Medicine and Health Sciences Commons^™

Evaluating The Frequencies Of Self-Reported Mental Health Conditions In Affluent Youth, Philip Bondurant

Walden Dissertations and Doctoral Studies

American youth are facing a mental health crisis. Rates of depression and suicide continue to rise among all children ages 12-17. While there is considerable research on the mental health of underserved children, much less is known about the mental health status of youth from affluent communities. The purpose of this study was to evaluate the effectiveness of community health assessment (CHA)-driven mental health interventions on the youth of affluent communities. Using a pre and post evaluation model, this study compared the frequencies of self-reported depression and suicide ideation for students in Grades 8, 10, and 12, and geographic location …

Relationship Between Skilled Nursing Facility Nurse Staffing Levels And Resident Rehospitalizations, Crystal Spring Bowens

Walden Dissertations and Doctoral Studies

Readmission of skilled nursing facility (SNF) residents has become a financial and quality-of-care concern for facility leaders. SNF administrators do not know whether nurse staffing levels are impacting readmission rates. The Affordable Care Act included measures to monitor and improve quality and to penalize SNFs that have high readmission rates. The purpose of this quantitative correlational study was to examine the relationship between SNF nurse staffing levels and readmission rates using the Skilled Nursing Facility Readmission Measure (SNF RM). The theoretical framework for the study was Donabedian's structure, process, outcome model. The research questions addressed the relationship between nurse staffing …

Work Engagement, Job Satisfaction, And Nurse Turnover Intention, Yolanda Marie Edwards-Dandridge

Walden Dissertations and Doctoral Studies

In the United States, the high turnover rate of registered nurses and indications of a future shortage of registered nurses is detrimental to healthcare organizations. The purpose of this correlational study was to examine whether, in hospitals, work engagement and job satisfaction predicted registered nurse turnover intention. The theoretical framework was Fishbein and Ajzen's theory of reasoned action. Probability sampling was used to identify 155 participants, all full-time registered nurses with 2 or more years of employment in New York hospitals. Data, obtained from surveys, were analyzed via multiple linear regression. The results revealed that only job satisfaction predicted turnover …

Barriers To Timely Activation Of Rapid Response Teams, Lajuanah Jean Herdrich

Walden Dissertations and Doctoral Studies

Timely activation of the rapid response team (RRT) depends on the nurse's willingness

and ability to make a rapid decision. The practice-focused questions for this DNP project

sought to identify barriers that contribute to delays in activating the RRT when needed in

medical-surgical patients. The self-efficacy theory was the guiding theory and was used

to examine self-confidence and performance along with Donabedian's health care model.

Qualitative data were obtained through focus groups and identified 2 prominent thematic

barriers among nurses with less than 3 years' experience: a lack of self-confidence and

the of lack of knowledge and experience. Results of …

Surgical Perioperative Leadership: The Association Between Leadership Style And Team Job Satisfaction, Corey Louise Jamison

Walden Dissertations and Doctoral Studies

Abstract

The perioperative operating room (OR) is a highly complex, fast-paced environment where countless transactions must be executed with efficiency, speed, and accuracy, and where mistakes of any kind could lead to adverse patient outcome, injury, or death. The surgeon, as leader of the procedure and the OR team, sets the overall climate of the OR and determines how willing (or unwilling) team members are to speak up about potential errors or unsafe patient conditions. This exploration of the relationship between perioperative surgeon leadership style and OR team member job satisfaction fills a gap unaddressed in the literature using items …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

Accelerated Online And Hybrid Rn-To-Bsn Programs: A Predictive Retention Algorithm, Melissa Knight

Walden Dissertations and Doctoral Studies

Predicting retention and time to graduation within accelerated online and a hybrid RN-to-BSN programs are significant elements in leveraging the pipeline of qualified RNs with BSN degrees, but the literature lacks significant accounts of retention and time to graduation outcomes within these programs and predictive algorithm developments to offset high attrition rates. The purpose of this study was to quantitatively examine the relationships between pre-entry attributes, academic integration, and institutional characteristics on retention and time to graduation within accelerated online RN-to-BSN programs in order to begin developing a global predictive retention algorithm. This study was guided by Tinto's theories of …

A Phenomenological Examination Of Resilience In Adult Children Of Alcoholics, Marcy Martens

