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2017

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Articles 13291 - 13320 of 14527

Full-Text Articles in Medicine and Health Sciences

Educating Nurses How To Critique Research Reports, Jacqueline Carol Pinkowski Jan 2017

Educating Nurses How To Critique Research Reports, Jacqueline Carol Pinkowski

Walden Dissertations and Doctoral Studies

When bedside acute care nurses support their clinical practice with current best evidence, patient outcomes improve. Most bedside acute care nurses base their clinical decision-making on tradition and not the application of evidence based practice (EBP). The ability to appraise research is a critical component in the application of EBP and best care practices. The purpose of the DNP project was to obtain 5 content experts' evaluations of an education module for bedside nurses on how to analyze a research report, complete a literature review, and create a table of evidence (TOE). The theoretical framework guiding the project was the …

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Role Of Midline Catheters In Patient Care, Tina K. Schlegel Jan 2017

Role Of Midline Catheters In Patient Care, Tina K. Schlegel

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSIs) are responsible for 100,000 patient deaths per year, creating a critical need for prevention of these deadly infections that occur with central venous lines (CVLs). Alternative forms of IV access such as midline catheters (MLCs) may offer lower rates of infection than those seen with CVLs. MLCs were implemented at the practice setting in 2016; however, no evaluation of their effectiveness had been conducted. The purpose of this project was to evaluate the effectiveness of MLCs using a retrospective, pre- post- comparison of CLABSI rates and device utilization rates (DUR) obtained from the practice setting …

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The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori Jan 2017

The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori

Walden Dissertations and Doctoral Studies

Type 2 diabetes has more than doubled in the past decade among Black Americans. Researchers have suggested that Black Seventh-day Adventists, who follow a plant-based diet, are concerned about preventing the complications from this disease. The purpose of this qualitative ethnographic study was to explore the chance and perceptions of complications from type 2 diabetes among 10 purposefully sampled Black Seventh-day Adventists. The health belief model (HBM) served as the conceptual framework. Two constructs, education and income, were chosen for this study. Education was chosen to increase understanding about the chronic nature of the disease, and income was chosen because …

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Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens Jan 2017

Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens

Walden Dissertations and Doctoral Studies

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General systems theory and the Donabedian model of health care quality provided the framework for the project. Electronic databases PubMed and the Cumulative Index of Nursing and Allied Health were searched for articles addressing electronic nursing documentation practices. The Cochrane systematic review methodology was used to analyze the articles. Articles were excluded if published before 2001 …

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Policies And Procedures To Address Respite Care, Hannah Washington Williams Jan 2017

Policies And Procedures To Address Respite Care, Hannah Washington Williams

Walden Dissertations and Doctoral Studies

Hospice services are utilized by more than 1.6 million people yearly, and there are a great number of caregivers who are tasked with caring for these individuals at home. Caregivers are at risk for fatigue, burnout, and decline in their own physical and mental health. While the Centers for Medicare and Medicaid Services (CMS) cover costs of temporary respite care for hospice patients, the caregivers' needs for respite care are often unrecognized and unaddressed. The purpose of this project was to plan a respite program within the hospice agency consisting of revised respite policy and procedures, the Caregiver Reaction Assessment …

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Measuring Determinants Of Oral Health Behaviors In Parents Of Low-Income Preschool Children, Josefine Ortiz Wolfe Jan 2017

Measuring Determinants Of Oral Health Behaviors In Parents Of Low-Income Preschool Children, Josefine Ortiz Wolfe

Walden Dissertations and Doctoral Studies

Dental decay is a preventable disease, but it remains the most unmet healthcare need of American children. Untreated dental decay has adverse and long-lasting effects on a child's quality of life. Healthy oral habits among preschool children are essential for a healthy permanent dentition and are achieved primarily by 3 oral health related behaviors: proper dental hygiene, a healthy noncariogenic diet, and regular dental visits. This quantitative study, based on the theory of planned behavior, explored the relationship between these 3 oral health behaviors and 4 determinants: attitude, subjective norms, perceived behavioral control, and intention, using a 71-item questionnaire. The …

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Maternal Health Literacy, Antenatal Care, And Pregnancy Outcomes In Lagos, Nigeria, Olubunmi Adanri Jan 2017

Maternal Health Literacy, Antenatal Care, And Pregnancy Outcomes In Lagos, Nigeria, Olubunmi Adanri

