Medicine and Health Sciences Commons^™

A Systematic Review Of Nurse Staffing Models, Elizabeth Ndidi Ubochi

Walden Dissertations and Doctoral Studies

Appropriate nurse staffing is essential to the delivery of high-quality patient care. Nursing leadership identifies nurse staffing model as an evidence-based staffing model following problems with nursing staff retention on 4 acute care units in a recently opened hospital. The linkage model guided the review of evidence on nurse staffing models and the relationship to nurse job satisfaction and nurse retention and to explore strategies that could lead to recommendations to nursing leadership. The 466 articles found were reduced to 7 articles, 2 at Level 1 (systematic review), 4 at Level VI (quantitative descriptive), and 1 at Level VII (expert …

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …

Self-Efficacy And Leadership Commitment During Lean Strategy Deployment, Angela Deloise Pearson

Walden Dissertations and Doctoral Studies

Lean strategy deployment (LSD) provides a means to create lasting value at reduced cost; yet most LSD efforts fail to attain sustainable improvements. The current study sought to gain an understanding of how leaders in oral healthcare manufacturing setting in the northeastern region of the United States can apply self-efficacy and leadership commitment during an LSD. Using Bandura’s theory of self-efficacy this qualitative phenomenological study examined the lived experiences and perceptions of 15 mid-to-senior level managers, concerning the use of self-efficacy and leadership commitment during a lean strategy deployment (LSD). The key findings resulted in 10 emergent themes. The top …

Clinical Practice Guideline: Posttraumatic Stress Disorder Screening Tool For Patients, Stephanie Lynn Smith

Walden Dissertations and Doctoral Studies

The National Institute of Health has estimated that over 1 million new cancer cases will occur yearly. Posttraumatic stress disorder (PTSD) is commonly associated with near death experiences or traumatic events, such as cancer diagnosis and treatment. There is a lack of knowledge and awareness by healthcare professionals in identifying PTSD in cancer patients. In this population, PTSD symptoms often contribute to anxiety, and there is no standardized protocol being used to screen these individuals for the trauma they are facing or have faced. The purpose of this project was to develop a clinical practice guideline for screening cancer patients …

Predicting Spiritual And Religious Competence Based On Supervisor Practices And Institutional Attendance, Andrew Phillip Secor

Walden Dissertations and Doctoral Studies

Counseling students report a lack of competence in spiritual and religious integration (SRI). As such, counselor educators and supervisors (CES) and students want to understand how to develop SRI competence. Although past research highlighted SRI dialogue in training, the problem is that no clear understanding exists about the role of faculty supervisor SRI on perceived student competence. The supervision models used to inform the study included the integrated developmental model, discrimination model, and spirituality in supervision model (SACRED). The purpose of this study was to determine if master’s-level graduate counseling students’ perception of their faculty supervisors’ SRI practices predicted students …

Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo

Walden Dissertations and Doctoral Studies

Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation …

The Impact Of Hiv Prevention Education In School On Young Men Who Have Sex With Men, Michael Edward Tachet

Walden Dissertations and Doctoral Studies

Sex education through the public school system has been identified by the Centers for Disease Control and Prevention as an excellent vehicle by which HIV prevention education can be presented to students, thereby decreasing the rate of HIV infection among young men who have sex with men (YMSM). However, YMSM continue to be at high risk for HIV infection in the United States despite educational efforts to prevent infection. The purpose of this qualitative study using a phenomenological approach was to explore what impact school-based HIV prevention education had on YMSM in the past, and what effect that education has …

Impact Of Transitional Care Model On Readmissions Of Adults With Chronic Heart Failure, Sheila Delaine Stuckey

Walden Dissertations and Doctoral Studies

Chronic heart failure (CHF) is often associated with high morbidity, mortality, and increased health expenditures. The readmission rate of patients with CHF is approximately 30% within 30 to 60 days following discharge. This project examined the literature to identify best practices based on the use of the transitional care model (TCM) in the reduction of hospital readmissions among older patients with CHF. The review included articles that were published between 2015 and 2019, used a quantitative study methodology, were peer-reviewed, and written in English. Keywords used in the search were chronic heart failure, the transitional care model, and hospital readmissions. …

