Medicine and Health Sciences Commons^™

Instructional Methods And Attitudes Among Nursing Faculty Related To Students With Disabilities, Melissa Anne Radecki

Walden Dissertations and Doctoral Studies

Nurse educators are tasked with preparing safe, competent nurses but are faced with unique challenges in helping students with disabilities. Students with learning disabilities require accommodations which are alterations or adjustments within the learning environment and are developed by the instructor. The purpose of this 3-manuscript dissertation, guided by the universal design for instruction (UDI), was to explore the attitudes and instructional methods used among nursing faculty related to teaching students with learning disabilities. Three research questions were framed as parallel studies to address the gap in understanding how faculty view nursing students with disabilities, how clinical specialty influences faculty's …

Successful Strategies For Implementing Health Information Technology In Primary Care Practice, Samuel O. Otoo

Walden Dissertations and Doctoral Studies

Health information technology (HIT) owner-practitioners who adopt effective strategies for HIT implementation can improve primary facility care delivery and profitability. However, some HIT owner-practitioners have ineffective implementation strategies, so they have not realized the total revenue increases of more than 8%. Grounded in general systems theory, the purpose of this multiple case study was to explore successful strategies primary care practitioners (PCPs) use to implement HIT to improve primary facility care delivery and profitability. The participants included 6 owner-practitioners located in Queens County, NY, who successfully implemented HIT to improve facility care delivery and profitability. Data were collected through face-to-face …

Improving Nurse Well-Being Through A Mindfulness-Based Education Strategy, Sandra Dearholt

Walden Dissertations and Doctoral Studies

Abstract

An estimated 33% to 54% of hospital nurses exhibit signs of emotional stress and

decreased well-being, which is associated with a negative impact on nurses’ health, job

performance, patient care outcomes, and healthcare cost. This project sought to improve

nurse well-being by providing nurses with education on mindfulness-based practices.

The practice question addressed whether implementing a mindfulness-based education

strategy for nurses improved nurse well-being. Three models informed this project: the

health promotion model, the andragogical model, and Kirkpatrick’s 4 levels of training

evaluation. Sources of evidence included the Maslach Burnout Inventory (MBI) and a

knowledge assessment administered to 10 …

Socioeconomic Determinants Of Physical Activity Among Adult Arab Immigrants In Edmonton, Alberta, Samer Kobrosly

Walden Dissertations and Doctoral Studies

Little is known about leisure-time physical activity (LTPA) habits of Arab immigrants in Canada. Leisure-time physical activity has been linked to decreased risks for cancer, cardiovascular disease, and all causes mortality and increased life expectancy. Socioeconomic status has been recognized as a significant factor affecting health and wellbeing due to its impact on individuals’ attitudes, experiences, and exposure to several risk factors. The purpose of this cross-sectional descriptive study was to explore the levels of participation in LTPA among adult Arab immigrants in central Alberta, Canada, to examine the socioeconomic determinants of LTPA, and to investigate which individual, social, and …

Affordable Care Act And Racial Inequity In Breast Cancer Survival Rates, Nadine Terry-Lawrence

Walden Dissertations and Doctoral Studies

African American women are more likely than White women to be diagnosed with breast cancer after the disease has progressed to advanced stages. Further, African American women experience higher breast cancer mortality rates than White women at all stages of cancer diagnosis. The purpose of this quantitative comparative study was to examine differences between implementation of the Affordable Care Act (ACA) and 5-year breast cancer survival rates among African American and White women. The independent variable was African American women and White women who were survivors of breast cancer after the ACA implementation; the dependent variables were breast cancer survival …

Civility Promotion Actions And Decisions Of Prelicensure Baccalaureate Nurse Faculty, Brooke Stelle Russo

