Medicine and Health Sciences Commons^™

Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje

Walden Dissertations and Doctoral Studies

Health-care-associated infections (HCAIs) affect hundreds of millions of people worldwide, causing morbidity and mortality among hospitalized patients. About 2 million patients suffer from HCAIs in the United States, and it is estimated that 99,000 of them die each year. Studies have indicated that transmission of health-care-associated microorganisms occurs through contaminated hands of health care workers. Hand hygiene (HH) is the single most effective way to prevent health-care-associated infections, yet health care workers' hand hygiene compliance remains low. One factor responsible for poor compliance with hand hygiene guide-lines are lack of knowledge of good hand hygiene and lack of hand hygiene …

Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic disease that affects millions of people in the United States. The purpose of this project was to develop a guideline to help clinical staff provide clear and concise diabetes self-management instructions to patients in a community setting. Orem's self-care deficit theory (SCD) and health belief model (HBM) provided a platform to assess how patients' self-care deficit contributes to illness and the effect of patients' perception of illness. SCD theory and the HBM provided the framework for the development of the guideline to decrease diabetes acute complications through self-management education. The practice-focused question was whether the …

Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price

Walden Dissertations and Doctoral Studies

The foundation of modern-day emergency medical service (EMS) systems began in 1966, based on hospital medical care. Demand for evidence to support prehospital practices that have been in existence for the past half-century has continued to grow; yet, researchers have not adequately explored the relationship between the medical certification level of emergency first responders and the amount of time an ambulance spends on the scene. The purpose of this quantitative study was to examine and compare ambulance scene times for emergency responses when basic life support (BLS) certified first responders or advanced life support (ALS) first responders are first on …

Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison

Walden Dissertations and Doctoral Studies

Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the …

Affordable Care Act And Human Papilloma Virus Vaccine Among Adolescent Females, Eunice Odaku Nnakwe

Walden Dissertations and Doctoral Studies

The human papilloma virus (HPV) is the most frequent cause of sexually transmitted diseases (STDs) and cancers for U.S. adults. The Affordable Care Act (ACA), enacted in 2010, eliminated copay expenses for childhood immunizations and expanded access to health care. The purpose of this secondary data analysis study was to determine if there was an association between ACA and the usage of HPV vaccine among adolescent females in Georgia. Data concerning HPV vaccinations from 2011 to 2015 were obtained from the National Immunization Survey-Teen dataset. Andersen's BM of health care use was applied to ascertain the factors that enhanced the …

Substance Abuse And Mental Illness Among Youth In The United States, Emmanuel Xavier Okoro

Walden Dissertations and Doctoral Studies

Despite the trends showing a reduction in the use and abuse of drugs among American adolescents, the prevalence rates remain high. There is also comorbidity of mental illnesses among the adolescents using drugs. The aim of this study was to determine the presence and nature of the association between the use and abuse of marijuana and alcohol and mental illnesses among the American adolescent population. The noted comorbidities and the hypothesized association between the substance abuse and mental illnesses were explained using the expectancy theory. Using a quantitative research methodology, secondary data from the National Survey on Drug Use and …

Women In Mississippi Undergoing Hysterectomies In Absence Of Comprehensive Informed Consent Law, Tammy Shaffer

Walden Dissertations and Doctoral Studies

Only three states have enacted informed consent laws aimed at providing more information concerning any alternative treatments for women who undergo hysterectomy. This study attempted to fill the research gap regarding consent laws and perceptions of women who underwent hysterectomy in a state with no informed consent laws. Supported by the health belief model (HBM), the research questions focused on the perceptions of women and their lived experiences. The purpose of this qualitative study was to examine the beliefs and attitudes of women in a state with no informed consent laws. Interviews were the main data collection technique. The participants …

Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies

Walden Dissertations and Doctoral Studies

Opioid drug misuse and dependence are a social and public health problem in the United States. Prescription opioid abuse and misuse have been associated with substantial morbidity and mortality rates as well as social and economic costs. The purpose of this project was to provide a systematic review of literature on the effectiveness of medication-assisted therapy interventions in addressing the problem of prescription opioid misuse in health care settings. The systematic review was completed through a literature search conducted across five electronic databases. The review was guided by the health belief model and eligible studies were rated using Johns Hopkins …

Strategies Department Store Managers Use To Increase Employee Engagement, Samara Desir

