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2018

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Articles 12961 - 12990 of 15421

Full-Text Articles in Medicine and Health Sciences

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist Jan 2018

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …

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Waterborne Disease Reduction Using Evidence-Based Microbiology Verification In Lower Nyakach, Kenya, Richard R. Blodgett Jan 2018

Waterborne Disease Reduction Using Evidence-Based Microbiology Verification In Lower Nyakach, Kenya, Richard R. Blodgett

Walden Dissertations and Doctoral Studies

Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 …

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Understanding Use Of Care For African Immigrants With Autistic Children, Leahnata Davies Jan 2018

Understanding Use Of Care For African Immigrants With Autistic Children, Leahnata Davies

Walden Dissertations and Doctoral Studies

The number of African immigrants in the United States is increasing. The incidence of children diagnosed with autism spectrum disorder in the United States is also on the rise. Despite these increases, little information exists about the adequacy of care for African immigrants with autistic children in the United States. The purpose of this grounded theory study was to understand the factors that affect use of care for African immigrants with autistic children in the United States. Using Aday-Anderson model of health care utilization framework, this study focused on African immigrants in the United States who had children with Autism …

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Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner Jan 2018

Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner

Walden Dissertations and Doctoral Studies

Nurse educators make decisions regarding the inclusion or exclusion of non-nursing courses in a curriculum. The current literature lacks research regarding which courses have the most impact on first-time nursing licensing examination pass-rates. The purpose of this quasi-experimental study was to investigate if there is a specific combination of courses that enhance first-time licensing examination pass-rates, using 161 randomly selected accredited associate degree nursing programs. General systems theory applied to nursing education was the framework for the study. ANOVA and independent t-tests were used to address the questions of non-nursing courses or discipline-specific set of non-nursing courses' impact on first-time …

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Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty Jan 2018

Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty

Walden Dissertations and Doctoral Studies

Incidents of falls among the elderly increase with age. About $31 million is spent annually in the United States on medical costs related to fall injuries in the elderly. This project evaluated the outcomes of a fall reduction program implemented in an assisted living facility (ALF). The Stop Elderly Accidents, Death & Injury program developed by the Centers for Disease Control and Prevention was implemented by the ALF for 60 days prior to the outcome evaluation project. The program included a convenience sample of 62 residents and involved medication evaluation, exercises, assistive devices, environmental risk reduction, and evaluation of blood …

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Human Immunodeficiency Virus Disparity In Black Men Who Have Sex With Men, Valencia L. Beckley Hildreth Jan 2018

Human Immunodeficiency Virus Disparity In Black Men Who Have Sex With Men, Valencia L. Beckley Hildreth

Walden Dissertations and Doctoral Studies

The HIV/AIDS epidemic continues to be a challenge in the men who have sex with men (MSM) population. Initiatives to decrease rates of new HIV infections have proven less than optimal. Despite evidence-based interventions to curtail the prevalence and incidence rates of HIV infection, Black MSM have been most impacted with increased HIV incidence. The purpose of this quantitative correlational study was to explore the relationship, if any, between age, online and physical venues attended by participants within the last thirty days, neighborhood's perceived social environment, and HIV incidence in the non-Hispanic Black MSM population in a metropolitan statistical area …

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Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial Jan 2018

Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial

Walden Dissertations and Doctoral Studies

The Joint Commission reported that communication failures in United States hospitals contribute to 30% of all malpractice claims, and in 2008, The Joint Commission listed the improvement of effective communication among healthcare providers as a National Patient Safety Goal. The purpose of this practice-focused project was to develop a scenario-based communication simulation for implementation approval by a panel of experts. The approved curriculum was designed to integrate a communication-based simulation scenario into the nurse residency program of a large, urban medical center to improve new graduate nurse communication skills, increase nurse communication competency and self-efficacy, and decrease communication errors. Kolb's …

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Impact Of Palliative Care On Patients With Severe Chronic Obstructive Pulmonary Disease, Celena Romero Jan 2018

Impact Of Palliative Care On Patients With Severe Chronic Obstructive Pulmonary Disease, Celena Romero