Walden Dissertations and Doctoral Studies

Acts of incivility in nursing education and practice settings are a growing concern. Previous research has indicated that uncivil behaviors, especially among nurses in the healthcare workplace, create toxic work environments and pose risks to patient safety. Uncivil behaviors among nurse educators and students were found to erode the learning environment and lead to poor program outcomes. Researchers provided evidence to show varied levels of incivility in academic and workplace environments and recommended solutions to improve civility, yet little evidence exists to show how nurse faculty approach civility promotion in their practices. This qualitative, descriptive study was designed to explore …

Fruit And Vegetable Consumption, Physical Activity, And Colorectal Cancer Among African Americans, Stella Francoise Nanga Ndzana

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a deadly and costly cancer, especially among African Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine African Americans' health behaviors that may have an association with CRC. The Health Belief Model was used to guide this study. The study addressed whether there is a statistical association between fruit intake, vegetable intake, and physical activity, and the occurrence of CRC while controlling for confounders, such as body mass index, smoking status, and income level. After conducting an overall analysis, the final research question examined if the association varied by race. In this study, …

Developing A Preceptor Training Program For Registered Nurses In A Teaching Hospital, Persephone Annis Munnings

Walden Dissertations and Doctoral Studies

In a report on the nursing shortage, the American Association of Colleges of Nursing cited insufficient preceptors as one of the factors influencing the decreased intake of nursing students to registered nurse (RN) programs, thus compounding the shortage issue. The site selected for this project was a teaching hospital that annually facilitates hundreds of nursing students for clinical practice. Graduate nurses rotating through the hospital are assigned to work with RNs within their assigned units. The purpose of this doctoral project was to develop a preceptor training program for RNs in a teaching hospital. The practice-focused question examined whether RNs …

Thirty-Day Readmission Risk Factors Of African American Adult Copd Patients With Tracheostomies, Shekeita Gibson

Walden Dissertations and Doctoral Studies

The purpose of this study was to assess the association between hospital readmission and demographic variables (age, BMI, gender, income, marital status, comorbidities, and smoking history), and size and type of tracheostomy among African American chronic obstructive pulmonary disease (COPD) patients with tracheostomies. The Andersen model was the theoretical framework for this quantitative study. Secondary data were obtained from a long-term acute care facility. The sample comprised 438 African American adult patients admitted between 2010 and 2017. Logistic regression was used to analyze each research question and assess the odds of 30-day hospital readmission. The results indicated that the odds …

Relationship Between Self-Determination And Employee Retention, Tiffany Edwards

Walden Dissertations and Doctoral Studies

Retention of registered nurses (RNs) is essential to the sustainability of quality health care services. More than 55% of hospitals in the United States have not translated retention initiatives into a formal retention strategy. The purpose of this study was to examine the relationship between training programs, new hire onboarding processes, frozen positions, and nurse retention. The self-determination theory was the theoretical framework for this study. Secondary data were collected from the 2016 Texas Hospital Nurse Staffing Survey. Data were analyzed using multiple linear regression. The results of the multiple linear regression were statistically significant, with F(3, 251) = .602, …

Health Disparities In Females With Rheumatic Heart Disease In Central Afghanistan, Ruhina Najem

Walden Dissertations and Doctoral Studies

This study surveyed healthcare professionals and rheumatic heart disease (RHD) female participants in two hospitals located in central Afghanistan to examine the effects of communication among healthcare professionals, ethnicity and socioeconomic status, and the health quality of life. The social ecological models (SEM) of health promotion was utilized in the individual (communication between healthcare professionals), community (health quality of life), and societal factors (ethnicity and socioeconomic status). Three research questions were explored in this study: the significance of RHD healthcare professional's education to their RHD female patients ages 16 to 45 years; a correlation between ethnicity and socioeconomic status among …

Hiv/Aids And Behavioral Risk Factors Among Former Texas Prison Inmates, Scarlett Lusk-Edwards

Walden Dissertations and Doctoral Studies

As of the end of 2010, .9% (20,093) of the inmate population under the care of the U.S. Federal Bureau of Prisons and 1.7% (2,394) of the inmate population under the care of the Texas Department of Criminal Justice were living with HIV/AIDS. The purpose of this quantitative correlational study was to analyze the relationships between HIV/AIDS status and former inmate demographic characteristics, intravenous drug use (IDU), and social support networks. The behavior models of importation and deprivation formed the theoretical frameworks used to explore the relationship between HIV/AIDS and behavioral risk factors for released Texas prison inmates. Fifty former …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey

