Medicine and Health Sciences Commons^™

Alarm Safety In A Regional Neonatal Intensive Care Unit, Piper Probst

Walden Dissertations and Doctoral Studies

Alarm fatigue is a practice problem that applies to hospitalized patients and the nurses who care for them. Addressing alarm fatigue is important to promote alarm safety and to decrease the risk of patient harm or death. The purpose of this study was to decrease alarm fatigue and improve alarm safety in a regional neonatal intensive care unit (RNICU). Guided by the conceptual model for alarm fatigue and alarm safety, this study addressed whether or not alarm management protocols designed to decrease false and nuisance alarms in the physiological monitoring of neonates improve alarm safety via decreased alarm burden and …

Strategies To Prevent The Unintentional Retention Of Foreign Objects In Surgical Patients, Leonard Harichand Ramdas

Walden Dissertations and Doctoral Studies

The Institute of Medicine's report in 2000, To Err Is Human: Building a Safer Health

System, highlighted the seriousness of medical errors in the U.S. health care system. The unintentional retention of foreign objects in surgical patients is one of those errors. At the time of this study, there was no standardized counting policy and process across operating rooms in the United States. The purpose of this project was to develop a best practice educational counting program to help prevent the unintentional retention of foreign objects in surgical patients. The Logic Model was used to guide the design of the …

Effect Of A Lifetime Health And Fitness Class On College Students, Tiffany Tara Young Klockziem

Walden Dissertations and Doctoral Studies

Physical inactivity and obesity, both of which are modifiable cardiovascular disease (CVD) risk factors, increase substantially during the transition from adolescence to young adulthood. CVD is the 5th leading cause of death in people ages 18 to 29. This disease has enormous social and financial repercussions; however, many college age students do not see chronic disease as a personal threat. Few researchers have examined chronic disease risk in young adults or used a consistent, objective measurement of physical activity. A pre-post, quasi-experimental study was conducted to evaluate the association between a health and fitness class, physical education 215 (PHED 215) …

Increasing Knowledge About Alpha-1 Antitrypsin Deficiency In The Chronic Obstructive Pulmonary Disease Population, Maureen Ann Wentink Barta

Walden Dissertations and Doctoral Studies

The purpose of the project was to increase awareness about alpha-1 antitrypsin deficiency (AATD) in chronic obstructive pulmonary disease (COPD), particularly among those with a familial history of genetic factor AATD; an additional goal was to understand its relationship to COPD. COPD is the third leading cause of death in the United States, with more than half of COPD patients experiencing significant disabilities. Major causes for COPD include smoking, air pollution, secondary smoke, upper respiratory infections, hereditary factors, occupational factors, environmental factors, and socioeconomic factors. Genetic factors, however, also play a significant role in early onset COPD and in those …

Concordance Of Genotyping And Phenotyping In The Classification Of Methicillin-Resistant Staphylococcus Aureus, Ali M. Bazzi

Walden Dissertations and Doctoral Studies

Methicillin-resistant Staphylococcus aureus (MRSA) strains have spread in Saudi Arabia, increasing morbidity, mortality, and financial burdens. Recent studies have suggested the phenotyping methods typically used to classify MRSA as either health care MRSA (HA-MRSA) or community-associated MRSA (CA-MRSA) cases are unreliable, because they lack concordance with the results of genotyping. Yet the expense associated with genotyping precludes its use in the Saudi Aramco population in Saudi Arabia. The absence of a standardized and affordable method to classify MRSA into CA-MRSA and HA-MRSA has been a challenge for infection control programs in Saudi Arabia. The objective of this quantitative, secondary data …

Moving From Productivity To Professional Value Model Of The Hospital-Based Registered Nurse, Crystal Maree Billings

Walden Dissertations and Doctoral Studies

There is a gap between organizational commitment to professional value of the nurse and the achievement of quality outcomes. This study explored the relationship between the productivity model and the professional value (PVS) model of the hospital-based registered nurse (RN). It was essential to understand how to measure nursing's contribution to patient care as a means to promote patient care outcomes. The current professional nursing dynamic provides an unprecedented opportunity for nurses to achieve their highest professional potential through increased demonstration of advocacy and accountability for the central tenets of nursing. The intent of this project was to explore the …

