Medicine and Health Sciences Commons^™

Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams

Walden Dissertations and Doctoral Studies

In spite of decades of research, concerning nurse's intention to leave their employer (ITL), in 2011, 31.2% of the British nurses surveyed indicated they had formed an ITL. Grounded in reasoned action theory as developed by Ajzen and Fishbein, the purpose of the correlational study was to provide hospital managers with information regarding the relationship among nurse's job satisfaction (JS), organizational culture (OC), and ITL. The archival data from the 2011 NHS Staff Survey included responses from nurses (n = 21,257) across the British National Health Service. The Spearman's rho correlates rs (21,257) indicated relationships among nurse's job satisfaction, organizational …

Relationship Between Family Income And Obesity Among African American Adults, Charles Dadzie Boison

Walden Dissertations and Doctoral Studies

Obesity is a chronic disease that is caused by a number of factors such as diet, genetics, physical inactivity, and poor dietary habits. This research focused on how income affects obesity among a target population in the African American community in Durham, North Carolina (NC). It has been noted that chronic diseases that are diet-related, for example, obesity, diabetes, hypertension, and high cholesterol, affect African Americans disproportionately, especially those who earn low income. Some studies have also reported that those who make higher income have higher rates of obesity. This inconsistency and gap in the literature prompted research on this …

Meaningfulness Of Work As Perceived By Women From Diverse Social Classes: A Grounded Theory Exploration, Jennifer L. Hutmire

Walden Dissertations and Doctoral Studies

Despite research connecting the meaningfulness of work with positive organizational outcomes, such as increased employee well-being, job satisfaction, engagement, and retention, there remains a lack of adequate, inclusive research explaining differences in women's perceptions of the meaningfulness of work. The purpose of this qualitative grounded theory study was to address this gap in the literature by developing a theory about the formation of perceptions of the meaningfulness of work and about the impact of those perceptions. Research questions explored perceptions that women from diverse social classes have of the meaningfulness of work, what influenced those perceptions, the impact of those …

Influence Of The Patient Protection And Affordable Care Act On Small Businesses, Sean Gallman

Walden Dissertations and Doctoral Studies

Business leaders lack strategies to implement the employer shared responsibility provision of the Patient Protection and Affordable Care Act (ACA). Small businesses pay approximately 18% more than larger companies for the same health coverage. Within a conceptual framework of management by objectives, the purpose of this qualitative multiple case study was to explore the strategies small business leaders use to implement the employer shared responsibility provision of the ACA. Data were gathered from the review of company documents, observations, and semistructured interviews with 5 senior business leaders from small business organizations in the Mid-Atlantic region of the United States. Data …

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

The Relationships Among Job Satisfaction, Length Of Employment, And Mentoring Of Nursing Faculty, Zelda Suzan

Walden Dissertations and Doctoral Studies

The shortage of faculty in nursing education programs has been well documented by the National League for Nursing. Job satisfaction is important in retaining nurse educators, and one New York nursing program was interested in examining the potential impact of mentoring on satisfaction. The purpose of this quantitative study was to examine job satisfaction, measured by the Job Descriptive Index/Job in General scale (JDI/JIG), between nurse faculty participants in formal mentoring programs compared to participants receiving an informal type of mentoring. In addition, the length of employment was examined as a possible factor in predicting job satisfaction. The theoretical framework …

The Effectiveness Of An Organizational Hospital-Acquired Pressure Ulcer Prevention Workshop On Pressure Ulcer Prevalence Rates, Stacey Johnson

Walden Dissertations and Doctoral Studies

The goal of this project was to evaluate a hospital acquired pressure ulcer (HAPU) prevention program implemented in a New York City hospital in 2012. The program objective was to encourage collaboration of team members to prevent HAPUs in order to reduce prevalence rates to national target benchmarks. The program provided caregivers information about epidemiology, etiology, prevention, and treatment of HAPUs, and presented HAPU prevention as a collaborative process in order to foster greater awareness in each participant's role as an agent of change by emphasizing the importance of communication between members of the health care team. This project evaluated …

