Medicine and Health Sciences Commons^™

Male Perspectives Of Lateral Violence In Nursing, Benita Kinard

Walden Dissertations and Doctoral Studies

Lateral violence is an intentional and harmful behavior in the workplace by one employee against another. In nursing lateral violence has impacted the performance of nurses as well as patient care. Research suggests that lateral violence behaviors are still prevalent in the nursing workplace and that there have been few interventions to change these behaviors or address the power dynamics that cause them. Though most of the research on lateral violence has been conducted on female nurses, the population of male nurses is growing. Thus, the purpose of the study was to explore lateral violence in the workplace from the …

Psychosocial Differences In Far Right, Far Left, Islamic, And Single Issue Lone Extremists, Tamara Marie Lamontagne

Walden Dissertations and Doctoral Studies

Acts of lone extremism are on the rise, yet little is known about who commits these acts. Research in this area has failed to delineate by extremist subtype. This has led to the misconception these acts and actors present with such variance psychosocially that they cannot be predicted. The purpose of this research was to assess whether statistically significant relationships exist between lone extremist subtypes on the psychosocial variables of mental illness, substance use, and having radicalized friends or family members. The conceptual framework for this study was De La Corte's psychosocial principles of terrorism, which addressed the social and …

Hand Hygiene And Compliance Rates In An Acute Care Setting, Ilona Lungui

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs) are a significant problem faced by healthcare organizations globally. The Centers for Disease Control reported that in 2014, 722,000 patients acquired an HAI, and of those, 75,000 died as a result. This project focused on reeducating healthcare staff on hand hygiene practices to prevent HAIs. Preintervention hand hygiene compliance rates were compared to postintervention hand hygiene compliance rates on 2 units in an acute care setting to evaluate if reeducation of healthcare staff on hand hygiene protocols and practices would increase hand hygiene compliance rates. The evidence-based practice model used for this project was Nightingale's environmental theory. …

The Role Of Advanced Practice Nurses In Advanced Care Planning For Cancer Patients, Sincere Mcmillan

Walden Dissertations and Doctoral Studies

In the United States, more than 75% of people will spend their last months of life in a health care facility. A key role for clinicians is to discuss care goals with the patients as part of a process called advanced care planning (ACP). As part of the oncology care team, advanced practice nurses (APNs) could help to increase the frequency of ACP discussions. The purpose of this project was to assess the knowledge and practice experiences of APNs regarding ACP at a National Cancer Institute designated cancer care hospital. Carper's patterns of knowing was the theoretical framework of this …

Guideline Development For An Adjunct Faculty Orientation In Prelicensure Nursing Programs, Pamela Ann Nehring

Walden Dissertations and Doctoral Studies

A research study conducted by the National Council of State Boards of Nursing noted adjunct faculty educators have significant learning requirements and that nursing education throughout the United States has not met the basic needs of novice adjunct faculty educators. Adjunct faculty at a local community college noted a deficit in the orientation process for new clinical faculty. The purpose of this quality improvement project was to develop a guideline for new clinical faculty orientation. The sources of evidence were a literature review and a survey using the Delphi process with an expert panel comprising a group of 7 interested …

Weight Management Toolkit For Patients On Methadone, Bolaji Olugboja

Walden Dissertations and Doctoral Studies

Methadone is a mu-opioid agonist used in the treatment of patients with an opioid use disorder in an outpatient addiction treatment clinic. A recognized knowledge gap exists among nurses managing overweight and obese patients in an outpatient methadone treatment center in the northeastern United States. The goal of this project was to develop a weight management toolkit to assist nurses in the identification, evaluation, and management of overweight and obese patients receiving methadone treatment at the center. The evidence-based weight management toolkit incorporated practice guidelines from the American Heart Association, American Association of Clinical Endocrinologists, America College of Cardiology, and …

Impact Of A Formal Mentorship Program On Frontline Nurse Managers, Tonya Ranee Roth

