Medicine and Health Sciences Commons^™

Identifying Cultural Themes In A Shared Experience Of Water Hygiene Education Partners, Sarah M. Etheridge-Criswell

Walden Dissertations and Doctoral Studies

Lack of safe drinking water and lack of water hygiene literacy contribute to a large disease burden in rural areas of Africa, and children suffer disproportionately more than adults from diarrheal diseases caused by nonpotable water. Research is needed to help merge education and water sanitation to provide more effective methods of preventing diarrheal diseases. The ecological model and hygiene improvement framework were used to guide the study. The purpose of this phenomenological study was to describe the shared experiences of people participating in the water hygiene education program provided by Lifewater International. Lifewater is a nonprofit organization focused on …

Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant

Walden Dissertations and Doctoral Studies

Health care professionals and nurse educators are concerned about increasing percentage of first time test takers failing the NCLEX-RN exam. The purpose of this retrospective study was to examine predictive accuracy of the Assessment Technologies Institute (ATI) RN Comprehensive Predictor for passing or failing the NCLEX-RN exam in a cohort of nursing students (N = 195). South Eastern Technical College in South Carolina is in jeopardy of losing accreditation for their nursing program because of the low percentage of first time test takers failing. The college's pass rate on the NCLEX-RN exam has been below the national and state averages …

Transforming Vulnerable Interactions To Effective Communication: An Application Of Evidence For The Tele-Intensive Care Unit Nurse, Bethann Mendez

Walden Dissertations and Doctoral Studies

Tele-intensive care collaboration in care of critically ill patients improves both the safety and quality of nursing care. However, the full benefits of the telemedicine service may not be realized unless tele-critical care nurses have the ability to communicate clearly with their remote nursing peers. The purpose of this DNP project was to create and validate an acronym style communication tool to assist the tele-critical care nurses with their communication. The relational coordination theory was the primary communication theory utilized for tool development. The tool creation phase of the project included informal observations and discussion with a convenience sample of …

Conducting A Needs Assessment At Outpatient Medical Clinic, Fidelia Ijeuru Ukah

Walden Dissertations and Doctoral Studies

Colorectal cancer is one of the most common cancers in the United States and confronting its challenges has remained a problem to the United States health sector, especially among outpatient clinics. Guided by health belief model, the purpose of this needs assessment was to identify patients age 50 and older in outpatient clinic located in a large metropolitan city in Texas who should receive information on the need for colorectal cancer screening based on their risk for developing colorectal cancer as outlined by American Cancer Society. A sample of 70 charts of patients age 50-75 years was randomly selected and …

Mining And Hiv/Aids Transmission Among Marampa Mining Communities In Lunsar, Sierra Leone, Alphajoh Cham

Walden Dissertations and Doctoral Studies

Since the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was first reported in Sierra Leone in 1987, its prevalence rate has stabilized at 1.5% in the nation's general population. However, concerns exist regarding the potential increase in high-risk populations, particularly among mineworkers and commercial sex workers. The potential spread of HIV/AIDS as a result of labor migration may threaten the mining sector, which has been identified as a critical driver of recent economic growth and development. A gap remains in the literature regarding the contextual factors in mining communities that lead to high rates of HIV/AIDS. Therefore, the purpose of …

The Effects Of A Concept-Based Curriculum On Nursing Students' Nclex-Rn Exam Scores, Patricia Allen Edwards

Walden Dissertations and Doctoral Studies

The Institute of Medicine and the National League of Nursing have called for curricular reform that promotes high first-time pass rates on the National Counsel of Licensure Examination for Registered Nurses (NCLEX-RN). A campus in the southeastern region of the United States implemented a concept-based curriculum; however, the effect on the first-time NCLEX-RN pass rates was unknown. The purpose of this comparative study was to determine if the concept-based curriculum improved student scores on the NCLEX-RN. Dreyfus' model of learning guided this study because of the andragogy tenets, which in turn supported the concept-based curricula. The research questions examined the …

Race/Ethnicity, Diet, And Physical Activity Behavior Among College Students, Ronda Herbert

Walden Dissertations and Doctoral Studies

Scarce knowledge exists about the lifestyle of college students from heterogeneous racial/ethnic backgrounds and how race/ethnicity may influence their diet and physical activity behaviors. College students, especially those who are members of minority groups, are at risk for unhealthy lifestyles resulting in negative health outcomes. The purpose of this quantitative study was to examine the role of racial diversity on dietary and physical activity habits. The study was guided by social cognitive theory, and the research questions examined the relationship between race/ethnicity on diet and physical activity in a multiracial ethnic population. The study research design was a quantitative cross-sectional …

Speech-Language Pathologists On Multicultural Counseling Competency, Denise Moore Revel

Walden Dissertations and Doctoral Studies

Despite reports of speech-language pathology graduate-level programs focusing on multicultural competence, the literature suggests speech-language pathologists are not adequately educated and trained to be culturally competent. The purpose of this study was to examine the experiences of public school-based speech-language pathologists' graduate-level academic instruction and the clinical practicum experiences in multicultural competence, specifically in the area of multicultural counseling. Guided by the theory of multicultural counseling and therapy, this study used a phenomenological approach, employing semistructured, in-person interviews with 7 participants. The inclusion criteria used for selecting study participants included: having a master's degree in speech-language pathology, graduation from an …