An Educational Module On High Blood Pressure Management And Control, Chinyere Ukomadu

Walden Dissertations and Doctoral Studies

An educational module, based on evidence-based practice (EBP) guidelines by the 8th Joint National Committee (JNC 8) and the American College of Cardiology (ACC), was created and implemented to determine if its implementation would impact the knowledge of clinic staff regarding current EBP guidelines about self-management of hypertension (HTN). The module has the potential to contribute to the resolution of patient noncompliance on HTN treatment and management by increasing nursing staff proficiency in knowledge transfer to patients on effective self-management of their health condition. The creation of the module was guided by the concept of need or asset assessment and …

Relationship Between Preparedness Training And Posttraumatic Stress Disorder Severity In Combat Veterans, Charles F. Snay

Walden Dissertations and Doctoral Studies

In the past decade, the military has deployed approximately 1 million members into combat, and a factor that plagues the military veterans returning from combat is the prevalence of posttraumatic stress disorder (PTSD). A factor to examine is preparedness training before combat because the research has shown that postcombat resilience training has been effective in reducing symptoms of PTSD. Using the social cognitive theory, the purpose of this study was to determine whether self-reported preparedness training before deployments was related to lower severity of self-reported PTSD. Based on prior research, age and gender are other variables that this study examined. …

A Phenomenological Study Of Lived Experiences Of Transport Nurses Experiencing Patient Death, Joshua B. Wall

Walden Dissertations and Doctoral Studies

Experiencing a patient death can directly affect the well-being of health care professionals; however, this phenomenon and the effects of patients' deaths are not well understood in the transport setting. Transport nurses work in unique settings with complex patients and significant autonomy in determining the plan of care; therefore, the experiences of other health care professionals may not be applicable in this environment. The purpose of this qualitative study was to explore the lived experiences of transport nurses who have experienced patient death using Husserl's life-world and phenomenological philosophies as a theoretical framework. Semistructured interviews were completed with 8 transport …

Effect Of Multiple Entry Levels Into Nursing Practice And Professionalism, Ogechi Abalihi

Walden Dissertations and Doctoral Studies

Entry into professional nursing practice in the United States occurs at varied education levels including a diploma, an associate degree, and a baccalaureate degree. These multiple entry levels into practice create a situation where academic preparedness for nursing practice varies, which may influence the professional behavior of nurses and, consequently, patient care and outcomes. The purpose of this quantitative comparative study, guided by Miller's wheel of professionalism in nursing, was to determine if there is a difference in the professional behaviors of associate degree prepared registered nurses (RNs) compared to the professional behaviors of baccalaureate degree prepared RNs. The Behavior …

Bedside Nurses' Perceptions Of Pursuing An Academic Career As Nursing Faculty, Suzanne Lynne Benfield

Walden Dissertations and Doctoral Studies

There is a nursing faculty shortage at a Mid-Atlantic associate degree nursing program. In response, program administrators have hired adjunct faculty with bachelor of science in nursing degrees (BSNs), hired full-time faculty with master of science in nursing degrees in areas other than education who also are not certified nurse educators, and reduced its minimum requirement for nursing faculty clinical experience. The nursing faculty shortage combined with the resulting gaps in practice are problematic because they may (a) negatively influence the program's ability to produce degreed nurses; (b) increase faculty workload; (c) decrease the quality of student education, which may …

The Effect Of Mindfulness Techniques On Teacher Resilience As Moderated By Conscientiousness, Aundrea T. Harris

Walden Dissertations and Doctoral Studies

Unmanaged stress in teachers often triggers burnout, which leads to a rise in healthcare costs and absenteeism. Therefore, teachers' resiliency needs improvement to lower the risk of burnout. The purpose of this cross-sectional design study was to examine the relationship between mindfulness techniques and resilience in high school teachers. An additional purpose of this study was to examine if the personality trait, conscientiousness, moderates the relationship between mindfulness techniques and resilience. The frameworks for this study were based on the self-awareness, -regulation, and -transcendence (S-ART) framework, theory of planned behavior, and the concepts of resilience and job burnout. Four surveys …

Factors That Influence The Prevalence Of Type 2 Diabetes Among Aboriginals In Canada, Olayinka Awoyemi

