Medicine and Health Sciences Commons^™

Undergraduate Nurse Educator Perceptions Of Preparation To Teach Interprofessional Collaboration, Tamara Powell Berghout

Walden Dissertations and Doctoral Studies

If nurse educators do not teach students to function in interprofessional teams, students may lack communication and teamwork skills, which can result in patient harm; however, nurse educators do not always understand the concept of interprofessional collaboration (IPC) and may, therefore, fail to teach it to students. The purpose of this multiple case study was to understand how undergraduate nurse educators prepared to teach IPC and how their preparation informed their teaching. The theory of transformative learning and the Interprofessional Education Collaborative core competencies of IPC framed this study. Data included semistructured interviews and associated documents from 9 nurse educators …

Development Of A Bundle For Hemodialysis Infection Control, Lora Susan Lewis

Walden Dissertations and Doctoral Studies

Hemodialysis patients are at high risk of acquiring a blood stream infection (BSI), the second leading cause of death in this population. The purpose of this project was to create a clinical practice guideline (CPG) based on current evidence-based practice (EBP) that would bring a cohesiveness to the policies and provide an auditing tool to monitor infection control practices. Current literature supports the bundle approach, a small set of EBPs combined as a group of recommended interventions that apply to a specific patient population with the goal of improved delivery of care. The hemodialysis bundle project incorporated the theory of …

Physical Activity And Dietary Interventions For Adolescent African Americans In Mississippi, Tanga Deson Hart Robinson

Walden Dissertations and Doctoral Studies

African American (AA) adolescents have higher rates of obesity than many other ethnic groups, which increases their risk for obesity-related diseases. Culturally sensitive obesity preventive interventions have been unsuccessful, resulting in a steady increase of obesity among AA adolescents. AA adolescents in the southern region of the United States are at a higher risk for obesity and physical inactivity; knowledge and understanding of causative factors remains limited. To identify the impact of programs, a systematic review of the literature focused on structured physical activity and/or dietary education interventions in Mississippi. The ecological framework was used to guide this study. The …

Nursing Knowledge On Pressure Injury Prevention In The Intensive Care Unit, Yanick Jacob

Walden Dissertations and Doctoral Studies

Over 60,000 hospital patients die each year from complications associated with hospital-acquired pressure injuries (HAPIs). Pressure-injury rates have increased by 2% within the past decade as life expectancy has also increased due to high cost in Medicare. Evidence shows that the incidence of pressure injuries (PIs) in healthcare facilities is increasing, with high rates of occurrence in intensive care units (ICUs). At the clinical site for which this project was developed, multiple in-services had been provided to staff regarding PIs, but uncertainty persisted about how knowledgeable the nurses were. This project, using the Academic Center for Evidence Star Model of …

Clinicians' Attitudes Toward Sex Offender Treatment, Vallerie Hancock

Walden Dissertations and Doctoral Studies

Clinician attitudes toward a client have a significant influence on outcomes for that client's treatment. Exploring the attitudes of clinicians toward sex offenders can provide additional insights into methods to improve treatments for this population. The purpose of this qualitative grounded theory study was to examine the attitudes of clinical professionals who work with sex offenders to identify the specific ways that these attitudes influenced professional behaviors and client interactions. Grounded theory was used to move beyond a general description of the issue to formulate a theory regarding clinician work with sex offenders and its implications. The sample comprised 10 …

Basic Quality Care Blood Pressure Teaching Plan, Dorine A. Lynch

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is a leading risk factor for cardiovascular disease complications, disability, and mortality. Delayed detection of HTN increases the risk of the patient developing heart disease, renal failure, and stroke, which are among the leading causes of death in the US. Educating healthcare providers is, therefore, necessary to ensure accuracy when measuring blood pressure (BP) to improve the likelihood of early detection and commencement of treatment. The BP teaching project involved the development of an evidence-based teaching program to educate nurses at an East Coast Veterans' Administration Center on the guidelines of measuring BP. The practice-focused question addressed whether …

A Staff Education Module For Depression Screening In Acute Care, Olufumilayo Sayo Onuoha

Walden Dissertations and Doctoral Studies

Depression is one of the most common mental health disorders in the United States. Although it can be treated, it may go unidentified for a long period of time. The World Health Organization (WHO) anticipates that, by 2020, depression will become responsible for more disabilities than a combination of other conditions, excluding heart conditions. The prevalence of depression among the general population is higher in patients who seek emergency healthcare services. The purpose of this project is to develop an evidence-based educational module for nurses to screen for depression in an acute care setting using the PHQ-2 and PHQ-9 depression …