Walden Dissertations and Doctoral Studies

A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of …

Hospital-Acquired Pressure Ulcer Prevention, Druscilla Willis Jones

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure ulcers (HAPUs) represent a significant challenge in the care provided for hospitalized patients. HAPUs impact morbidity, mortality, and quality of life. At the local practice site, the incidence of HAPUs increased in the perioperative setting. The practice-focused question for this project asked if an education program for staff nurses working in a perioperative care setting with high HAPU incidence can advance nurse knowledge regarding prevention, early assessment, symptoms, and treatment of HAPUs. The purpose of this educational project was to develop a pretest and posttest designed education program on HAPU prevention and care for perioperative nurses. The Iowa …

Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers

Walden Dissertations and Doctoral Studies

Most organizational change initiatives fail because managers lack effective change management strategies. The purpose of this single case study was to explore change management strategies that outpatient care facility managers used to positively affect process improvements. The population consisted of 6 managers who completed change initiatives at a military, outpatient medical facility in Texas and 6 of their team members. Data were collected using semistructured interviews and organization documents, then analyzed based on the conceptual framework of Lewin’s change theory. Rowley’s 4-step process for analysis—organizing; getting acquainted with; classifying; coding and interpreting; and presenting and writing up the data—was used …

Accessibility Of Innovative Services In Radiation Oncology, Patricia Sansourekidou

Walden Dissertations and Doctoral Studies

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion …

Oromo Ethiopians Perceptions Of The Prevalence, Causes, Treatment And Prevention Of Trachoma, Linda L. Gross

Walden Dissertations and Doctoral Studies

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic …

Education Program For Critical Care Nurses On Preventing Catheter-Associated Urinary Tract Infections, Olatunde Olatunji

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) are the most frequently reported hospital-acquired condition, affecting more than 560,000 patients each year. CAUTIs prolong hospital stays and increase health care costs, and they can result in patient morbidity and mortality. Nurses can be empowered by receiving education and knowledge to manage and identify urinary catheters that are not clinically indicated. The purpose of this project was to develop an education program on CAUTI prevention for critical care nurses using the teach-back method. The conceptual framework that guided this project was Knowles's adult learning theory. The theoretical model was based on 4 fundamental assumptions …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Predictive Relationship Between Socio-Demographics, Medication, And Treatment Completion Among Persons Experiencing Homelessness Treated For Tuberculosis, Sophia Ajoku

Walden Dissertations and Doctoral Studies

Approximately 80% of people who contract tuberculosis (TB) in the United States are first infected with untreated latent tuberculosis infection (LTBI). LTBI is an ongoing public health concern in people who experience homelessness. Because of the transient nature of this population, it is often difficult for them to adhere to and complete treatment for LTBI. In this quantitative, correlational of a cross-sectional study, secondary data was from a public health clinic in southern U.S. The theoretical framework used for the study was the social ecological framework. Multiple logistic regression was used to determine if a statistically significant predictive relationship existed …

Improving Care For Transgender Veterans Through Staff Education, Stephanie C. Henrickson

Walden Dissertations and Doctoral Studies

The VHA Directive 1341 (2018a): Providing Health Care for Transgender and Intersex Veterans, outlines care for transgender patients. Staff members at the project site lacked knowledge of the directive and available resources, making their care of transgender veterans inefficient. The purpose of the project was to implement staff education about the directive and resources to increase transgender patient visits and access to care. The practice-€focused question asked whether the development and implementation of staff education about the national directive and transgender services would affect the number of transgender patient visits in a 2-€month period. The Iowa and Community Readiness Models …

Exploring Healthcare Transitions And Health Equity: An Integrative Review, Susan Ann Jordan