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) requiring long-term oxygen therapy (LTOT) is an incurable lung disease often complicated by other comorbidities. Research is limited for hospitalized COPD exacerbations with LTOT and palliative care services. The purpose of this quantitative research study was to determine the correlation between palliative care interventions and COPD patient outcomes specific to an intensive care unit (ICU) stay, invasive mechanical ventilator support, physician orders for cardiopulmonary resuscitation (CPR) code status, and hospital discharge to hospice care. The theoretical base for this study was Donabedian's quality improvement theory. The quasi-experimental, nonequivalent groups design divided COPD hospitalized patient sample …

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Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth Jan 2018

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …

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Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu Jan 2018

Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu

Walden Dissertations and Doctoral Studies

Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were …

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Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina Jan 2018

Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina

Walden Dissertations and Doctoral Studies

The Supplemental Nutrition Assistance Program (SNAP) is the United States' largest government assistance program that aims to alleviate food insecurity. The SNAP program allows low-income individuals and families the ability to purchase nutritious foods through a monthly benefit. However, the current body of literature presents evidence of the program's counterproductive effect. The purpose of this study was to determine whether incentivizing SNAP recipients to purchase additional fruits and vegetables was beneficial in increasing such purchases. Social cognitive theory was used as a theoretical framework to address research questions associated with shopping patterns and attitudes and beliefs. This quantitative study used …

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The Survival Of Healthcare In Rural Texas, Destin Cook Jan 2018

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

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The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach Jan 2018

The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach

Walden Dissertations and Doctoral Studies

Inadequate interprofessional collaboration (IPC) and communication among health care professionals are associated with medical errors and mortality. Guided by the theory of goal attainment and the chronic care model, a systematic review was conducted to explore the evidence related to whether interprofessional collaborative primary care can have a positive effect on health outcomes for patients living with diabetes (PLWD). The systematic review followed the Joanna Briggs Institute method for systematic reviews and results were complied with the PRISMA evidence-based minimum set for reporting. Data were analyzed to identify if IPC positively impacted the health outcomes of PLWD, as evidenced by …

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Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze Jan 2018

Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze

Walden Dissertations and Doctoral Studies

This project explored the challenges confronting clinicians who work with the Assertive Community Treatment Program (ACT), a government-sponsored clinic-based program providing services for individuals with persistent and recurrent mental health challenges in a large metropolitan city in the southern United States. The project involved semi-structured interviews with 15 health care clinicians to explore what they perceived as challenges and their recommendations for addressing them. Themes were organized around the 6 dimensions of the the relationship-based care model: leadership, teamwork, professional nursing, care delivery, resources, and outcomes. Identified patient challenges included transportation, lack of health insurance, housing, acceptance of certified peer …

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Impact Of Acculturation On Body Mass Index In Haitians, Nirva Berthold Jan 2018

Impact Of Acculturation On Body Mass Index In Haitians, Nirva Berthold

Walden Dissertations and Doctoral Studies

Longer-term immigrants residing in the United States exhibit physical health decline related to higher body mass index (BMI). Theories on immigrant acculturation have been used to examine health patterns by length of stay in the United States. The purpose of this cross-sectional study, guided by the Schwartz model of acculturation, was to examine the effect of acculturation and length of stay in the United States on BMI in a sample of Haitian immigrants living in the Northeast Metropolitan area. The research question was used to examine the effects of acculturation and length of stay on BMI in the convenience sample …

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Factors Affecting Completion Of Childhood Immunization In North West Nigeria, Sule Abdullahi Jan 2018

Factors Affecting Completion Of Childhood Immunization In North West Nigeria, Sule Abdullahi

Walden Dissertations and Doctoral Studies

North West Nigeria has the lowest vaccination rate of the geopolitical regions of the country. The purpose of this cross-sectional study was to examine associations between the parents'/caregivers' biological, cultural, and socioeconomic factors and the completion or noncompletion of routine immunization schedules. Andersen's behavioral model provided the framework for the study. Data were obtained from the 2013 National Demographic Health Survey. Descriptive statistics were calculated for all variables. Chi-square tests were used for categorical predictor variables, simple logistic regression models were used for the age variable, and multiple linear regression models were used for the biological, cultural, and socioeconomic variables …