Implementing An Evidence-Based Educational Module On Nurses' Role On Management Of Postpartum Hemorrhage, Stella Motanya

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage is the second leading cause of maternal death in the United States. According to American College of Obstetricians and Gynecologists, postpartum hemorrhage is an obstetric emergency. Between 2012 and 2013, a medical facility reported 369 postpartum hemorrhages, a 4.7% increase from previous years. It is important to address this practice issue because postpartum hemorrhage can lead to maternal mortality. The purpose of this project was to increase staff nurses' awareness and knowledge of their role on the management of postpartum hemorrhage. The outcome of the project paper was implementation of an educational module on postpartum hemorrhage at this …

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 …

Maternal Depression, Infant Feeding Practices, And Weight Gain Among African American And Hispanic Women, Alphonsus Maduwuba Agbaere

Walden Dissertations and Doctoral Studies

Childhood overweight and obesity are public health concerns that have negative health consequences and affect many children. Efforts are needed to identify children who are at a higher risk of developing overweight and obesity so that early detection and treatment may be offered. The intent of this study was to investigate the differences in the effects of postpartum depression on infant feeding practices and infant weight gain between Hispanic and African American women. Data were obtained from Infant Feeding Practices Study 11, a longitudinal study involving mothers in their third trimester through infants first year of life. The overall test …

Diffusion Of Technology In Small To Medium Medical Providers In Saudi Arabia, Ziad Hisham Arnaout

Walden Dissertations and Doctoral Studies

The Saudi ministry of health reported that government health care spending doubled from 2008 to 2011. To address increased demand, the government encouraged small to medium enterprise (SME) growth. However, SME leaders could not leverage technology as a growth enabler because they lacked strategies to address operating inefficiencies associated with technology. Only 50% of hospitals fully implemented information technology. The purpose of this phenomenological study was to explore lived experiences of SME leaders on strategies needed to accelerate technology implementation. This exploration drew on a conceptual framework developed from Wainwright and Waring's framework addressing issues of technology adoption. Data were …

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 …

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 …

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 …

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, …

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 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 …

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), …

Female Genital Mutilation/Circumcision: Culture And Sexual Health In Igbo Women In Dallas-Fort Worth, Texas, Dorothy Ebere Ukoha

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is practiced primarily in many African countries as well as some in Asia and the Arab Peninsula; however, it also takes place elsewhere around the globe among those who migrate from countries to which it is indigenous. This study was designed (a) to investigate the prevalence of FGM among the Igbo women in the Dallas-Fort Worth (DFW) area in Texas and (b) to understand the factors that support the continuation of the practice and the effects on women's sexual health. Using a quantitative approach to examine a variety of social variables aligning with the ecological framework, …

Decreasing Attrition Of Novice And Newly Hired Professional Nurses Through Preceptorship, Brenda Gould-Johnson

Walden Dissertations and Doctoral Studies

Approval

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Brenda Gould-Johnson

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. Eric Anderson, Committee Chairperson, Health Services Faculty

Dr. Patti Urso, Committee Member, Health Services Faculty

Dr. Jonas Nguh, University Reviewer, Health Services Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2015

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Brenda Gould-Johnson

has been found to be …

Assessing The Impact Of Major Health Policies On Provider Practice, Nadine Josephs

Walden Dissertations and Doctoral Studies

Many health care stakeholders have expressed concerns with the distribution and availability of primary care physicians (PCP) across the United States. Despite programs such as Healthy People 2010 and 2020 Initiatives, statewide and local health care expansion efforts and policies; access to PCP remains a challenge for health care consumers. The purpose of this mixed method research study was to evaluate the impact of several health care access policies on the practices of primary care providers and assess their perspectives regarding disparities in access. Patton and Sawicki's policy analysis and evaluation process was the framework used in this study as …

Perceptions Of The Community Of Inquiry In An Online Rn To Bsn Program, Beth Ann Townsend

Walden Dissertations and Doctoral Studies

Basic nursing education is no longer sufficient to meet the escalating demands of today's complex healthcare environment. Recognizing the need for the advanced cognitive skills incurred by these demands, increasing numbers of registered nurses (RNs) have been enrolling in online Bachelor of Science in Nursing (BSN) programs. The problem identified in the RN to BSN degree completion program at a large Midwestern university was the lack of information as to how online teaching and learning strategies were experienced by students. Research has demonstrated that the online community of inquiry (CoI) model facilitates higher order thinking through collaborative learning strategies and …

Effect Of A Cardiology Nurse Practitioner Service On The Reduction In Length Of Stay For Low Risk Chest Pain Patients, Marcia Andrea Reid

Walden Dissertations and Doctoral Studies

Healthcare organizations are responding to changes in reimbursements by redesigning and re-evaluating existing programs to improve patient outcomes. .One such intervention at the project setting was the re-evaluation of the treatment of patients with low risk for chest pain and implementing a cardiology nurse practitioner (NP) service focusing on the reduction of length of stay (LOS) with the goal of improving patient outcomes. The purpose of this doctor of nursing practice project was to evaluate the effectiveness of a nurse practitioner-led service on the reduction of LOS of patients with low risk for chest pain. An established evidenced-based guideline developed …