Walden Dissertations and Doctoral Studies

Compared to their typically developing peers, adolescents, and emerging adults with special healthcare needs (AEA-SHCN) disproportionately experience healthcare transition (HCT) disparities and poor access to adult care. Theoretical models that describe how access gaps develop and strategies to address unmet HCT needs are not well understood. While HCT researchers describe both system and patient healthcare barriers, a comprehensive approach that discovers how these factors interact and interfere remains misunderstood. An integrative review (IR) was conducted to understand the multiplicity of these factors. An intersectional theory (IT) provided further clarity on how key findings influence patient HCT experiences. Several themes were …

Staff Education On Metabolic Syndrome In Patients Taking Antipsychotic Medications, Juliana Ifeoma Omile

Walden Dissertations and Doctoral Studies

Second-generation antipsychotics (SGAs) are prescribed for treatment of psychosis. A major side effect of SGAs is an increased risk of metabolic syndrome (MetS) with symptoms of hypertension, hyperlipidemia, hyperglycemia, and truncal obesity. A clinic in the northeastern United States was not screening patients for MetS when being treated with SGAs. The purpose of this project was to educate staff on MetS risk factors, signs, symptoms, and patient management with a goal to improve their knowledge of MetS. Lewin's change theory provided a conceptual framework for the project. The project question explored the development and evaluation of an educational module on …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Impact Of The Prophecy Job Fit Predictor On New Graduate Nurse Satisfaction, Joi Alesha Johnson

Walden Dissertations and Doctoral Studies

Research has shown that job satisfaction influences retention of nurses, and policies focused on nursing satisfaction are more beneficial for retaining new nurses than adjusting work hours and wages. The prophecy job fit predictor is a quality improvement initiative designed to identify where a nurse should be assigned based on behavior, clinical capabilities, and personality assessment. The practice-focused question for this project focused on whether satisfaction rates of recently graduated registered nurses were influenced by their unit placement. The conceptual frameworks that guided this project were the plan, do, study, and act method and Herzberg's 2-factor theory. Data were obtained …

Lived Experiences With Social Networking Technology To Improve Physical Activity, Paula Nobles Eubanks

Walden Dissertations and Doctoral Studies

Research suggests that Black women living in the United States are not engaging in sufficient physical activity, which is a major factor negatively impacting their health outcomes. Black Girls Run (BGR) is a targeted national health movement using the capacity of social networking technology as a tool to interact with and inspire Black women to live healthy through running. Literature lacked the voice and perspective of Black women who were embracing the innovation of technology to positively improve their health behaviors. The purpose of this qualitative phenomenological study was to gain a better understanding of the composite experiences of women …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

Perceptions Of Higher Education Health Science Faculty On Debriefing After Simulation-Based Activities, Maureen Ellen Johnson

Walden Dissertations and Doctoral Studies

Health science faculty striving to be academically competitive can adopt debriefing after simulation-based activities to help transition occupational therapy and physical therapy students from classroom skills to clinical competence. The purpose of this qualitative study was to discover the perceptions and experiences of health science faculty during and after their adoption of debriefing after simulation-based activities. The theory of diffusion and experiential learning theory were used as a conceptual framework. The research questions related to the perceptions and experiences of faculty from their training sessions and implementing debriefing sessions after simulation-based activities in their courses and how these experiences related …

Factors Affecting Health Care Access And Utilization Among U.S. Migrant Farmworkers, Melinda R. Kelly

Walden Dissertations and Doctoral Studies

There are over 3 million seasonal and migrant farmworkers in the U.S. agricultural industry with a significant percentage of farmworkers documented or native to the United States. Migrant farmworkers live below the federal poverty levels at high rates and experience low health care access and utilization. Guided by the fundamental cause theory, the purpose of this phenomenological study was to examine the lived experiences of migrant farmworkers and identify the factors impacting their health care access and utilization. Face-to-face interviews were conducted with 12 migrant farmworkers who had worked in Southwest Texas agricultural stream. Data were analyzed and coded to …