Development Of Mentors To Facilitate Evidence-Based Practice In A Nurse Residency, Susan Annette Breit

Walden Dissertations and Doctoral Studies

Evidence-based practice has resulted in better patient outcomes, higher patient satisfaction, and effective patient-centered care. Leadership of a large teaching hospital determined that new nurses lacked the education and experience to design and implement an evidence-based project at the bedside, which was an expected outcome for completion of the established nurse residency program. The purpose of this project was to develop a design-only project in which Masters of Science in Nursing-prepared mentors were added to the residency program to establish the required evidence-based project. A mentor workshop was developed to guide the mentors in this role using Benner's novice to …

Ventilator-Associated Pneumonia Prevention Bundle, Patricia Cal

Walden Dissertations and Doctoral Studies

Ventilator-associated pneumonia (VAP) is a serious complication in critically ill patients; it can prolong intubation, increase intensive care unit and hospital length of stay, and increase mortality to twice the level of patients who do not develop VAP. The purpose of this project was to determine the effect of an evidence-based educational program to prevent VAP on ICU nurses' actual and documented practices for preventing VAP. The research questions addressed whether an educational program focused on VAP prevention will affect critical care nurses' compliance with a VAP prevention bundle, and whether the education will result in maintenance of a rate …

Uterine Fibroid Symptom Severity And Impact On Health-Related Quality Of Life Among African American Women, Ilisher Ford

Walden Dissertations and Doctoral Studies

A disproportionate number of African American women are at increased risk for uterine fibroid tumors (UF) compared to their Caucasian, Asian, and Hispanic counterparts. Researchers have indicated that women diagnosed with UF can have a poorer health-related quality of life (HRQOL) when compared to women who do not have a diagnosis of UF. The overall aim of this study was to explore the impact of UF symptoms on the HRQOL of African American women. A quantitative, cross-sectional design was employed utilizing the revised version of Wilson and Cleary's model of HRQOL. A sample was gathered of 80 participants who were …

The Effects Of Buddhist Psychological Practices On The Mental Health And Social Attitudes Of Lesbian, Gay, And Bisexual People, Jessica Lynn Fritzges

Walden Dissertations and Doctoral Studies

This non-experimental, quantitative study explored the effects of the Buddhist-derived practices of mindfulness and loving-kindness meditations on the wellness of lesbian, gay, and bisexual (LGB) people. LGB people are at higher risk of mental illness and increased social isolation due to minority stress; Buddhist-derived mindfulness practices mediate these effects in other groups. Lazarus and Folkman's transactional model of stress and coping was the theoretical model explaining how positive cognitive appraisal induced by meditation can mediate effects of stress. This study examined whether mental health scores on the Emotional Symptoms Checklist (ESC), social attitudes measured on the Unjust World Views Scale, …

The Impact Of Crisis Alleviation Lessons And Methods Program On Injuries In Healthcare, Andra Lynn Ferguson

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine whether Crisis Alleviation Lessons and Methods -© (CALM), as a behavioral crisis management program, was effective in reducing patient and healthcare professional injuries in a long-term residential care setting. This research was needed due to the lack of peer-reviewed scholarly literature on the effectiveness of behavioral crisis management programs, especially on programs using both nonphysical and physical de-escalation techniques, such as CALM. An auto-regressive integrated moving average (ARIMA) time series analysis was performed to examine the effect the implementation of the CALM program (independent variable) had on the rate of injuries to …

Physicians' Perceptions And Practice Regarding The Prevention Of Catheter-Associated Urinary Tract Infections In The Icu, Marilyn Keng-Nasang Mbi Feh

Walden Dissertations and Doctoral Studies

Catheter associated urinary tract infection (CAUTI) incidence continue to rise despite all prevention efforts. The state of Georgia incidence of CAUTI between 2012 and 2013 showed an increase by 350 cases. The challenge is translating CAUTI prevention knowledge into practice by all physicians. The purpose of this correlational study was to improve the epidemiological understanding of CAUTI. Looking at physicians’ perception and practice of CAUTI preventions was necessary. A total of 336 physicians from the state of Georgia completed a 26-item survey. Additionally, a pilot study was conducted on a small sample of participants. The result of the Cronbach alpha …