Comparison Of Thyroid Disease Mortality Between Urban And Rural Populations In Southwest Georgia, Donyale Bouie Childs

Walden Dissertations and Doctoral Studies

Twenty million people in the United States have some form of thyroid disease. In 2014, there were 62,980 new cases of thyroid cancer and 1,890 deaths. Water source is a known risk factor for thyroid disease. Pollutants that are known to alter thyroid function can find their way into water sources. The effect of various water sources on thyroid- related mortality has not been determined in the state of Georgia. The purpose of this correlational study was to investigate whether invasive thyroid disease mortality differs between urban participants who drank municipal water and rural participants who drank untreated water in …

Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith

Walden Dissertations and Doctoral Studies

Individuals suffering from mental illness are often adversely affected by tobacco use. Historically, clinicians are reluctant and inadequately prepared to recognize and treat comorbid nicotine addiction in the chronic mentally ill (CMI) client. As evidenced by a review of the literature, healthcare providers are missing opportunities for nicotine cessation treatment. There is a lack of educational preparation amongst clinicians to treat nicotine addition and a concern that treatment of nicotine addiction can negatively impact existing psychiatric disorders. The purpose of this project was to create an educational plan for nicotine cessation for CMI clients at a community health center. The …

Educating Nurses About Spirituality's Effects On Quality Of Life With Chronic Illness, April Gant

Walden Dissertations and Doctoral Studies

Spirituality has been associated with wholeness, inner peace, and key elements of well-being or quality of life. Spirituality support is particularly important for patients with chronic illness and patients who view spirituality as a way of coping with suffering. Evidence-based education is lacking in schools of nursing and in places of nursing employment on spirituality interventions that nurses can use to improve patient quality of life. The purpose of this project was to determine whether an educational intervention would increase knowledge of spiritual care in a small sample of clinic nurses (n = 37). This project used Watson's caring theory, …

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …

Predictive Factors Of Compassion Fatigue Among Firefighters, Teresa Michelle Robinson

Walden Dissertations and Doctoral Studies

Few existing studies have examined compassion fatigue among emergency responders even though firefighters and emergency medical service (EMS) professionals have repetitive direct exposure to traumatic events. This study focused on identifying predictor variables for the development of compassion fatigue in firefighters. Karasek's demand-control model, a commonly used work stress model, was the study's theoretical framework as it focuses on specific construct interactions that predict employee well-being. Accordingly, this correlational study examined the predictive nature of EMS license level, years of service, and personality type on the development of compassion fatigue in career firefighters. Data collection occurred with surveys incorporating the …

An Integrative Review Focusing On Accuracy And Reliability Of Clinical Thermometers, Julie Black Black

Walden Dissertations and Doctoral Studies

Technological advances in clinical thermometers have resulted in a variety of minimally invasive devices that give rapid results but may not have the accuracy necessary for use in acutely ill adults. Inaccurate temperatures can result in missed opportunities for the early identification and treatment of infection and sepsis. Following the methodology outlined by Whittemore and Knafl, the purpose of this project was to conduct an integrative review of the research on the accuracy of clinical thermometers used for acutely ill adults. The evidence was categorized using the Hierarchy of Evidence for Interventional Studies, and the quality of the studies was …

Social Demography Of Health Seeking Experiences Among Transgender African Americans, Alicia Cutrice Fritz

Walden Dissertations and Doctoral Studies

Access to and receipt of health care is an essential human right; however, transgender people often have negative health seeking experiences that give way to the many health disparities seen in the transgender community. Using the social ecological model, this study determined, through multiple logistic regressions, that correlations existed between socioeconomic, health behaviors, and sociocultural variables and 6 measures of health seeking experiences among transgender African Americans. Secondary data from the 2010 National Transgender Discrimination Survey were used, yielding a sample size of 253 transgender African Americans. Those in the African American transgender community at most risk for negative health …

Evaluation Of Low Immunization Coverage Among The Amish Population In Rural Ohio, Christine Marie Kettunen

Walden Dissertations and Doctoral Studies

Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, …

Outcomes Of Aggression Replacement Training For U.S. Adolescents In Residential Facilities, Coral Ann Ondrus