Walden Dissertations and Doctoral Studies

Business leaders are challenged with sustaining an engaged workforce to achieve economic prosperity in their organizations. The implementation of effective strategies to increase employee engagement can mitigate the challenges of employee disengagement. The purpose of this qualitative, single case study was to explore the strategies that department store managers used to increase employee engagement. The conceptual frameworks selected for the research were Vroom's expectancy theory of motivation and Kahn's engagement theory. The research participants consisted of 5 department store managers, from the northeastern United States, who successfully used strategies to increase employee engagement. Data were collected from the participants in …

The Impact Of Shared Governance On Nursing Satisfaction And Retention, Melanie Wetmore

Walden Dissertations and Doctoral Studies

Shared governance is a practice model that supports shared decision making between direct care nurses and their leaders. Developed from Kanter's theory of structural empowerment, shared governance allows employees to influence decisions made in an organization. Shared governance has been shown to increase nursing satisfaction, positively impact outcomes, and reduce nursing turnover. The purpose of this project was to examine the relationship between implementation of a system-wide, multihospital shared governance structure and registered nurse (RN) satisfaction, turnover, and perceptions of shared governance. The 3 sources of evidence used in the study were 2016-2017 organizational RN engagement survey results, 2016-2017 organizational …

Medication Reconciliation In The Elderly, Munjanja Yvonne Litell

Walden Dissertations and Doctoral Studies

Medication therapy is the most prevalent and critical intervention of health delivery and the source of most errors in healthcare. Medication errors and associated adverse drug events (ADE) have serious health and economic ramifications, and in elderly patients ADE are the leading cause of morbidity and mortality. Medication reconciliation is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing ADEs. This education project answered the question whether education provided to long term care staff would improve knowledge of medication reconciliation and be retained over time. The …

A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan

Walden Dissertations and Doctoral Studies

Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and …

Counselors' Perceptions On Adolescent Access And Use Of School-Based Mental Health Services, Samuel C Godwin Okeorji

Walden Dissertations and Doctoral Studies

The role of school-based mental health counselors (SBMHCs) is essential in addressing the mental health needs of U.S. adolescents. The purpose of this phenomenological study was to examine SBMHCs' perceptions about factors that affect the use of SBMH services by adolescents from a school district in Connecticut. SBMHCs were chosen for this study because they provide direct mental health services to adolescents. Mechanic's general theory of help-seeking provided the framework to interpret research findings using the 10 interrelated constructs. Fifteen SBMHCs participated in face-to-face semistructured interviews. Colaizzi's 6-steps-guide was used to organize, code, and identify common themes. The following themes …

Impact Of Violent Rapes Among Women In Eastern Democratic Republic Of Congo, Benoit Munganga Mirindi

Walden Dissertations and Doctoral Studies

For the last 22 years, systematic rapes and punitive violence against women in the Democratic Republic of Congo (DRC) were utilized as weapons of war and a control strategy. This quantitative study built upon the ecological model of impact of sexual assault on women's mental health to investigate the relationship between the health impacts and chronic pain and depression among women survivors of sexual rape in eastern DRC. The sample included 156 female rape survivors, between 18-80 years old, and raped between 2010 and 2014 while residing in the conflict area. The research questions focused on the association between fistulas, …

Strategies To Mitigate Information Technology Discrepancies In Health Care Organizations, Oluwatosin Tolulope Oluokun

Walden Dissertations and Doctoral Studies

Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 …

Leadership Strategies For Implementing Quality Improvement Initiatives In Primary Care Facilities, Jose A. Poncevega

Walden Dissertations and Doctoral Studies

Health care spending accounts for 17.7% of the gross domestic product in the United States, and it is expected to continue rising at an annual rate of 5.3%. Despite high costs, health care quality lags behind other high-income countries; yet, over 70% of change initiatives fail. The purpose of this multiple case study was to explore strategies primary care leaders use for implementing quality improvement initiatives to improve patient outcomes and reduce waste in primary care facilities. The target population consisted of 3 health care leaders of 3 primary care facilities in southern California who successfully implemented quality improvement initiatives. …

Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr

Walden Dissertations and Doctoral Studies

The focus of this quality improvement doctoral project was the evaluation of an organization's standardized use of the teach-back process for patient education implemented in February 2018. Teach-back is a process in which the patient restates the key concepts for self-management, so the nurse can assess the effectiveness of the teaching and learning process. The practice-focused question compared 4 questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey with literature and recommendations from major health care organizations. The Iowa Model was used to guide the project. The literature review was completed using the Cumulative Index to …

Perceptions Of An Ebp Module Mobile Application By New Graduate Nurses, Kristin Wilson Carlson

