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2019

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Articles 12601 - 12630 of 16112

Full-Text Articles in Medicine and Health Sciences

Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman Jan 2019

Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman

Walden Dissertations and Doctoral Studies

Emergency department nurses are faced with traumatic patient events while functioning as members of multidisciplinary teams. Critical incident debriefing has been shown to benefit health care professionals and patient clinical outcomes. The purpose of this quantitative correlational study was to examine the relationship between the use of formal post-resuscitation debriefings and perceptions of teamwork in emergency department nurses. The study also addressed the type and timing of debriefing to determine whether these factors impacted perceptions of teamwork. The nurse as wounded healer theory served as the theoretical framework. Data from the Nursing Teamwork Survey were collected from 68 emergency department …

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Development Of A Tele-Healthcare Clinical Practice Guideline For Diabetic Patients, Kathy J. Montgomery Jan 2019

Development Of A Tele-Healthcare Clinical Practice Guideline For Diabetic Patients, Kathy J. Montgomery

Walden Dissertations and Doctoral Studies

Lack of access to healthcare in rural communities has resulted in increased morbidity and mortality rates among diabetic patients. The problem identified in this project was the lack of access to healthcare among diabetic patients living in rural southeast Ohio. Tele-healthcare is a strategy that provides healthcare remotely and has been introduced into the rural setting and offers an appropriate healthcare delivery mode for the rural community. The purpose of the project was to develop a tele-healthcare clinical practice guideline, including smart phone applications, for the management of diabetic patients. An expert panel consisting of 2 advanced practice nurses in …

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Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann Jan 2019

Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann

Walden Dissertations and Doctoral Studies

The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …

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Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse Jan 2019

Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse

Walden Dissertations and Doctoral Studies

High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …

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Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson Jan 2019

Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson

Walden Dissertations and Doctoral Studies

Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …

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A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa Jan 2019

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …

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Health Awareness On High Blood Pressure, High Cholesterol, And Risk For Cardiovascular Disease, Innocent Bibi Jan 2019

Health Awareness On High Blood Pressure, High Cholesterol, And Risk For Cardiovascular Disease, Innocent Bibi

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for 25% of the annual deaths in the United States and represents a major public health burden, as patients often require screening and lifestyle changes related to multiple risk factors such as high blood pressure and high cholesterol. The purpose of this quantitative correlational study was to determine if there was a statistically significant association between high blood pressure and high cholesterol awareness (prevention and management) and cardiovascular health outcomes (angina pectoris, coronary heart disease, and heart attack). The theoretical framework that guided this study was the health belief model. Data from adults over the …

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Successful Strategies For Increased Dental Practice Competitiveness, William Eyster Jan 2019

Successful Strategies For Increased Dental Practice Competitiveness, William Eyster

Walden Dissertations and Doctoral Studies

The rapid expansion of dental service organizations (DSOs) continues to disrupt the traditional dental practice model and there was a 12.2% increase in DSOs between 2015 and 2016. Some solo and small group dental practice owners lack strategies to adapt their businesses to be successful in newly competitive markets including DSOs. Grounded in systems theory, the purpose of this qualitative multicase study was to explore strategies dental practice owners use to adapt their businesses to be successful in newly competitive markets. The participants included 3 solo and 2 small group dental practice owners in central Kentucky who demonstrated success in …

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Embracing Ujima: A Grounded Theory Of African Americans Choosing The Counseling Profession, Rashida Karriem Fisher Jan 2019

Embracing Ujima: A Grounded Theory Of African Americans Choosing The Counseling Profession, Rashida Karriem Fisher

Walden Dissertations and Doctoral Studies

Racial and ethnic diverse populations experience discrimination in educational and career attainment and remain underrepresented in the counseling profession. The current literature provides limited guidance for the counseling profession and academic institutions for successfully recruiting racial and ethnic minority students in a master's level counselor training program. Social Constructivist theory and Adlerian/ Individual Psychology are the theoretical foundations of the study. This constructivist grounded theory study sought to understand the career decision-making process of African Americans choosing to enter in the counseling profession and the influence of racial and ethnic identity on this decision-making process. Utilizing semistructured interviews via video-conferencing; …