Correlation Analysis Of Climatic Variables, Migration And Dengue Cases In Southeast Florida, Brunilda Lugo

Walden Dissertations and Doctoral Studies

Dengue fever is a debilitating, viral, mosquito-borne disease occurring in tropical and subtropical areas in the world. The majority of dengue cases in the United States were acquired in endemic areas by travelers or immigrants. However, in recent years, autochthonous (locally acquired) dengue cases have been diagnosed in Florida. The purpose of this study was to find an association between potential risk factors and the expansion of dengue fever in the United States. Guided by the eco-bio-social framework, which offers a broad assessment of risk factors for the illness, a retrospective design was used with archival data to correlate changes …

The Relationship Between Senior Healthcare Executives' Emotional Intelligence And Employee Satisfaction, Carmen Mcdonald

Walden Dissertations and Doctoral Studies

The healthcare industry evolved on March 23, 2010, when the Affordable Care Act (ACA) was signed into law. The general problem prompting the need for this study was that healthcare workers are affected by patient and family anxiety, evolving evidence based practices and treatments, and regulatory complexities. Outdated managerial skills with leaders lacking emotional intelligence may produce employee dissatisfaction, and satisfied workers may influence the quality of care and patient satisfaction. The purpose of this study was to examine the relationship between senior healthcare leaders' EI and employee satisfaction. EI theory was the conceptual foundation for this research. This quantitative …

Association Of Bisphenol A And C-Reactive Protein Concentrations With Cardiovascular Diseases, Hassan Salim Naji

Walden Dissertations and Doctoral Studies

Bisphenol A (BPA), a widely used chemical in plastic, has drawn wide attention due to its presence in many consumer products and the environment. The purpose of this study was to examine the association between urinary BPA and the reporting of cardiovascular diseases (CVD), and then to examine the effect of C-reactive protein (CRP) as a moderating variable. The data used in this research were extracted from the National Health and Nutrition Examination Survey collected in 2009-2010. Guided by the advanced epidemiological triangle, analysis involved 2 stepwise binary logistic regressions. The first step suggested that the controls were significant in …

Interdisciplinary Bedside Rounding: Patient Satisfaction With Nursing Communication And Decreased Hospital Readmissions, Luanne Parks

Walden Dissertations and Doctoral Studies

There is a lack of quality communication among health care professionals and patients in the hospital setting, which can negatively impact patient satisfaction and increase hospital readmission rates. Interdisciplinary bedside rounding (IBR) is a method of rounding that uses direct communication and discussion of the patient at the bedside, and the use of IRB may improve the quality communication among health care professionals and patients. The purpose of this program outcomes evaluation project was to evaluate whether IBR increased patient satisfaction with nursing communication and if IBR decreased hospital readmission rates. The Iowa model of evidence-based practice provided a framework …

Can Nurse-Facilitated Support Groups Foster Self-Awareness?, Althea Lenore Phillips

Walden Dissertations and Doctoral Studies

Students with learning disabilities (LDs) represent 9% of students attending college, and college administrators must comply with a large number of federal requirements outlining the provision of educational services for students with LDs, including offering support groups. Nurse-facilitated support groups, held within the university setting, could provide effective social support, increasing likelihood of college success among students with LDs. The purpose of this project was to develop a plan for implementing nurse-facilitated support groups for students with LDs within the student health services (SHS) department at a university designed to improve their coping skills on personal, social, and academic levels. …

Cultural Competence In Certified Registered Nurse Anesthetists, Martina Renee Steed

Walden Dissertations and Doctoral Studies

For several decades, the field of nursing has focused on the integration of cultural competence content into its prelicensure educational programs. Despite this focus, little is known about the cultural competence of nurses extending their education past initial licensure into an advanced practice nursing specialty, such as nurse anesthesia. Researchers in other fields have found that provider race and previous cultural competence training are associated with higher levels of cultural competence. This research, guided by the culture care diversity and universality theory, sought to determine the relationship between the two subscales, Cultural Awareness and Sensitivity (CAS) and the Cultural Competence …

