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Walden Dissertations and Doctoral Studies

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Full-Text Articles in Medicine and Health Sciences

Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd Jan 2017

Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd

Walden Dissertations and Doctoral Studies

Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …

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The Influence Of Culture On Hiv Disclosure Among Gay Asian Males, David C. Doan Jan 2017

The Influence Of Culture On Hiv Disclosure Among Gay Asian Males, David C. Doan

Walden Dissertations and Doctoral Studies

HIV-positive, Asian Pacific Islander (API) men who have sex with men (MSM) experience triple minority stigma including HIV, sexual orientation, and minority ethnicity. To date, there is no research that examines the influence of cultural factors, level of acculturation, social determinants of health, and other confounding variables (e.g., age, education, level of income, and length of time since diagnosis) on HIV-positive disclosure behaviors, attitudes, and intentions to casual sexual partners for API MSM. The theoretical framework for this study was based on Hofstede's original cultural values and Triandis's cultural dimensions. In this 2-phase, mixed methods, sequential explanatory study, 24 API …

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Effects Of Lifestyle Changes On The Health Of African Americans With Type 2 Diabetes, Charles Duro Jan 2017

Effects Of Lifestyle Changes On The Health Of African Americans With Type 2 Diabetes, Charles Duro

Walden Dissertations and Doctoral Studies

African Americans are adversely affected by Type 2 diabetes at a greater rate than their European American counterparts; however, research on the effects of Type 2 diabetes on African Americans is limited. Lifestyle modifications that include the incorporation of physical activity and dietary changes can help patients with Type 2 diabetes better manage their disease and improve their overall quality of health. The purpose of this phenomenological study was to explore the experiences of African Americans with Type 2 diabetes who incorporated these self-management behaviors, discerning if they had improved health and quality of life. The self-efficacy framework was applied …

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Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá Jan 2017

Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá

Walden Dissertations and Doctoral Studies

There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand …

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Night Shift Work And Weight Gain Among Female Filipino Nurses, Raymundo Mintac Apellido Jan 2017

Night Shift Work And Weight Gain Among Female Filipino Nurses, Raymundo Mintac Apellido

Walden Dissertations and Doctoral Studies

The research problem is the increasing numbers of overweight and obese nurses working the night shift. Study on overweight and obesity among female Filipino nurses has not been conducted. It was important to conduct a research study among female Filipino nurses to find out if there are statistically significant associations between night shift work and weight gain. The purpose of this correlational and cross-sectional study was to determine if there are statistically significant associations between insufficient sleep, abnormal eating patterns, working 12-hour shifts, years of working night shift, age, stress, marital status, nursing units, decreased physical activity, and level of …

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Non Medical Prescription Drug Use In Rural Communities And Social Work, Izetta Mounice Briggs-Bolling Jan 2017

Non Medical Prescription Drug Use In Rural Communities And Social Work, Izetta Mounice Briggs-Bolling

Walden Dissertations and Doctoral Studies

This study explored the roles and responsibilities of social workers providing services to nonmedical prescription drug users (NMPDU). Researchers have indicated NMPDU disproportionately affects people living in rural communities. The overarching research question sought to explore the concerns of social workers when providing services to patients coping with NMPDU in the rural community of Ulster County, New York. The intention was to examine systemic challenges facing rural social workers when attempting to decrease morbidity risks and increase the health of Ulster County residents. A total of 7 social workers participated in 3 focus groups to explore their ideas for defining, …

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Alcohol Use Disorder And Withdrawal Syndrome In Correctional Facilities: An Evidence-Based Clinical Practice Guideline To Prevent Alcohol-Related Adverse Events, Wanda Wilma González-Méndez Jan 2017

Alcohol Use Disorder And Withdrawal Syndrome In Correctional Facilities: An Evidence-Based Clinical Practice Guideline To Prevent Alcohol-Related Adverse Events, Wanda Wilma González-Méndez

Walden Dissertations and Doctoral Studies

In the United States, one in every 100 adults is confined to a correctional facility. Approximately 60% of inmates have an alcohol use disorder (AUD). When compared to the general population, inmates are twice as likely to have AUD. As they are unable to readily access alcohol, inmates entering a correctional facility with AUD are at high risk for the lethal alcohol withdrawal syndrome (AWS). AWS is preventable and yet correctional nurses process new inmates without an evidence-based clinical practice guideline (CPG) to assess for AUD, the prerequisite for AWS. The purpose of this project was to develop an evidence-based …

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Factors Affecting Inadequate Growth During Early Childhood In Guyana, South America, Valescia Xenobia John Jan 2017

Factors Affecting Inadequate Growth During Early Childhood In Guyana, South America, Valescia Xenobia John

