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Walden Dissertations and Doctoral Studies

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Women's Experiences Using Health Facilities For Childbirth In South Sudan, Gillian Magda Garnett Jan 2018

Women's Experiences Using Health Facilities For Childbirth In South Sudan, Gillian Magda Garnett

Walden Dissertations and Doctoral Studies

There is low use of health facilities for childbirth in South Sudan despite the majority of households reporting access to a health facility. South Sudan has a high maternal mortality ratio with 789 maternal deaths for every 100,000 live births. The absence of a midwife during labor and delays in reaching health facilities for childbirth remain the leading contributing factors to the high maternal mortality. Little is known, however, about factors influencing use and non-use of health facilities for delivery in the country. This phenomenological study, therefore, seeks to build a body of evidence by describing the experiences of women …


Socioeconomic Characteristics Of Farmers And Agrochemical Use In Grenada, Lindonne Marcia Glasgow Jan 2018

Socioeconomic Characteristics Of Farmers And Agrochemical Use In Grenada, Lindonne Marcia Glasgow

Walden Dissertations and Doctoral Studies

The World Health Organization classified carbaryl, glyphosate, and paraquat as hazardous to human health. In the Agriculture Health Study in the United States, health problems were associated with the use of these 3 agrochemicals 12 or more times per year. These 3 agrochemicals were commonly used in Grenada. The purpose of this quantitative cross-sectional study was to investigate the relationship between the social and economic characteristics of the farmers who participated in the 2012 agriculture survey and the use of agrochemicals at frequencies that could pose health risks. Five constructs of the social cognitive theory were used as the premise …


Preparing Novice Nurses For Early Recognition Acute Deterioration, Norma Patricia Harris Jan 2018

Preparing Novice Nurses For Early Recognition Acute Deterioration, Norma Patricia Harris

Walden Dissertations and Doctoral Studies

Hospitalized patients increasingly present with complex health issues that place them at risk for acute patient deterioration (APD). Novice nurses are ill-equipped with the critical clinical skills to function competently in recognizing APD, placing patients at risk for negative health outcomes. This project addressed the need to educate novice nurses to recognize APD and answered the project focused questions that asked if an educational intervention with high-fidelity simulation (HFS) would improve nurse knowledge and clinical confidence in recognizing APD. Benner's novice-to-expert and the constructivism theory were used to guide the project. Based upon a review of the literature, the HFS …


Staff Educational Program To Prevent Medication Errors, Rita Chinyere Hawthorne-Kanife Jan 2018

Staff Educational Program To Prevent Medication Errors, Rita Chinyere Hawthorne-Kanife

Walden Dissertations and Doctoral Studies

Medication administration errors (MAEs) may lead to adverse drug events, patient morbidity, prolonged hospital stays, and increased readmission rates, and may contribute to major financial losses for the health system. MAEs are the most common type of error occurring within the health care setting leading to an estimated 7,000 patient deaths every year. Interventions have been designed to prevent MAEs including education for nurses who administer medications; however, little effort has been made to design systematic educational programs that are based on local needs and contexts. The purpose of this project was to identify internal and external factors related to …


Country Girls Fight, Too: The Relationship Between Social Support And Rural Female Youth Violence, Redhonda Vanessa Malone Jan 2018

Country Girls Fight, Too: The Relationship Between Social Support And Rural Female Youth Violence, Redhonda Vanessa Malone

Walden Dissertations and Doctoral Studies

This study was conducted to explore the relationship between social support and youth violence by testing the relationships between violence victimization, violence exposure, violence perpetration, delinquency, and the moderating variable of social support for rural female adolescents in the United States. This research, guided by the social disorganization theory, involved analyses of data from Wave 3 of the National Survey for Children's Exposure to Violence. The logistic regression analyses (n = 278; female; rural area; mean age 13.5) showed no moderating effect of social support on youth violence perpetration. However, there was a positive association between delinquency and violence perpetration, …


Individual Understanding Of The Risks Associated With Polypharmacy, Michelle Patricia Mchenry Jan 2018

Individual Understanding Of The Risks Associated With Polypharmacy, Michelle Patricia Mchenry