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Destination Arrival And Discharge Unit To Improve Patient Flow, Shelia Celeste Jeter Jan 2019

Destination Arrival And Discharge Unit To Improve Patient Flow, Shelia Celeste Jeter

Walden Dissertations and Doctoral Studies

The increase in patients presenting to the emergency department (ED) for primary care poses a serious safety issue in the care that can be provided. In a care area that is overcrowded, physicians, nurses, ancillary department staff, and other care team members may have a difficult time delivering care. Poorly managed flow in the ED leads to overcrowding, and patients with life-threatening illnesses are less likely to be transitioned to designated specialized areas in a safe and efficient manner. The practice-focused question was whether processes to improve the flow of patients entering the ED decreased the number of patients leaving …

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A Practice Guideline For Triaging Mental Health Patients In The Emergency Setting, Florence Nguh Jan 2019

A Practice Guideline For Triaging Mental Health Patients In The Emergency Setting, Florence Nguh

Walden Dissertations and Doctoral Studies

Today's emergency departments (EDs) are challenged with increasing numbers of patients with behavioral health (BH) issues and associated management problems. Patients presenting in the ED are increasingly in need of BH services due to a lack of available services in the community. The implication is that ED staff are faced with conducting a comprehensive review of their systems and processes for BH care delivery to ensure that the needs of this population are safely met. Specifically, this DNP project addressed the lack of evidence-based screening tools for the ED triage area for patients with BH issues. The purpose was to …

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A Systematic Review Of Nurse Staffing Models, Elizabeth Ndidi Ubochi Jan 2019

A Systematic Review Of Nurse Staffing Models, Elizabeth Ndidi Ubochi

Walden Dissertations and Doctoral Studies

Appropriate nurse staffing is essential to the delivery of high-quality patient care. Nursing leadership identifies nurse staffing model as an evidence-based staffing model following problems with nursing staff retention on 4 acute care units in a recently opened hospital. The linkage model guided the review of evidence on nurse staffing models and the relationship to nurse job satisfaction and nurse retention and to explore strategies that could lead to recommendations to nursing leadership. The 466 articles found were reduced to 7 articles, 2 at Level 1 (systematic review), 4 at Level VI (quantitative descriptive), and 1 at Level VII (expert …

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Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins Jan 2019

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …

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Self-Efficacy And Leadership Commitment During Lean Strategy Deployment, Angela Deloise Pearson Jan 2019

Self-Efficacy And Leadership Commitment During Lean Strategy Deployment, Angela Deloise Pearson

Walden Dissertations and Doctoral Studies

Lean strategy deployment (LSD) provides a means to create lasting value at reduced cost; yet most LSD efforts fail to attain sustainable improvements. The current study sought to gain an understanding of how leaders in oral healthcare manufacturing setting in the northeastern region of the United States can apply self-efficacy and leadership commitment during an LSD. Using Bandura’s theory of self-efficacy this qualitative phenomenological study examined the lived experiences and perceptions of 15 mid-to-senior level managers, concerning the use of self-efficacy and leadership commitment during a lean strategy deployment (LSD). The key findings resulted in 10 emergent themes. The top …

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Clinical Practice Guideline: Posttraumatic Stress Disorder Screening Tool For Patients, Stephanie Lynn Smith Jan 2019

Clinical Practice Guideline: Posttraumatic Stress Disorder Screening Tool For Patients, Stephanie Lynn Smith