The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVD) are responsible for more deaths than any other disease, continue to threaten the quality of life for many, and is a major burden to the health care system. The Framingham Heart Study (FHS) identified the major CVD risk factors that became essential to effective CVD screening strategies and the Framingham Risk Score (FRS), is used to assess CVD risk. Based on the concepts of the health behavior model and CVD as a cardiometabolic disorder, multivariate logistic regression analysis was used to evaluate the association between fasting blood glucose (FBG) levels and a CHD event, and to determine …

Clinical Resource Practice Scenarios To Mitigate Bullying, Sabrina Renea Brown - Oliver

Walden Dissertations and Doctoral Studies

Workplace bullying is repeated, aggressive action towards a victim, which especially affects new graduate nurses and can inhibit growth and lead to nursing burnout and staff turnover. The purpose of this Doctor of Nursing Practice project was to develop a clinical resource educational module. The case scenarios were developed using literature on workplace bullying and lateral violence. Clegg's circuits of power theory was applied to frame the organizational authoritative nursing power struggles that exist as a circular flow between different nursing group members, and the American Nurses Association (ANA) Practice Standards and Code of Ethics guided the assertive communication. The …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Patients' Perceptions Of Quality Of Life And Resource Availability After Critical Illness, Michelle Mcmoon

Walden Dissertations and Doctoral Studies

Physical, psychological, and social debilities are common among survivors of critical illness. Survivors of critical illness require rehabilitative services during recovery in order to return to functional independence, but the structure and access of such services remains unclear. The purpose of this qualitative study was to explore the vital issues affecting quality of life from the perspective of critical illness survivors and to understand these patients' experiences with rehabilitative services in the United States. The theoretical framework guiding this study was Weber's rational choice theory, and a phenomenological study design was employed. The research questions focused on the survivors' experiences …

Preventing Acute Myocardial Infarction Readmission Rates, Sherin Abraham

Walden Dissertations and Doctoral Studies

Unplanned readmissions to the hospital are a problem faced by most health care organizations in the United States; hospitals are penalized for such readmissions. The project site identified high readmission rates for patients who were discharged after acute myocardial infarction (AMI), making careful transition home a necessity for post-AMI patients. The focus of this quality improvement (QI) project was implementation of an early follow-up appointment of AMI patients following discharge. The purpose of this project was to evaluate the effectiveness of changing follow-up appointments for patients with an AMI from 14-30 days to 7-14 days post discharge to reduce unplanned …

Associations Between Healthcare Utilization Factors And Diabetic Retinopathy Among Adult African Americans, Olusina Adesanya

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by diabetes mellitus (DM) and complications that include diabetic retinopathy and its disease and socioeconomic burdens. This study examined the relationships between diabetic retinopathy and health care utilization factors, such as gender, DM comorbidities of hypertension and hyperlipidemia, and health care access, among sampled African Americans with DM in the United States. The Andersen health care utilization model was the framework for the study. In this correlational cross-sectional study, data from the 2011-2016 National Health and Nutrition Examination Survey datasets were analyzed. Results of complex samples logistic regression showed that there were no significant associations …

Impact Of A Healthcare Workplace Violence Prevention Module On Staff Knowledge, Michelle Leigh Arroyo

Walden Dissertations and Doctoral Studies

The healthcare sector experiences violence 4 times as much as any other civilian domain, including law enforcement and corrections facilities. The clinical practice problem addressed in this project was the lack of adequate healthcare workplace violence (HWV) prevention in a not-for-profit community hospital. The purpose of this project increase awareness of HWV prevention through the use of an education module. Rogers’ diffusion of innovation model served as the foundation for analysis of scores from pre- and posteducation tests. The practice-focused question asked if a module on HWV prevention based on current clinical practice guidelines and peer-reviewed literature would improve staff …

Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is the most common form of dementia and affects an individual’s overall cognitive function, including orientation, memory, and executive function. Most AD patients in the United States reside in residential care facilities or private homes under the care of individuals with little education on the challenges of the AD patient. Among the challenges faced by caregivers are behavioral and psychological symptoms related to dementia (BPSD). Education has been shown to improve caregivers’ treatment of BPSD in AD patients and to improve caregiver retention. The purpose of this project was to develop an evidence-based education module guided by …

Effects Of Pregnancy-Related Depression On Low Birth Weight Infants, Kimberly J. Bauer-Schaub

Walden Dissertations and Doctoral Studies

Maternal depression during pregnancy can have a negative impact on the developing child. Numerous studies have focused on postpartum depression and the influences on infant outcomes; however, there are limited data on pregnancy-related depression. The problem addressed in this study was the inadequacy and insufficiency of depression screening during the pregnancy period and access to quality-related health services for women. The purpose of this quantitative retrospective study was to test social cognitive theory on low birth weight and prenatal care adherence to pregnancy-related depression in women residing in Colorado. This research measured an association between pregnancy-related depression and both low …

Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush

Walden Dissertations and Doctoral Studies

Hospital systems in the United States are facing a dilemma regarding capacity management in the emergency department (ED) and the inpatient care setting. The average wait time in EDs across the United States exceeds 98 minutes, which is also the point at which patients begin to abandon healthcare treatment. The purpose of this quantitative study was to examine the use of queueing theory in capacity management on length-of-stay (LOS) rates, left-without-being-seen (LWBS) rates, and boarding rates in the ED and inpatient setting. The boarding rates represent the rate in which patients were roomed in the ED but required inpatient care. …

Multidisciplinary Simulation Training To Improve Nursing Knowledge Of Intraoperative Malignant Hyperthermia, Heather Burrell

Walden Dissertations and Doctoral Studies

Malignant hyperthermia (MH) is a rare but severe reaction that can occur in the operating room. Due to the low volume of these reactions, nurses are often unprepared to handle the event; however, not recognizing the event and intervening can lead to the death of the patient. This is a practice problem that can be addressed through a nursing staff education simulation training program. The purpose for this doctoral project was to develop a multidisciplinary MH simulation program that could improve nursing knowledge when caring for patients experiencing an MH crisis in the operating room. The practice-focused question for this …

Yoga As A Women’S Population Health Intervention, Lisa Ann Clow

Walden Dissertations and Doctoral Studies

Women’s mortality rate in the United States has increased in almost every age group in the past several years. However, more women in the United States are choosing yoga as a complementary health approach to improve general well-being. Thus, research on yoga and other factors that affect women’s health in the United States may inform public health initiatives to address the health disparities in women’s mortality rates. Grounded in the health belief model, the purpose of this study was to explore whether the factors of practicing the components of yoga, doctor’s recommendation for increased physical activity, body mass index (BMI) …

Screening For Depression During The Early Perinatal Period, Loretta Ann Donnelly-Moreno

Walden Dissertations and Doctoral Studies

The clinical practice guideline (CPG) is the implementation of a depression screening tool to be used in the early perinatal period. The practice change occurred in a rural Obstetrical and Gynecological (OBGYN) practice in the southern United States. The CPG change has been guided by recommendations from both the American Congress of Obstetrics and Gynecology and the American College of Nurse Midwives. Implementation of this CPG change addresses the gap in practice of not doing depression screening during the perinatal period, and only screening during the postpartum period, which was being done at the OBGYN office. Theorist Lewin’s ‘change theory’ …

Mental Health Disparities Among Minority Populations, Arrey Irenee Eyongherok

Walden Dissertations and Doctoral Studies

Despite the existence of effective treatments, mental health care disparities exist in the availability, accessibility, and quality of services for racial and ethnic minority groups. People living with serious mental complaints often resist engaging in treatments and experience high rates of dropout; poor engagement can lead to worse clinical outcomes. Addressing the complex mental health care needs of racial and ethnic minorities warrants considering evidence-based strategies to help reduce disparities. This systematic review sought to provide an analysis of published literature about the barriers and effective strategies in identifying and treating minority patients with mental health disorders. The practice-focused question …

Development Of Nursing Staff Education For Central Line Maintenance, Doreen Lynn Farley

Walden Dissertations and Doctoral Studies

Patients with cancer who receive bone marrow transplants (BMT) are at increased risk for central line-associated blood stream infections (CLABSI), a serious complication leading to increased costs, length of stay, and even death. Recognition of an increased CLABSI rate at one BMT unit in the southwestern United States prompted development of an evidence-based staff development education program to improve nurses’ knowledge of central line maintenance and CLABSI prevention practices. Guided by Lewin change theory, the program was developed based on a nurse-led analysis and synthesis of the evidence, and a formative evaluation of the educational program conducted by a 3-member …

The Association Between Behavior Disorders And Return Visit To The Emergency Department, Destiney Fraguada

Walden Dissertations and Doctoral Studies

Presently, extensive research supporting the overcrowding of emergency departments (EDs) and behavior disorder patients presenting to EDs are prevalent. There exists a knowledge gap between specific behavior disorders diagnoses associated to repeated visits to the ED. The purpose of this quantitative study was to address whether a relationship exists between patients with psychotic and/or substance abuse disorders and the repeated ED visits within 72 hours. The Andersen Behavioral framework model and the secondary data were used in the study. The cross-sectional archival data from the 2016 National Ambulatory Medical Care Survey was analyzed by using cross-tabulation with the 2 test …

