidities, reasons for readmissions, and demographic characteristics that may lend insight into reasons for readmissions. The research design was a retrospective analysis of a health system’s electronic medical record with a …
Increasing Compliance Of Chlorhexidine Wipes To Prevent Hospital-Acquired Infections, Kelly Jean Dunn
Increasing Compliance Of Chlorhexidine Wipes To Prevent Hospital-Acquired Infections, Kelly Jean Dunn
Walden Dissertations and Doctoral Studies
AbstractHealthcare-acquired infections (HAIs) are complications of healthcare linked to increased mortality, morbidity, and length of stay. Assiduous surveillance and constant reeducation can decrease HAI incidence and reduce the healthcare burden caused by these events. Evidence has demonstrated that using 2% chlorhexidine wipes instead of bathing with soap and water greatly reduces the bacteria on the skin and prevents infections such as catheter-associated urinary tract infections and central line-associated bloodstream infections. The practice-focused question for this quality assurance doctoral project was to evaluate if an educational intervention improved compliance of chlorhexidine wipe use among ICU nurses with the hope of improving …
Family Functioning During Deployment And Reintegration Of Military Members, Heather Graham
Family Functioning During Deployment And Reintegration Of Military Members, Heather Graham
Walden Dissertations and Doctoral Studies
Military members and their families face unique stressors related to separation and reintegration. These life-changing events can lead to domestic violence, divorce, depression, suicide, and behavioral problems within the family. It was unknown whether the implementation of a nursing clinical practice guideline (CPG) would help nurses to identify family functioning concerns or psychosocial issues enabling earlier interventions. The purpose of this doctoral project was to create a CPG that can be used at military treatment facilities (MTFs) to screen military members and their families to identify family functioning concerns so that the provider can make referrals as needed. The circumplex …
The Lived Experiences Of Clinical Nursing Faculty With Student Performance Anxiety, Heather Lapoint
The Lived Experiences Of Clinical Nursing Faculty With Student Performance Anxiety, Heather Lapoint
Walden Dissertations and Doctoral Studies
The nursing shortage in the United States has led to a call for nursing education reform. Current clinical educational methods precipitate nursing student performance anxiety (PA). PA can inhibit the clinical judgment, reasoning, critical thinking, and the adaptability required for advancing healthcare initiatives and reducing the nursing shortage. PA has not been defined nor addressed in undergraduate nursing education. The purpose of this descriptive phenomenological study was to explore the lived experiences of associate degree (AD) nursing program faculty in addressing student PA as it occurs in the clinical setting. Specifically, how faculty define PA and recognize, address, and assess …
Childhood Obesity, Yvette Ledjo
Childhood Obesity, Yvette Ledjo
Walden Dissertations and Doctoral Studies
AbstractObesity in adolescents is a worldwide epidemic. According to the Centers for Disease Control and Prevention, approximately 17% of adolescents in the United States are obese. These statistics put pressure on public health nationally and internationally. Obesity leads to chronic diseases such as cardiovascular disease, diabetes, and arthritis. This doctor of nursing practice project was carried out in a juvenile correctional facility’s clinic, where detainees visited for treatment of acute and chronic health-related issues. Clinicians address detainees’ problems, but a gap was identified in the knowledge of these clinicians. This project focused on closing that knowledge gap by providing a …
Perceptions On Maternal Mortality Among The Ekpeye Community, Theresa Tenim Ogide-Alaeze
Perceptions On Maternal Mortality Among The Ekpeye Community, Theresa Tenim Ogide-Alaeze
Walden Dissertations and Doctoral Studies
In Africa, especially Nigeria, maternal mortality is a public health issue among women of childbearing age (WCBA). WCBA living in the Ekpeye community located in Rivers state in Nigeria are at high risk of maternal deaths during pregnancy and labor or delivery. Data were obtained through key informant interviews with 9 relatives, friends, and health workers. The purpose of the key informant interviews was to identify perceived barriers that result in high maternal deaths and facilitators seen as promoters to reduce pregnancy-related deaths. The participants identified 11 core themes as contributors to maternal death: (a) postpartum death, (b) financial insecurity, …