Walden Dissertations and Doctoral Studies

The National Institute of Health has estimated that over 1 million new cancer cases will occur yearly. Posttraumatic stress disorder (PTSD) is commonly associated with near death experiences or traumatic events, such as cancer diagnosis and treatment. There is a lack of knowledge and awareness by healthcare professionals in identifying PTSD in cancer patients. In this population, PTSD symptoms often contribute to anxiety, and there is no standardized protocol being used to screen these individuals for the trauma they are facing or have faced. The purpose of this project was to develop a clinical practice guideline for screening cancer patients …

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Predicting Spiritual And Religious Competence Based On Supervisor Practices And Institutional Attendance, Andrew Phillip Secor Jan 2019

Predicting Spiritual And Religious Competence Based On Supervisor Practices And Institutional Attendance, Andrew Phillip Secor

Walden Dissertations and Doctoral Studies

Counseling students report a lack of competence in spiritual and religious integration (SRI). As such, counselor educators and supervisors (CES) and students want to understand how to develop SRI competence. Although past research highlighted SRI dialogue in training, the problem is that no clear understanding exists about the role of faculty supervisor SRI on perceived student competence. The supervision models used to inform the study included the integrated developmental model, discrimination model, and spirituality in supervision model (SACRED). The purpose of this study was to determine if master’s-level graduate counseling students’ perception of their faculty supervisors’ SRI practices predicted students …

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Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo Jan 2019

Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo

Walden Dissertations and Doctoral Studies

Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation …

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The Impact Of Hiv Prevention Education In School On Young Men Who Have Sex With Men, Michael Edward Tachet Jan 2019

The Impact Of Hiv Prevention Education In School On Young Men Who Have Sex With Men, Michael Edward Tachet

Walden Dissertations and Doctoral Studies

Sex education through the public school system has been identified by the Centers for Disease Control and Prevention as an excellent vehicle by which HIV prevention education can be presented to students, thereby decreasing the rate of HIV infection among young men who have sex with men (YMSM). However, YMSM continue to be at high risk for HIV infection in the United States despite educational efforts to prevent infection. The purpose of this qualitative study using a phenomenological approach was to explore what impact school-based HIV prevention education had on YMSM in the past, and what effect that education has …

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Impact Of Transitional Care Model On Readmissions Of Adults With Chronic Heart Failure, Sheila Delaine Stuckey Jan 2019

Impact Of Transitional Care Model On Readmissions Of Adults With Chronic Heart Failure, Sheila Delaine Stuckey

Walden Dissertations and Doctoral Studies

Chronic heart failure (CHF) is often associated with high morbidity, mortality, and increased health expenditures. The readmission rate of patients with CHF is approximately 30% within 30 to 60 days following discharge. This project examined the literature to identify best practices based on the use of the transitional care model (TCM) in the reduction of hospital readmissions among older patients with CHF. The review included articles that were published between 2015 and 2019, used a quantitative study methodology, were peer-reviewed, and written in English. Keywords used in the search were chronic heart failure, the transitional care model, and hospital readmissions. …

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An Educational Module On High Blood Pressure Management And Control, Chinyere Ukomadu Jan 2019

An Educational Module On High Blood Pressure Management And Control, Chinyere Ukomadu

Walden Dissertations and Doctoral Studies

An educational module, based on evidence-based practice (EBP) guidelines by the 8th Joint National Committee (JNC 8) and the American College of Cardiology (ACC), was created and implemented to determine if its implementation would impact the knowledge of clinic staff regarding current EBP guidelines about self-management of hypertension (HTN). The module has the potential to contribute to the resolution of patient noncompliance on HTN treatment and management by increasing nursing staff proficiency in knowledge transfer to patients on effective self-management of their health condition. The creation of the module was guided by the concept of need or asset assessment and …

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Relationship Between Preparedness Training And Posttraumatic Stress Disorder Severity In Combat Veterans, Charles F. Snay Jan 2019

Relationship Between Preparedness Training And Posttraumatic Stress Disorder Severity In Combat Veterans, Charles F. Snay