Walden Dissertations and Doctoral Studies

The focus of this study was on potential social determinants of health factors that influence the prevalence of type 2 diabetes in the general population of Canada, with emphasis on the disproportion in rates of the disease between Aboriginal and non-Aboriginal populations of Canada. This study also examined the risk factors that are peculiar to the general, Aboriginal, and non-Aboriginal population of Canada. A total number of 101,080 individuals who were 18 years and above provided data for this study. The data and information obtained from these participants were used to answer the major research questions regarding if there was …

Risk Factors That Predict Asthma Among Adult, Foreign-Born African Americans In California, Alphajor Umaru Barrie

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine possible risk factors that predict asthma among adult, foreign-born African Americans in California. A total of 794 foreign-born African Americans (87 asthma cases) were included from the 2017-2018 California Health Interview Survey database. Data analysis included both descriptive and inferential statistical methods including chi-square analysis and multiple logistic regression techniques. The socioeclogical model was used to help understand and interpret the findings. The dependent variable was asthma status and the independent variables were the risk factors (tobacco smoking, alcohol use, health insurance, income level, and education level). Confounders included in the …

Analysis Of Control Measures Used During Cholera Outbreaks Among Internally Displaced Persons, Nicole Devine Carneal-Frazer

Walden Dissertations and Doctoral Studies

Cholera remains a major public health problem affecting high-risk populations such as camps of internally displaced persons. During a cholera outbreak, it is essential to reduce transmission and minimize new infections. The Miasma theory, host-agent-environment model and Ecosocial theory were utilized for this study. This study was a retrospective comparison to determine whether historical cholera control measures are effective during current cholera outbreaks within camps of internally displaced persons. A quantitative approach ascertained changes in incidence and mortality rates following implementation of primary and/or secondary control measures. Cholera outbreaks were identified from the World Health Organization's (WHO) Disease Outbreak News …

Improving Nurses' Knowledge Of Central Line-Associated Bloodstream Infection, Misty Cooper

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSI) are usually attributable to suboptimal line insertion, care, or maintenance and are associated with poor patient outcomes. Nursing plays a pivotal role in preventing CLABSI, because nurses are generally responsible for the routine care and maintenance of central lines. The purpose of this project was to determine if CLABSI nursing education and demonstration-based competency could improve nurses' knowledge on a neurology unit as compared to current practice of an annual e-learning module as the sole source of nurse education. This project was informed by Lewin's planned change theory and involved changing behaviors, attitudes, and practices …

Impact Of Social Influence On Willingness To Participate In Clinical Trials Among African Americans, Chika Okere

Walden Dissertations and Doctoral Studies

Global rate of participation in clinical trials is especially low among African Americans in the United States due to social factors identified by research, which adversely impact this group's willingness to participate in clinical trials. The purpose of this cross-sectional quantitative study was to evaluate the role of social influence in the decision-making patterns of African Americans as it relates to clinical trial participation. The theory of planned behavior was used as the theoretical framework to understand an individual's interaction with social factors and how it affects their willingness to participate in clinical trials. The participants in the study were …

African American Women's Experiences And Understanding Of Secondary Infertility, Claudelle Parchment

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to describe the lived experiences of African American women with secondary infertility, defined as an inability to conceive or carry a baby to term after a previous conception. Research on secondary infertility has ignored the prevalence of the condition in African American women. The implications of secondary infertility in African American women have immediate and far-reaching health and psychosocial consequences. African American women rely on interconnectedness and social networks; therefore, social networks and social support served as the key concepts underwriting the study's conceptual framework. Social networks and social support underscore the connection …

A Comparison Of The Safety And Efficacy Of Three Medical Abortion Protocols, Dhammika Perera

Walden Dissertations and Doctoral Studies

Unsafe abortions pose serious threats to women's health. Medical abortion provides safer abortion access to many. The lengthy interval between misoprostol and mifepristone creates multiple barriers for women and providers.

A paucity of research exists about medical abortion protocols that allow single day procedures. The efficacy and the safety of 3 medical abortion protocols of varying lengths were explored in this study.

