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Walden Dissertations and Doctoral Studies

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Dissertation: Sociodemographics And Pancreatic Cancer Survival Rate, Sylvester Lewis Jan 2018

Dissertation: Sociodemographics And Pancreatic Cancer Survival Rate, Sylvester Lewis

Walden Dissertations and Doctoral Studies

Pancreatic carcinoma or pancreatic cancer (PaCa) is an insidious disease with a prognosis of 6- to 12-month survival time for a late stage diagnosis. This problem has become crucial given that no study to date had been able to establish a definitive association between independent factors (other than a few diseases) and the survival rate of pancreatic cancer. The purpose of this quantitative, cross-sectional study was to determine whether an association exists between the independent, sociodemographic variables (marital status, age, education, income, and employment) and the outcome variable of survival rate. The social cognitive theory was the framework that provided …


Effectiveness Of Guardrails At Reducing Medication Errors Indrug Administration, Teresa Mosley Jan 2018

Effectiveness Of Guardrails At Reducing Medication Errors Indrug Administration, Teresa Mosley

Walden Dissertations and Doctoral Studies

Medication errors during drug administration are an issue in the nursing profession. The errors that occur due to intravenous vein infusions pose threats to patients due to the mode of administration and the risk of occurrence. Strategies such as guardrails have been implemented to reduce the rate of such errors. Despite these guardrails, facilities record mixed results on the effectiveness of infusion pumps in reducing medication errors. The project was designed as a quantitative study to evaluate the effectiveness of guardrails in reducing medication errors at the facility. Data analysis included error reports from the facility before and after the …


Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip Jan 2018

Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip

Walden Dissertations and Doctoral Studies

Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …


Effect Of Socioeconomic And Neighborhood Factors On Stroke Hospitalization Rate In Virginia, Esther Musu Stephens Jan 2018

Effect Of Socioeconomic And Neighborhood Factors On Stroke Hospitalization Rate In Virginia, Esther Musu Stephens

Walden Dissertations and Doctoral Studies

The stroke rate in Virginia is above the national rate. Stroke results in poor quality health, morbidity, and mortality. This quantitative epidemiological study was conducted to investigate whether a significant association exists between stroke and (a) socioeconomic and (b) neighborhood factors among people who were admitted to Virginia hospitals between 2010 and 2015. An ecological design, including ecosocial theory, was used to examine associations between environmental factors and stroke. Data (746 census output areas) were acquired using patients' billing zip codes from the Virginia Health Information System in combination with socioeconomic and neighborhood data by Zip Code Tabulation Area from …


Organizational Strategies To Reduce Hospital Readmissions, Steven Warchol Jan 2018

Organizational Strategies To Reduce Hospital Readmissions, Steven Warchol

Walden Dissertations and Doctoral Studies

Reducing hospital readmissions is critical to the success and sustainability of both hospitals and the communities in which they reside. The purpose of this multiple case study was to explore organizational strategies hospital leaders use to reduce hospital readmissions. The study was limited to hospitals in Southwest Missouri with readmission rates below the state average. Complex adaptive systems was the conceptual framework for the study because of the complex nature and numerous stakeholders of the healthcare system. Data were collected from a purposive sample of 15 hospital leaders via semistructured interviews and an analysis of organizational artifacts. Member checking was …


Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu Jan 2018

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …


Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck Jan 2018

Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck

Walden Dissertations and Doctoral Studies

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to …


Depression Management In Outpatient Settings: A Systematic Review Of The Literature, Modupe Mary Okonofua Jan 2018

Depression Management In Outpatient Settings: A Systematic Review Of The Literature, Modupe Mary Okonofua

Walden Dissertations and Doctoral Studies

Depression is a mental illness that requires prompt identification and treatment due to grave consequences if untreated. Depression can affect a person's level of functioning, lead to worsening health conditions, comorbid substance abuse, and suicide. Despite these facts, the current state of nursing practice includes an inadequate diagnosis of patients with depression, lack of guidelines for the use of assessment tools and diagnostic tests to identify depression, and insufficient information concerning the accuracy of depression assessment tools. This systematic literature review examined 6 depression assessment tools in regard to their accuracy as identified by specificity, sensitivity, reliability, and validity. This …


Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker Jan 2018

Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker

Walden Dissertations and Doctoral Studies

The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than …


Bleach-It-Away Clostridium Difficile, Kim Ione Hecker Jan 2018

Bleach-It-Away Clostridium Difficile, Kim Ione Hecker

Walden Dissertations and Doctoral Studies

Hospital-associated infections (HAIs) are infections patients contract as a result of being hospitalized. HAI rates decreased for almost all pathogens in the past few years, with the exception of Clostridium difficile infections (CDIs), which have been steadily climbing, placing hospital-acquired CDI at the top of the HAI list. The Center for Disease Control and Prevention reported in 2010 almost a half a million people were infected with CDIs yearly in the United States, and CDIs claimed the lives of approximately 29,000 people, representing a 4-fold increase from 1993. To address the problem in the local hospital, a quality improvement initiative …