Walden Dissertations and Doctoral Studies

In the past decade, the military has deployed approximately 1 million members into combat, and a factor that plagues the military veterans returning from combat is the prevalence of posttraumatic stress disorder (PTSD). A factor to examine is preparedness training before combat because the research has shown that postcombat resilience training has been effective in reducing symptoms of PTSD. Using the social cognitive theory, the purpose of this study was to determine whether self-reported preparedness training before deployments was related to lower severity of self-reported PTSD. Based on prior research, age and gender are other variables that this study examined. …

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A Phenomenological Study Of Lived Experiences Of Transport Nurses Experiencing Patient Death, Joshua B. Wall Jan 2019

A Phenomenological Study Of Lived Experiences Of Transport Nurses Experiencing Patient Death, Joshua B. Wall

Walden Dissertations and Doctoral Studies

Experiencing a patient death can directly affect the well-being of health care professionals; however, this phenomenon and the effects of patients' deaths are not well understood in the transport setting. Transport nurses work in unique settings with complex patients and significant autonomy in determining the plan of care; therefore, the experiences of other health care professionals may not be applicable in this environment. The purpose of this qualitative study was to explore the lived experiences of transport nurses who have experienced patient death using Husserl's life-world and phenomenological philosophies as a theoretical framework. Semistructured interviews were completed with 8 transport …

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Effect Of Multiple Entry Levels Into Nursing Practice And Professionalism, Ogechi Abalihi Jan 2019

Effect Of Multiple Entry Levels Into Nursing Practice And Professionalism, Ogechi Abalihi

Walden Dissertations and Doctoral Studies

Entry into professional nursing practice in the United States occurs at varied education levels including a diploma, an associate degree, and a baccalaureate degree. These multiple entry levels into practice create a situation where academic preparedness for nursing practice varies, which may influence the professional behavior of nurses and, consequently, patient care and outcomes. The purpose of this quantitative comparative study, guided by Miller's wheel of professionalism in nursing, was to determine if there is a difference in the professional behaviors of associate degree prepared registered nurses (RNs) compared to the professional behaviors of baccalaureate degree prepared RNs. The Behavior …

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Bedside Nurses' Perceptions Of Pursuing An Academic Career As Nursing Faculty, Suzanne Lynne Benfield Jan 2019

Bedside Nurses' Perceptions Of Pursuing An Academic Career As Nursing Faculty, Suzanne Lynne Benfield

Walden Dissertations and Doctoral Studies

There is a nursing faculty shortage at a Mid-Atlantic associate degree nursing program. In response, program administrators have hired adjunct faculty with bachelor of science in nursing degrees (BSNs), hired full-time faculty with master of science in nursing degrees in areas other than education who also are not certified nurse educators, and reduced its minimum requirement for nursing faculty clinical experience. The nursing faculty shortage combined with the resulting gaps in practice are problematic because they may (a) negatively influence the program's ability to produce degreed nurses; (b) increase faculty workload; (c) decrease the quality of student education, which may …

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The Effect Of Mindfulness Techniques On Teacher Resilience As Moderated By Conscientiousness, Aundrea T. Harris Jan 2019

The Effect Of Mindfulness Techniques On Teacher Resilience As Moderated By Conscientiousness, Aundrea T. Harris

Walden Dissertations and Doctoral Studies

Unmanaged stress in teachers often triggers burnout, which leads to a rise in healthcare costs and absenteeism. Therefore, teachers' resiliency needs improvement to lower the risk of burnout. The purpose of this cross-sectional design study was to examine the relationship between mindfulness techniques and resilience in high school teachers. An additional purpose of this study was to examine if the personality trait, conscientiousness, moderates the relationship between mindfulness techniques and resilience. The frameworks for this study were based on the self-awareness, -regulation, and -transcendence (S-ART) framework, theory of planned behavior, and the concepts of resilience and job burnout. Four surveys …