Walden Dissertations and Doctoral Studies

A National Survey indicated that 1.6 million adolescents in the U.S. were arrested in 2010 and 1.5 million in 2011 for erratic aggressive behaviors, thus showing a decline from the 2.18 million adolescent arrests in 2007. Residential facilities in the state of Pennsylvania offer a group intervention called Aggression Replacement Training (ART) to help adjudicated adolescents regain control of erratic behaviors. The purpose of this study was to examine the extent to which level of group participation in ART and certain demographic factors (age, gender, ethnicity, family socioeconomic status, parental involvement, and education) predict decreased aggression and increased anger control …

Perspectives Of Young Adults Toward Tobacco Use, Caroline Oluwatosin Omoalako-Adesanya

Walden Dissertations and Doctoral Studies

Conditions related to tobacco use constitute the single most preventable cause of death in the United States. Approximately 443,000 U.S. adults die each year from smoking-related illnesses. During young adulthood, social and behavioral changes occur; experimentation with tobacco products such as cigarettes is common and may lead to a habit of smoking. A gap was identified in the literature on the perceived impact of family communication on young adults' decisions regarding smoking. The purpose of this descriptive phenomenological study was to address this gap by gathering information on the perspectives of young adults toward tobacco use. Fifteen young adults aged …

Master's Students' Self-Assessment Of Competency In Grief Education And Training In Cacrep-Accredited Counseling Programs, Jane Earline Wood

Walden Dissertations and Doctoral Studies

Counseling can promote positive outcomes for grieving clients by addressing personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as psychological stress, poor health, or an increased risk of depression. Education and training in grief counseling can improve counselors' problem recognition and skills in treatment planning. The purpose of this study was to examine whether Council for Accreditation of Counseling and Related Educational Programs (CACREP) master's degree counseling students view themselves as having been adequately trained in grief theories …

Chronic Disease Self-Management Program, Raquel Marie Biati

Walden Dissertations and Doctoral Studies

The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting …

Health Literacy Program Proposal For Health Care Workers, Shevon Naomi Howard

Walden Dissertations and Doctoral Studies

Health information literacy influences patient health outcomes, yet almost 90% of adults

struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals' methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

Perceptions Of Licensed Pharmacist Managers Regarding Formally Versus Informally Trained Pharmacy Technicians, Shalonica Marie Cluse

Walden Dissertations and Doctoral Studies

Pharmacists rely on pharmacy technicians to assist with accurately dispensing prescriptions and providing information to clients. Texas does not have regulations for the education or training of pharmacy technicians, which may result in mistakes when dispensing prescriptions, causing significant harm to customers. The purpose of this qualitative phenomenological study was assessing formally and informally trained pharmacy technicians' job performance as perceived by licensed pharmacists/managers. Data were collected via face to face interviews with 9 pharmacy managers in Texas to gain insight into their lived experiences of supervising not formally and formally trained technicians. Audio recorded interview data were transcribed and …

An Ecological Perspective On Pertussis, Jody Ruth Goard

Walden Dissertations and Doctoral Studies

In 2012, 48,277 cases of pertussis were diagnosed in the United States. Pertussis, otherwise known as whooping cough, is a highly contagious, often debilitating, sometimes deadly, vaccine-preventable disease with an increasing incidence and death rate in the U.S, which may be due to vaccine exemptions. The purpose of this project was to determine if a relationship exists between immunization policies and immunization exemption rates, immunization exemption rates and pertussis rates, and immunization policies and pertussis rates in each state. Bronfenbrenner's bio-ecological framework was used to guide the project. Publically available data from the Centers for Disease Control and Prevention (CDC), …

Preventing Urinary Tract Infections In The Acute Care Setting, Charlotte Evette Philyaw

