Medicine and Health Sciences Commons^™

Collaborative Treatment Plan Development, Sally Kangas

Walden Dissertations and Doctoral Studies

The practice problem for this quality improvement project was the lack of engagement of chronic back pain patients at a Midwest clinic in evidence-based risk/benefit discussions regarding treatment options. The project was designed to explore whether practice guidelines increase patient engagement as measured by the Patient Activation Measure (PAM). Practice guidelines for interactive patient/nurse practitioner discussions regarding treatment options were developed, implemented, and evaluated. The concepts of chronic pain, chronic pain treatment options, and patient engagement were researched, and the evidence was evaluated using the Grades of Recommendation Assessment, Development, and Evaluation system. The clinical practice guideline was developed following …

Association Between Age Of Women When Diagnosed With Endometriosis And Infertility, Whitney Kennedy

Walden Dissertations and Doctoral Studies

Abstract

Because endometriosis is considered to be the primary cause of infertility in women and

the diagnosis is known to be delayed by many years, it is important to understand the

association between endometriosis and infertility. The purpose of this cross-sectional,

secondary data analysis study was to determine whether there was an association between

the age of women when diagnosed with endometriosis and infertility. Using the general

model of total patient delay (i.e., the Andersen model) as a theoretical foundation, data

for this study was collected by assessing patient medical records of women with

endometriosis at multiple OB-GYN clinics in …

Workplace Violence Among Nurses And Nursing Assistants In Texas, Tamala Norris

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) is ranked as one of the leading causes of occupational injury in the United States and is common in health settings. Nurses have the highest rate of violent victimization reported in the U.S., thus presenting a significant issue for healthcare leaders. Various researchers focus on prevalence rates of WPV among nurses discussing types of violence, location, and the setting where the WPV occurred. Less information exists regarding time taken off work and factors associated with WPV among nurses versus nursing assistants (NAs). This information is important due to the impact on safe work environments for nursing employees. …

Time Banks As Aging-In-Place Initiatives, Calli Sajnani

Walden Dissertations and Doctoral Studies

There has been growing concern over how state and federal governments can support the increasing population of aging Americans and their need for long-term care. Current insurance funding models cover acute hospitalization and skilled care only, leaving unskilled care needs and homemaker services at the full expense of those in need. Time banking allows individuals to exchange or barter time for goods or services without monetary payment. There is insufficient evidence to determine if members believe time banks to be a viable alternative to support aging-in-place care needs. This phenomenological study explored time banking as a potential vehicle for nonskilled …

Integration Of Learning Activities For Improved Performance On The Nclex-Rn Exam, Erika Wilkinson

Walden Dissertations and Doctoral Studies

An institute of higher education located in the United States was unable to maintain the required first-time pass rate, on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, by nursing graduates, as defined by their State Board of Nursing and accreditation body. Failure to meet these requirements resulted in a corrective action plan and fewer licensed nurses able to enter practice. The purpose of this study was to identify curricular changes to the associate nursing program to improve the first time pass rate by their nursing graduates. Benner's theory of skill acquisition was used as the conceptual framework …

Spiritual Wellness As A Predictor For Moral Injury In Combat Veterans, Steve Zappalla

Walden Dissertations and Doctoral Studies

Many combat veterans face difficulties coping with their personal lives, relationships, and families when they leave the service and return to civilian life. Most studies examining the effects of combat on veterans focus on posttraumatic stress disorder (PTSD) as well as a collection of related consequences. Interest in the term moral injury of military veterans as a related mental health construct has grown. Researchers have investigated the effects of spiritual wellness of combat veterans. However, there is a paucity of counseling literature on the relationship between spiritual wellness and moral injury when combat veterans return to civilian life. Investigating the …

Evidence-Based Practice Guideline For Peripheral Artery Disease, Jenny Ann Salve Managbanag

Walden Dissertations and Doctoral Studies

The absence of a practice guideline for peripheral artery disease (PAD) in the cardiology department creates differing practice preferences among providers, leading to deviations in practice among staff. Variations in practice can affect the quality of care that is provided to patients. This project was guided by research statements indicating that there was a difference in the screening approach for PAD among health practitioners at preimplementation and postimplementation and that an 85% compliance with the guideline would signify consistency in the provision of care. Rogers' theory of diffusion of innovations was used to facilitate the adoption of the guideline. This …