Walden Dissertations and Doctoral Studies

Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by …

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Dentists As Clinician Managers: Leadership Influences On Dental Team Empowerment And Engagement, Scott Hinckley Craven Jan 2017

Dentists As Clinician Managers: Leadership Influences On Dental Team Empowerment And Engagement, Scott Hinckley Craven

Walden Dissertations and Doctoral Studies

Leadership training is virtually nonexistent for dental students, and practicing dentists rarely engage in any form of leadership development, relying primarily on mentoring by senior colleagues and on-the-job experiences. Dentists serve in a hybrid role as clinicians and managers to provide quality dental care and establish a profitable business, respectively. This quantitative study investigated the ways in which the emotional intelligence (EI) and leadership styles of 16 dentist clinician managers (DCMs) affected their dental teams. Specifically, the effects of leadership style and EI of DCMs on individual psychological empowerment (PE), team PE, and employee engagement were explored. Team PE effects …

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A Developmental Project Focusing On Young Adult Hispanic-Americans, Tarsicio Gacheru Jan 2017

A Developmental Project Focusing On Young Adult Hispanic-Americans, Tarsicio Gacheru

Walden Dissertations and Doctoral Studies

Reducing diabetes risk among Hispanic-American adults in the United States is a critical public health need and programs targeting young Hispanic-American adults with prediabetes can reduce the risk for developing diabetes. The purpose of this project was twofold: (a) to examine the literature related to diabetes prevention best practices among young adult Hispanic-Americans with prediabetes and (b) create an intervention program to promote these best practices to delay or reverse the trajectory toward diabetes. The inclusion criteria for the literature review were studies with at least a 12-month follow-up and reported outcomes related to changes in diet, increased exercise, and …

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Walking Versus Jogging In Patients With Cardiac Problems Including Congestive Heart Failure, Rosalie Roberta Garcia Jan 2017

Walking Versus Jogging In Patients With Cardiac Problems Including Congestive Heart Failure, Rosalie Roberta Garcia

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a growing epidemic that affects more than 50% of the world's population. CHF is a preventable disease, but prevention requires a healthy lifestyle from a young age. Most patients already diagnosed with CHF receive advice and strict instructions for care to prevent further cardiac injury. This quantitative descriptive research study was designed to address walking and jogging as the best exercises for patients diagnosed with CHF and in patients diagnosed with other cardiac problems. The results revealed that walking is the best exercise to improve patients' resting heart rate and overall cardiac function. This study …

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Program Evaluation Of Patient Safety And Risk Mitigation Educational Interventions For Medical Errors In Primary Care Settings By Patricia Rose Gould, Patricia Rose Gould Jan 2017

Program Evaluation Of Patient Safety And Risk Mitigation Educational Interventions For Medical Errors In Primary Care Settings By Patricia Rose Gould, Patricia Rose Gould

Walden Dissertations and Doctoral Studies

The Institute of Medicine reported in 2016 that medical errors are the 3rd leading cause of death in the United States. In the primary care setting, frequency and severity are unknown. Medical error research is limited related to evaluation of interventions conducted by medical professional liability (MPL) companies of risk mitigation strategies. The purpose of this program evaluation was to determine the impact of multifaceted patient safety and risk mitigation educational interventions conducted in primary care settings on patient safety, reporting, and liability. The program evaluation employed a retrospective secondary analysis of actuarial data from a MPL carrier's educational interventions …

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Alleviating Discharge Confusion For Older Patients Using The Teach-Back Method, Tracey Marie Haire Jan 2017

Alleviating Discharge Confusion For Older Patients Using The Teach-Back Method, Tracey Marie Haire

Walden Dissertations and Doctoral Studies

Discharge instructions and medication directions can be overwhelming for older adults, which can lead to potential medication errors, noncompliance, readmissions, and patient safety concerns. At a specialty lung clinic, the goal is to improve patient safety and to decrease the chance of errors by standardizing the discharge process via a Teach-Back education policy and protocol. Without consistency, there is a potential for mistakes and misunderstandings. The Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) considers the Teach-Back discharge method as best practice and should be considered universal practice among health care workers. Using the …

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Identification, Diagnosis, Counseling, And Referral Of Overweight Military Dependent Children To Reverse Early Childhood Obesity, Gerald William Hall Jan 2017

Identification, Diagnosis, Counseling, And Referral Of Overweight Military Dependent Children To Reverse Early Childhood Obesity, Gerald William Hall