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is a key driver of care and advancements within nursing. It is essential to emphasize EBP early in a nurse's career to promote inquisitive minds and enthusiasm for seeking evidence. The purpose of this project was to implement an EBP mobile app into a nurse residency program (NRP) to improve the process of providing EBP information and resources to new graduate nurses. The intent of the project was to leverage mobile technology to engage new graduate nurses in evidence-based practice. Roger's diffusion of innovation framework guided the project. The target audience for the project was 16 new …

Cultural Awareness And Sensitivity Of Students In A Physical Therapy Program – A Pilot Survey, Olaide Oluwole-Sangoseni, Michelle Jenkins-Unterberg

Internet Journal of Allied Health Sciences and Practice

Background: Attempts to address health and health care disparities in the United States have led to a renewed focus on the training of healthcare professionals including physical therapists. Current health care policies emphasize culturally competent care as a means of promoting equity in care delivery by health care professionals. Experts agree that cultural insensitivity has a negative association with health professionals’ ability to provide quality care.

Objective: To evaluate the cultural awareness and sensitivity of physical therapy (PT) students in a didactic curriculum aimed to increase cultural awareness.

Methods: Using the Multicultural Sensitivity Scale (MSS), a cross-sectional …

Addressing Opioid Misuse And Abuse Through Interprofessional Engagement And Education, Marta J. Brooks, Suzanne E. Holm, Shelene Thomas, Amy J. Rich

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this initiative was to develop and implement an interprofessional panel aimed to expose a university audience to the magnitude of opioid misuse and abuse, as well as demonstrate each health professional’s role in curbing the epidemic. Further, this experience was to provide a platform for interprofessional discussion and to share with attendees tangible action items to begin combatting the opioid epidemic.

Methods: An interdisciplinary committee of healthcare professionals collaborated to initiate a dialogue around opioid misuse and abuse to highlight the power of interprofessional (IP) collaboration in addressing the opioid epidemic. Each panel member shared …

Improvements In Research Orientation And Reductions In Barriers To Research Utilization Among Undergraduate Students In Health Sciences, Andrew A. Peachey, Stephanie Baller, Carolyn Schubert

Internet Journal of Allied Health Sciences and Practice

Purpose: Developing research skills while improving research orientation among undergraduate students may increase evidence-based practice later in their professional careers.

Method: Undergraduate Health Science students (n=241) participated in a pretest-posttest design to determine the impact of a course that includes team-based, student initiated research projects completed within one semester. Modified versions of the Edmonton Research Orientation Survey (EROS) and the Barriers to Research Utilization Scale (BARRIERS) were completed at the beginning and end of the semesters.

Results: Students reported gains in six research skills and improvements in two of the Edmonton Research Orientation Survey subscales: involvement in research and evidence-based …

An Examination Of Concussion Legislation In The United States, Kelly L. Potteiger, Adam J. Potteiger, William Pitney, Paul M. Wright

Internet Journal of Allied Health Sciences and Practice

There is legislation in the United States designed to protect children and adolescents from the risks associated with concussion. The scope and reach of these laws vary greatly.

Purpose: It is important that health care professionals are aware of the limitations of each law. Since 2009, every state in the nation and the District of Columbia passed legislation designed to protect student-athletes who suffer from concussions resulting from participation in sport.

Method: Therefore, select components of state policies were identified including: 1) Affected entities, 2) Stipulations for concussion awareness/education, 3) Requirements for removal/return to play, and 4) Requirements for return …

Athletic Training Students Demonstrate Supplemental Oxygen Administration Skill Decay, But Retain Knowledge Over Six Months, David C. Berry, Jennifer K. Popp

Internet Journal of Allied Health Sciences and Practice

Purpose: Research suggests skill decay occurs with emergency skills, such as supplemental oxygen administration (OA), since the frequency of medical emergencies in clinical settings is low. Identifying the presence and timeline for skill decay allows educators to employ strategies to prevent this occurrence. Therefore, this study evaluated retention of knowledge and clinical skills associated with supplemental oxygen administration, specifically nasal cannula (NC) and non-rebreather mask (NrM) usage in professional athletic training students.