Hospice Interdisciplinary Use Of The Social Work Assessment Tool For Military Families, Miranda Lishell Rankin
Hospice Interdisciplinary Use Of The Social Work Assessment Tool For Military Families, Miranda Lishell Rankin
Walden Dissertations and Doctoral Studies
The development of the social work assessment tool (SWAT) was an initiative designed by members of the National Hospice and Palliative Care Organization to move hospice and palliative care social workers into the arena of viewing the family as an extension of the patient. Of those dying in the United States, 1 out of 4 is a military veteran (vet) in need of assessments, culturally relevant interventions, and/or supports at the end of life. For military families, caring for vets at the end of life can prompt stressors that may require culturally unique assessments and/or interventions. Tsai’s (2003) theory of …
Understanding The Experiences Of Young Adults Receiving Community-Based Eating Disorder Care, Hali Sitarz
Understanding The Experiences Of Young Adults Receiving Community-Based Eating Disorder Care, Hali Sitarz
Walden Dissertations and Doctoral Studies
AbstractIn Ontario, Canada, eating disorder care is predominately delivered through nurse practitioner-led community outreach programs; however, there is a paucity of evidence informing the role of nurses in terms of outpatient treatment, community-based care, and young adult patient experiences. With high rates of morbidity and mortality, it is imperative to establish an evidence-informed approach to eating disorder treatment and ensure that care is patient-centered. This interpretive phenomenological study explored the experiences of young adults receiving community-based treatment in Ontario. Reigel, Stromberg & Jaarsma’s Middle Range Theory of Self-Care in Chronic Illness was used as an orientating framework. Seven young adults, …
Partner Notification Of Hiv Status Among Cameroonian Men Who Have Sex With Men, Pius Muffih Tih
Partner Notification Of Hiv Status Among Cameroonian Men Who Have Sex With Men, Pius Muffih Tih
Walden Dissertations and Doctoral Studies
AbstractHIV prevalence rates are higher among men who have sex with men (MSM) than in the general population. Although there is ample evidence that partner notification (PN) effectively breaks the HIV transmission chain among MSM, it has not been practiced consistently in Cameroon. This study aimed to assess the perceptions and acceptability of PN of HIV status among MSM and use by health care workers (HCWs) in Cameroon. The health belief model underpinned this qualitative inquiry, in which I recruited 15 HCWs and 16 MSM using snowball sampling. I used in-depth personal interviews for data collection with notes taken using …
Effects Of A Blended Basic Telemetry Course On The Telemetry Reading Proficiency Of Newly Licensed Registered Nurses, Joan Yankalunas
Effects Of A Blended Basic Telemetry Course On The Telemetry Reading Proficiency Of Newly Licensed Registered Nurses, Joan Yankalunas
Walden Dissertations and Doctoral Studies
Telemetry interpretation is a common skill required by registered nurses (RNs) to take care of patients in an acute care setting. Telemetry education guidelines are needed because there are no established standards for the amount, type, or scope of education needed for RNs who take care of patients on continuous telemetry monitoring. The purpose of this retrospective analysis design study, guided by Benner’s skill acquisition model and Kirkpatrick’s learning outcomes measurement theory, was to (a) determine the effect of a blended telemetry course, which is a combination of eLearning and an instructor-led class, on the telemetry reading proficiency of RNs …
The Relationship Between Cervical Cancer And Women Living With Disabilities In Kentucky, Carolyn Akakpo
The Relationship Between Cervical Cancer And Women Living With Disabilities In Kentucky, Carolyn Akakpo
Walden Dissertations and Doctoral Studies
AbstractDespite many national interventions, cervical cancer (CC) rates persist, and in Kentucky (KY), CC incidence rates are on the rise. Additionally, women with disabilities face more barriers to secondary prevention and healthcare access, have more known risks, and experience more health disparities than women without disabilities. Given that 1 in 4 persons live with a disability, the purpose of this observational, cross-sectional, quantitative study was to explore the relationship between CC and women with disabilities as evidenced by reproductive cancer discharges from inpatient hospital (IHD) and outpatient services databases (OSD) so as to compare population-specific differences from social determinants of …