Early Detection Of Neonatal Abstinence Syndrome By Neonatal Intensive Care Unit Nurses, Ebele Oraka

Walden Dissertations and Doctoral Studies

Neonatal abstinence syndrome (NAS) is a public health concern that is increasing in the United States due to the use of illicit drugs by pregnant women, which exposes the fetus to these substances. NAS results in increased infant morbidity and prolonged stay in the hospital, which can lead to increased cost of care. The inability of the nurses to care for at-risk infants can lead to inconsistent NAS scores, which can affect the infant's care treatment. The project examined the effectiveness of educating the neonatal intensive care unit (NICU) nurses on the correct use of the modified Finnegan Neonatal Abstinence …

Factors That Influence Whether Mexican Americans With Depression Seek Treatment, Irene Rodriguez

Walden Dissertations and Doctoral Studies

Mexican Americans, the largest Hispanic subgroup in the United States, tend to underuse mental health services. Grounded in Andersen's behavioral model of health services use, the purpose of this nonexperimental study was to examine the likelihood of birth country, education, income, and insurance predicting which respondents would report seeking mental health services to treat depression. The Mini International Neuropsychiatric Interview was used to diagnose depression in 203 Mexican Americans whose data was archived from the primary study. This archived data was analyzed within this study. The results of the 2 x 2 chi-square tests of independence indicated a significant association …

An Educational Program For Using The Distress Themometer, Mabel M. Che-Tuma

Walden Dissertations and Doctoral Studies

The distress thermometer (DT) is a screening tool designed to measure the level of stress in oncology patients. Clinical oncology nurses (CONs) at the local site lacked knowledge and training on how to administer and apply the DT. Because of this practice gap, patients were not receiving referrals to the necessary support services. The purpose of this project was to design and validate a CON staff education program on the use of the DT. The diffusion of innovation theory along with the theory of interpersonal relations served as the conceptual framework for the project. The project was organized into a …

Strategies To Reduce Occupational Injuries And Illnesses In Government Agencies, Sandra Montgomery

Walden Dissertations and Doctoral Studies

Despite regulatory efforts of the Occupational Safety and Health Administration (OSHA), 104 cases of nonfatal occupational illnesses and injuries (OIIs) per 10,000 full-time workers required time away from work in 2015. Although OII rates in private and public sectors are high, the rates among state and local government agencies were over 50% higher than private sector rates in 2015, especially in the healthcare industry. OIIs can lead to reduced organizational productivity and performance. Guided by the leader member exchange theory (LMXT) and risk homeostasis theory (RHT), the purpose of this single case study was to explore effective strategies that supervisors …

Nonpharmacological Behavioral Interventions For Patients With Dementia: An Integrative Literature Review, Michelle Monique Spears

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in older adults with dementia increases risk of

mortality; therefore, it is critical that nurses use nonpharmacological interventions in dementia care. The nurses' role is integral to implementation of treatment strategies to dementia patients and efforts to improve care in patients with dementia using a nonpharmacological approach are necessary. Therefore, guidelines outlining nonpharmacologic dementia care management will enable nurses to provide a wider spectrum of care to dementia patients. The purpose of this project was to make recommendations for the development and implementation of interdisciplinary practice guidelines to standardize care in the organizational setting. An …

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 …

Development Of A Sexual Assault Support Group For Female Rape Victims, Ann Marie Nichole Willoughby

Walden Dissertations and Doctoral Studies

Survivors of sexual assault struggle to cope with subsequent psychological disturbances. The project facility was a rural hospital in the southwestern United States in which postasault care was initially provided, but survivors later returned to the emergency department. Support groups can be a powerful tool to alleviate long-term consequences of assault by helping individuals cope and improving socialization. This project used the social-ecological theory to explore whether a sexual assault support group would impact the progress of survivors toward improved social interaction, improved socialization, and decreased psychological disturbance. The purpose of the quality improvement (QI) project was the development of …

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 …

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 …

Understanding Parenting Styles Of Second-Generation Parents Of Residential School Survivors Within Treaty 8 Reserves, Judy Kim-Meneen