Walden Dissertations and Doctoral Studies

Since 1980, the obesity rate in children 5 to 11 years of age has increased from 7% to 18%. The lack of structured physical activity and poor dietary habits childhood are primary risk factors for obesity related comorbidities in adulthood. Guided by primary care providers, families can reverse childhood obesity by implementing healthy dietary habits and engaging in structured physical activity. The purpose of this quality improvement project was to develop an evidenced-based policy with procedures to standardize the timely and consistent identification of overweight children at a primary care clinic serving military families. With an emphasis on obesity prevention …

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Promoting Policy Advocacy In Nursing Via Education, Carolyn Sue Jurns Jan 2017

Promoting Policy Advocacy In Nursing Via Education, Carolyn Sue Jurns

Walden Dissertations and Doctoral Studies

Nurses have a professional, ethical, and social responsibility to advocate for optimal healthcare and an optimal professional environment. However, nurses often default on that responsibility. Leadership at a national nursing organization's state affiliate (SNO) perceived a need to optimize its members' policy advocacy. To meet that need, the Policy Advocacy Toolkit for Nurses (PATN) was developed for this doctoral project. The evidence-based PATN relied on established theories and frameworks, notably Knowles' adult education theory and Kingdon's multiple streams approach; research specific to this project; evidence from other researchers, healthcare organizations, and government websites; and input from a statistician, nursing education …

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Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk Jan 2017

Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk

Walden Dissertations and Doctoral Studies

Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow's hierarchy of needs theory, and the opposing theory, Vroom's expectancy theory. Semistructured interviews occurred with 5 leaders. The review …

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Managerial Intervention Strategies To Reduce Patient No-Show Rates, Charl Mattheus Jan 2017

Managerial Intervention Strategies To Reduce Patient No-Show Rates, Charl Mattheus

Walden Dissertations and Doctoral Studies

High patient no-show rates increase health care costs, decrease healthcare access, and reduce the clinical efficiency and productivity of health care facilities. The purpose of this exploratory qualitative single case study was to explore and analyze the managerial intervention strategies healthcare administrators use to reduce patient no-show rates. The targeted research population was active American College of Healthcare Executives (ACHE), Hawaii-Pacific Chapter healthcare administrative members with operational and supervisory experience addressing administrative patient no-show interventions. The conceptual framework was the theory of planned behavior. Semistructured interviews were conducted with 4 healthcare administrators, and appointment cancellation policy documents were reviewed. Interpretations …

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Hourly Rounding: A Fall Prevention Strategy In Long-Term Care, Robyn Mitchell Jan 2017

Hourly Rounding: A Fall Prevention Strategy In Long-Term Care, Robyn Mitchell

Walden Dissertations and Doctoral Studies

Falls and injuries related to falls are some of the most common and costly incidents that occur in the long-term care environment. Purposeful hourly rounding is a proactive way for nursing staff to identify patient needs and demonstrate positive fall prevention outcomes. This project examined a process improvement endeavor of a long-term care unit that experienced an increase in the number of falls over 3 months. The purpose was to evaluate whether staff education and implementation of an evidence-based hourly rounding program would affect the number of patient falls. The Johns Hopkins nursing evidence-based conceptual model, Kurt Lewin's change model, …

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Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz Jan 2017

Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz

Walden Dissertations and Doctoral Studies

Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three …

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Gender Inequality In Women's Knowledge And Awareness Of Hiv/Aids In Port Harcourt, Maureen A. Wagbara Jan 2017

Gender Inequality In Women's Knowledge And Awareness Of Hiv/Aids In Port Harcourt, Maureen A. Wagbara

Walden Dissertations and Doctoral Studies

In Nigeria, gender inequality significantly impacts women's knowledge and awareness of the transmission of the human immunodeficiency virus (HIV) and the proliferation of acquired immunodeficiency syndrome (AIDS). Early marriage, traditional beliefs, religion, and polygamy all contribute to gender inequality. This study explored the role of these and other sociocultural practices in the gender inequalities that increase vulnerability of contracting HIV/AIDS among women in Port Harcourt, Rivers State, Nigeria. The study employed a phenomenological design, collected data through a semistructured interview approach, which was managed using NVivo software. The purposive sample comprised 20 female students from a college in Port Harcourt. …