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Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie Jan 2018

Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie

Walden Dissertations and Doctoral Studies

Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …

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Lived Experiences Of The Individual Mandate Of The Affordable Care Act, Wendy Berry Jan 2018

Lived Experiences Of The Individual Mandate Of The Affordable Care Act, Wendy Berry

Walden Dissertations and Doctoral Studies

In 2014, the individual mandate of the Affordable Care Act (ACA) came into effect. More than 7 million Americans paid a tax penalty for not carrying insurance during the previous tax year. Millions of others were forced to purchase a health insurance plan to avoid that penalty. This study filled a gap in public health policy research by incorporating qualitative data to offer narratives along with statistical data that could help explain health outcomes to make successful policy changes in 2019. The purpose of this study was to research the use of market competitive theory by learning people's lived experiences …

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Understanding The Lived Experiences Of Hispanic Immigrants With Diabetes Toward Disease Self-Management, Dahlia Connors Jan 2018

Understanding The Lived Experiences Of Hispanic Immigrants With Diabetes Toward Disease Self-Management, Dahlia Connors

Walden Dissertations and Doctoral Studies

The Hispanic population has a higher incidence of diabetes and poorer health outcomes compared to other populations in the United States. Although previous research has reported that cultural and ethnic beliefs play a role in poorer diabetes self-management by Hispanic individuals, limited studies have been focused on the barriers to self-management from the perspectives of Hispanic immigrants. The purpose of this qualitative study was to gain an understanding, through oral history narrative, of the experiences of Hispanic immigrants living with diabetes. In this study, the influence of cultural and ethnic beliefs on diabetes self-management in Hispanic immigrants in the Bronx …

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Exploring Relationships Of Meaning, Co-Occurring Diagnoses, And Attitudes About Substances, Misty Grant Jan 2018

Exploring Relationships Of Meaning, Co-Occurring Diagnoses, And Attitudes About Substances, Misty Grant

Walden Dissertations and Doctoral Studies

It is increasingly important to understand the factors associated with individuals struggling with addiction and their quality of life, especially with those struggling with co-occurring diagnoses (CODs). The purpose of this study was to explore the extent to which meaning, and CODs of anxiety and depression predict an individual's attitudes and beliefs about addiction among persons receiving treatment for substance use disorders (SUDs). The theoretical foundation used to guide this study was logotherapy, which emphasizes the importance of increasing meaning in life through choices, while also centering on being able to find meaning in all situations. A cross-sectional correlation design …

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Strategies For Shipping Temperature-Sensitive Medical Devices Using Cognitive Mapping, Eric C. Guynes Jan 2018

Strategies For Shipping Temperature-Sensitive Medical Devices Using Cognitive Mapping, Eric C. Guynes

Walden Dissertations and Doctoral Studies

Supply chain management (SCM) practitioners who ship temperature-sensitive diagnostic medical devices (DMDs) to clinicians must use effective cold chain management (CCM) strategies to avoid temperature excursions that contribute to medical device errors. Such errors have caused patient harm and death, which costs the U.S. health care system billions of dollars per year. The purpose of this qualitative multiple case study was to explore strategies for selecting and managing cold chain shipping solutions (CCSSs) requiring SCM executives to trade cost for regulatory compliance and predictability when mitigating temperature variations that occur during shipping. The conceptual framework for the study was the …

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Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus Jan 2018

Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus

Walden Dissertations and Doctoral Studies

Members of the healthcare industry have not fully understood organizational climate factors that enhance organizational citizenship behaviors (OCBs). This lack of understanding can result in negative patient outcomes. The purpose of this cross-sectional quantitative study was to examine the relationships between organizational climate factors and OCBs of employees at hospitals via person-organization fit theory. More, specifically, the purpose of this research was to explore (a) the relationships between organizational climate variables (i.e., welfare, autonomy, involvement, effort, training, integration, and supervisory support) and OCBs (n = 218), (b) differences in OCB scores between hospital leaders (n = 72) and followers (n …

