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Articles 4651 - 4680 of 5875
Full-Text Articles in Medicine and Health Sciences
A Phenomenological Inquiry Of Nurses' Lived Experiences Of Implementing Evidence In Practice, Monnie Abraham
A Phenomenological Inquiry Of Nurses' Lived Experiences Of Implementing Evidence In Practice, Monnie Abraham
Walden Dissertations and Doctoral Studies
Research-informed practice is crucial to ensure best possible decisions are made during care delivery. In reality, research-based evidence often does not reach patient care due to many elements that impede the implementation process. The purpose of this phenomenological study was to discover the lived experiences of nurses involved in implementing evidence-based practice (EBP) in clinical settings within hospitals in United Arab Emirates. The theoretical and conceptual basis for the study was derived from Promoting Action on Research Implementation in Health Services framework for knowledge translation and Benner's Novice to Expert theory. Twelve nurses who had experience implementing evidence to practice …
Educational Module Toolkit To Assist Adult Patients With Type Ii Diabetes Mellitus, Dometrives Armstrong
Educational Module Toolkit To Assist Adult Patients With Type Ii Diabetes Mellitus, Dometrives Armstrong
Walden Dissertations and Doctoral Studies
Diabetes is a challenging chronic disease for adult patients to manage effectively. Poor adherence to prescribed medications treatment is one of the main reasons for poor blood sugar control. Despite healthcare providers' efforts to emphasize the importance of taking medications, adult patients with Type II diabetes frequently present with complications related to persistent failure to adhere to prescribed medication regimen. These patients should thoroughly understand why adhering to a strict medication regimen to maintain control of their blood sugar is so important. The purpose of this project, guided by Orem's self-care deficit nursing theory, was to develop an educational module …
Staffing Standards And Care Outcomes In For-Profit And Not-For-Profit Religious-Based Nursing Homes, Ara Omobola Omotowa
Staffing Standards And Care Outcomes In For-Profit And Not-For-Profit Religious-Based Nursing Homes, Ara Omobola Omotowa
Walden Dissertations and Doctoral Studies
Vulnerable older adults residing in nursing homes continue to experience poor care outcomes due to nurse staffing levels that are below the levels required for maintaining their well-being. Studies have shown that patient care outcomes in nursing homes are related to nurse staffing standards/levels, which are affected by profit maximization on adherence to registered nurses and licensed nurse staffing standards. The purpose of this descriptive study was to determine if there was a relationship between adherence to staffing standards and care outcomes in for-profit (FP) and not-for-profit religious-based (NFPRB) nursing homes using the profit maximization theory. Research questions focused on …
Use Of Physician Credentialing Standards By U.S. Medical Services Professionals, James Allen Reeder
Use Of Physician Credentialing Standards By U.S. Medical Services Professionals, James Allen Reeder
Walden Dissertations and Doctoral Studies
Credentialing in hospitals is the first line of defense for improving patient safety and reducing medical errors by verifying a physician's medical knowledge and skills. There is no single set of standards for physician credentialing followed by all hospitals in the United States. Using May's normalization process theory, the purpose of this quantitative study was to survey medical services professionals (MSPs) to determine which physician credentialing standards were being used, the sources being used, and the frequency of standards used. The dependent variables in this study were the 13 ideal credentialing standards developed by the National Association of Medical Staff …
Retention Of The Experienced Nurse, Tina Melissa Brinegar
Retention Of The Experienced Nurse, Tina Melissa Brinegar
Walden Dissertations and Doctoral Studies
The nursing profession is facing a potentially devastating shortage of nurses by the year 2020. Contributing to the shortage is the retirement of experienced nurses who are over the age of 45, and an aging baby boomer population. The loss will place a considerable strain on the overloaded health systems. As a result, it is important to identify successful strategies for addressing the problem of experienced nurse retention. Therefore, the purpose of this project was to conduct a systematic review of literature to answer the question of what retention strategies have been used to prevent the loss of the experienced …
Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor
Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor
Walden Dissertations and Doctoral Studies
Job satisfaction and employee turnover affect the health care industry in the form of overworked staff, inadequate health care, and loss of profits. In 2015, the United States health care industry had a shortage of over 923,000 registered nurses. Health care organizations lose an estimated $1.4 to $2.1 billion each year because of registered nurse (RN) turnover. These factors indicate that some managers lack the strategies to increase job satisfaction and reduce RN turnover. The purpose of this single case study was to use the Herzberg 2-factor theory to explore strategies 5 health care leaders use to improve nurses' job …
Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand
Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand
Walden Dissertations and Doctoral Studies
Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …
Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech
Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech
Walden Dissertations and Doctoral Studies
People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which …
Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell
Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell
Walden Dissertations and Doctoral Studies
Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients …
Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan
Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan
Walden Dissertations and Doctoral Studies
Obesity is a risk factor for chronic diseases among the ethnic minorities for adult immigrants in the United States. There have been many research studies conducted to examine the relationship between the predictors and obesity in minority groups in the United States, that relationship was unknown in Meskhetian Turk (Ahiska) immigrant populations. Guided by social ecological model and acculturation theory, this study examined the predictors of obesity in the Meskhetian Turk (Ahiska) immigrant population in the western United States. Data were collected from 109 participants using CDC's Behavioral Risk Factor Surveillance System, Stephenson Multigroup Acculturation Scale, and Perceived Stress Scale. …
A Case Study Of Student Success In Physical Therapist Assistant Programs: A Systems Approach, Penelope Lescher
A Case Study Of Student Success In Physical Therapist Assistant Programs: A Systems Approach, Penelope Lescher
Walden Dissertations and Doctoral Studies
Graduating sufficient numbers of healthcare providers to fill the needs of an aging population in the United States is a major social concern. To address this problem physical therapist assistant (PTA) programs need to improve their graduation rates to keep up with the demand for qualified personnel. Applying Senge's theory of effective systems, 1 medium-sized community college with an average pass rate of over 90% on the National Physical Therapist Assistant Examination (NPTAE) was selected to address the research question: What are the systems factors and how do they operate together to support student success in an associate degree PTA …
Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko
Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko
Walden Dissertations and Doctoral Studies
In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual …
Walkability Assessment To Reduce Childhood Obesity In Wilson County Kansas, Nancy Lee Carpenter
Walkability Assessment To Reduce Childhood Obesity In Wilson County Kansas, Nancy Lee Carpenter
Walden Dissertations and Doctoral Studies
Promoting physical exercise is necessary to combat childhood obesity. Walking to school is an encouraged physical activity, but the feasibility of walking to school depends on the walkability of the environment. During the last 40 years, the number of U.S. schoolchildren who walk to school has declined. The purpose of this evidence-based practice project was to perform a walkability assessment of the 2 largest communities in Wilson County Kansas to identify and address walkability issues. Frameworks for this practice initiative were social cognitive theory and the Health Promotion model. Questions for the project addressed whether sidewalks along the main pedestrian …
A Comparison Of Neuropathic Pain In Hiv Disease And Diabetes Mellitus, Mary Catherine George
A Comparison Of Neuropathic Pain In Hiv Disease And Diabetes Mellitus, Mary Catherine George
Walden Dissertations and Doctoral Studies
Neuropathy is a nerve disorder found in HIV disease and diabetes mellitus that indicates damage in the peripheral nervous system. Burning, tingling, stabbing, shooting, and painful sensations in the hands and feet are common symptoms of this chronic disorder, and no treatments are available that repair the nerves. The approved pain treatments are few and only available for the diabetic neuropathy population. A mixed-methods study of archival data was performed to compare patients with painful neuropathy (PN) associated with 2 diseases: HIV (HIV-PN) and diabetes mellitus (DPN). This study examined the similarities and differences of the pain narratives and common …
Assessing Provider Use Of Veterans Health Administration Tobacco-Cessation Guideline, Francisca Ogbonna
Assessing Provider Use Of Veterans Health Administration Tobacco-Cessation Guideline, Francisca Ogbonna
Walden Dissertations and Doctoral Studies
Cigarette use is more prevalent among veterans who have mental disorders than it is in the general population. Rates of tobacco use are also high among individuals who suffer from post traumatic stress disorder, addiction, and human immune deficiency disease. Approximately 22.7 million American veterans and their families are at risk of tobacco-related health problems. Concerned about heavy tobacco use among veterans, the U.S. Department of Veterans Affairs developed a Tobacco-Cessation Guideline to be used nationally. This guideline was updated in 2008 to include the '5A' mnemonic (ask, assess, advise, assist, and arrange) and is recommended for use by physicians, …
Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li
Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li
Walden Dissertations and Doctoral Studies
Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …
Nurse-To-Nurse End Of Shift Report, Winifred N. Nzeribe
Nurse-To-Nurse End Of Shift Report, Winifred N. Nzeribe
Walden Dissertations and Doctoral Studies