Walden Dissertations and Doctoral Studies

With many individuals experiencing multimorbidity, individuals are being prescribed more medications. Although there are benefits to taking medications to manage symptoms and treat disease processes, there are also risks to taking multiple medications. The purpose of this phenomenological study was to explore participants' understanding of the risks associated with practicing polypharmacy. Game theory, credibility theory, and belief bias were the conceptual frameworks used to explain how individuals experienced their care and being prescribed 5 or more medications. Eight participants residing in subsidized housing in a small Midwest city, who were taking 5 or more medications volunteered to take part in …


Achieving Glycemic Control In Rural Clinics, Gayla Diane Mclaughlin Jan 2018

Achieving Glycemic Control In Rural Clinics, Gayla Diane Mclaughlin

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States and is the main cause of chronic kidney failure, nontraumatic limb amputations, blindness, myocardial infarction, and stroke. Many patients with diabetes do not meet goals for at least 1 control measure of blood sugar, blood pressure, or cholesterol. The purpose of the project was to implement a template for documentation--a toolkit for patient care management-to improve blood glucose and blood pressure levels in a rural health clinic in central Texas for 33 patients with diabetes during a 6- to 8-week timeframe. The practice-focused question asked whether management of …


Laughter Frequency, Pain Perception, And Affect In Fibromyalgia Patients, Deidre Gayl Molchan Jan 2018

Laughter Frequency, Pain Perception, And Affect In Fibromyalgia Patients, Deidre Gayl Molchan

Walden Dissertations and Doctoral Studies

Fibromyalgia syndrome (FMS), a common chronic pain condition, is often incompletely treated by conventional medical therapies. It can cause disability, psychological distress, work-related absenteeism, increased use of healthcare resources, and result in the inability to carry out the tasks of daily living. The purpose of this quantitative, correlational study was to investigate the potential influence of laughter on affect and pain in individuals with FMS. Laughter produces beneficial effects on acute pain and on chronic pain in general and has been found to improve temporary affective states, but there have been no studies testing the effects of laughter on the …


Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa Jan 2018

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …


An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson Jan 2018

An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson

Walden Dissertations and Doctoral Studies

Childhood obesity is a national problem in the United States and has known implications as a potential cause of chronic illnesses as the child transitions into adulthood. A primary care clinic in the southwestern United States had a high percentage of obese Hispanic children within its population; therefore, the nurses and the pediatrician needed an evidence-based clinical practice guideline (CPG) to manage Hispanic children with a body mass index greater than the 95th percentile for their age. The purpose of the project was to develop a culturally competent CPG to manage childhood obesity in this primary care practice. The social …


Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell Jan 2018

Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …


Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett Jan 2018

Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett

Walden Dissertations and Doctoral Studies

Bariatric surgery is a major surgery that has become a frequent procedure in North America; growth in the number of bariatric surgery procedures has resulted in an increase in readmissions after the procedure. A systematic review of the literature using the shifting processes model as a guide was used to answer the practice-focused questions regarding reasons for hospital readmissions for postoperative bariatric surgery patients and strategies that reduce complications of the procedure. Providing Innovative Service Models and Assessment chart (PRISMA) was used to quantify 17 studies that met the inclusion criteria. Results demonstrated that the reasons for readmissions after bariatric …


Reducing Clabsi Rate Among Icu Patients, Rita L. Walker Jan 2018

Reducing Clabsi Rate Among Icu Patients, Rita L. Walker

Walden Dissertations and Doctoral Studies

Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a …


Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean Jan 2018

Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean

Walden Dissertations and Doctoral Studies

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health …


A Qualitative Grounded Theory Approach To Reducing Breast Cancer Disparities In The Latina Population, Dbora Schrett Jan 2018

A Qualitative Grounded Theory Approach To Reducing Breast Cancer Disparities In The Latina Population, Dbora Schrett

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of death among Latinas. Several barriers persist when accessing health care and utilization of healthcare services such as annual mammograms, leading to a late-stage diagnosis or death related to breast cancer illness. Consequently, this study was important to further examine potential risk factors such as beliefs, cultural context, health insurance, and socioeconomic status for this population. Further, gaps in research provide limited evidence of risk factors adversely influencing high morbidity and mortality incidence. The purpose was to focus on disparities in breast cancer experiences within Latina communities in the United States. A qualitative foundation …


Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang Jan 2018

Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang

Walden Dissertations and Doctoral Studies

Every year thousands of patients in the United States undergo cardiothoracic surgery. These patients have high levels of anxiety because they do not know what to expect. At the same time, many nurses on the cardiac telemetry/surgical floor are not aware that effective preoperative teaching can make a significant difference in patients' outcomes; thus, nurses had focused on postoperative teaching. The purpose of this project was to develop a preoperative teaching program through which nurses could help patients undergoing open heart surgery. The mentioned above practice initiative used Neuman's systems model as a framework. The project used a before-and-after design: …


Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry Jan 2018

Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry

Walden Dissertations and Doctoral Studies

Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the …


Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown Jan 2018

Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown

Walden Dissertations and Doctoral Studies

Obesity is a crucial health care issue that has a global effect on the health care industry. Not only does obesity decrease the patients' quality of life, it also places an astronomical burden on health care delivery systems. The purpose of this quality improvement project was to establish a weight management program derived from evidence-based research. The research question is can the utilization of mindfulness meditations and practices with traditional weight loss methodologies produce sustainable weight loss? Pender's health belief model was the conceptual framework utilized to guide and provides structure for this project. The health belief model has been …


Influence Of Psychological Capital And Thinking Perspectives On Construction Safety Climate And Performance, Anne-Perrine Pascale Cades Jan 2018

Influence Of Psychological Capital And Thinking Perspectives On Construction Safety Climate And Performance, Anne-Perrine Pascale Cades

Walden Dissertations and Doctoral Studies

Understanding safety factors in construction is critical to reducing accident frequency and severity. Grounded in the safety performance model, this study was conducted to examine the impact of psychological capital (PsyCap), which consists of the shared variance of hope, efficacy, resilience and optimism, and Past, Present, and Future thinking perspectives, on safety climate and performance. A nonexperimental quantitative design was used to determine whether PsyCap and thinking perspectives of construction project employees predicted safety performance and/or moderated the relationship between safety climate and performance across construction sites in different countries. 411 construction employees were recruited via a multistage and clustering …


Maternal Socioeconomic Status And Human Papilloma Virus Vaccine Uptake, Shawn Lockett Jan 2018

Maternal Socioeconomic Status And Human Papilloma Virus Vaccine Uptake, Shawn Lockett

Walden Dissertations and Doctoral Studies

There are more than 79 million people in the U.S. currently infected with human papillomavirus (HPV), with an estimated 14 million new infections annually. There is a lack of knowledge about the maternal socioeconomic influences and uptake of the HPV vaccine series. Infection with HPV can cause cervical cancer in women, and there are over 11,000 cervical cancer diagnoses in the U.S. responsible for 4000 deaths annually. Vaccination coverage to prevent HPV infection does not meet the Healthy People 2020 goals of an 80% vaccination rate in the U.S. In this study, associations were tested between maternal SES variables and …


Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston Jan 2018

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …


Staff Education Module For Bar Code Medication Administration, Francoise Juste Jan 2018

Staff Education Module For Bar Code Medication Administration, Francoise Juste

Walden Dissertations and Doctoral Studies

Bar Code Medication Administration (BCMA) is a technology-supported nursing tool that has become the standard of practice for medication administration. When used effectively and efficiently, this tool has the potential to reduce medication errors in acute care settings. In a pediatric unit at a major urban hospital in the northeast region of the United States, the absence of a BCMA nursing staff educational module affected the use of this safety tool leading to an increase of medication errors. The purpose of this DNP project was to develop a comprehensive educational module to promote BCMA in the pediatric unit of the …


Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde Jan 2018

Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde

Walden Dissertations and Doctoral Studies

The complex challenges facing the sexual assault nurse examiners program in a midwest state are underreporting, late reporting, and poor coordination of care for pediatric victims of child maltreatment with sexual abuse. The main objective of this quality improvement project was the identification of necessary practice-related approaches to care to decrease barriers associated with reporting suspicions of abuse or neglect. An evidence-based, multidisciplinary assessment clinical toolkit that followed clinical components of trauma-sensitive, child-centered screenings triggering a coordinated response to conduct a forensic medical exam within 96 hours of the alleged incident was evaluated. During 3 rounds of surveys following the …


Impediments Of Self-Managed Type 2 Diabetes In Mgbidi Women, Nigeria, Augustina Oha Jan 2018