Walden Dissertations and Doctoral Studies

Researchers have identified adult children of alcoholics (ACOAs) as being susceptible to substance abuse, intimate partner violence, mental health instability, and a myriad of psychosocial inadequacies. Growing up within an adverse childhood environment has also imprinted an unwanted stigma among ACOAs. Although there are many studies on the ACOA population, there is a significant gap in the literature between ACOAs exhibiting resilience and those who succumb to the negative characteristics of growing up within an adverse environment. The purpose of this hermeneutic, phenomenological study was to examine the lived experiences of adult children of alcoholics who have succeeded despite their …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

The Cost Of Treating Human Papillomavirus-Related Oropharyngeal Cancer, Karla Smalley Houston

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is a sexually transmitted infection contributing to 70% of oropharyngeal cancers in the United States. The incidence of HPV-related oropharyngeal cancers is greater in Kentucky's population than in any other state. Research has demonstrated the cost of treating oropharyngeal cancer on a national level, but little information exists as to state-specific costs. The purpose of this quantitative study was to examine radiation therapy costs for treating HPV-related oropharyngeal cancer in Kentucky in relation to age, gender, race, and insurance. A theory by Aday and Andersen was applied to explain the relationship between the independent and dependent variables. …

Clinical Nursing Faculty Competency, Christine Lee Kalt

Walden Dissertations and Doctoral Studies

Nursing faculty are responsible for graduating competent students and being competent themselves; however, the required competencies of clinical nursing faculty who instruct students in the clinical area are unidentified. The practice problem addressed in this project was the lack of a structured, organized process for identifying initial and ongoing competencies of a clinical nursing facility. The purpose of this project was to explore nursing faculty clinical competency and provide a multimethod, multispecialty approach for implementing clinical nursing faculty competency. The target population was clinical nursing faculty (n= 30) in an academic setting. This project explored the impact of a multimethod, …

Determinants Of Cervical Cancer Screening In Hiv-Positive Young Women In Swaziland, Marianne Calnan

Walden Dissertations and Doctoral Studies

In Swaziland, cases of cervical cancer among Human Immunodeficiency Virus (HIV)-positive adolescent girls and young women (AGYW) are increasing, but there is low uptake of cervical cancer screening. This study was conducted using the systems thinking theory to explore the relationships between the uptake of cervical cancer screening among HIV-positive AGYW in Swaziland and the availability of trained health providers, cervical screening services, and the provision of referrals for cervical screening. The study also investigated any differences in uptake of cervical screening based on age group. For this quantitative cross-sectional study, secondary HIV program data that were collected routinely between …

Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai

Walden Dissertations and Doctoral Studies

Every year, 2 million patients in the United States suffer with at least 1 hospital-acquired infection resulting in an estimated 99,000 deaths annually. The purpose of this exploratory single case study was to explore strategies healthcare managers in U.S. hospitals used to reduce hospital-acquired infections. The study included face-to-face, semistructured interviews with 5 healthcare managers from a hospital in Maryland who were successful in reducing these infections. The conceptual framework was human capital theory. Field notes, hospital documents, and transcribed interviews were analyzed to identify themes regarding strategies used by healthcare managers. The data analysis and coding process resulted in …

Effects Of High-Fidelity Simulation On The Critical Thinking Skills Of Baccalaureate Nursing Students, Janine Roth Blakeslee

Walden Dissertations and Doctoral Studies

This project study addressed the decline in successful passing rates for the National Licensure Exam for Registered Nurses (NCLEX-RN) in a nursing program at a private university in the Midwestern United States. There is support from the literature for a connection between critical thinking skills of nursing students and successful passing of the NCLEX-RN. The purpose of this quantitative study was to examine whether significant differences existed in mean critical thinking skill scores across time within groups (pretest to posttest) and between groups (simulation versus written case studies), as measured by the Health Science Reasoning Test. Cognitive learning theory as …

A Systematic Review Of The Effectiveness Of The Nln Jeffries Simulation Framework, Angela Feeler

Walden Dissertations and Doctoral Studies

Simulation theoretical frameworks serve as guidelines for the development, planning, implementation, and evaluation phases during nursing simulation activities. Simulation frameworks provide a substantive foundation for research, education, and practices that contribute to the science of nursing education. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to recommend the National League for Nursing (NLN) simulation education framework for simulation activities. The Academic Center for Evidence-Based Practice star model of knowledge transformation and descriptive theory were used as frameworks to guide this systematic literature review. The practice question for this systematic literature …