Chronic Low Back Pain- A Needs Assessment For Practice Change, Chukwudi Oduah Jan 2018

Chronic Low Back Pain- A Needs Assessment For Practice Change, Chukwudi Oduah

Walden Dissertations and Doctoral Studies

There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for …


Educational Program For Parents Of Neonates On Nasal Continuous Positive Airway Pressure, Irina Sher Jan 2018

Educational Program For Parents Of Neonates On Nasal Continuous Positive Airway Pressure, Irina Sher

Walden Dissertations and Doctoral Studies

Parents in the neonatal intensive care unit (NICU) whose term or preterm infants are receiving nasal continuous positive airway pressure (NCPAP) experience stress. They often worry about being able to hold their child and possible complications of NCPAP, such as nasal deformities and compromised organ function. Lacking standard educational programming to provide parents information that they need to understand the care their infant is receiving, parents experience unnecessary stress that affects their capacity to care for their infants. A review of the literature suggested family-centered educational programs are able to decrease stress and increase parental confidence. The purpose of this …


A Nutrition Education Program For Advanced Practice Registered Nurses Caring For Obese Patients, Kathy Lynn Wilson Jan 2018

A Nutrition Education Program For Advanced Practice Registered Nurses Caring For Obese Patients, Kathy Lynn Wilson

Walden Dissertations and Doctoral Studies

Obesity is a major U.S. public health epidemic. A review of the current literature identified a lack of obesity counseling with individuals. The gap in practice was a lack of understanding of nutrition, nutrition labeling, and how foods affect health. The objective of this project was to identify the community assessment need related to obesity and then educate APRNs on ways to better communicate with obese patients. This project focused on an education program for advanced practice registered nurses (APRNs) on using the 5 A's framework for obesity counseling to improve their knowledge and skill in counseling their overweight and …


Correlating Residual Stress With Personal And Professional Characteristics In Aircraft Pilots, Erik Eckblad Jan 2018

Correlating Residual Stress With Personal And Professional Characteristics In Aircraft Pilots, Erik Eckblad

Walden Dissertations and Doctoral Studies

Every day aircraft pilots must successfully resolve significant inflight situations and then manage the possibility of residual psychological and physiological stress. Previous research has shown primary attention is given to presignificant event training and stress management, however there remains an important gap in the current literature regarding postsignificant event stress within the aviation profession. The purpose of this cross-sectional quantitative study was to use the observational lens of stress theory and survey U.S. pilots who have experienced an inflight emergency, looking for correlation between factors such as age, gender, flight experience, and training against a pilot's self-reported level of residual …


A Meta-Analysis Of Video Based Interventions In Adult Mental Health, Lauretta Kaye Montes Jan 2018

A Meta-Analysis Of Video Based Interventions In Adult Mental Health, Lauretta Kaye Montes

Walden Dissertations and Doctoral Studies

Symptoms of mental illness such as anxiety and depression diminish functioning, cause distress, and create an economic burden to individuals and society. This meta-analysis was designed to evaluate the effectiveness of video based interventions (VBIs) for the treatment of adults in mental health settings. VBIs comprise four different ways of using video in mental health therapy, including video modeling, video exposure, video feedback, and videos used for psychoeducation. Bandura's social learning theory, Beck's cognitive theory, and Dowrick's theory of feedforward learning form the theoretical framework for understanding how VBIs work. The research questions were: (a) what is the range of …


Locus Of Control, Poverty And Health Promoting Lifestyles, Cara Stephenson-Hunter Jan 2018

Locus Of Control, Poverty And Health Promoting Lifestyles, Cara Stephenson-Hunter

Walden Dissertations and Doctoral Studies

Despite increased access to care and interventions aimed to change health behavior, socioeconomic health disparities have remained unchanged, even for preventable illness and disease. Health behavior theories and interventions heavily rely on perceptions of control over one's fate and thus ignore populations with low perceptions of personal control. Poverty is associated with an external locus of control (LOC), while both poverty and external LOC are associated with less health protective behavior. The purpose of this quantitative study was to explore the role of LOC as an adaptive response to poverty and to discover the risks and benefits to physical and …


Knowledge, Perceived Barriers, And Preventive Behaviors Associated With Cardiovascular Disease Among Gallaudet University Employees, Andy Kenji Tao Jan 2018