Impediments Of Self-Managed Type 2 Diabetes In Mgbidi Women, Nigeria, Augustina Oha

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a complex metabolic disorder characterized by hypoglycemia or hyperglycemia that affects fat, protein, and carbohydrate metabolism. Researchers have identified that for individuals with Type 2 diabetes, staying on interventions for diabetes self-management is sometimes difficult and challenging. It is an increasing public health concern, especially in certain minority populations and in many developing and developed nations. This is especially true for the population of women 40 years and older in Mgbidi, Nigeria. In the Enugu State of Nigeria, women bear most of the burden of Type 2 diabetes when compared to the males in the state. …


Relationship Between Remission Of Symptoms And Screening For Depression, Juliann Molecavage Jan 2018

Relationship Between Remission Of Symptoms And Screening For Depression, Juliann Molecavage

Walden Dissertations and Doctoral Studies

Depression is the leading cause of disability in the United States. Insufficient evidence is available about the types of follow-up care that may be most effective. The purpose of this quantitative, retrospective cohort study was to determine whether remission of depression symptoms was associated with recommended follow-up care when controlling for age, gender, and number of previous episodes of depression, and whether symptom reduction was more likely for those who completed a course of treatment from a mental health specialist in comparison to those who were treated by their primary care providers (PCPs) when controlling for the same variables. The …


Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna Jan 2018

Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna

Walden Dissertations and Doctoral Studies

Sport-related injuries (SRI) can be foreseen and averted when mechanisms and risk factors are completely understood. An appreciation of the relationship between sport-related concussion (SRC) and lower extremity musculoskeletal injuries (LEMI) is emerging amid professional and collegiate athletes. However, findings of such a relationship in adults may not be generalizable to younger populations, and the literature has not addressed this relationship in adolescents. The purpose of this cross-sectional quantitative study was to examine the relationship between SRC and LEMI in high school athletes. The dynamic model of etiology in sport injury provided the study's conceptual framework. A de-identified secondary dataset …


Intensive Outpatient Treatment Program For Patients With Depressive Disorder: A Parental Perspective, Emmanuel Akpan Jan 2018

Intensive Outpatient Treatment Program For Patients With Depressive Disorder: A Parental Perspective, Emmanuel Akpan

Walden Dissertations and Doctoral Studies

Psychosocial support from family is important in outpatient treatment programs for individuals with depressive disorder. The purpose of this phenomenological study was to explore the lived experiences and perceptions of parents of patients with depressive disorder regarding intensive outpatient treatment. The research question was what are the experiences and perceptions of parents of patients with depression regarding their role as caretakers in intensive outpatient treatment? The conceptual framework was a biopsychosocial framework and family systems theory. Content analysis was used to analyze data provided from interviews with parent participants (n = 8). Many participants reported high levels of involvement with …


Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun Jan 2018

Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun

Walden Dissertations and Doctoral Studies

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …


Systematic Review Of Nurse Residency Programs, Abiola Olatokunbo Ajanaku Jan 2018

Systematic Review Of Nurse Residency Programs, Abiola Olatokunbo Ajanaku

Walden Dissertations and Doctoral Studies

The first 2 years of a new graduate nurses career can be stressful and traumatic. Many new graduates leave the profession within their first 2 years of employment. Organizations have sought to implement programs that will promote new graduate job retention. Nurse residency programs (NRPs) are programs geared toward fostering and nurturing new graduates once they begin their nursing careers. Residency programs can last anywhere from 3 months to 1year, depending on the nursing specialty. A key component in retaining new graduates is to facilitate a successful transition into nursing practice. This project served as a systematic review regarding the …


Association Between Adaptive Sports Programs And Quality Of Life Among Amputee Veterans, Sean V. Seay Jan 2018

Association Between Adaptive Sports Programs And Quality Of Life Among Amputee Veterans, Sean V. Seay

Walden Dissertations and Doctoral Studies

Adaptive sports programs (ASPs) are important for enhancing the physical, psychological, and social aspects of life for amputee combat veterans while reducing the risk of depression and anger. Although the role of ASPs in improving quality of life (QoL) has been researched in relation to amputee combat veterans of World War II, the Korean War, and the Vietnam War, there has been limited examination of the role of ASPs in improving QoL among veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation Noble Eagle (OND). Therefore, the purpose of this study was to assess the effects of …