Incorporation Of The Caring Moment In Scripting, Anita E. Barker

Walden Dissertations and Doctoral Studies

A large healthcare system in Texas mandated scripting as way to improve patient satisfaction. The purpose of this project was to incorporate a caring moment into scripting by the nursing staff to improve patient satisfaction. The project was guided by Watson's caring theory, the adult learning theory, and Lewin's planned change theory. All 35 nurses from the primary care and specialty care outpatient clinics of the Texas healthcare system participated in a staff development training to learn how to incorporate a caring moment into their script. Of these 35 nurses, 13 (37%) chose to complete the pre-education and postproject surveys. …

Staff Education Project Using The Stop Elderly Accidents Deaths And Injuries (Steadi) Toolkit, Carla Fisher

Walden Dissertations and Doctoral Studies

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change …

Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster

Walden Dissertations and Doctoral Studies

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …

Advisory Committee On Immunization Practices Recommendations, Socioeconomics, Demographics, And Influenza Vaccine Uptake, Jennifer Gadarowski

Walden Dissertations and Doctoral Studies

Seasonal influenza outbreaks are associated with morbidity and mortality in the United States. Though children are the most susceptible to influenza infection and are most likely to transmit the illness to others, many children are not vaccinated. The purpose of this study was to examine the relationship between seasonal influenza vaccination Advisory Committee on Immunization Practices (ACIP) recommendations, demographic characteristics, socioeconomic factors, and vaccine type among children over 3 consecutive flu seasons. This quantitative cross-sectional study was guided by the social ecology of health model. Secondary data from 3 consecutive flu seasons (2014-2015, 2015-2016, and 2016-2017) provided by the National …

Evaluating An Educational Initiative For Postsurgical Vascular Patients, Cynthia Ann Gillespie

Walden Dissertations and Doctoral Studies

The educational medium GetWellNetWork (GWNW) in a large magnet teaching facility offered few educational videos specific to vascular patients with a focus on leg elevation after lower extremity bypass surgery. Supplying patient-specific education has the potential for providing cost-effective nursing care to vascular patients and improving hospital reimbursement. Guided by the interactive care model, a storyboard was developed using best-practice evidence for vascular postoperative patients that could lead to the development of a video to address the educational needs of vascular patients upon discharge. The practice focused question asked if a video addressing the importance of leg elevation would improve …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams

Walden Dissertations and Doctoral Studies

Transitions of care is a model designed to ensure that patients have resources needed to assist them to care for themselves at home after hospital discharge, which helps to decrease preventable adverse events. For people with heart failure (HF) to transition home from the hospital successfully, specific education is needed that is individualized to the disease process, but most patients' educational needs after discharge are unmet. The purpose of this qualitative study, guided by the Meleis middle range theory of transition, was to explore the perspectives of people with HF about their educational needs in order to gather data that …

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

An Educational Program For Primary Nursing, Marsha-Gail Mcdonald

Walden Dissertations and Doctoral Studies

To increase continuity of care and reduce clinical errors, management in an inpatient rehabilitation unit of a private, nonprofit hospital chose to change the care delivery model to primary nursing; unit nurses had inadequate understanding of primary nursing, creating a gap in practice. The purpose of this project was to develop an educational program on primary nursing to address the question of how education on primary nursing would impact the understanding of the model among the nurses in the patient rehabilitation unit of the project site. Rogers's diffusion of innovation model provided a framework for developing the educational program. The …

Nursing Staff Education For Heart Failure Disease Management, Kerri Murphy

Walden Dissertations and Doctoral Studies

Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this …

Reducing Central Line-Associated Bloodstream Infections, Alexis Genarrian Whitfield

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infection (CLABSI) at the local healthcare setting exceeded the benchmark of 0 CLABSI. The Infection Prevention and Control (IPC) department determined that a role as CLABSI nurse champion would address the problem; however, no comprehensive education on CLABSI prevention and maintenance was available at the site. The purpose of this project was to develop a CLABSI prevention and maintenance education module using Knowles's adult learning theory and the chain of infection model. The practice-focused question asked whether a CLABSI educational module would provide the necessary information to educate nurse champions on CLABSI prevention and maintenance. The education …

Predicting Risk For Opioid-Induced Sedation And Respiratory Depression In Hospitalized Patients, Alison Partridge

Walden Dissertations and Doctoral Studies

Pain assessment and management is a fundamental part of nursing care. Opioids are 1 of the interventions utilized to manage pain within the hospital setting and have a known adverse effect called opioid-induced sedation and respiratory depression (OSRD). The purpose of this quantitative study was to create a prediction model with the known risk factors present on admission, to determine how well they predict OSRD. This served as a first step in the creation of a risk screen tool, supported by the cognitive continuum theory, in understanding the judgment and decision-making process to provide safe care. The combination of factors …