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Leadership Among Directors Of Social Services At Rehabilitative Healthcare Chains, John Paul Tuanqui Abenojarj Jan 2017

Leadership Among Directors Of Social Services At Rehabilitative Healthcare Chains, John Paul Tuanqui Abenojarj

Walden Dissertations and Doctoral Studies

Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention …

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Arizona's Mentally Ill And Their Use Of The Emergency Department, Charlalynn Harris Jan 2017

Arizona's Mentally Ill And Their Use Of The Emergency Department, Charlalynn Harris

Walden Dissertations and Doctoral Studies

Emergency departments (ED) are an integral component of the United States' health care system. The underlying factors related to ED use among Arizona's mentally ill are not fully understood and the patterns necessary to classify patients as frequent users have not been examined. The purpose of this study was to increase the understanding of frequent users and further examine the conditions by which they present to the ED. The theoretical foundation for this study was the fourth version of Andersen's behavioral model (1995) and this model's use to frame this study allowed for an objective analysis of ED use among …

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Essential Executive Coaching Competencies For Enhancing Executive On-The-Job Performance: A Modified Delphi Study, Arturo Small Maxwell Jan 2017

Essential Executive Coaching Competencies For Enhancing Executive On-The-Job Performance: A Modified Delphi Study, Arturo Small Maxwell

Walden Dissertations and Doctoral Studies

Approximately 93% of Fortune 1000 companies in the United States rely upon executive coaching to accelerate executive performance. However, there is a lack of empirical research identifying effective executive coaching competencies. In this modified Delphi study, a panel of 17 executive coaching experts was purposefully selected from the International Coach Federation and the Society for Industrial and Organizational Psychology. Participant selection criteria included training in executive coaching, executive coaching credentialing, and -?¥3 years practicing executive coaching or purchasing executive coaching services. Participants used a 5 point Likert-type questionnaire to provide their expert opinion regarding essential executive coaching competencies for enhancing …

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Multifamily Subsidized Housing Seniors' Awareness Of Aging And Disability Resource Center Services, Katrina Polk Jan 2017

Multifamily Subsidized Housing Seniors' Awareness Of Aging And Disability Resource Center Services, Katrina Polk

Walden Dissertations and Doctoral Studies

Over 75% of adults 60 years of age or older who live in Washington, D.C. are unaware of access to Aging and Disability Resource Centers' (ADRC) community-based services. Approximately 25% of these individuals are low-income and reside in multifamily subsidized housing. With a theoretical basis in Penchansky and Thomas' construct of access, this phenomenological study explored whether increased awareness of access to ADRC service delivery may potentially better meet the needs of this socioeconomically marginalized population. Data were collected through semi-structured interviews with 20 senior citizens in Washington, D.C. who received some programmatic assistance, such as housing or meal delivery, …

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Public Health Implications Of Oil Pollution In Koluama: Nigeria, Esther Bridget Sako Jan 2017

Public Health Implications Of Oil Pollution In Koluama: Nigeria, Esther Bridget Sako

Walden Dissertations and Doctoral Studies

As the global demand for oil increases, human health implications related to its discovery and transport remain a serious concern. The Niger Delta has been the site of severe environmental degradation since the oil boom of the 1970s. While some researchers have examined the environmental effects of oil procurement, few have explored human health implications in this region. This phenomenological study investigated the human physical and mental health consequences of oil-related environmental degradation through the perceptions and lived experiences of villagers in Koluama, Nigeria. The conceptual framework for the study was based on research conducted by Morello-Frosch, Zuk, Jerrett, Shamasunder …

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Caregiver Burden And Emergency Room Utilization For Enhanced Recovery Surgery Cancer Patients, Mindy Sovel Jan 2017

Caregiver Burden And Emergency Room Utilization For Enhanced Recovery Surgery Cancer Patients, Mindy Sovel

Walden Dissertations and Doctoral Studies

Advances in surgical technique and medical management have led to fundamental changes in surgical care allowing for a paradigm shift from inpatient to outpatient surgery. Enhanced recovery pathways have moved surgical recovery from inpatient to outpatient settings requiring informal caregiver support. The purpose of this study was to determine the prevalence of caregiver burden in this patient population and to explore whether caregiver burden contributes to preventable use of emergency room services. The conceptual framework supporting this retrospective cross-sectional study was Andersen's behavioral model of health services utilization. Data collected from 28 urologic patient/caregiver pairs were analyzed using descriptive statistics …