Handing over patient care at the end of a shift is a complex part of nursing practice that is commonly fraught with challenges. Ineffective communication continues to be the leading cause of sentinel events in the hospital setting. In response to this practice problem, this project involved the implementation of a standardized bedside reporting protocol in a surgical unit in line with the best available evidence. The overarching goal of this project was to determine how an end of shift reporting tool would impact communication, involvement of patient in care provision, and continuity of care at the bedside. The protocol …
Higher Education Leaders' Transformative Learning And Leadership Experiences Responding To Student Drug Abuse, James Vernon Battin
Higher Education Leaders' Transformative Learning And Leadership Experiences Responding To Student Drug Abuse, James Vernon Battin
Walden Dissertations and Doctoral Studies
Today's academic and social environment creates uncertainties, new roles, frequent changes, and challenging situations for student affairs academic leaders. The purpose of this study was to explore how student affairs academic leaders described their recent challenging experiences in addressing student drug abuse in higher education. The conceptual framework was based on adult transformative learning theory and applied transformative leadership perspectives. An interview format with open-ended questions was used to explore the experiences of 8 student affairs leaders who had faced challenging situations in the context of student drug abuse. A qualitative interpretive analysis was used that involved open coding of …
Influence Of Leadership Styles On Expatriate Nurses' Professional Integration In The Uae, Emmah Ncube
Influence Of Leadership Styles On Expatriate Nurses' Professional Integration In The Uae, Emmah Ncube
Walden Dissertations and Doctoral Studies
Transnational nurse migration has evoked a growing interest in the phenomenon of professional integration of expatriate nurses into their host societies. Despite research connecting employee and organizational outcomes such as job satisfaction and organizational citizenship behavior to the quality of leadership styles, there remains a lack of research linking professional integration of expatriate nurses to nurse leadership styles in the United Arab Emirates (UAE). The purpose of this grounded theory study was to develop a theory that would explain how nurse leadership styles and behaviors impacted the professional integration of expatriate nurses into the multicultural work environment of the UAE. …
Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres
Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres
Walden Dissertations and Doctoral Studies
The growing number of individuals suffering from mental illnesses and their inability to access intervention methods has adverse effects on the criminal justice system. These impairments increase the likelihood that police officers will have negative attitudes about persons with mental illnesses. This study sought to understand whether police officers' empathy, education, experience outside of work as well as on the job, and officers' training in the field of mental health all related to police officers' attitudes relating to persons with mental illness. The purpose of this study was to expand the body of knowledge and determine how factors such as …
Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson
Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson
Walden Dissertations and Doctoral Studies
Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in …
Teacher And Student Variables Affecting Special Education Evaluation And Referral, Lorenzo Adrian Woodson
Teacher And Student Variables Affecting Special Education Evaluation And Referral, Lorenzo Adrian Woodson
Walden Dissertations and Doctoral Studies
Past research has revealed that African American/Black boys are referred for special education evaluation at disproportionately higher rates than boys of other racial/ethnic groups. This correlational study used survey methodology to examine whether student and teacher demographic variables predicted how likely a teacher would refer boy students for special education evaluation. The following questions guided this research: 1) To what degree does student race/ethnicity, teacher gender, teacher race/ethnicity, and teacher attitude toward inclusion predict how likely a teacher would refer boys' to special education after controlling for teacher's years of experience in general and special education? 2) What are the …
Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim
Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim
Walden Dissertations and Doctoral Studies
The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the …
Recovery-Oriented Care In A Psychiatric Health Setting, Renita Denise Hargrow
Recovery-Oriented Care In A Psychiatric Health Setting, Renita Denise Hargrow
Walden Dissertations and Doctoral Studies
Psychiatric recovery-oriented care is aimed at improving patients' quality of care while increasing the efficiency of health care providers. Despite the benefits of recovery-oriented care, this approach is often lacking in health care settings. The purpose of this project was to implement a recovery-oriented training on psychoeducational groups on a 26-bed psychiatric unit. The Iowa model of evidence-based practice and adult learning theory provided the framework for the project. The objectives were to (a) assess training needs, (b) evaluate barriers for recovery-oriented psychiatric nursing, (c) develop strategies to address barriers, (d) train staff in psychoeducational approaches, and (e) evaluate the …