Walden Dissertations and Doctoral Studies

Children under 5 years of age in Guyana are at an increased risk for inadequate growth. According to the United Nations Development Programme, 1 out of 3 children of preschool age are undernourished globally. This is a major public health concern as undernourishment in children under 5 years can lead to lifelong health complications. The study assessed the relationship between inadequate growth and urban classification in children under 5 years in Guyana, South America, after controlling for the following variables: mother's level of education, mother's age at birth of the child, household size, wealth, and marital status. The study framework …

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Educational Intervention For Engaging Adolescents And Their Parents In Hpv Vaccination, Alvin Mena Cantero Jan 2017

Educational Intervention For Engaging Adolescents And Their Parents In Hpv Vaccination, Alvin Mena Cantero

Walden Dissertations and Doctoral Studies

In the United States, 79 million people are currently infected with Human Papilloma Virus (HPV) and it is estimated that an additional 14 to 20 million people will be infected with HPV every year. Infection with HPV increased to 52.7 % of preventable infections within the United States in 2012, and 39.6% of the infected population are adolescents engaged in sexual activities. The practice-focused question that this project addressed was: To what extent can an educational program influence the HPV vaccination rate in a small family practice clinic located in Texas? The main purpose of this project was to increase …

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Educational Interventions To Improve Aggressive Behavior Recognition For An Acute Psychiatric Setting, Marie Elois Ortiz Jan 2017

Educational Interventions To Improve Aggressive Behavior Recognition For An Acute Psychiatric Setting, Marie Elois Ortiz

Walden Dissertations and Doctoral Studies

Nurses working in an acute psychiatric setting within a veterans' administration hospital must maintain a therapeutic milieu by recognizing and managing aggressive behaviors before violence ensues to reduce injuries to staff nurses and patients. The purpose of this project was to develop an evidence-based and theoretically grounded educational program that will help staff nurses manage escalating aggression, violence, and acting out behaviors to provide a safe environment for patients and staff through high risk identifier recognition and intervention training. During the data and information gathering stage, 23 articles were reviewed, rated, and graded to provide the most significant information used …

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Evidence-Based Practice Project Proposal: Reducing Chfrr Through The Get Well Networks Chf Prevention Education Materials, Susan Kay Richmond Jan 2017

Evidence-Based Practice Project Proposal: Reducing Chfrr Through The Get Well Networks Chf Prevention Education Materials, Susan Kay Richmond

Walden Dissertations and Doctoral Studies

In the United States, congestive heart failure (CHF) impacts 6.5 million adults and costs about $39 billion year with a projected incidence increasing by 25% by 2030. CHF can be addressed by advancing patient self-care knowledge through interactive patient education. For this project, the Health Beliefs Model guided a strategy to stimulate behavior modification based on perceived benefits of self-care. The purpose of this quality improvement project was to implement an interactive patient education video system, called the Get Well Network, to encourage patient self-care to reduce CHF readmission rates at a veteran's administration hospital. Four evidence-based CHF video order …

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Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce Jan 2017

Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce

Walden Dissertations and Doctoral Studies

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses …

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Caregiver Burden And Emergency Room Utilization For Enhanced Recovery Surgery Cancer Patients, Mindy Sovel Jan 2017

Caregiver Burden And Emergency Room Utilization For Enhanced Recovery Surgery Cancer Patients, Mindy Sovel

Walden Dissertations and Doctoral Studies

Advances in surgical technique and medical management have led to fundamental changes in surgical care allowing for a paradigm shift from inpatient to outpatient surgery. Enhanced recovery pathways have moved surgical recovery from inpatient to outpatient settings requiring informal caregiver support. The purpose of this study was to determine the prevalence of caregiver burden in this patient population and to explore whether caregiver burden contributes to preventable use of emergency room services. The conceptual framework supporting this retrospective cross-sectional study was Andersen's behavioral model of health services utilization. Data collected from 28 urologic patient/caregiver pairs were analyzed using descriptive statistics …

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Implementation And Evaluation Of Code Stroke In Emergency Department For Maternity Patients, Linda Catherine Castillo Jan 2017

Implementation And Evaluation Of Code Stroke In Emergency Department For Maternity Patients, Linda Catherine Castillo

Walden Dissertations and Doctoral Studies

Strokes are a significant source of morbidity and mortality in pregnant women, influenced by the physiologic changes in pregnancy and the trend of older and sicker women becoming pregnant. Despite the role of stroke in pregnant women, emergency departments in specialized maternity hospitals may not be as experienced in stroke recognition and care as are typical emergency departments. The purpose of this project was to create a protocol to facilitate rapid assessment and treatment of pregnant and postpartum women with symptoms of stroke in a maternity emergency department. The IOWA model of evidence-based practice to promote quality care guided a …

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Relationship Between Quality Of Life For Patients With Neuroendocrine Tumors And Novel Biomarkers, Stephanie L. Ford-Scheimer Jan 2017