Walden Dissertations and Doctoral Studies

More than 13,000 deaths and $340 million in health care costs are the result of catheter-associated urinary tract infections (CAUTIs) annually in the United States. CAUTIs can also result in acute patient discomfort and potentially preventable exposure to antibiotics. The hospital for which this quality improvement project was developed was above the National Healthcare Safety Network CAUTI bench mark. Framed within the Iowa model of evidence-based practice, a multidisciplinary team of 8 hospital stakeholders guided the project (n=8). The purpose of the project was to develop an indwelling urinary catheter maintenance checklist using evidence-based practice guidelines related to preexisting inappropriate …

Increasing Awareness And Consideration Of Bariatric Surgery Treatment Option In Obese Type 2 Diabetes Mellitus Patients, Cynthia Bolaji

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Current research indicates the efficacy of bariatric surgery (BS) in the treatment of obese Type 2 Diabetes Mellitus (T2DM) patients, but only a few actually get this treatment option. This is evident when a comparison of the prevalence of T2DM and obesity is compared to the actual number of surgeries conducted. The American Society of Metabolic and Bariatric Surgery (ASMBS) states that less than 1 % of eligible patients (general) have access to BS. The option most frequently considered to manage obesity and T2DM (i.e. lifestyle modification), is ineffective and results in weight regained in an average of 4 …

Improving Medication Adherence Among Adult Patients With Coronary Heart Disease: A Pilot Study, Xinxin Tang

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Medication adherence reduces morbidity, premature mortality, and healthcare costs related to CHD treatment. Therefore, a patient-centered intervention for both staff and patients was conducted to improve medication adherence in an outpatient setting. 4 Methodology: A pilot study was conducted utilizing a quasi-experimental, pre-post, one group design. Study participants completed an eight-item modified Medication Adherence Scale (MMAS-8) questionnaire to measure self-reported medication adherence before and after the intervention, which consisted of an interview and six weekly follow-up counseling sessions. The study compared the difference in MMAS-8 scores before and after the intervention. The Statistical Package for the Social Science (SPSS) …

The Influence Of Obstructive Sleep Apnea On Post-Anesthesia Duration Of Monitoring: Informing Policy Recommendations For Best Practice In A Veteran Population, George Chris Bone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Obstructive sleep apnea (OSA) is a common problem affecting millions of Americans annually. In fact, between nine and fourteen percent of the entire population is affected by OSA (Diffee, Beach & Cuellar, 2012). Its impact on post-operative care unit (PACU) patients can necessitate the need for an extended recovery time. At the Dallas Veterans Affairs North Texas Health Care System (VANTHCS) hospital, there was no minimum PACU stay time policy specified for OSA patients. These patients had an increased risk of complications beyond the thirty minute period of stability (as defined by the general PACU stay-time policy). While there was …

A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill

Walden Dissertations and Doctoral Studies

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio …

The Effect Of Dietary Fruits & Vegetable Consumption And Physical Activity On Obesity In African American Adolescent Females., Tanisha Brooks

Walden Dissertations and Doctoral Studies

Obesity is epidemic among Black adolescent females, and adolescent obesity often leads to adult obesity. Previous research suggests that there may be an interaction between physical activity and dietary fruit and vegetable intake on body mass index (BMI) in obese adolescent females in general, but it was unclear whether the same pattern is evident in Black adolescent females, who, on average, tend to have low levels of physical activity and fruit and vegetable intake. Bandura's social learning theory implies the possibility that adolescent females might model their behaviors on the behavior of others in their high school years, including physical …

Diminishing Stigma Sentiments In Individuals With Depression: Sociopsychological Predictors Of Deflecting And Challenging Coping Orientations, Jennifer Marie Lee

Walden Dissertations and Doctoral Studies

Individuals who suffer from depression can be stigmatized by labeling and resort to negative stigma coping orientations such as secrecy and withdrawal, resulting in internalized self-stigma. Self-stigma can have negative effects such as low self-esteem, low self-efficacy, isolation, and feeling like a failure. Guided by modified labeling theory, the purpose of this study was to fill a gap in the literature on predictors of two orientations (challenging and deflecting) of positive stigma coping. Challenging stigma involves taking action, and deflecting is a cognitive strategy; both are used to positively cope with the stigma of mental illness. Predictors included symptom severity, …