Medicine and Health Sciences Commons^™

Characteristics Of Adult Icu Patients With Device Associated Nosocomial Infections, Doramarie Arocha

Walden Dissertations and Doctoral Studies

Nosocomial infections are a cause of concern for hospital patients and the incidence rates of these infections are greater in intensive care units (ICUs) due to the invasive nature of treatments, additional risk factors and comorbidities, and therapies used. Invasive devices, such as vascular central lines, Foley catheters, and mechanical ventilators pose a risk for critically ill patients in the ICUs to develop device-related, healthcare-associated infections (HAI). The purpose of this study was to describe the epidemiological characteristics of patients who developed device-related HAIs within 3 ICU units (medical-surgical, cardiovascular, and neurosurgical) of an academic medical facility. The ecosocial theory …

Barriers To Colorectal Cancer Screening In People Obtaining Care From Community Mental Health Agencies, Kelly L. Gardiner

Walden Dissertations and Doctoral Studies

Barriers to Colorectal Cancer Screening in People Obtaining Care

From Community Mental Health Agencies

by

Kelly Gardiner

MSN, Wayne State University, 1997

BSN, Wayne State University, 1988

Dissertation Submitted in Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

August 2016

Despite being highly treatable with early intervention and preventative screenings, the overall mortality rate of colorectal cancer is substantially higher in participants with a preexisting mental disorder. Variables affecting the likelihood of completing screening for those with mental illnesses were unknown in people who obtain services from a Community Mental Health agency. Using …

Chronic Disease Management Of The Uninsured Patient At Ohio Free Clinics, James Benedict

Walden Dissertations and Doctoral Studies

Management of chronic disease requires a different service delivery model from that of acute illness. The uninsured population experience poorer health status and increased incidence of chronic disease than do the insured population. The purpose of this study was to identify the supports and barriers present in providing chronic disease management to patients at Ohio free clinics. Wagner's theory of chronic disease management served as the theoretical lens. The sequential, exploratory mixed methods study collected data from 13 free clinics belonging to the Ohio Association of Free Clinics (OAFC). Quantitative questions focused on processes in clinics with high and low …

A Qualitative Examination Of Surviving Homeless In Alaska, Reynaldo Espera

Walden Dissertations and Doctoral Studies

The homeless population in Anchorage, Alaska faces many unique challenges. Over the past several winters, a number of homeless individuals have succumbed to the effects of exposure despite available cold weather services. This study investigated individual experiences within the homeless population of Anchorage, Alaska during times of inclement winter weather. Self-determination theory was used to explore motivations of behaviors of the population and to uncover the reasons why this population does not use cold weather services offered by the Municipality of Anchorage. The research questions addressed participant awareness of available cold weather services, survival strategies during inclement winter weather, and …

Symptom Presentation Frequency And Severity Associated With Adult Lyme Disease By Ross Scale Review, Vicki A. Stanavitch

Walden Dissertations and Doctoral Studies

Although Lyme disease is the most frequently reported vector-borne illness in the United States, recent evidence from the CDC suggests that Lyme disease incidence in the United States may be much higher than reported. Lyme disease symptoms can be mistaken for a wide variety of diseases, which can complicate the diagnosis. To date, no diagnostic criteria analysis has been conducted examining the association between sociodemographic variables (sex and age) and seasonality of infection with the severity and symptomology found in Lyme disease cases. Using the CDC's outbreak investigation model, a primary case/control study was conducted using the ROSS Scale to …

Guideline Use In Asthma Management In Primary Care Setting: A Systematic Review, Nkiru Ezeani Ezeani

Walden Dissertations and Doctoral Studies

Asthma is a chronic airway inflammatory disease that is characterized by reversible airway obstruction due to hyper-responsiveness of the tracheobronchial tree. The condition disproportionately affects male children, females, and the aged globally, and its prevalence keeps rising despite being a preventable condition in terms of relapse. Most asthmatic patients receive care in primary care settings. Various health agencies have developed asthma management guidelines to improve the quality of asthma care; however, in some cases, adherence to these guidelines is substandard. The overarching aim of this study was to determine whether primary care providers manage asthma in line with the available …

Factors Related To Prescription Drug Abuse Among Young Adults In Florida, Mabel Gonzalez Gonzalez

Walden Dissertations and Doctoral Studies

A lack of available data exists regarding environmental factors related to prescription drug abuse (PDA), which could explain the ineffectiveness of efforts to reduce PDA in Florida. Prescription drug abuse among adults older than age 18 varies with the level of education achieved, and these metrics potentially reflect socioeconomic differences. The purpose of this quantitative study was to examine the connections between contextual aspects of prescription opioid abuse among Florida's middle and high school students to understand youth PDA in relation to their environments. This study consisted of a secondary analysis of existing PDA data (dependent variable) in relation to …

