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Walden Dissertations and Doctoral Studies

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Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu Jan 2018

Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu

Walden Dissertations and Doctoral Studies

Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were …

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Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina Jan 2018

Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina

Walden Dissertations and Doctoral Studies

The Supplemental Nutrition Assistance Program (SNAP) is the United States' largest government assistance program that aims to alleviate food insecurity. The SNAP program allows low-income individuals and families the ability to purchase nutritious foods through a monthly benefit. However, the current body of literature presents evidence of the program's counterproductive effect. The purpose of this study was to determine whether incentivizing SNAP recipients to purchase additional fruits and vegetables was beneficial in increasing such purchases. Social cognitive theory was used as a theoretical framework to address research questions associated with shopping patterns and attitudes and beliefs. This quantitative study used …

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The Survival Of Healthcare In Rural Texas, Destin Cook Jan 2018

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

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The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach Jan 2018

The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach

Walden Dissertations and Doctoral Studies

Inadequate interprofessional collaboration (IPC) and communication among health care professionals are associated with medical errors and mortality. Guided by the theory of goal attainment and the chronic care model, a systematic review was conducted to explore the evidence related to whether interprofessional collaborative primary care can have a positive effect on health outcomes for patients living with diabetes (PLWD). The systematic review followed the Joanna Briggs Institute method for systematic reviews and results were complied with the PRISMA evidence-based minimum set for reporting. Data were analyzed to identify if IPC positively impacted the health outcomes of PLWD, as evidenced by …

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Influence Of An Educational Program On Opioid Drug Abuse, Gloria Nkiru Nnah Jan 2018

Influence Of An Educational Program On Opioid Drug Abuse, Gloria Nkiru Nnah

Walden Dissertations and Doctoral Studies

Prescription opioid abuse in the United States is an alarming health issue. In 2015, approximately 2 million people abused prescription opioids, and 12 million individuals misused their prescription opioid pain relievers. The percentage of individuals who died as a result of opiate abuse increased from 22% in 2013 to 76% in 2014. The purpose of this project was to evaluate the influence of an inner-city drug treatment (DTBF) program on opioid users' behavior. The practice question addressed whether knowledge of signs and symptoms of opioid withdrawal obtained from the DTBF program resulted in a significant behavioral change in opioid use …

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Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda Jan 2018

Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda

Walden Dissertations and Doctoral Studies

Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …

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Sexual History Screening Tools For Individuals With Developmental Disabilities, Sarah Musu Onyenwe Jan 2018

Sexual History Screening Tools For Individuals With Developmental Disabilities, Sarah Musu Onyenwe

Walden Dissertations and Doctoral Studies

Individuals with developmental disabilities are at high risk for sexual abuse, exploitation, sexually transmitted diseases and unwanted pregnancies. Thorough screening by clinicians in outpatient settings recommending preventative measures to promote reproductive and sexual health, and developing caregiver trust are essential. The aim of this systematic review was to provide screening tools to assist clinicians in assessing the sexual histories of individuals with developmental or intellectual disabilities. The Iowa model and the cognitive behavioral theory were used as the theoretical frameworks that guided and informed this project. A total of 148 articles were sought and, of the 34 articles reviewed, 19 …

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Sexual Orientation And Intimate Partner Violence Among Women Who Have Sex With Women, Shanna Renn Smith Jan 2018

Sexual Orientation And Intimate Partner Violence Among Women Who Have Sex With Women, Shanna Renn Smith

Walden Dissertations and Doctoral Studies

Limited knowledge exists about sexual orientation and intimate partner violence among women who have sex with women. These women are at risk for adverse physical and mental health hygiene outcomes that may result from unhealthy lifestyles secondary to intimate partner violence. The purpose of this study was to examine the association between sexual orientation and intimate partner violence among women who have sex with women. The constructs of the biopsychosocial model guided the study and examination of the relationships among biological factors (sexual orientation), social contexts (support of family and friends and use of community services), and psychological influence (mental …