Nursing Faculty Perceptions Of And Responses To Student Incivility, Lori Linn Theodore

Walden Dissertations and Doctoral Studies

Student incivility has become a problem in nursing schools around the country. Researchers have noted that uncivil behavior that goes unaddressed may compromise the educational environment. Nursing faculty have differing standards about uncivil behavior; thus, students experience inconsistencies in approaches to incivility. The purpose of this mixed-methods explanatory study was to explore nursing faculty experiences with, understandings of, and responses to student incivility. The conceptual framework was Clark's continuum of incivility and the conceptual model for fostering civility in nursing education. Descriptive analysis of the level and frequency of uncivil behaviors of nursing faculty members (17 full-time and 15 part-time), …

Effect Of Social Support And Hiv-Related Stigma On Depression In Hiv/Aids Patients, Chinedu Anthony Umeadi

Walden Dissertations and Doctoral Studies

HIV has remained a public health problem in Nigeria. The purpose of this cross-sectional study was to examine the effect of social support and HIV-related stigma on depression in people living with HIV/AIDS (PLWHA) and to examine the moderating effect of sociodemographic factors, Quality of Life (QOL), and time since HIV diagnosis on this relationship. This study was based on the social cognitive theory. Data were collected from 98 PLWHA attending the antiretroviral clinic of Federal Medical Center, Umuahia, Nigeria. Regression analyses were used to examine the relationships between the variables. Some 24.5% of the study participants were depressed. Significant …

The Effect Of Breastfeeding Self-Efficacy On Breastfeeding Initiation, Exclusivity, And Duration, Adria Vincent

Walden Dissertations and Doctoral Studies

Breastfeeding self-efficacy is considered one of the key components of a successful breastfeeding experience. The benefits of breastfeeding are well established in the literature and have been widely communicated to the public, resulting in an increasing trend of breastfeeding initiation. However, the United States still falls short of Healthy People 2020 breastfeeding goals. The purpose of this project was to examine the effects of a standardized hospital-based prenatal breastfeeding class on breastfeeding self-efficacy. Dennis's breastfeeding self-efficacy theory was the foundation for the breastfeeding self-efficacy tool used in this project. A quasi-experimental design used a convenience sample of 30 breastfeeding class …

Reasons For Living And Self-Reported Suicidal Behavior Among A Sample Of U.S. Army Personnel, Deborah Elaine Willis

Walden Dissertations and Doctoral Studies

Suicidal Behavior in the U.S. Army is a problem that persists despite significant efforts to promote help-seeking behaviors and the investment of millions of dollars to develop resilience-building interventions. Evidence-based literature supports the use of reasons for living as a protective factor against suicidal behavior in clinical and nonclinical samples, yet it has rarely been studied in an active duty (AD) Army population. This study examined the relationship between self-reported reasons for living and self-reported suicidal behavior, to determine if high levels of reasons for living correlated with low risk of suicidal behavior, over and above demographics, depression, stressful life …

The Severity Of Obstructive Sleep Apnea And Hypertension Among Middle Aged Asians, Michel Juson Benin

Walden Dissertations and Doctoral Studies

This study examined the prevalence rate of obstructive sleep apnea (OSA) as an independent variable in association with hypertension as an outcome. Studies conducted outside of the United States suggest that differences in craniofacial features among middle-aged Asians increase the prevalence of OSA in comparison to Caucasians with similar age and lower BMI. No similar study had been conducted in the United States. The sufficient component cause theory guided this study and was able to describe the association between OSA and hypertension among middle-aged Asians. The objective of this cross sectional retrospective study was to determine the prevalence rate of …

Chlamydia Trachomatis And Neisseria Gonorrhoeae: Impact Of Health Literacy On Prevalence, Patricia Alice Abshier

Walden Dissertations and Doctoral Studies

Millions of dollars are spent each year on preventing sexually transmitted diseases (STDs), yet the rates of chlamydia trachomatis (chlamydia) and neisseria gonorrhoeae (gonorrhea) infection continue to be high. Health literacy and its impact have been recognized in diabetes maintenance, control of hypertension, medical adherence, and reproductive health outcomes, yet no research has been conducted regarding the relationship between health literacy and chlamydia and gonorrhea prevalence. This study examined the relationship between health literacy scores and chlamydia and gonorrhea prevalence health literacy scores and reproductive health/STD knowledge, and reproductive health/STD knowledge and chlamydia and gonorrhea prevalence. Participants included 114 women …