Relationship Between Quality Of Life For Patients With Neuroendocrine Tumors And Novel Biomarkers, Stephanie L. Ford-Scheimer

Walden Dissertations and Doctoral Studies

Research in the field of neuroendocrine tumors (NETs) has increased over the last decade, including studies focused on biochemical markers (biomarkers) of the disease. There is also growing interest in how NETs impact patients' quality of life (QOL). Consequently, there is a paucity of information about whether the expression of the specific disease biomarkers affects QOL as well as whether the primary tumor site impacts QOL. Using the explanatory model of health promotion and quality of life in chronic disabling conditions as the theoretical framework and data collected with the Norfolk QOL-NET instrument, this study's purpose was to fill that …

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Demographic Factors Associated With Consistent Hand Hygiene Adherence Among Icu Nurses, Sharon Lea Kurtz Jan 2017

Demographic Factors Associated With Consistent Hand Hygiene Adherence Among Icu Nurses, Sharon Lea Kurtz

Walden Dissertations and Doctoral Studies

Healthcare associated infections cause 75,000 to 80,000 deaths a year. Many are preventable with proper hand hygiene adherence (HHA). Worldwide, HHA range is between 40-60%, far below the 100% recommended. The purpose of this quantitative, cross-sectional, prospective study was to investigate any association between 15 demographic variables and HHA of ICU nurses. A convenience sample of 613 hand hygiene opportunities was collected by direct observation at each of 5ICUs (4 hospitals) in Texas for 8 consecutive hours each day for 3-5 days. The theoretical foundation guiding this study was the healthcare environment theory. The Statistical Package for Social Sciences software …

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Educating Nurses On Workflow Changes From Electronic Health Record Adoption, Rhoda Lynn Atienza San Jose Jan 2017

Educating Nurses On Workflow Changes From Electronic Health Record Adoption, Rhoda Lynn Atienza San Jose

Walden Dissertations and Doctoral Studies

Workflow issues related to adoption of the electronic health record (EHR) has led to unsafe workarounds, decreased productivity, inefficient clinical documentation and slow rates of EHR adoption. The problem addressed in this quality improvement project was nurses' lack of knowledge about workflow changes due to EHR adoption. The purpose of this project was to identify changes in workflow and to develop an educational module to communicate the changes. This project was guided by both the ADDIE model (analysis, design, development, implementation, and evaluation) and the diffusion of innovations theory. Five stages were involved: process mapping, cognitive walkthrough, eLearning module development, …

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Frequent Fall Risk Assessment Reduces Fall Rates In Elderly Patients In Long-Term Care, Omokhele Rosemary Aliu Jan 2017

Frequent Fall Risk Assessment Reduces Fall Rates In Elderly Patients In Long-Term Care, Omokhele Rosemary Aliu

Walden Dissertations and Doctoral Studies

Falls are a serious issue for the elderly living in long-term care facilities, as falls contribute to signiï¬?cant health problems such as increased dependence, loss of autonomy, confusion, immobilization, depression, restriction in daily activities, and, in some cases, death. An estimated 424,000 fatal falls in elderly patients residing in long-term facilities occur annually in the United States costing $34 billion in direct medical costs. One way to reduce falls among elderly patients in long-term care is to assess for fall risk frequently and implement evidence-based strategies to prevent falls. Patients in this project site facility had been assessed for fall …

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The Lived Experiences Of School Nurses: Transitioning From Hospital To School Worksite, Irene Campbell Jan 2017

The Lived Experiences Of School Nurses: Transitioning From Hospital To School Worksite, Irene Campbell

Walden Dissertations and Doctoral Studies

School nurses who transition from hospital or clinic-based settings to a school-based work environment often lack sufficient transitioning skills and orientation to cope with the roles and responsibilities of school-based nursing. The result is a high attrition rate among school-based nurses. School nurses may leave their positions due to experiences of marginalization, including isolation, role confusion, and barriers to practice. In this phenomenological study, the lived experiences of 12 school-based nurses who transitioned from hospital or clinical settings were explored. Bandura's self-efficacy and Spreitzer's psychological empowerment theories were used in interpreting the findings. Data were collected via face-to-face individual interviews …

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Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire Jan 2017

Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire

Walden Dissertations and Doctoral Studies

Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital's outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer …

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Ambulatory Registered Nurse Perspectives On Health Literacy Roles And Patient Communication, Gloria Medina Redden Jan 2017

Ambulatory Registered Nurse Perspectives On Health Literacy Roles And Patient Communication, Gloria Medina Redden