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Maternal Characteristics And The Risk Of Cleft Lip And Palate In The United States, Letha Thomas Jan 2018

Maternal Characteristics And The Risk Of Cleft Lip And Palate In The United States, Letha Thomas

Walden Dissertations and Doctoral Studies

Cleft lip with or without cleft palate (CLP) is an ongoing public health issue across the globe, and in the United States. The estimated number of babies born each year in the United States with cleft palate (CP) is about 2,650, while CLP affects approximately 4,440 babies. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between CLP and maternal characteristics such as reproductive history (advanced maternal age, maternal obesity, prenatal visits, month prenatal care began, number of pregnancies, gestational age at birth, assisted reproductive technology used, gestational diabetes, and hypertension), socioeconomic status of …

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Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney Jan 2018

Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney

Walden Dissertations and Doctoral Studies

Delirium is a frequent complication of intensive care unit (ICU) admissions manifesting as acute confusion with inattention and disordered thinking. Patients in the ICU who develop acute delirium are more likely to experience long term disability and mortality. The purpose of this doctoral project was to evaluate an existing organizational quality improvement project to guide recommendations on improving care in the ICU. The practice-focused research question was: Does improving adherence to the ICU Liberation ABCDEF bundle for patients admitted to the ICU decrease incidence of delirium compared to outcomes prior to implementation? The Program Logic Model served as a framework …

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Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown Jan 2018

Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown

Walden Dissertations and Doctoral Studies

Lead exposure during childhood is a significant global public health concern as the potential effects of exposure can result in the need for long-term treatment, diminished productivity in society, and financial strain on the health care system. There is strong evidence of a relationship between lead exposure and attention-deficit/hyperactivity disorder (ADHD); however, there is a gap in the current literature regarding the relationship between lead exposure and specific symptoms of ADHD and the strength of that relationship. The purpose of this meta-analysis was to examine and help quantify this relationship. Cohen's d was used as the standardized mean effect size …

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Effect Of Lung Cancer Treatment On Health-Related Quality Of Life, Festus Frempong Dokyi Jan 2018

Effect Of Lung Cancer Treatment On Health-Related Quality Of Life, Festus Frempong Dokyi

Walden Dissertations and Doctoral Studies

Advances in lung cancer treatment among older adults require a risk-benefit analysis for health professionals, patients, and family members to assess increased survival and health-related quality of life (HRQL). The purpose of this study was to assess the effect of lung cancer treatment with surgery or tumor ablation on HRQL domains. A lung cancer quality of life model guided the study. The research design was a quantitative ancillary study in which 70 participants were recruited from those who had already consented to undergo a randomized clinical trial of lung cancer treatment. Data consisted of repeated administrations (baseline, 1- and 3-months) …

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Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing Jan 2018

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

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Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez Jan 2018

Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) and burnout (BO) in the novice nurse population can negatively affect the organization, patient safety, patient satisfaction, and the individual. Novice nurses are susceptible to the development of CF and BO due to a lack of knowledge about the causes and the stress experienced as the novice nurse transitions to practice. The purpose of this staff education project was to fill the gap in practice by creating awareness about CF and BO during the nurse orientation process and by providing prevention strategies. The relationship-based care model and the theory of planned behavior were used to guide the …

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Effects Of Transformational Learning On Student Nurses' Perceptions And Attitudes Of Caring For Dying Patients, Kristina Mccall Jan 2018

Effects Of Transformational Learning On Student Nurses' Perceptions And Attitudes Of Caring For Dying Patients, Kristina Mccall

Walden Dissertations and Doctoral Studies

Nurses spend more time with patients than members of any other discipline in the hospital setting, and most nurses will provide care for dying patients. However, nurses tend to feel uncomfortable providing care to dying patients, which may be due to a lack of education and knowledge about care for dying patients. The purpose of this quasiexperimental 1-group pretest-posttest study was to determine the effect education had on nursing students' attitudes and perceptions about the care they give to their patients at the end of life. The End of Life Nursing Education Consortium (ELNEC) education modules were used for quality …