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Congregational Health Promotion By African American Female Pastors In The Christian Faith, Arlene Obazee Jan 2018

Congregational Health Promotion By African American Female Pastors In The Christian Faith, Arlene Obazee

Walden Dissertations and Doctoral Studies

Health disparities have mostly affected African Americans who are poor, uninsured, under insured and unemployed. This population of African Americans seek spiritual solace and social counseling from their pastors, and church-based health promotion (CBHP) offers the opportunity to reach millions of the U. S. Black population. The lack of studies on female African American pastors implementing congregational health promotion activities influenced this study. This qualitative study helped in understanding the experiences, perspectives, and influences of 13 female African American Christian pastors on health-related issues within their congregation. Feminist theory and CBHP model guided this qualitative case study. Open-ended interview questions, …

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Perspectives Of Primary Care Physicians On Adopting Electronic Medical Records In The Atlanta, Georgia Area, Chris U. Okoro Jan 2018

Perspectives Of Primary Care Physicians On Adopting Electronic Medical Records In The Atlanta, Georgia Area, Chris U. Okoro

Walden Dissertations and Doctoral Studies

Slow adoption of electronic medical records (EMR) by primary care physicians in medical office practices has not facilitated the EMR adoption process. The problem is the slow pace of EMR adoption by primary care physicians in the Atlanta, Georgia area has become a public health concern. Research regarding the lived experiences of these physicians with EMR implementation and utilization may identify reasons for the slow adoption. The purpose of this phenomenological study was to explore the lived experiences of primary care physicians, who practice in the Atlanta area, regarding their perception, successes, barriers, and urgency of adoption of EMR in …

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Complementary And Alternative Medicine Careers Following A Science Academy For Underrepresented Minority Students, Tolulope Oyelowo Jan 2018

Complementary And Alternative Medicine Careers Following A Science Academy For Underrepresented Minority Students, Tolulope Oyelowo

Walden Dissertations and Doctoral Studies

Minority groups experience disproportionately worse health outcomes. An identified solution is to increase the number of minorities providing healthcare in their own communities. Primary care complementary and alternative medicine (CAM) providers are a potential resource. Many investigators have demonstrated the efficacy of science-based pipeline programs for increasing the roles of students in allopathic health professions. Whether these programs influence matriculation of minorities into a CAM university is unknown. The main purpose of this study was to gain an understanding of a pre-college science academy at a CAM university and determine whether the experience increased interest in and motivation for CAM …

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A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak Jan 2018

A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak

Walden Dissertations and Doctoral Studies

Assistive technology may delay cognitively impaired elders' need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah's 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer's or other dementia by 2037. Data were collected from a focus group of 10 seniors …

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An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson Jan 2018

An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson

Walden Dissertations and Doctoral Studies

Childhood obesity is a national problem in the United States and has known implications as a potential cause of chronic illnesses as the child transitions into adulthood. A primary care clinic in the southwestern United States had a high percentage of obese Hispanic children within its population; therefore, the nurses and the pediatrician needed an evidence-based clinical practice guideline (CPG) to manage Hispanic children with a body mass index greater than the 95th percentile for their age. The purpose of the project was to develop a culturally competent CPG to manage childhood obesity in this primary care practice. The social …

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Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell Jan 2018

Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …

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Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett Jan 2018

Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett

Walden Dissertations and Doctoral Studies

Bariatric surgery is a major surgery that has become a frequent procedure in North America; growth in the number of bariatric surgery procedures has resulted in an increase in readmissions after the procedure. A systematic review of the literature using the shifting processes model as a guide was used to answer the practice-focused questions regarding reasons for hospital readmissions for postoperative bariatric surgery patients and strategies that reduce complications of the procedure. Providing Innovative Service Models and Assessment chart (PRISMA) was used to quantify 17 studies that met the inclusion criteria. Results demonstrated that the reasons for readmissions after bariatric …

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Reducing Clabsi Rate Among Icu Patients, Rita L. Walker Jan 2018

Reducing Clabsi Rate Among Icu Patients, Rita L. Walker

Walden Dissertations and Doctoral Studies

Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a …

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