Black Msm And Hiv Testing History Levels In The Clinical And Nonclinical Settings, Naana Cleland
Black Msm And Hiv Testing History Levels In The Clinical And Nonclinical Settings, Naana Cleland
Walden Dissertations and Doctoral Studies
Black men who have sex with men (BMSM) are more likely unaware of their HIV status, are less likely to get tested annually, and prefer to use HIV testing services (HTS) in the nonclinical settings, compared to other MSM subgroups. Guided by the behavioral model for vulnerable populations and a cross-sectional quantitative design, three substudies were conducted using secondary data for 1189 BMSM, 18 years or older, from the HIV Prevention Trial Network 061 Study. Chi-square, multinomial logistic regression (MLR), and z-test methods were used to examine the association between population characteristics (predisposing, enabling, and need factors) and HIV testing …
Reducing Heart Failure Readmissions Through Staff Education, Christopher Davio
Reducing Heart Failure Readmissions Through Staff Education, Christopher Davio
Walden Dissertations and Doctoral Studies
Heart failure is a chronic health condition that can have devastating effects on thephysical and social well-being of patients. One critical component to heart failure treatment is understanding of the disease process and daily self-management for patients. The gap in practice at an acute care facility in the northwest United States was the lack of comprehensive discharge patient teaching to patients diagnosed with heart failure. The project explored if a heart failure education session for nurses would increase knowledge and competency on heart failure education. Knowle’s theory of adult learning was used to frame the project components. Thirty-one nursing staff …
Structural Empowerment And Employee Commitment Among Millennial Newly Registered Nurses, Janice Hill
Structural Empowerment And Employee Commitment Among Millennial Newly Registered Nurses, Janice Hill
Walden Dissertations and Doctoral Studies
AbstractThe nursing shortage is one of the most challenging issues in global healthcare. While not an all-encompassing solution, labor force retention could alleviate the crisis. The purpose of this study, guided by Kanter’s structural theory of organizational behavior, was to determine the relationships between access to power, opportunity for growth, structural empowerment (SE), and employee commitment among millennial newly registered nurses (NRNs) and to determine if there is a difference in SE between male and female millennial NRNs. Survey data collected from 148 participants were analyzed using Spearman rank-order correlation tests and showed statistically significant correlations between access to power …
Effect Of Educational Training On Nurse Leaders’ Knowledge, Attitude, And Behavior Toward Suicide Prevention, Ruth Odochi Idediora
Effect Of Educational Training On Nurse Leaders’ Knowledge, Attitude, And Behavior Toward Suicide Prevention, Ruth Odochi Idediora
Walden Dissertations and Doctoral Studies
Suicide is the 10th leading cause of death among adults in the United States and one of the top 10 most commonly occurring events that lead to serious injury or death in the hospital. Nurse leaders who are not working in psychiatric facility are instrumental in promoting culture of safety to mitigate adverse outcomes like suicide. The purpose of this single group pre-and post-test study, guided by the theory of planned behavior, was to determine the effect of the American Psychiatric Nurses Association Competency-Based Training for Suicide Prevention (Acute Care Setting Course) on the knowledge, attitude, and behavior (KAB) of …
Nurse Perception Of Pain And Innovative Approaches To Pain Management, Tracey-Ann Nichole Knight
Nurse Perception Of Pain And Innovative Approaches To Pain Management, Tracey-Ann Nichole Knight
Walden Dissertations and Doctoral Studies
AbstractInsufficient assessment and management of pain among the patient population during their hospital stay may result in ineffective delivery of care, increased length of stay, poor clinical outcomes, and decreased patient satisfaction. The quality report at a local facility showed compliance scores of 78% for administration of pain medication and 79% for reassessment of pain. These scores and the weekly patients’ satisfaction survey results suggested a substandard adherence to the facility’s pain management guidelines. One identified barrier to properly managing patients’ pain was nurses’ lack of knowledge and understanding of the theoretical foundation of pain management. The purpose of this …
Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu
Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu
Walden Dissertations and Doctoral Studies
The purpose of this ecological quantitative study was to examine the predictors of health systems building blocks and their interactions in improving access and uptake of immunizations in nine sub-Saharan African countries. Immunization rates in this region remain lower than global targets leading to preventable diseases and mortality. Using the systems approach, the study examined the relationships among five independent variables: quality of service delivery, governance, vaccine supply, health financing, socioeconomic factors and the dependent variable, access to immunizations. Datasets from the WHO and UNICEF were used. Analysis included a series of descriptive statistics, logistic and linear regression, and correlations. …
The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik
The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik
Walden Dissertations and Doctoral Studies
Research studies have shown that organizational leadership and support affect organizational outcomes in many sectors, including healthcare. However, less is known about how organizational leadership influences the quality of patient care by physicians. This study was guided by the perceived organizational support theory and leader-member exchange theory that provide general understanding of how supportive leadership influences staff wellbeing and productivity. Ninety-five resident physicians residing in Lebanon participated in this cross-sectional study and completed an online survey, which consisted of demographics and five tools, namely, the Leader-Member Exchange 7, Perceived Organization Support 8, Maslach Burnout Inventory 7, Utrecht Work Engagement 9, …
Staff Education Program For Nurses Caring For Patients With Medical Decline On A Geriatric Psychiatric Unit, Portia Denise Risper
Staff Education Program For Nurses Caring For Patients With Medical Decline On A Geriatric Psychiatric Unit, Portia Denise Risper
Walden Dissertations and Doctoral Studies
AbstractElderly patients admitted to psychiatric units are a vulnerable population, some may have mental disorders, physical decline, cognitive challenges; along with other comorbidities in addition to their mental illness. However, their physical health needs may be overlooked due to the presenting behaviors mimicking mental health behaviors. The nurses working in the local hospital facility’s geri-psych unit failed to recognize signs and symptoms of physical decline in their severely mentally ill (SMI) patients. Not recognizing and reporting acute changes resulted in patients’ prolonged hospitalization, decreased quality of life, and increased cost to the facility. The purpose of this DNP project was …
A Retrospective Program Evaluation Of Existing Quality Improvement Project Colorectal Cancer Screening, Laveda Lynn Roberts
A Retrospective Program Evaluation Of Existing Quality Improvement Project Colorectal Cancer Screening, Laveda Lynn Roberts
Walden Dissertations and Doctoral Studies
The United States Preventive Services Task Force (USPSTF) makes recommendations on preventive health screenings based on the level of evidence. Colorectal Cancer is the third most commonly diagnosed cancer. The practice problem for this DNP QI project, is that providers are not following the USPSTF Guidelines on colorectal cancer screening with the FQHC scores below the HRSA expectation of 80% showing only a 43% screening compliance rate for patients age 50 -75 years. The purpose of this DNP QI project was to evaluate the effectiveness of the existing QI initiative for provider colorectal screening of patients age 50-75 years, then …
Examining The Efficacy Of A School-Based Mental Health Program In Iowa, Karen A. Rodriguez
Examining The Efficacy Of A School-Based Mental Health Program In Iowa, Karen A. Rodriguez
Walden Dissertations and Doctoral Studies
Evidence shows that treating mental health issues positively impacts academic and other life outcomes for students. However, there remains a gap in knowledge specific to academic outcomes and to rural school districts. It is important for mental health providers, educators, and third-party payers to gain an understanding of how treating mental health in the school setting affects student performance. The purpose of this quantitative study, which had contribution analysis as its theoretical framework, was to examine the academic and behavioral outcomes of participating in a school-based mental health (SBMH) program in rural school districts in Iowa. The specific focus was …
Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia
Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia
Walden Dissertations and Doctoral Studies
Patient satisfaction presents an emerging area of research for healthcare providers because major healthcare providers like Medicare/Medicaid control the finances of healthcare institutions as based on their patient and customer satisfaction. The purpose of this study was to examine the impact of servant leadership on customer service, and patient satisfaction, in the Inland Empire Region of Southern California. The theoretical framework applied to this study was the servant leadership theory. Participants consisted of 82 managerial staff within the University Health System, which is comprised of a teaching hospital, 5 behavioral health centers, 10 federally qualified health centers, and a public …
Retention, Viral Suppression, And Care Models In Hiv Positive Children And Adolescents In Cameroon, Eveline Mboh Khan
Retention, Viral Suppression, And Care Models In Hiv Positive Children And Adolescents In Cameroon, Eveline Mboh Khan
Walden Dissertations and Doctoral Studies
Human Immunodeficiency Virus (HIV) remains a significant public health problem in Sub-Saharan Africa with poor treatment outcomes in children and adolescents (C&As). There is a lack of information on the effects of various HIV care models (Child and Adolescent Friendly Clinic model and Support Group model) on retention in care and Viral Suppression (VS) in Cameroon. This study was carried out to identify the care model with the best outcomes for C&As, inform national scale-up strategies, resource prioritization, and contribute to the existing literature. A quantitative retrospective cohort review approach guided by the social cognitive theory was used to analyze …
Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano
Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano
Walden Dissertations and Doctoral Studies
The present work explored the role of family rejection on the sexual behavior of Latino gay men under the guidance of the minority stress model. Family rejection was analyzed as a distal stressor, self-esteem as a proximal stressor, and unprotected sex as the outcome. The hypotheses were tested using regression, mediation, and multiple regression of secondary data from the Latino men who have sex with men (MSM) community involvement project. The results suggested that family rejection is a weak predictor of low self-esteem and engaging in receptive unprotected sex with more partners. Low self-esteem did not mediate the relationship between …
Job Satisfaction, Work Environment, Job Stress, And Professional Identity Among Psychiatric Nurses, Tosin Rabiu-Akewusola
Job Satisfaction, Work Environment, Job Stress, And Professional Identity Among Psychiatric Nurses, Tosin Rabiu-Akewusola
Walden Dissertations and Doctoral Studies
Job satisfaction is one of the most complex issues in the healthcare industry in regard to employees. To boost employees' productivity and job satisfaction, nurse leaders must satisfy their employees' needs by providing the right working conditions, reducing job stress, and promoting professional identity development. This quantitative, cross-sectional correlational study guided by Herzberg et al.s two-factor theory investigated the relationship among work environment, job stress, professional identity, and job satisfaction among 105 registered nurses working in inpatient psychiatric hospitals in the United States. It was determined that the moderating effect of demographic factor (years of experience) on the extent to …
Cybersecurity Using Risk Management Strategies Of U.S. Government Health Organizations, Ian Cornelius Wilkinson
Cybersecurity Using Risk Management Strategies Of U.S. Government Health Organizations, Ian Cornelius Wilkinson
Walden Dissertations and Doctoral Studies
Seismic data loss attributed to cybersecurity attacks has been an epidemic-level threat currently plaguing the U.S. healthcare system. Addressing cyber attacks is important to information technology (IT) security managers to minimize organizational risks and effectively safeguard data from associated security breaches. Grounded in the protection motivation theory, the purpose of this qualitative multiple case study was to explore risk-based strategies used by IT security managers to safeguard data effectively. Data were derived from interviews of eight IT security managers of four U.S. government health institutions and a review of relevant organizational documentation. The research data were coded and organized to …