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Strategies For Sustaining Small Businesses In The U.S. Health Care Sector, James Utobunwa Nwachukwu Jan 2018

Strategies For Sustaining Small Businesses In The U.S. Health Care Sector, James Utobunwa Nwachukwu

Walden Dissertations and Doctoral Studies

In the United States, many small businesses fail within the first 5 years due to poor implementation of sustainability strategies. Researchers and business practitioners have indicated that small business owners face challenges on how to maintain their businesses beyond 5 years due to lack of sustainability strategies. The purpose of this qualitative multiple case study was to explore the strategies that health care small business owners and managers in New York State use to maintain their businesses beyond 5 years. Sustainability development theory was used for the study's conceptual framework. Semistructured face-to-face interviews were conducted with 6 purposively-selected participants who …

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Evaluation Of A Difficult Urinary Catheter Team In An Academic Medical Center, David Price Jan 2018

Evaluation Of A Difficult Urinary Catheter Team In An Academic Medical Center, David Price

Walden Dissertations and Doctoral Studies

The placement of an indwelling urinary catheter (IUC) is a commonly performed clinical procedure which may become challenging for the clinician and painful for the patient. In response to urologic complications attributed to repeated failed IUC insertion attempts by nurses, a difficult urinary catheter (DUC) team program was launched in October 2012. The purpose of the doctoral project was to conduct a quality improvement evaluation of the effectiveness of the DUC team program using retrospective data from May 1, 2013 through May 31, 2017. Benner's novice to expert model was chosen as the theoretical framework to guide the additional training, …

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Strategies For Developing And Implementing Information Technology Systems For Ehrs, Priscilla Riddley Jan 2018

Strategies For Developing And Implementing Information Technology Systems For Ehrs, Priscilla Riddley

Walden Dissertations and Doctoral Studies

Some hospital leaders lack the technical expertise to implement electronic health records (EHRs) even though the healthcare industry has a government mandate. The purpose of this single case study was to explore strategies healthcare executives use to develop and implement information technology systems for processing EHRs. The target population consisted of healthcare leaders and managers successful in implementing EHR systems in a healthcare organization. Lewin's 3-step change theory was used as the conceptual framework for this study with data collected from observations (5), semistructured interviews (5), and organizational documents. Descriptive coding was used to identify 3 themes that emerged from …

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Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua Jan 2018

Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua

Walden Dissertations and Doctoral Studies

In comparison to the European healthcare system, the U.S. healthcare system has lower quality care, higher costs, and covers a smaller percentage of the population. Despite the high costs, the U.S. healthcare system remains dysfunctional. The purpose of this exploratory single case study was to identify the strategies that some healthcare managers in a hospital setting in the midwestern region of the United States use to improve efficiency while decreasing healthcare costs. Complex adaptive systems theory was used to frame this study that included face-to-face interviews with 6 highly experienced healthcare managers. Data were collected from audio recorded interviews and …

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Evidence-Based Practice For Influenza And Pneumococcal Nurse-Driven Protocol, Melissa Tunc Jan 2018

Evidence-Based Practice For Influenza And Pneumococcal Nurse-Driven Protocol, Melissa Tunc

Walden Dissertations and Doctoral Studies

At the project site in New Jersey, eligible patients were leaving the hospital without receiving the influenza or pneumococcal vaccine. The field site has an established, evidence-based, nurse-driven protocol. The purpose of this project was to increase adherence to the current influenza and pneumococcal nurse-driven protocol on one medical-surgical unit. This unit had experienced low adherence rates to the nurse-driven protocol for vaccines, not reaching the New Jersey state target of 96% administration prior to discharge. The practice-focused question was: Will increasing awareness of evidence-based practice increase adherence to the influenza and pneumococcal vaccine protocol? A quality improvement plan was …