A secondary data set of over 55,000 patients from the United Kingdom was retrospectively analyzed using binomial logistic regression. Efficacy results showed no significant difference between the conventional and the simultaneous protocols; when compared to those, the 6- …

Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet

Walden Dissertations and Doctoral Studies

Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use …

Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie

Walden Dissertations and Doctoral Studies

The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization …

Living Arrangements, Referral Source And Young Adult Admissions To Drug Treatment, Daniel Samaila

Walden Dissertations and Doctoral Studies

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse …

Staff Education Intervention To Enhance Care Planning For Older Adults, Mozhgan Peiravi

Walden Dissertations and Doctoral Studies

The increased prevalence of cognitive deterioration has increased the challenges of caring for older adults. This study's project site offers a psychiatric program for older adults with customized care for complex geriatric mental health patients. Clinical assessment and care management are often overlooked in geriatric mental health patients diagnosed with behavioral and psychological symptoms of dementia (BPSD). The purpose of this project was to deliver an education program developed from the Staff Training in Assisted Living Residences-Veterans Administration, P.I.E.C.E.S model and the Castle framework to 42 nursing and allied health staff of the project site. The project question explored whether …

Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon

Walden Dissertations and Doctoral Studies

Clinical supply chain managers who do not apply effective employee turnover strategies could negatively affect team performance, employee morale, employee well-being, patient outcomes, productivity, profitability, and the sustainability of organizational activities. The purpose of this multiple case study was to explore strategies that supply chain managers used to decrease employee turnover in clinical logistics organizations. The targeted population consisted of 6 clinical logistics supply chain managers working in 6 community hospitals located in Maryland who had experience implementing successful strategies to decrease employee turnover. The servant leadership theory served as the study's framework. Data collection included semistructured interviews and a …

Educating Medical--Surgical Nurses To Improve Nursing Knowledge And Understanding Of Health Literacy, Heather Smith

Walden Dissertations and Doctoral Studies

Low health literacy levels put patients at greater risk for poorer compliance and access to care, which leads to worse patient outcomes. Nurses must understand health literacy to improve health literacy for their medical surgical patient population. It is necessary for a formal education program on this topic. The purpose of this project was to increase medical surgical nurses' awareness and knowledge of the importance of health literacy and to introduce the REALM-SF tool to assess a patient's literacy level, allowing a nurse to better individualize the education provided to the patient. Lewin's change management theory was key in the …

Home Health Aides' Performance And Home Health Clients' Quality Of Life, Ronny Terrell Smith

Walden Dissertations and Doctoral Studies

Home health aides' performance can help home health clients achieve quality of life. This quantitative, cross-sectional study examined which work-related factors of home health aides influence home health clients' quality of life. A socioecological perspective was used to understand influences on behaviors. Participants in this study were 400 home health clients who received services from home health agencies. A binary logistic model was used to determine the predictor variables of home health aides that contributed to home health clients' quality of life. Findings indicated that psychosocial skills were among the most predicted work-related performance of home health aides that lead …

Geographically Distributed Employees' Perceptions Of Employee Assistance Program Access, Davina Smith

Walden Dissertations and Doctoral Studies

Many investigators have documented high levels of stress in the U.S. workplace and the underutilization of employee assistance programs (EAP). Researchers in other studies have concluded that an employee's perception of a service influences participation and service use. However, the perceptions of geographically distributed employees, who represent a growing population, have not been sufficiently examined. The purpose of this study was to investigate geographically distributed employees' perceptions regarding access to EAP stress management services to address the problem of EAP underutilization. Organizational justice theory served as the theoretical framework. The study design was generic qualitative. A purposeful sample of 15 …

Stress, Social Support, And Mindfulness In Parents Of Children With Neurodevelopmental Deficits: A Quantitative Analysis, Branden D. Syrotchen

Walden Dissertations and Doctoral Studies

Parenting children with neurodevelopmental deficits (NDDs) is very stressful, more so than the parenting of typically developing children. There is considerable research on the topic of chronic stress experienced by caregivers; however, less is understood of parental stress experienced when raising children with NDDs. The purpose of this study was to examine how parental traits and habits, in the forms of mindfulness and social support levels, affect this cohort's general stress levels. The study was guided by Self-Determination Theory, which explored how parental acts could be classified along a continuum of being intrinsically or extrinsically derived. A convenience sample of …