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Implementation And Evaluation Of Code Stroke In Emergency Department For Maternity Patients, Linda Catherine Castillo Jan 2017

Implementation And Evaluation Of Code Stroke In Emergency Department For Maternity Patients, Linda Catherine Castillo

Walden Dissertations and Doctoral Studies

Strokes are a significant source of morbidity and mortality in pregnant women, influenced by the physiologic changes in pregnancy and the trend of older and sicker women becoming pregnant. Despite the role of stroke in pregnant women, emergency departments in specialized maternity hospitals may not be as experienced in stroke recognition and care as are typical emergency departments. The purpose of this project was to create a protocol to facilitate rapid assessment and treatment of pregnant and postpartum women with symptoms of stroke in a maternity emergency department. The IOWA model of evidence-based practice to promote quality care guided a …

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Relationship Between Quality Of Life For Patients With Neuroendocrine Tumors And Novel Biomarkers, Stephanie L. Ford-Scheimer Jan 2017

Relationship Between Quality Of Life For Patients With Neuroendocrine Tumors And Novel Biomarkers, Stephanie L. Ford-Scheimer

Walden Dissertations and Doctoral Studies

Research in the field of neuroendocrine tumors (NETs) has increased over the last decade, including studies focused on biochemical markers (biomarkers) of the disease. There is also growing interest in how NETs impact patients' quality of life (QOL). Consequently, there is a paucity of information about whether the expression of the specific disease biomarkers affects QOL as well as whether the primary tumor site impacts QOL. Using the explanatory model of health promotion and quality of life in chronic disabling conditions as the theoretical framework and data collected with the Norfolk QOL-NET instrument, this study's purpose was to fill that …

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Demographic Factors Associated With Consistent Hand Hygiene Adherence Among Icu Nurses, Sharon Lea Kurtz Jan 2017

Demographic Factors Associated With Consistent Hand Hygiene Adherence Among Icu Nurses, Sharon Lea Kurtz

Walden Dissertations and Doctoral Studies

Healthcare associated infections cause 75,000 to 80,000 deaths a year. Many are preventable with proper hand hygiene adherence (HHA). Worldwide, HHA range is between 40-60%, far below the 100% recommended. The purpose of this quantitative, cross-sectional, prospective study was to investigate any association between 15 demographic variables and HHA of ICU nurses. A convenience sample of 613 hand hygiene opportunities was collected by direct observation at each of 5ICUs (4 hospitals) in Texas for 8 consecutive hours each day for 3-5 days. The theoretical foundation guiding this study was the healthcare environment theory. The Statistical Package for Social Sciences software …

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The Patient-Centered Medical Home And Diabetes Mellitus Outcomes: A Systematic Review, Lisa Sullivan Mcmanus Jan 2017

The Patient-Centered Medical Home And Diabetes Mellitus Outcomes: A Systematic Review, Lisa Sullivan Mcmanus

Walden Dissertations and Doctoral Studies

Ineffectively managed chronic diseases such as diabetes mellitus (DM) increase overall health care expenditures and negatively affects health outcomes such as exacerbations, functional decline, disability, and death. The purpose of this systematic review (SR) was to review the DM outcomes reported by patient-centered medical homes (PCMHs). The goal was to determine how care coordination and evidence-based clinical management impacted financial and health outcomes. The SR followed the Cochrane protocol and complied with the PRISMA evidence-based minimum set for reporting. Overall, DM management in the PCMH demonstrated statistically significant completion rates for essential screenings and preventive care, including HgA1c (p = …

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Educating Nurses On Workflow Changes From Electronic Health Record Adoption, Rhoda Lynn Atienza San Jose Jan 2017

Educating Nurses On Workflow Changes From Electronic Health Record Adoption, Rhoda Lynn Atienza San Jose

Walden Dissertations and Doctoral Studies

Workflow issues related to adoption of the electronic health record (EHR) has led to unsafe workarounds, decreased productivity, inefficient clinical documentation and slow rates of EHR adoption. The problem addressed in this quality improvement project was nurses' lack of knowledge about workflow changes due to EHR adoption. The purpose of this project was to identify changes in workflow and to develop an educational module to communicate the changes. This project was guided by both the ADDIE model (analysis, design, development, implementation, and evaluation) and the diffusion of innovations theory. Five stages were involved: process mapping, cognitive walkthrough, eLearning module development, …

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