Methods: Cross-sectional study. Twenty-nine athletic training students (males=11, females=18; age=21.03+1.38) enrolled in a Commission on Accreditation of Athletic Training Education (CAATE)-accredited professional athletic training programs. Participants’ …

Quitting Together: Formative Research To Develop A Social Marketing Plan For Smoking Cessation Among Women In A Residential Treatment Facility For Substance Abuse Recovery, August D. Anderson

Theses and Dissertations--Communication

Both smoking addiction and illicit substance abuse are prevalent issues in the United States today. Furthermore, these are issues that have significant impact on women’s health and mental state. Despite research that shows that smoking cessation coupled with substance abuse recovery can decrease likelihood of relapse post-recovery, few substance abuse recovery facilities today offer smoking cessation programming options. To address the issue of smoking addiction on top of substance abuse recovery, formative research was conducted through this study to determine the underlying causes of smoking habits coupled with recovery efforts and the attitudes. Through focus group sessions with women in …

Opioid Addiction Litigation And The Wrongful Conduct Rule, Samuel Fresher

University of Colorado Law Review

The United States is facing an opioid addiction crisis. Can our civil courts help? This Comment explores obstacles to recovery for plaintiffs in tort suits against health care institutions and practitioners in opioid addiction litigation. It argues that defenses based on plaintiffs' wrongful conduct, which deny plaintiffs access to civil remedies due to their immoral or illegal conduct, should be eliminated or avoided in suits arising out of addiction. This Comment concludes that comparative fault principles adequately protect the interests of plaintiffs and defendants in drug addiction suits and advance important public policy goals. Finally, this Comment suggests that irrespective …

Novel Anti-Obesity Effects Of Beer Hops Compound Xanthohumol: Role Of Ampk Signaling Pathway, Janaiya S Samuels, Rangaiah Shashidharamurthy, Srujana Rayalam

PCOM Scholarly Works

Background: Obesity alters adipose tissue metabolic and endocrine functioning, leading to an increased adiposity and release of pro-inflammatory cytokines. Various phytochemicals have been reported to contribute to the beiging of white adipose tissue in order to ameliorate obesity by increasing thermogenesis. Here, we show that the prenylated chalcone, xanthohumol (XN), induces beiging of white adipocytes, stimulates lipolysis, and inhibits adipogenesis of murine 3T3-L1 adipocytes and primary human subcutaneous preadipocytes and these effects are partly mediated by the activation of the AMP-activated protein kinase (AMPK) signaling pathway.

Methods: 3T3-L1 adipocytes and primary human subcutaneous preadipocytes were differentiated using a standard protocol …

Chlamydia Pneumoniae: An Etiologic Agent For Late-Onset Dementia, Brian J. Balin Phd, Christine Hammond, Christopher S. Little, Susan Hingley, Zein Al-Atrache, Denah Appelt, Judith A Whittum-Hudson, Alan P Hudson

PCOM Scholarly Works

The disease known as late-onset Alzheimer's disease is a neurodegenerative condition recognized as the single most common form of senile dementia. The condition is sporadic and has been attributed to neuronal damage and loss, both of which have been linked to the accumulation of protein deposits in the brain. Significant progress has been made over the past two decades regarding our overall understanding of the apparently pathogenic entities that arise in the affected brain, both for early-onset disease, which constitutes approximately 5% of all cases, as well as late-onset disease, which constitutes the remainder of cases. Observable neuropathology includes: neurofibrillary …

Aps’Aalooke Led Diabetes Prevention Program, Lucy Hollingsworth Williamson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The primary objective of this proposed program is to decrease the burden of diabetes mellitus type II among the Crow Indian tribe members in Montana by preventing the progression of prediabetes to diabetes. Type II diabetes mellitus (DMII), is a debilitating disease that contributes to increased morbidity and mortality, in addition to billions of healthcare costs annually. In the United States, minority populations carry a higher burden of DMII, however American Indians have the highest prevalence of all. In fact, American Indians are 2.4 times more likely to be diagnosed with diabetes than white people.

In Montana, the Crow Indian …

Consultation Experience In Public Health, Xiangya Meng

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project describes the results of a consultative experience in biostatistics.

Evaluation Of A Pharmacist Led Medication Reconciliation Process In Primary Care, Benjamin T. Gatlin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Medication safety should be at the forefront of public health initiatives. Medication reconciliations in primary care are key to successful, accurate, and safe medication use. Pharmacists are well positioned and educated to have an impact on medication safety by conducting reconciliations in primary care centers. Guidelines for training pharmacists on how to conduct medication reconciliations would be a useful tool for any health board striving to improve medication safety. This study uses observations from pharmacists currently conducting medication reconciliations in primary care to propose such guidelines in the form of a flow sheet. The resulting flow sheet and observations are …