Adventist Affiliation And Type 2 Diabetes Pre- And Post-Complete Health Improvement Program (Chip), Janie Unruh

Walden Dissertations and Doctoral Studies

Adventists following a plant-based diet have half the prevalence and incidence of type 2 diabetes than nonvegetarian Adventists. This study used a quantitative, correlational study design to assess if there was a significant difference in type 2 diabetes prevalence rate between Adventists and non-Adventists preprogram, and if there were significant differences in biometrics between Adventists and non-Adventists with diabetes pre- and post-Complete Health Improvement Program (CHIP). This study incorporated the social ecological model for its conceptual framework and examined pre- and postprogram changes among Adventists (n=210; 20.1%) and non-Adventists (n=836; 79.9%) with type 2 diabetes. It used secondary data from …

Consistency In Clinical Preceptor Field Training For Sonography Students, Cathy Herring Daniels

Walden Dissertations and Doctoral Studies

Consistency in clinical preceptor training for sonography students is important in assuring equity in sonography student evaluation. Review of a local community college sonography program revealed a gap between expected roles and responsibilities of clinical preceptorship and what was actually done in the clinical setting. The purpose of this project study was to explore perceptions of graduates and preceptors regarding what constituted best practices in the evaluation of sonography students in the clinical setting. Knowles's theory of active learning provided a framework for understanding the student-preceptor relationship in the evaluation process. Research questions focused on sonography graduates' and clinical preceptors' …

Young Adults Adherence To Cancer Treatment As Compared To Older Adults, Laurie Ann Cox

Walden Dissertations and Doctoral Studies

As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, …

Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus

Walden Dissertations and Doctoral Studies

One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes …

An Exploration Of The Effectiveness Of Problem-Based Learning In Nursing Education, Yvette Marie Jackson

Walden Dissertations and Doctoral Studies

Critical-thinking is an essential skill that graduate nurses need to make sound clinical decisions. While traditional lecturing is the method most commonly used in nursing education, incorporating problem-based learning (PBL) into nursing curricula has been suggested as a better option for students' learning of theory and practice. The purpose of this study was to explore the difference in critical-thinking and problem-solving skills between nursing students taught using PBL versus those taught with traditional classroom lectures. A quasi-experimental approach, with cognitive learning theory as the foundation, was used to compare the results of an Assessment Technologies Institute (ATI) Comprehensive Predictor posttest …

Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider

Walden Dissertations and Doctoral Studies

Type 1 diabetes mellitus (T1DM) is one of the most frequently diagnosed endocrine and metabolic conditions that occur during childhood. This research study utilized a phenomenological study design to examine how the lived experiences of 20 African American (AA) parents of children with T1DM recruited using social media affects their management and control of the disease among AA youth age 5-17 years old. The interview questions were outlined in categories that tested key constructs of the health belief model (HBM) to determine the perceived barriers, seriousness, and susceptibility to maintaining good glycemic control for their children. Data from each interview …

National Center For Healthcare Leadership Competency Model Use In A Midwestern Healthcare Organization, Jimly Hariss

Walden Dissertations and Doctoral Studies

The purpose of this study was to explore senior leaders integration of the National Center for Healthcare Leadership (NCHL) competency model within their employee evaluation system. This case study was conducted to explore how the NCHL leadership competency model is used within their organization's employee evaluation system. The NCHL leadership competency model guided this study. The research was an exploration of themes in leadership competencies used in the healthcare organization. Data collection included in-depth interviews with 10 healthcare junior leaders in a single healthcare organization in the Midwestern United States who had at least 1 year of experience as a …

Perinatal Drug Abuse Intervention: Policy Development For Drug Screening, Joeanna Lee Larson

Walden Dissertations and Doctoral Studies

Perinatal drug abuse is becoming a profound issue facing the health and wellbeing of neonates. The community serviced by the project site, which lies within the boundaries of an Indian Reservation, suffers from perinatal drug abuse at a higher rate than state and federal averages. The purpose of this project was to provide the project site with a policy to consistently screen for perinatal drug abuse. Lave's theory of situational learning and the Sanford Way model for quality improvement framed this project. To guide policy development, data were compiled through a systematic review of current literature, national and state guidelines, …

Socioeconomic Status Mobility And Lifetime Exposure To Discrimination On Cardiovascular Disease Events, Nkenge H. Jones-Jack