Walden Dissertations and Doctoral Studies

Registered nurses (RNs) have a significant role in communicating health information to patients. The problem addressed in this study was RNs roles with health literacy and communicating health information using words that the patient understands. This study found that ambulatory RN perspectives on their roles in health literacy and patient communication may improve health outcomes and optimal wellness. The purpose of this qualitative study was to examine and describe ambulatory RN perspectives on their roles in health literacy and patient communication, as these are necessary components linked to better health outcomes. The conceptual framework for this study was the nurse …

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Leadership Development For The Formal Nurse Leader, Lori Neu Jan 2017

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

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Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki Jan 2017

Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki

Walden Dissertations and Doctoral Studies

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …

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Translating Evidence Of Skin-To-Skin And Rooming-In To Practice, Francisca Njoku Jan 2017

Translating Evidence Of Skin-To-Skin And Rooming-In To Practice, Francisca Njoku

Walden Dissertations and Doctoral Studies

The old practice of separating the mother-baby-dyad was without measurable benefits to mothers or their infants. Evidence has shown that skin-to-skin care (SSC) prevents hypothermia and hypoglycemia, decreases crying during painful procedures in newborns, and reduces maternal anxiety, stress, and postpartum depression. Rooming-in care (RIC) has been linked to an increase in the rate of breastfeeding and mother-infant interaction, as well as a decrease in the infant morbidity rate. This project assessed the effect of an educational intervention to increase rates of SSC and RIC in an obstetric unit, in addition to measuring nurses' attitudes and barriers in relation to …

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Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari Jan 2017

Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari

Walden Dissertations and Doctoral Studies

Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …

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Restaurant Management Strategies To Comply With Food Safety Regulations, Dr. Carlos Juan Calcador Jan 2017

Restaurant Management Strategies To Comply With Food Safety Regulations, Dr. Carlos Juan Calcador

Walden Dissertations and Doctoral Studies

The recent economic crisis in Puerto Rico has created decreased health department fiscal capabilities, adding more responsibilities to health department officials in charge of restaurant inspections without adding more operational funds, which in turn led to less regulatory capacity. This situation instigated increased food safety regulation violations, and food safety legislation changes, imposing more economic pressure to restaurant owners, which leads to a lack of restaurant sustainability. The purpose of this case study was to explore strategies six business visionaries, smart entrepreneurs, who have positioned themselves as successful restaurateurs, in the restaurant industry in Puerto Rico. They were key factors …

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Development Of A Program Evaluation For A Preceptor Preparation Program, Olivia Hagos Jan 2017

Development Of A Program Evaluation For A Preceptor Preparation Program, Olivia Hagos

Walden Dissertations and Doctoral Studies

A significant nursing shortage exists in the United States, which is compounded by high turnover rates. Skilled nurse preceptors are needed to train and assimilate nurses, which would improve retention of nurse preceptors, facilitate transition of nurses to the practice environment, and increase the number of preceptors within the organization. A preceptor preparation program in a 300-bed hospital was developed to promote nurse preceptor success while enhancing learning outcomes and creating a supportive work environment. The organization's leaders are interested in the successes of the program and its long-term role in retaining nurse preceptors who completed the preceptor preparation program. …

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Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross Jan 2017

Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross

Walden Dissertations and Doctoral Studies

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at …

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Development Of An Evidence-Based Practice Guideline For Prevention Of Diaper Dermatitis, Nanita Flavier Lim-Sulit Jan 2017

Development Of An Evidence-Based Practice Guideline For Prevention Of Diaper Dermatitis, Nanita Flavier Lim-Sulit

Walden Dissertations and Doctoral Studies

Diaper dermatitis, an acute inflammatory reaction of the skin, is one of the most common forms of dermatitis among neonatal and pediatric patients. The problem addressed in this quality improvement project was the absence of an evidence-based practice (EBP) guideline for perineal care which resulted in 4 unexpected cases of diaper dermatitis per 100 hospital days at a non free standing children's hospital. Framed within Rosswurm and Larrabee's model for EBP, the purpose of this project was to develop an educational initiative encompassing an EBP guideline for perineal care, an educational curriculum plan for staff members, and a Power Point …

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Assessing Plant-Based Food Lifestyle To Reduce Obesity Risk, Erna Siregar Jan 2017

Assessing Plant-Based Food Lifestyle To Reduce Obesity Risk, Erna Siregar

Walden Dissertations and Doctoral Studies

Despite an increasing number of healthy lifestyles throughout the country, Americans, including Native Hawaiians, keep gaining weight. Unlike several American lifestyles that have resulted in weight gain within the American population, the vegetarian lifestyle is a scientifically proven method for decreasing body weight and maintaining the weight loss for more than 1 year. This study aimed to compare the lifestyle patterns of 4 vegetarian lifestyles and 1 nonvegetarian lifestyle among Native Hawaiians aged 21 and older using their body mass index (BMI). This quantitative study utilized a correlational design, which is particularly suitable for examining the relationship of BMI to …

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