Medicine and Health Sciences Commons^™

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 …

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …

Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson

Walden Dissertations and Doctoral Studies

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) initially emerged in the 1980s and ever since, a battle has been underway with regard to understanding some of the root issues attributed to behavior and HIV/AIDS. AIDS is prevalent in the men sleeping with men (MSM) community. There is lack of studies evaluating the quality and quantity of communication between MSM and medical professionals, which can be a catalyst to help reduce HIV/AIDS within this community. The aim of this quantitative study was to evaluate the relationship between quantity and quality of medical professionals' communication and regular HIV …

Parent/Patient Satisfaction And Physician/Nurse Interaction At A Children's Hospital, Veronica L. Givan

Walden Dissertations and Doctoral Studies

Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Veronica Laviece Givan

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Diana Naser, Committee Chairperson, Health Services Faculty

Dr. Nicoletta Alexander, Committee Member, Health Services Faculty

Dr. Michael Brunet, University Reviewer, Health Services Faculty

The Office of the Provost

Walden University

2019

Parent/patient satisfaction surveys are important tools used to measure quality of health care provided by physicians, nurses, and hospitals. Research has been conducted …

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …

Development And Evaluation Of A Long-Term Care Skills Simulation Program, Tina Marie Gerovac

Walden Dissertations and Doctoral Studies

New graduate nurses often lack clinical skill competency. In a single year, a long-term care facility located in the midwestern region of the United States reported 25 clinical errors, each costing the facility approximately $10,000. Root-cause analysis revealed 85% of those errors were made by nurses in their 1st year of practice. The increase in clinical errors were attributed to insufficient clinical preparation prior to independent practice. A review of the current scholarly literature suggested simulation had demonstrated efficacy in the development and maintenance of clinical nursing skills and answered the practice-focused question: Development of a skills simulation program for …

Ethnic Minority Young Adult Perspectives On Health Literacy Readiness For Adulthood, Selwyn A. B. Carrington

Walden Dissertations and Doctoral Studies

Health literacy is a social determinant of health and health disparity and low health literacy contributes to poor health outcomes in ethnic minority young adults (EMYAs). There is a gap in the literature regarding the health literacy readiness (HLR) of EMYAs transitioning to adulthood. The overarching research question concerned the perspectives of EMYAs on HLR for the transition to adulthood. A phenomenological study design was used with a theoretical framework that integrated concepts from the socioecological and health belief models. Twelve purposefully selected EMYAs ages 18-22 from a southern U.S. county participated in the study. Data were collected by telephone …

Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee

Walden Dissertations and Doctoral Studies

High no-show rates in the ambulatory setting lead to underutilized resources, decreased clinic revenue, and lower productivity. The purpose of this single case study was to explore strategies that administrators used to maintain acceptable no-show rates and maintain the sustainability of the healthcare practice. The target population for this study included local chapter members of a professional healthcare organization that provided access to practice managers and administrators in the Las Vegas, Nevada regional area where there are a large number of practices that are not part of a health system; the sustainability of these practices is dependent on allocation of …

Help-Seeking Experiences Of African American Men With Depression, Tiffany Coleman

Walden Dissertations and Doctoral Studies

Research indicated that depression is now the leading cause of disability globally. Depression and help-seeking experiences among African American men have not been adequately studied. The purpose of this phenomenological study was to explore the help-seeking experiences of African American men with depression. The theoretical framework was Andersen's Behavioral Model of Health Services. Purposive sampling was used to recruit participants. Inclusion criteria were (a) African American men, (b) aged 18 through 65, (c) having a medical diagnosis of depression or symptoms of depression, (d) not currently in treatment, and English speaking. Six African American men with depression or depressive symptoms …

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …

Participant Experiences In Christian-Based Recovery, Joshua Mjolsness

Walden Dissertations and Doctoral Studies

Health care leaders are challenged with addressing addiction and the treatment of addiction. Many studies have been conducted around addiction treatment; however, no studies have been conducted on Christian-based recovery programs that use the same approach regardless of the addiction. The purpose of this phenomenological study was to explore the experiences of participants in a Christian-based recovery program that uses the same approach for all addictions. The social learning theory provided the framework for this study. Data were collected by interviewing participants of the Christian-based recovery program Free Grace Recovery (FGR). Eight participants selected had a variety of reasons for …

Reducing Child Maltreatment Through Prevention, Chantel Marie Eckert

Walden Dissertations and Doctoral Studies

Child maltreatment is a public health problem directly linked to poor outcomes across the lifespan, including chronic health conditions and even death. The local population served by the agency in which the project took place experienced an increase in reports of child maltreatment. Agency leadership identified deficiencies in parental knowledge about positive parenting practices as a contributing factor to the problem. To address the problem, the agency implemented a quality improvement evidence-based home visiting pilot initiative. The evaluation of that initiative was the purpose of this project. Bandura's social cognitive learning theory provided the theoretical framework for the project, and …

Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller

Walden Dissertations and Doctoral Studies

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …

The Impact Of Exercise During Radiation Therapy For Breast Cancer Patients, Diane Yu

Walden Dissertations and Doctoral Studies

Breast cancer is one of the leading causes of death among women. In 2017, breast, lung and bronchus, prostate, and colorectal cancers accounted for almost 50% of all new cancer cases in the United States. Breast conservation therapy with lumpectomy (i.e., surgery) and adjuvant radiation therapy is commonly used as treatment for early stage breast cancer. However, side effects such as pain and poor sleep quality can affect quality of life for breast cancer patients undergoing radiation treatment. The main purpose of this quantitative study, using the health belief model (HBM) theoretical framework, was to investigate the correlations between the …

Education Of Clinic Providers To Promote Improved Diabetes Management, Olubunmi Roseline Awe

Walden Dissertations and Doctoral Studies

Diabetes is one of the most common major illnesses in the United States population and can lead to severe complications if not properly managed. Research has shown that over the past 2 decades there has been an increase in the prevalence of prediabetes, Type 2 diabetes, and associated complications and chronic diseases. Diabetes management is an ongoing challenge faced by providers nationally and it is the focus of this staff education development project at the outpatient clinic site. The purpose of this project was to ensure that clinic staff used an evidence-based approach to identify patients with diabetes, manage patients …

Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin

Walden Dissertations and Doctoral Studies

Epic morbidity and mortality, and intractability make prescription opioid diversion a wicked problem. Meanwhile, college undergraduates are vulnerable to opioid misuse and its consequences. The purpose of this quantitative study was to assess U.S. undergraduate students' opioid misuse and the relationship between mediating factors. The study's theoretical framework rested on Wakeland's et al. opioid system model and Shaw and McKay's social disorganization theory. This study bridged the gap, measuring collective efficacy and testing its relationship to undergraduate decisions to regulate misuse. Thus, research questions focused on gauging the problem's scope and assessing relationships between factors that drive or potentially regulate …

Impact Of Smoking Cessation Education On Workplace Wellness, Monica Coles

Walden Dissertations and Doctoral Studies

Guidelines and laws prohibit smoking in public places, and evidence supports the safety and effectiveness of workplace wellness programs in promoting healthy environments. A long-term care (LTC) facility selected as the focus for this project does not offer wellness programs and does not restrict on-site smoking by employees. The purpose of this project was to construct an evidence-based smoking cessation education program for delivery to employees at the LTC facility. The practice-focused question addressed whether a workplace wellness smoking cessation education program would increase employees' knowledge of the harmful effects of smoking and promote engagement in smoking cessation strategies. A …

Examining Fear Of Recurrence In Cancer Survivors, Christina L. Dixon

Walden Dissertations and Doctoral Studies

Improvements in the medical field have given many cancer patients and survivors better odds of long-term survival. As more patients become survivors, the demand for psychological treatment becomes greater. The most prevalent concern of survivors is getting help with a psychosocial condition known as fear of recurrence (FOR). Prior to this study, few researchers had explored how having a more aggressive cancer influences the development of FOR. The purpose of this quantitative study was to determine whether cancer stage and type (a measurement of severity) are predictive of FOR development in the high-risk cancer groups lung and bronchus and female …

Social Support And Glycohemoglobin Level Among Older Adults, Emma O. Fakiya

Walden Dissertations and Doctoral Studies

Diabetes is a public health concern among older adults in the United States due to the increasing prevalence of diabetes among this age group and the associated long-term and financial impacts. Self-management is a key strategy in the control of diabetes. The purpose of this quantitative study was to examine the association between social support and glycohemoglobin level. The social cognitive theory was the conceptual framework for this study. The research questions were designed to determine whether social support played a role in diabetes management. Data were collected using a cross-sectional survey of secondary data from the 2007-2008 National Health …

Strategies To Improve Employee Ethical Conduct In Health Care Organizations, Shannon La'vone Hill

Walden Dissertations and Doctoral Studies

Organizational leaders face challenges related to implementing ethical standards, which influence performance, organization sustainability, and culture. The purpose of this single case study was to explore ethics strategies that health care business leaders used to improve employees' ethical conduct. Data were collected through face-to-face, semistructured interviews with a purposive sample of 7 business leaders of a health care organization located in central Georgia and a review of organization documents. The conceptual framework was Brady's Janus-headed model of ethical theory. Using a priori coding during the data analysis process provided 3 thematic categories: policy strategies for the improvement of employee ethical …

Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes

Walden Dissertations and Doctoral Studies

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …

Hydraulic Fracturing And Cause-Specific Mortality: A Multicity Comparative Epidemiological Study, Uzoma C. Nduka