Walden Dissertations and Doctoral Studies

Blacks in the United States have the highest rates of hypertension in the world, and their cardiovascular disease mortality rates are higher than for any other population group as a result of traditional risk factors such as obesity and stronger family history. However, additional underlying factors, such as social determinants of health (e.g., socioeconomic status [SES]) and macrosocial factors (e.g., racism), also correlate with adverse health outcomes. This study investigated whether the interaction between SES mobility over the lifecourse and lifetime racial discrimination influenced the extent to which hypertension contributed to the cardiovascular disease health disparities observed among Blacks in …

Communicating Periodontal Disease Risk To American Indian Patients With Diabetes, Jennifer Jordan

Walden Dissertations and Doctoral Studies

Type 2 diabetes is epidemic in the American Indian population. One problem health care providers face when working with the American Indian population is communicating about secondary complications, such as periodontal disease. From a public health standpoint, periodontal disease prevention is important not only to prevent unnecessary oral pain and tooth loss, but also to prevent other more serious systemic problems from occurring such as cardiovascular disease, strokes, and bacterial pneumonia. The purpose of this qualitative study was to examine the communication efforts of health care providers and understand if and how they discuss periodontal disease with their American Indian …

Preventive Health Education Media And Older Worker Health Literacy, Lori Michelle Williams-Johnson

Walden Dissertations and Doctoral Studies

The United States has experienced an increase in older workers as individuals born between 1946 and 1964 have remained in the labor force. Preventive health screening education, such as an immunization flyer, is necessary to avert preventable illness among older workers. Based on previous research, there is a gap regarding age-specific methods for educating the older worker about preventive health. Therefore, the purpose of this study was to explore the relationship between various media providing preventive health screening information and the assessed health literacy of the older worker. Based on the health belief model, a quantitative, cross-sectional method was used. …

Decreasing Surgical Site Infections In Vascular Surgery Patients, Charlene Knight Little

Walden Dissertations and Doctoral Studies

Postoperative surgical site infections are common complications in the operating room. Infections prolong hospital stays, heighten costs, and increase morbidity and mortality. The purpose of this evidence-based quality improvement project was to develop policy, program, and practice guidelines to prevent surgical site infections in vascular surgery patients. Rosswurm and Larrabee's change model was used to develop materials using the best evidence for the recommended practice changes. The Plan, Do, Check, Act model was selected to guide quality improvement. The project goal was to decrease the surgical site infection rate to below the national average. Products of the project include policy, …

Differences In Preferences For Using Microbicides Among Gay Men Seeking Internet, Nnenna Jean Wilson

Walden Dissertations and Doctoral Studies

Efforts to reduce the spread of human immunodeficiency virus (HIV) and find innovative alternatives to condom use are important public health challenges. While the incidence of HIV is leveling off among some populations, it is escalating in other populations such as young African American men who have sex with men (MSM). Guided by the health belief model (HBM) and the AIDS risk reduction model (ARRM), this quantitative, cross-sectional study sought to use multiple linear regression, binary logistic regression, and Fisher's exact test to determine how perceived susceptibility, as measured by the AIDS Health Belief Scale (AHBS), and labeling of unprotected …

Development Of Emotional Intelligence Training For Certified Registered Nurse Anesthetists, Rickey Don King

Walden Dissertations and Doctoral Studies

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Rickey King

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Marisa Wilson, Committee Chairperson, Health Services Faculty

Dr. Murielle Beene, Committee Member, Health Services Faculty

Dr. Deborah Lewis, University Reviewer, Health Services Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2015

Abstract

Development of Emotional Intelligence Training for Certified Registered Nurse Anesthetists

by

Rickey King

MSNA, Gooding Institute of Nurse Anesthesia, 2006

BSN, Jacksonville …

Doctor Of Nursing Practice, Sharon Jean Scott

Walden Dissertations and Doctoral Studies

Evidence demonstrates the health benefits of early breastfeeding for mothers as well as infants. The World Health Organization states, "Breast milk should be given within the first hour of life." This purpose of this project was to develop a breastfeeding educational toolkit to promote breastfeeding in the hospital environment. The question that guided this project was, "Will the development of a breastfeeding education toolkit, designed to serve as a learning tool to support the breastfeeding mothers, be found to be useful and valid by professional staff and lay end-users?" The goals of the project were to provide an educational toolkit …

Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly

Walden Dissertations and Doctoral Studies

Many children under the age of 5 die each year of invasive pneumococcal disease. Childhood vaccination against this disease reduces morbidity and mortality. Despite the introduction of a pneumococcal conjugate vaccine (PCV13) in a central African country in 2011, all provinces have not yet been vaccinated. The purpose of this quantitative quasi-experimental study was to determine whether there was an association between the introduction of PCV13 and new cases of pneumococcal disease in 2 provinces in central Africa. The sample size for the study was 380. The theoretical framework for this study was the epidemic model supported by the concept …