Walden Dissertations and Doctoral Studies

Approximately 150,000 First Nation, Metis, and Inuit children attended Canadian residential schools from the 1840s to 1996. Most residential school children had negative experiences of physical, verbal, and sexual abuse that led to parenting repercussions once these children became parents. These repercussions of residential schools led to a rate of neglect for First Nation children 12 times higher than non-First Nation children. The purpose of this qualitative phenomenological descriptive study was to explore the lived experiences of second generation parents, who were schooled in residential schools as children and their current parenting styles. The conceptual frameworks of trauma theory and …

Emotional Self-Management Experiences Of Practical Nursing Students, Cindy Ko

Walden Dissertations and Doctoral Studies

In Ontario, Canada, practical nurses (PN) are educated through a 2-year diploma program. A review of PN program curricula in Ontario suggested that emotional intelligence (EI) and the core concept of emotional self-management are not specified in curriculum outcomes or courses. The study explored PN students' lived experiences with emotional self-management in the clinical settings where they are exposed to stress related situations using van Manen's orientation to hermeneutic phenomenology. The original four-branch ability model of EI by Mayer and Salovey was used as the theoretical framework to guide the explorative and interpretative processes of the study. Face-to-face interviews were …

Predictors Of Blood Pressure And Lipids Levels Among African Americans, Frank Lanor

Walden Dissertations and Doctoral Studies

African Americans disproportionately develop cardiovascular disease risk factors including high blood pressure and high cholesterol levels in comparison to European Americans. The purpose of this study was to examine the associations of diet quality and physical activity with blood pressure levels and cholesterol levels among African Americans. The social ecological model was the theoretical foundation for the study. Research questions were designed to examine the extent to which diet quality and physical activity predict blood pressure levels and cholesterol levels. The research design was quantitative cross-sectional secondary analysis of 959 participants. After controlling for demographic factors, body mass index, and …

Dissertation: Sociodemographics And Pancreatic Cancer Survival Rate, Sylvester Lewis

Walden Dissertations and Doctoral Studies

Pancreatic carcinoma or pancreatic cancer (PaCa) is an insidious disease with a prognosis of 6- to 12-month survival time for a late stage diagnosis. This problem has become crucial given that no study to date had been able to establish a definitive association between independent factors (other than a few diseases) and the survival rate of pancreatic cancer. The purpose of this quantitative, cross-sectional study was to determine whether an association exists between the independent, sociodemographic variables (marital status, age, education, income, and employment) and the outcome variable of survival rate. The social cognitive theory was the framework that provided …

Effectiveness Of Guardrails At Reducing Medication Errors Indrug Administration, Teresa Mosley

Walden Dissertations and Doctoral Studies

Medication errors during drug administration are an issue in the nursing profession. The errors that occur due to intravenous vein infusions pose threats to patients due to the mode of administration and the risk of occurrence. Strategies such as guardrails have been implemented to reduce the rate of such errors. Despite these guardrails, facilities record mixed results on the effectiveness of infusion pumps in reducing medication errors. The project was designed as a quantitative study to evaluate the effectiveness of guardrails in reducing medication errors at the facility. Data analysis included error reports from the facility before and after the …

Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip

Walden Dissertations and Doctoral Studies

Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …

Maternal Characteristics And The Risk Of Cleft Lip And Palate In The United States, Letha Thomas

Walden Dissertations and Doctoral Studies

Cleft lip with or without cleft palate (CLP) is an ongoing public health issue across the globe, and in the United States. The estimated number of babies born each year in the United States with cleft palate (CP) is about 2,650, while CLP affects approximately 4,440 babies. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between CLP and maternal characteristics such as reproductive history (advanced maternal age, maternal obesity, prenatal visits, month prenatal care began, number of pregnancies, gestational age at birth, assisted reproductive technology used, gestational diabetes, and hypertension), socioeconomic status of …

The Editors’ Perspective: A Successful First Year Of The Journal Of Occupational Therapy Education, Cynthia L. Hayden, Renee Causey-Upton, Dana Howell

Journal of Occupational Therapy Education

No abstract provided.