Walden Dissertations and Doctoral Studies

Cause-specific mortality (CSM), among other global health estimates, has garnered prominence in the contemporary public health field. CSM has been associated with several factors, however, research comparing CSM for prefracking versus postfracking periods is sparse. Hydraulic fracturing or fracking is a technique of extracting oil and gas from deep underground. The purpose of this study was to evaluate the difference among mean CSM scores from 1975 through 2015 in the available cities and counties of residence in Colorado and to determine the impact of gender, marital status, county of residence, and city of residence on CSM scores (prefracking period 1975-1977 …

Compassion Fatigue In Emergency Department Nurses, Michelle Candice Lawrence

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is defined as a sudden onset of the inability to experience feelings or compassion for others that is triggered by a nurse's inability to separate his/her feelings of stress and anxiety associated with caring for patients who have suffered from a traumatic event. The practice problem addressed in this doctoral project was the lack of knowledge of emergency department nurses (EDNs) related to CF in the work setting, resulting in a negative impact on a nurse's ability to provide quality care to patients. The purpose of the project was to present an educational program on how to …

Preventing Falls In Long-Term Care Facilities, Kay Keise

Walden Dissertations and Doctoral Studies

Falls and related injuries have affected residents in long-term care facilities for many years. It has been well-established that patient fall prevention includes staff education and hourly rounding in addition to adequate risk assessment. These steps, taken together, have the potential to decrease a 52.7% fall rate on the long-term care pilot unit. The purpose of this quality improvement project was to: (a) educate staff on the process of properly performing hourly rounding and (b) and achieve a decreased incidence of falls from the current fall rate. Thus, the practice-focused question for the project addressed whether rounding hourly on patients …

Relationship Between Hospital Size, Staff Communication, Physician Communication, And Patient Experience Scores, Cheryl Marie Layton

Walden Dissertations and Doctoral Studies

Healthcare leaders who struggle to understand the importance of interactions between patients, staff, and physicians can result in poor patient experience. Healthcare care leaders who understand the importance of patient experience can develop customer service training modules and tutorials to improve organizational outcomes. The purpose of this correlational study was to examine the relationship between staff communication, physician communication, size of the hospital, and patient experience. House's path-goal theory was used to frame the study. Secondary data were collected from hospitals in Northeastern Ohio, that reported patient experience scores through the Centers for Medicare and Medicaid's Hospital Consumer Assessment of …

Ambidexterity And Innovation In Chief Nursing Officers In The Healthcare Setting, Jennifer Wasilewski

Walden Dissertations and Doctoral Studies

Leaders in the healthcare setting are challenged with competing responsibilities as they seek to provide high-quality services, ensure the implementation of safety measures, and engage in workforce maintenance. Many researchers have described innovation as a strategic approach to organizational concerns and have noted a failure to implement innovative measures in healthcare. This study was an investigation of the impact of ambidexterity in healthcare leaders on innovation. The purpose of this quantitative study, guided by the ambidexterity theory of leadership for innovation, was to analyze the extent to which ambidextrous leadership characteristics of healthcare executives and chief nursing officers (CNOs) influence …

Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi

Walden Dissertations and Doctoral Studies

The impact of end-stage renal disease (ESRD) on healthcare costs is significant. In 2013, the cost of providing care for the ESRD patient population was 7.1% of total Medicare expenses. ESRD patients' non-adherence with the medical plan is a reason for the high cost of care and poor patient outcomes. Staff education can have a positive impact on patient adherence in terms of the management of chronic illnesses, such as ESRD. This DNP project was an education program for hemodialysis (HD) staff regarding empowering patients to learn about self-care strategies aimed at improving ESRD patients' adherence to fluid restriction and …

A Narrative Study Focusing On Survivors Of Forced Labor Trafficking, Taras Nk Raggio

Walden Dissertations and Doctoral Studies

Throughout history, the media's rendering of slavery depicts vulnerable groups caught in a network of trafficking looking for a better life. Scholars of trafficking cite challenges in understanding the health care needs of domestic forced labor trafficking survivors in the United States. Seminal trafficking findings have shown that variations of trafficking affect the survivors' health after surviving trafficking. Therefore, in this qualitative, narrative inquiry I sought to understand how 8 survivors of forced labor trafficking, ages 25 years and older, described their health following trafficking beyond 5 years. The theory of social constructionism constituted the theoretical foundation, and the salutogenic …

Toxic Air Discharge And Infant Mortality: Effects Of Community Size And Socioeconomics, Khabira Salter

Walden Dissertations and Doctoral Studies

Living in counties where manufacturers release environmental toxins, such as those tracked by the Environmental Protection Agency's (EPA) toxic release inventory (TRI), may elevate infants' health risks. Because infant mortality (IM) is a strong indicator of a population's health status, it is an important topic in public health research. The purpose of this research was to examine the potential relationships between IM, community size, and factors related to mothers' SES in counties where more than 25,000 pounds of annual toxic air releases occur. The dependent variable was IM per 1,000 live births in a given community for each of the …