Knowledge, Perceived Barriers, And Preventive Behaviors Associated With Cardiovascular Disease Among Gallaudet University Employees, Andy Kenji Tao

Walden Dissertations and Doctoral Studies

When the Minority Health Improvement and Health Disparity Elimination Act of 2007 went into effect, there was a corresponding increase in research focused on cardiovascular disease (CVD) in underrepresented groups, except for 1: culturally Deaf Americans. Guided by the health belief model, the purpose of this study was to determine if there were significant differences in the level of knowledge, perceived barriers, and preventive behaviors associated with CVD among Deaf and hearing employees at Gallaudet University, Washington D.C. This cross-sectional quantitative research study used a survey with questions derived from 2 existing national surveys. One hundred eighty-six subjects were recruited …


Simulation-Based Education To Decrease Cauti Rates In The Intensive Care, Janet Belanger Bell Jan 2018

Simulation-Based Education To Decrease Cauti Rates In The Intensive Care, Janet Belanger Bell

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) occur frequently in Intensive Care Unit (ICU) patients, who are hospitals' most vulnerable population. This quality improvement project is the evaluation of 2 interventions used in one acute care facility's ICU to decrease CAUTI rates over a 3-year timeline. The 2 interventions used for the project were 1) an evidence-based guideline developed from the Comprehensive Unit-based Safety Program and 2) simulation-based education for teaching the guideline. Using the Iowa model and Havelock's theory of planned change as a framework, the 2 interventions were evaluated over a 3-year timeline: 2014 pre- intervention, 2015 intervention, and 2016 …


Implications Of An All Bsn Workforce Policy, Mary Clifford Jan 2018

Implications Of An All Bsn Workforce Policy, Mary Clifford

Walden Dissertations and Doctoral Studies

Discussion continues about requiring a Bachelor of Science in Nursing (BSN) as the minimum requirement for entry into registered nursing practice. A Magnet-® recognized hospital located in the Northeast United States is requiring all registered nurses without a BSN (n=284 or 28%) to obtain their BSN by 2022 as a condition for employment. The purpose of this project was to quantify the potential number and rationale of nurses who are not planning to return to school. The 2 practice focused questions are (a) What is the rationale for nurses who do not plan to pursue their BSN degree and (b) …


Successful Project Management, Tomomi M. Horning Jan 2018

Successful Project Management, Tomomi M. Horning

Walden Dissertations and Doctoral Studies

High project failure rates result in billions of wasted dollars each year. Project failure does not discriminate by type of project or the industry from which they originate. The purpose of this qualitative single case study was to explore strategies that leaders at a health care organization located in Pennsylvania use to manage projects successfully. This population was selected due to the health care organization's reputation for successful project completion. The conceptual framework for this study was Fiedler's contingency theory. Data were collected by conducting semistructured interviews with 9 project leaders and reviewing project documents provided by study participants. Interviews …


Stroke Risk Factor Knowledge, Attitude, Prevention Practices, And Stroke, Adaku Ngozika Madubuko Jan 2018

Stroke Risk Factor Knowledge, Attitude, Prevention Practices, And Stroke, Adaku Ngozika Madubuko

Walden Dissertations and Doctoral Studies

Regardless of the advances that have been made in stroke research and treatment and the overall decrease in stroke mortality, the stroke mortality rate for African Americans is still high at 45.2/100,000 and is still the leading cause of adult disability. Knowledge of the risk factors of stroke is paramount to reducing the morbidity and mortality of stroke, but knowledge of stroke risk factors has been found to be suboptimal in the African American population. The purpose of this study was to examine if there is a relationship between the knowledge, perception, and sources of stroke information of risk factors …


Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline Jan 2018

Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline

Walden Dissertations and Doctoral Studies

Researchers have predicted that by 2020 the United States will experience a severe shortage of registered nurses. The purpose of this correlation study, using the National Sample Survey of Registered Nurses 2008, was to investigate the relationship between nurse job satisfaction and its effect on nurse retention nationwide. Secondary data sets from the 2008 National Sample Survey of Registered Nurses and examining relationships between the variable of nurse retention and job satisfaction. Bivariate (correlation coefficient, chi squares, and simple linear regression) and multivariate (logistic regression) analyses identified and connected associations and examined measurement levels between the dependent and independent variables, …


Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha Jan 2018

Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha

Walden Dissertations and Doctoral Studies

Although it is known that the prevalence of type 2 diabetes is on the rise in Canada, more information is needed on how well type 2 diabetes patients living in Cambridge, Ontario self-manage their diabetes and what factors influence their adherence to diabetes medication regimens. The objective of this cross-sectional study based on the theory of planned behavior was to determine if there are predictors of adherence to diabetes medications among patients living with type 2 diabetes in Cambridge. The World Health Organization STEPwise Approach to Surveillance was used to collect demographic data. Adherence and diabetes knowledge were assessed with …


Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes Jan 2018

Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes

Walden Dissertations and Doctoral Studies

Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care …


Practice Guidelines For Continuous Pulse Oximetry Monitoring For Obstructive Sleep Apnea Patients, Bridgette Smart Jan 2018

Practice Guidelines For Continuous Pulse Oximetry Monitoring For Obstructive Sleep Apnea Patients, Bridgette Smart

Walden Dissertations and Doctoral Studies

As the rate of obesity has increased in the United States to include approximately 40% of the adult population, there has been a corresponding rise in the number of patients with obstructive sleep apnea (OSA). The OSA population is at risk for adverse perioperative respiratory depression. Continuous pulse oximetry monitoring is indicated for these patients upon discharge from the recovery room into other treatment settings and when cared for by telemetry or by trained hospital staff in the patient's room. The practice question was whether an evidence-based practice guideline could be developed to help ensure safe postoperative monitoring of patients …


Household Determinants Of Malaria In Mutasa District Of Zimbabwe, David Takudzwa Zinyengere Jan 2018

Household Determinants Of Malaria In Mutasa District Of Zimbabwe, David Takudzwa Zinyengere

Walden Dissertations and Doctoral Studies

Malaria is a vector borne, acute febrile illness, caused by Plasmodium parasites. Malaria impacts the medical and socioeconomic development programs of affected communities, as it diverts both individual and national resources into managing the disease burden. The purpose of this study was to explore and evaluate household determinants of malaria in Mutasa District, Zimbabwe. The precede-proceed theoretical model guided the study. Secondary data from Demographic Health Survey and District Health Management Information System, and current data from household determinant questionnaires, were used to evaluate the influence and significance of identified household determinants. Multiple logistic regression models were used to examine …


Congregational Health Promotion By African American Female Pastors In The Christian Faith, Arlene Obazee Jan 2018

Congregational Health Promotion By African American Female Pastors In The Christian Faith, Arlene Obazee

Walden Dissertations and Doctoral Studies

Health disparities have mostly affected African Americans who are poor, uninsured, under insured and unemployed. This population of African Americans seek spiritual solace and social counseling from their pastors, and church-based health promotion (CBHP) offers the opportunity to reach millions of the U. S. Black population. The lack of studies on female African American pastors implementing congregational health promotion activities influenced this study. This qualitative study helped in understanding the experiences, perspectives, and influences of 13 female African American Christian pastors on health-related issues within their congregation. Feminist theory and CBHP model guided this qualitative case study. Open-ended interview questions, …


Perspectives Of Primary Care Physicians On Adopting Electronic Medical Records In The Atlanta, Georgia Area, Chris U. Okoro Jan 2018

Perspectives Of Primary Care Physicians On Adopting Electronic Medical Records In The Atlanta, Georgia Area, Chris U. Okoro

Walden Dissertations and Doctoral Studies

Slow adoption of electronic medical records (EMR) by primary care physicians in medical office practices has not facilitated the EMR adoption process. The problem is the slow pace of EMR adoption by primary care physicians in the Atlanta, Georgia area has become a public health concern. Research regarding the lived experiences of these physicians with EMR implementation and utilization may identify reasons for the slow adoption. The purpose of this phenomenological study was to explore the lived experiences of primary care physicians, who practice in the Atlanta area, regarding their perception, successes, barriers, and urgency of adoption of EMR in …


Complementary And Alternative Medicine Careers Following A Science Academy For Underrepresented Minority Students, Tolulope Oyelowo Jan 2018

Complementary And Alternative Medicine Careers Following A Science Academy For Underrepresented Minority Students, Tolulope Oyelowo

Walden Dissertations and Doctoral Studies

Minority groups experience disproportionately worse health outcomes. An identified solution is to increase the number of minorities providing healthcare in their own communities. Primary care complementary and alternative medicine (CAM) providers are a potential resource. Many investigators have demonstrated the efficacy of science-based pipeline programs for increasing the roles of students in allopathic health professions. Whether these programs influence matriculation of minorities into a CAM university is unknown. The main purpose of this study was to gain an understanding of a pre-college science academy at a CAM university and determine whether the experience increased interest in and motivation for CAM …


A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak Jan 2018

A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak

Walden Dissertations and Doctoral Studies

Assistive technology may delay cognitively impaired elders' need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah's 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer's or other dementia by 2037. Data were collected from a focus group of 10 seniors …