Clinician, Educator, And Student Perceptions Of Entry-Level Academic Degree Requirements In Occupational Therapy Education, Whitney M. Lucas Molitor, Ranelle Nissen

Journal of Occupational Therapy Education

Entry-level occupational therapy degree requirements have varied since the establishment of the profession. Currently multiple degree paths exist. There are cited benefits for a multiple degree path system; however, barriers also exist. Most notable among these are confusion among recipients of services and other health care providers. As other healthcare professional programs have transitioned to a single point of entry at the doctoral level, occupational therapy, until recently, had not yet made this change. A nationwide online survey was used to assess perceptions of the entry-level doctorate. Participants included current occupational therapy practitioners (clinicians or educators) and students in entry-level …

Entry-Level Occupational Therapy Programs’ Emphasis On Play: A Survey, Anita W. Mitchell, Jennifer Hale, Meg Lawrence, Erwin Murillo, Katie Newman, Hannah Smith

Journal of Occupational Therapy Education

Play is a key occupation for children. Despite this, research suggests that pediatric occupational therapists primarily use play as a modality rather than addressing it as an outcome. Lack of education related to play has been identified as a factor contributing to the limited use of play in intervention; therefore, this study examined entry-level occupational therapy programs’ emphasis on play in their curricula. Faculty from entry-level occupational therapy programs in all regions of the U.S. responded to a validated survey. The majority (82%, n = 33) reported meeting Accreditation Council for Occupational Therapy Education (ACOTE) standards related to play, notwithstanding …

Using Online Professional Development To Increase Self-Efficacy In School-Based Occupational Therapy Fieldwork Educators, Meghan Suman, Ingrid Provident

Journal of Occupational Therapy Education

The purpose of this study was to determine if school-based occupational therapists who participated in a series of online professional development modules on the topic of fieldwork education reported increased feelings of self-efficacy regarding the ability to fulfill the role of fieldwork educator. In this single-group design, participants completed a series of six online professional development modules. Each module consisted of a narrated slideshow presentation, case study activity, and online discussion board. Participants completed a self-efficacy survey before and after completing the series of modules. Results indicated a significant increase in self-efficacy related to fieldwork education following completion of the …

Innovations In Occupational Therapy Education: The Centralized Service Learning Model, Lauren E. Milton, Robyn Otty

Journal of Occupational Therapy Education

Partnerships between community organizations and engaged university members creates realistic learning experiences for occupational therapy students while encouraging civic responsibility. The authors propose service learning as the core of an innovative course design framework using the Centralized Service Learning Model (CSLM). Three phases are described. Phase One provides a description of the CSLM using a generalizable model, with specific application within existing occupational therapy program coursework. Phase Two provides leadership opportunities for a subsequent cohort of students within the curriculum. Finally, Phase Three integrates faculty scholarship. To understand students’ knowledge-level awareness, a survey based on course objectives can be administered, …

The Impact Of Classroom Instruction On Cultural Awareness And Sensitivity In Occupational Therapy Students, Sierra Grady, Kym Brungardt, Joy Doll

Journal of Occupational Therapy Education

As the population in the United States increases, it is essential that occupational therapy students and practitioners be aware of, respond to, and effectively interact with clients from diverse cultural backgrounds. Current literature identifies a gap in the cultural competence education for occupational therapy students and has demonstrated the importance of developing a culturally sensitive curriculum that will prepare students for today’s work environment. This study employed a quasi-experimental approach with a one group pretest-posttest design to explore the development of cultural awareness in occupational therapy students with classroom instruction on culturally sensitive practice. Data was collected from 43 students …

On-Campus Occupational Therapy Clinic Enhances Student Professional Development And Understanding, Kelly Erickson

Journal of Occupational Therapy Education

Changing healthcare systems impact clinical sites that provide fieldwork for occupational therapy programs and require students to be prepared for the pace and demands of the clinical settings. Occupational therapy programs strive to enhance hands-on experiences in didactic curriculum to better prepare students for Level II fieldwork. An on-campus clinic course was implemented over two semesters with students engaging in the occupational therapy process with adult and pediatric clients from the community under the supervision of faculty. Student surveys and focus group data were analyzed over five years. Survey responses to open-ended question were triangulated with data from focus group …