Effects Of Increasing Education For Clinicians On Stress While Treating Pressure Injuries, Roscelyn Garner

Walden Dissertations and Doctoral Studies

Previous healthcare professionals researched the effects of treating and healing pressure

injuries within long-term care facilities. This study was conducted to explore the stress clinicians face when treating pressure injuries in the long-term care setting. This qualitative study provides information for the need to educate nurses about treating and healing pressure injury. It was derived from a phenomenological study that incorporated real life perspectives of individuals responsible for treating and healing pressure injury. This study was guided by Castles and Ferguson’s conceptual framework related to employee perceptions on pressure injuries, employee level of education and knowledge about improving quality initiatives …

Improving Disaster Preparedness And Planning For Chronic Disease Populations, Gladys N. Gichomo

Walden Dissertations and Doctoral Studies

The significant rise of both chronic diseases and disasters in the last 20 years and the healthcare outcomes of individuals with chronic diseases during and in the aftermath of disasters have raised concerns among public health practitioners, healthcare providers, the U.S government, and the general public. Researchers have indicated that during disasters, the health outcomes of individuals with chronic diseases are significantly unfavorable compared to the general public. However, there is inadequate information on the management of chronic diseases, quality of care, and resource identification and allocation by disaster responders. This qualitative, grounded theory study, explored how the study participants …

A Urinary Catheter Insertion And Care Program For Reducing Catheter-Related Infections, Rodney R. Hauch

Walden Dissertations and Doctoral Studies

Many inpatients in U.S. hospitals acquire an hospital-acquired infection (HAI), the majority of which can be attributed to an indwelling urinary catheter. The use of urinary catheters is a common practice within the acute care setting although the placement comes with risk. Improper catheter placement or a lack of care and maintenance can increase patient morbidity and mortality, as well as increase financial strain for the hospital. The purpose of this quality improvement (QI) evaluation was to determine if using a safety checklist and a 2-person urinary indwelling catheter-insertion team would reduce the rate of catheter-associated urinary tract infections (CAUTIs). …

Effects Of Maternal Obesity On Preterm Birth And Birthweight, La Tosha Headley

Walden Dissertations and Doctoral Studies

Obesity is one of the major risk factors for neonate low birthweight among reproductive women. The purpose of this quantitative study was to examine the association between 3 categories of obese status (moderate, severe, and very severe) and low neonate birthweight and preterm birth among women ages 18 to 39 years at all socioeconomic levels. Secondary data were obtained from 141,859 women ages 18-39 years living in the United States who had participated in the 2012-2015 Pregnancy Risk Assessment Monitoring System. Social-ecological theory was used to guide the study, and binary logistic regression was used for the analyses adjusting for …

Reducing Falls In The Vulnerable Elderly: Implementing An Inpatient Fall Prevention Program, Bibi Farida Khan

Walden Dissertations and Doctoral Studies

Inpatient falls are a leading cause of fatal and serious injuries among hospitalized elderly patients, often with devastating consequences. This quality improvement project was conducted on a geriatric unit in a large southeastern U. S. hospital, following recognition of an increase in the number of falls with several sustained injuries. After an analysis of the previous fall prevention strategies, a panel of stakeholders who formed a falls prevention committee determined that implementing an evidence-based fall risk assessment tool to help identify risk factors, as well as implementing interventions to address those risk factors, would make fall prevention more patient specific …

Perceptions Of Lifestyle As Mental Health Protective Factors Among Midwestern Amish, Gregory Lantz

Walden Dissertations and Doctoral Studies

The Amish are commonly known for horse-and-buggies, simple clothing, and refusal to use electricity. Less commonly known is their rate of mental illness, which is significantly lower than the non-Amish population. The literature that points to lower depression and anxiety among the Amish does not adequately explain what elements of their lifestyle contribute to this phenomenon. Depression and anxiety are a widespread problem in the United States, increasing the importance of understanding a lifestyle that can reduce these issues. The purpose of this study was to explore the Amish way of life through the words of its members. The three …

Effects Of Teach-Back On Children’S Treatment In Parents With Low Health Literacy, Marion Ines Kopulos

Walden Dissertations and Doctoral Studies

Health literacy (HL) skills are necessary to understand the context of medical information provided to patients in all settings including the emergency room. People with low health literacy (LHL) have difficulty comprehending and implementing basic tasks such as understanding medication administration. The purpose of this quasi-experimental study guided by Orem’s self-care theory was to determine the effect of using the teach-back method for discharge instructions compared to standard written instructions based on parents’ learning style and HL skills assessed during their visit to the emergency room. The Newest Vital Sign (NVS) tool was reworded to assess the parents’ HL. A …