A Concurrent Mixed Method Study Exploring Iraqi Immigrants' Views Of Michigan, Kerry Luise Chamberlain

Walden Dissertations and Doctoral Studies

Failure of emergency response personnel to communicate effectively with different cultures can have dire consequences during an emergency, including loss of lives and litigation costs. For emergency response personnel to communicate the risk of an emergency, it is important to understand how different groups, especially newly arrived foreign immigrants, perceive warnings and related messages. This study addressed how one of the largest category of immigrants in Michigan perceived severe tornados, influenza pandemics, power outages, severe floods, and snowstorms. The research question examined the degree to which the equation, Risk = Hazard + Outrage, explained perceptions of these hazards in Michigan …

Equine Assisted Activities And Therapies: The Measuring Of Equine Temperament, Thecla M. Helmbrecht Howard

Walden Dissertations and Doctoral Studies

The field of equine assisted activities and therapies (EAAT) is growing in popularity as an alternative healing approach. However, there is a paucity of peer-reviewed research on the horses who serve as equal partners in EAAT. The purpose of this quantitative study was to discover the impact of equine-facilitated therapeutic activities on the temperament of horses, and to determine how to select a better human-to-horse therapeutic match when providing EAAT services. The theoretical framework for this research drew from Romanes' theory of animal intelligence, which predicts that temperament would change as a result of prolonged participation in specific work (EAAT …

Comparing African- And U.S.-Born Blacks At Stage Of Diagnosis And Treatment For Nonsmall Cell Lung Cancer, Relindis K. Fofung

Walden Dissertations and Doctoral Studies

Lung cancer is a disease with a high mortality rate for the U.S. Black population. There had been considerable research done on different population demographics, necessary to achieve the Healthy People 2020 overarching goals to eliminate health disparities, gain health equity and maintain quality health. Yet, the African-born Black (AFBB) population has been understudied for nonsmall cell lung cancer (NSCLC). This study sought to determine whether within race differences in stage at diagnosis and treatment of NSCLC exists between AFBB and American-born Blacks (AMBB) populations in the United States. The study data is secondary data collected as part of the …

Hypertension Management Through Community Outreach Services For Inmates Released From Jail, Janet Baby Wurie

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is the most common chronic disease among jail inmates. Many inmates treated for HTN while incarcerated in the Fairfax County Jail do not continue treatment when they return to their communities. Factors that contribute to discontinuing HTN management once the inmate returns to the community include homelessness, low income, and lack of access to care. The purpose of this quality improvement project was to educate inmates with HTN about community-based outreach services for HTN management and continuity of care while in the community. The outcome measured was the number of inmates who returned to jail reporting use of …

The Relationship Between Physical Fitness And Academic Achievement In Sixth Grade Students, Shannon Usco Shook

Walden Dissertations and Doctoral Studies

Researchers have reported on the relationship between academic achievement and physical fitness levels. At one rural middle school, 25% of the students enrolled were either overweight or obese and failing at least one course. Educators at the local site were seeking methods to improve the academic achievement of their students. The purpose of this quantitative study was to examine the relationship between academic achievement and physical fitness of middle school students at the study site. Framed by the theoretical connection between improved physical fitness levels and academic achievement, the research questions examined the relationship between physical fitness levels of 6th …

Predictive Ability Of Emotional Intelligence Scores On Employee Self-Reported Perception Of Comprehensive Organizational Credibility Inventory, Leif Allen Ford

Walden Dissertations and Doctoral Studies

Research has shown that emotional intelligence (EQ) is positively related to beneficial outcomes in organizations. Research has also found that negative perceptions of organizational credibility (OC) can result in adverse economic and social costs for organizations and communities. To date, the existing research has failed to examine whether employee EQ might affect employee perceptions of OC. A quantitative, non-experimental study was conducted using a sample of employees in large health and medical organizations throughout the United States. The variables in the study were measured using the Assessing Emotions Scale and the Comprehensive Organizational Credibility Inventory. Multiple regression analyses and Pearson …

Perioperative Orientation, Education, And Mentoring (Poem) Program, Esther M. Johnstone

Walden Dissertations and Doctoral Studies

Perioperative registered nurses (RNs) are vital to the provision of safe patient care for those undergoing invasive and surgical procedures within acute care settings. Unrealistic transition-to-practice (T2P) expectations for novice RNs (newly licensed and experienced RNs new to perioperative nursing) have resulted in significant turnover and attrition rates as high as 45%. A T2P program, known as the Perioperative Orientation, Education, and Mentoring (POEM) program, was developed to address attrition and turnover through mentoring and professional development. The POEM program was a pilot program implemented at a large academic medical center. An evaluation tool known as the Surgical Skill Assessment …