Implementation Of A Standardized Multifactorial Fall Prevention Program In A Rehabilitation Facility, Shanetta Monique Ancrum-Lee
Implementation Of A Standardized Multifactorial Fall Prevention Program In A Rehabilitation Facility, Shanetta Monique Ancrum-Lee
Walden Dissertations and Doctoral Studies
One and a half million people are currently living in residential care facilities; as the baby boomer generation ages, this number will increase to 3 million. Approximately 3 out of 4 residents of these facilities fall each year, and 10% to 20% of those falls result in serious injuries such as fractures, disability, and a decreased quality of living. The BOUNCE Back fall initiative is a multifactorial program that uses a systematic approach starting on admission and to re-evaluate a resident following a fall. Nursing and therapy uses the Morse Fall Scale and the Elderly Mobility Scale to assess and …
Exploring The Strategies To Implement A Sustainable Energy Program In Hong Kong Public Hospitals, Terry Ting
Exploring The Strategies To Implement A Sustainable Energy Program In Hong Kong Public Hospitals, Terry Ting
Walden Dissertations and Doctoral Studies
Healthcare is one of the most energy-intensive industries because of its 24 hour-a-day and 7-days-a-week operation model. Climate change, due to environmental pollution, has increased the incidence of respiratory disease, cardiovascular disease, and cancer, which further overload the financial burden of our healthcare system. The National Health Service Sustainable Development Unit suggested that a sustainable healthcare sector also requires using their resources in an efficient and responsible way. Hong Kong public hospitals are facing this problem along with high energy expenditure. The purpose of this qualitative, multiple site case study was to explore strategies for Hong Kong's public hospital leaders …
Performance Improvement Data And Staff Responsibility, Tabitha Anne Bentley
Performance Improvement Data And Staff Responsibility, Tabitha Anne Bentley
Walden Dissertations and Doctoral Studies
Improving the role the nurse plays in health care delivery should be embodied in the performance improvement initiatives to successfully improve the quality of care that is delivered. The purpose of this evidence-based practice project was to collect performance improvement data and present it to staff who, in turn, used the information to improve practice and influence patient safety outcomes. The practice-focused question addressed what would occur if a tool that allowed frequent data trending was used to measure effectiveness of care and thereby influence key outcome measures. Duffy's quality caring model provided a framework for the study to support …
Improving Seasonal Influenza Vaccine Uptake Among Health Care Workers, Debra Gray
Improving Seasonal Influenza Vaccine Uptake Among Health Care Workers, Debra Gray
Walden Dissertations and Doctoral Studies
Yearly influenza (flu) immunization rates for hospital healthcare workers (HCW) continue to be lower than those suggested by the Centers for Disease Control and the World Health Organization. Vaccination is considered a valuable step in the process to protect patients against influenza infection. The goal of Healthy People 2020, and most hospital administrators, is that 90% of HCWs are being immunized. The objectives for this systematic literature review were to identify best practice recommendations for improving the vaccine rate among HCWs. The Cochrane methodology framed this systematic review, and Fineout-Overholt's and Melnyk's levels of evidence were used to evaluate the …
The Development And Validation Of A Novice Nurse Decision-Making Skills Education Curriculum, Joanne Stephanie Simmons
The Development And Validation Of A Novice Nurse Decision-Making Skills Education Curriculum, Joanne Stephanie Simmons
Walden Dissertations and Doctoral Studies
Novice nurses (NNs) are entering critical care environments with limited knowledge, skills, and decision-making expertise. They are expected to care for complex patients in a dynamic healthcare setting. The research question for this project examined whether NNs improve their knowledge and skills by participating in a nursing decision-making skills curriculum. The purpose of the project was to develop and validate a nursing decision-making skills education curriculum working in an intermediate critical care unit. Taba's instructional theoretical model was used to guide the new curriculum development along with current evidence based practice found in the current literature. Scaffolding approach theory encouraged …
Appraisal Of Nonpharmacological Chronic Pain Management, Yvonne Larue Anthony
Appraisal Of Nonpharmacological Chronic Pain Management, Yvonne Larue Anthony
Walden Dissertations and Doctoral Studies
Chronic pain is a condition that impacts millions of men and women around the globe. It is a compelling disease that particularly impacts quality of life (QOL) for many veterans with undertreated or untreated pain. The focus of this systematic literature review was the appraisal of articles and clinical practice guidelines to better understand best-practice nonpharmacological strategies for management of chronic pain. Key words used in the literature search included chronic pain and veterans, complementary alternative medicine (yoga, tai chi, music therapy, acupuncture, and massage), and cognitive behavioral therapy (CBT). The articles included in the review were limited to those …