Screening For Peripheral Artery Disease, Cheryl Gordon

Walden Dissertations and Doctoral Studies

Peripheral artery disease (PAD) affects 8 to 10 million Americans, and the incidence of PAD is expected to increase as the population ages. A high percentage of the PAD is undiagnosed prior to the onset of a serious cardiovascular event; therefore, the inability to screen and diagnose for PAD in the early stages could hinder efforts to decrease adverse consequences of cardiovascular disease. Individuals with PAD have a 3 to 5 times increased risk of cardiovascular disease (CVD) mortality when compared to people without PAD. Guided by the Stetler model, the purpose of this project was to evaluate the relationship …

Predictors Of Cervical Cancer Screening Among Hispanic Women In The United States, Benedicta Ngozi Ilouno

Walden Dissertations and Doctoral Studies

Minority women groups in the United States have the highest incidence and mortality rates of cervical cancer. Hispanic women have the highest incidence rate and the second highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared to other groups of U.S. women, but researchers have not examined the extent to which socioeconomic status, acculturation, and sexual activity impact Hispanic women's compliance with screening. The purpose of this study was to examine the association between compliance with cervical cancer screening and acculturation, socioeconomic status, and sexual activity among U.S. …

Counselor Supervisors' Perceptions Of Tertiary Trauma, Eric David Jett

Walden Dissertations and Doctoral Studies

Vicarious trauma impacts counselors in various ways: by diminishing their feelings of importance in the profession, hindering their completion of adequate work with clients, and negatively affecting their personal life choices. Although numerous qualitative and quantitative studies have been conducted on vicarious trauma over the past 20 years, there is a rarity of research investigating the implications of trauma for counseling supervisors. The purpose of this study was to examine the lived experiences and perceptions of tertiary trauma among 11 counselor supervisors from Oklahoma and Missouri who were providing active supervision. This study was approached through a hermeneutic phenomenological methodology. …

Health Literacy And Health Decision Making Attitudes In People With Human Immunodeficiency Virus, Christine Miranda

Walden Dissertations and Doctoral Studies

Health literacy has been recognized as a vital issue in the self-care management of persons living with HIV/AIDS (PLWHA). The purpose of this study was to determine the impact of functional, communicative, and critical health literacy dimensions on positive and negative attitudes toward health decision making. The transtheoretical model of health behavior change (TTM) provided the theoretical framework to explain this association. A culturally-adapted survey was used in this cross-sectional study to measure health literacy dimensions, positive and negatives attitudes toward health decision making, and other factors in 100 Puerto Ricans living with HIV/AIDS. Demographic factors and clinical and immunological …

Perception Of Anal Hpv Infection By Hiv-Positive Men Practicing Male-Male-Sex, Philecia Simone Mullings

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is a preventable, sexually transmitted infection whose prevalence has been rising dramatically among men who have sex with men (MSM) in the United States since 2008. The HPV infection rate for MSM is rising even faster for MSM who are infected with the human immunodeficiency virus (HIV) and for those who have developed acquired immune deficiency syndrome (AIDS). It is not clear whether MSM in general and MSM with HIV have the knowledge necessary to prevent infection of themselves and their partners. This phenomenological study explored the knowledge, health perceptions, attitudes, and norms of the community of …

The Association Between Dietary Patterns And Diabetes Status Among U.S. Adults, Latonia Richardson

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus, or T2DM, is a leading cause of preventable death in the United States. Multiple studies have found that certain dietary patterns can significantly influence the risk of T2DM. The purpose of this study was to understand the dietary patterns associated with diabetes by comparing the relative adherence to these dietary patterns by individuals in 5 stages of diabetes: no diabetes, undiagnosed prediabetes, diagnosed prediabetes, undiagnosed diabetes, and diagnosed diabetes. Using the health belief model as the theoretical foundation, the primary research question examined whether adherence to specific dietary patterns significantly differed between individuals in different stages …