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Factors That Influence The Prevalence Of Type 2 Diabetes Among Aboriginals In Canada, Olayinka Awoyemi Jan 2019

Factors That Influence The Prevalence Of Type 2 Diabetes Among Aboriginals In Canada, Olayinka Awoyemi

Walden Dissertations and Doctoral Studies

The focus of this study was on potential social determinants of health factors that influence the prevalence of type 2 diabetes in the general population of Canada, with emphasis on the disproportion in rates of the disease between Aboriginal and non-Aboriginal populations of Canada. This study also examined the risk factors that are peculiar to the general, Aboriginal, and non-Aboriginal population of Canada. A total number of 101,080 individuals who were 18 years and above provided data for this study. The data and information obtained from these participants were used to answer the major research questions regarding if there was …

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Risk Factors That Predict Asthma Among Adult, Foreign-Born African Americans In California, Alphajor Umaru Barrie Jan 2019

Risk Factors That Predict Asthma Among Adult, Foreign-Born African Americans In California, Alphajor Umaru Barrie

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine possible risk factors that predict asthma among adult, foreign-born African Americans in California. A total of 794 foreign-born African Americans (87 asthma cases) were included from the 2017-2018 California Health Interview Survey database. Data analysis included both descriptive and inferential statistical methods including chi-square analysis and multiple logistic regression techniques. The socioeclogical model was used to help understand and interpret the findings. The dependent variable was asthma status and the independent variables were the risk factors (tobacco smoking, alcohol use, health insurance, income level, and education level). Confounders included in the …

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Analysis Of Control Measures Used During Cholera Outbreaks Among Internally Displaced Persons, Nicole Devine Carneal-Frazer Jan 2019

Analysis Of Control Measures Used During Cholera Outbreaks Among Internally Displaced Persons, Nicole Devine Carneal-Frazer

Walden Dissertations and Doctoral Studies

Cholera remains a major public health problem affecting high-risk populations such as camps of internally displaced persons. During a cholera outbreak, it is essential to reduce transmission and minimize new infections. The Miasma theory, host-agent-environment model and Ecosocial theory were utilized for this study. This study was a retrospective comparison to determine whether historical cholera control measures are effective during current cholera outbreaks within camps of internally displaced persons. A quantitative approach ascertained changes in incidence and mortality rates following implementation of primary and/or secondary control measures. Cholera outbreaks were identified from the World Health Organization's (WHO) Disease Outbreak News …

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Improving Nurses' Knowledge Of Central Line-Associated Bloodstream Infection, Misty Cooper Jan 2019

Improving Nurses' Knowledge Of Central Line-Associated Bloodstream Infection, Misty Cooper

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSI) are usually attributable to suboptimal line insertion, care, or maintenance and are associated with poor patient outcomes. Nursing plays a pivotal role in preventing CLABSI, because nurses are generally responsible for the routine care and maintenance of central lines. The purpose of this project was to determine if CLABSI nursing education and demonstration-based competency could improve nurses' knowledge on a neurology unit as compared to current practice of an annual e-learning module as the sole source of nurse education. This project was informed by Lewin's planned change theory and involved changing behaviors, attitudes, and practices …

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Impact Of Social Influence On Willingness To Participate In Clinical Trials Among African Americans, Chika Okere Jan 2019

Impact Of Social Influence On Willingness To Participate In Clinical Trials Among African Americans, Chika Okere

Walden Dissertations and Doctoral Studies

Global rate of participation in clinical trials is especially low among African Americans in the United States due to social factors identified by research, which adversely impact this group's willingness to participate in clinical trials. The purpose of this cross-sectional quantitative study was to evaluate the role of social influence in the decision-making patterns of African Americans as it relates to clinical trial participation. The theory of planned behavior was used as the theoretical framework to understand an individual's interaction with social factors and how it affects their willingness to participate in clinical trials. The participants in the study were …

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