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Using Diabetes Self-Management Education To Enhance Adolescent Transition, Jessica Adkins Jan 2018

Using Diabetes Self-Management Education To Enhance Adolescent Transition, Jessica Adkins

Walden Dissertations and Doctoral Studies

Type 1 diabetes is a long-term diagnosis, the prognosis of which is directly related to the patient's ability to self-manage the disorder. Adolescents are not currently taught how to manage diabetes; instead, parents and educators expect self-management to be more of a learned behavior from their parents. The purpose of this project was to create a quality improvement plan which the regional pediatric diabetes center study site could implement to improve adolescent glycemic control. Orem's self-care theory was used as theoretical framework for the design and evaluation of the project. The practice-focused question for this doctoral project was: Can a …

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Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe Jan 2018

Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe

Walden Dissertations and Doctoral Studies

This DNP project focused on the spiritual aspects of care that are often neglected in the outpatient setting. Most patients value their spiritual health and believe that it is just as important as their mental and physical health. The purpose of this project was to improve the overall spiritual care provided to patients, their families, and/or caregivers in times when they were experiencing spiritual distress. This quality improvement (QI) project was designed to determine whether embedding a chaplain in an outpatient clinic instead of providing a pamphlet about chaplain services increases patient satisfaction. Secondary analysis of the data in this …

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Impact Of Social Support On Malaria Management By Burundian Community Health Workers, Bonaventure Bazirutwabo Jan 2018

Impact Of Social Support On Malaria Management By Burundian Community Health Workers, Bonaventure Bazirutwabo

Walden Dissertations and Doctoral Studies

Malaria is the main cause of mortality for children under the age of 5 in Burundi. The access to malaria diagnostics and treatment is hampered not only because of logistical issues, but also due to the lack of qualified human resources and their inequitable distribution across the country. To mitigate the lack of human resources for health, the government of Burundi, along with its partners, shifted some tasks to community health workers (CHWs) to cover unmet healthcare needs for selected diseases such as malaria, diarrhea, and pneumonia. The purpose of this study was to determine whether the social support provided …

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Chronic Disease And Injury Prevention Programming For Canada's Indigenous Population, Nicole Blackman Jan 2018

Chronic Disease And Injury Prevention Programming For Canada's Indigenous Population, Nicole Blackman

Walden Dissertations and Doctoral Studies

Local public health units in the province of Ontario, Canada, are often the primary source of health promotion and health education resources, but many do not provide programming specific to the Indigenous population. As of January 2018, modernization of the Ontario Public Health Standards requires public health units to work with the Indigenous population in providing culturally appropriate programs and services. The practice question guiding the capstone project was to determine what chronic disease and injury prevention programs exist that are culturally appropriate for the Indigenous population. The purpose of this project was to do an environmental scan and compile …

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Low-Income Uninsured Perceptions, Beliefs, And Level Of Knowledge Concerning Primary Care Services, Pamela Ann Brown Jan 2018

Low-Income Uninsured Perceptions, Beliefs, And Level Of Knowledge Concerning Primary Care Services, Pamela Ann Brown

Walden Dissertations and Doctoral Studies

In the United States, there is an issue with low-income uninsured patients using emergency services for nonurgent conditions instead of using primary care services. Primary care services are more beneficial than emergency services for such patients, in that they can receive continual or follow-up care through primary care and thus achieve better health outcomes over the long term. Though information is available concerning factors in (or the rationale for) low-income uninsured patients choosing the emergency department (ED) instead of primary services for nonurgent conditions, research focusing on low-income uninsured patients' perspectives, beliefs, and level of knowledge about this matter is …

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Perceptions Of First-Time Antiguan And Barbudan Mothers Towards Breastfeeding And Weaning, Janelle Dion Charles-Williams Jan 2018

Perceptions Of First-Time Antiguan And Barbudan Mothers Towards Breastfeeding And Weaning, Janelle Dion Charles-Williams

Walden Dissertations and Doctoral Studies

Antigua and Barbuda, in the eastern Caribbean, is one of several countries with exclusive low breastfeeding rates and premature weaning. Researchers have demonstrated that babies exclusively breastfed for the first 6 months of life are better protected from childhood diseases and experience a better quality of life into adulthood, while early weaning is associated with morbidity and mortality. However, at 6 weeks postpartum, only 30% of Antiguan and Barbudan mothers are exclusively breastfeeding. Researchers have explained why mothers in general cease exclusive breastfeeding prematurely: insufficiency of breast milk, returning to paid employment, lack of social support; but an explanation specific …

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Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik Jan 2018

Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik

Walden Dissertations and Doctoral Studies

Patients with Alzheimer's disease or other types of dementia often require long-term care in nursing facilities (NF) where they may display out-of-character behaviors complicating their care. While antipsychotic medications are sometimes prescribed for NF residents, their use is considered inappropriate for the control of dementia behaviors. The Centers for Medicare and Medicaid Services have rated Texas the worst state in the country for the inappropriate use of antipsychotic medications for NF residents with dementia. This project was guided by the star model of knowledge transformation with the goal to reduce inappropriate use of antipsychotic medications through NF staff education. The …

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The Impact Of Lemongrass, Oregano, And Thyme Essential Oils On Candida Albicans' Virulence Factors, Jennifer Marie Eddins Jan 2018

The Impact Of Lemongrass, Oregano, And Thyme Essential Oils On Candida Albicans' Virulence Factors, Jennifer Marie Eddins

Walden Dissertations and Doctoral Studies

Increased systemic infections and growing resistance of Candida species in immunosuppressed people have prompted research for additional treatment options. The purpose of this quantitative study was to investigate the potential of lemongrass, oregano, and thyme essential oils tested individually, combined, and combined with the antifungal agents fluconazole and caspofungin to kill Candida albicans isolates in a controlled laboratory setting. This study was grounded on the theoretical concepts of the epidemiologic triangle model. The experimental data collected were used to investigate risk factors related to age, gender, race, and comorbidities. Kill rates of lemongrass, oregano, and thyme essential oils individually and …

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Factors Associated With Menthol Cigarettes Smoking Among Youths Ages 12 To 19, Eniye Emmanuel Eguae Jan 2018

Factors Associated With Menthol Cigarettes Smoking Among Youths Ages 12 To 19, Eniye Emmanuel Eguae

Walden Dissertations and Doctoral Studies

Menthol is added to cigarettes to make smoking more convenient. Menthol is considered a contributing factor that makes smoking appealing to youths and their continuous smoking initiation, which progresses to regular cigarette smoking and addiction, especially among youths ages 12 to 19. Menthol encourages approximately 4,000 youths to experiment with smoking daily in the United States, of which approximately 1,000 become active smokers. Not enough is known regarding the influence of menthol on youth smoking initiation/smoking behavior. A quantitative analysis of data from the 2014 National Youth Tobacco Survey (NYTS) was used to explore the association between age, race/ethnicity, gender, …

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Reintegration Among Combat Veterans Suffering From Psychological Conditions, Virginia Falck Jan 2018

Reintegration Among Combat Veterans Suffering From Psychological Conditions, Virginia Falck

Walden Dissertations and Doctoral Studies

Active duty personnel as well as combat veterans of the United States often engage in military operations during their service that require deployments to participate in missions, which may lead to extended periods away from home. When active duty men and women are appointed to combat zones, they may return with psychological burdens such as post traumatic stress disorder, which can complicate their reintegration into civilian life. This study explored the experiences of combat veterans who faced challenges when returning home from a war zone, along with the experiences of their family members. The study involved 26 combat veterans, spouses, …

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