Walden Dissertations and Doctoral Studies

There are numerous factors that influence a nurse manager's job satisfaction and intention to remain in a job. The purpose of this project was to evaluate whether a formal mentorship program for nurse managers impacted job satisfaction and intention to remain in a job. A pilot program was developed and 15 nurse managers from 2 hospitals in the Pacific Northwest participated in a 6-month mentorship program. The program was guided by mentorship enactment theory and Kouzes and Posner's exemplary leadership framework. Using the Leadership Profile Inventory (LPI) and the Nurse Manager Practice Environment Scale (NMPES), job satisfaction, intention to stay …

Care Intervention And Reduction Of Emergency Department Utilization In Medicaid Populations, Eno J. Rouse

Walden Dissertations and Doctoral Studies

Expansion of Medicaid and private health insurance coverage through passage of the Affordable Care Act of 2010 was expected to increase primary care access and reduce emergency department (ED) use by reducing financial burden and improving affordability of care. The aim of this study was to examine the differences in utilization patterns that exist among the Medicaid population that participated in an optimal level of care (OLC) intervention inclusive of appointments scheduled to primary care providers. Using the integrated behavior model as a theoretical framework, the key research question focused on determining if there was a difference in ED use …

Hypertension Experience Of Foreign-Born West African Immigrant Women In The United States, Assumpta Onyinye Ude

Walden Dissertations and Doctoral Studies

Foreign-born African immigrants (FBAI) have a high rate of severe hypertension (HTN) and psychosocial-cultural factors have underlying roles in this, as in other chronic diseases. Literature lacks studies on FBAI women living with HTN. This study explored the HTN experience of FBAI women in the Washington Metropolitan area. This qualitative phenomenological study, was guided by a theoretical framework that included the Health Belief Model, Patient Centered Access to Health Care and the Transactional Model of Stress and Coping. Highly educated health care professional of 15 women participated in in-depth interviews. Thematic analysis was used for data analysis. Key findings included …

The Relationship Between Parents' And Caregivers' Demographics And Their Knowledge About Congenital Heart Disease, Adeola Barakat Animasahun

Walden Dissertations and Doctoral Studies

The lack of knowledge regarding congenital heart disease (CHD) among the Lagos populace is leading to late presentation, late diagnosis and poor outcomes. The purpose of the research was to document the level of knowledge of parents and caregivers regarding CHD using the Leuven questionnaire for assessing knowledge of parents on CHD (LKQCHD). A quantitative correlational cross-sectional study, with purposeful convenience sampling strategy, was used. Health belief model was the theoretical framework used. Primary data of demographic information such as gender, age, the level of education, and the number of years of accessing care were obtained using a survey. The …

Intraoperative Neurophysiological Monitoring Reimbursement Post International Classification Of Diseases-10, Cindy A. Akkerman

Walden Dissertations and Doctoral Studies

International Classification of Diseases the 10th Revision (ICD-10) was implemented October 1, 2015, and there was little knowledge how the transition to ICD-10 would impact the revenue cycle for intraoperative neurophysiological monitoring medical practices in Oklahoma. This correlational quantitative study examined the changes in dependent variables of reimbursements due to the change from ICD-9 to ICD-10 for independent variables of intraoperative neurophysiological monitoring procedure codes. The reimbursements from 2014 were compared to reimbursements from 2016. Prices were adjusted for inflation to 2016 dollar values. Annual reimbursements decreased for all intraoperative neurophysiological monitoring procedures examined except the remote monitoring code. The …

Evaluating The Frequencies Of Self-Reported Mental Health Conditions In Affluent Youth, Philip Bondurant

Walden Dissertations and Doctoral Studies

American youth are facing a mental health crisis. Rates of depression and suicide continue to rise among all children ages 12-17. While there is considerable research on the mental health of underserved children, much less is known about the mental health status of youth from affluent communities. The purpose of this study was to evaluate the effectiveness of community health assessment (CHA)-driven mental health interventions on the youth of affluent communities. Using a pre and post evaluation model, this study compared the frequencies of self-reported depression and suicide ideation for students in Grades 8, 10, and 12, and geographic location …

Relationship Between Skilled Nursing Facility Nurse Staffing Levels And Resident Rehospitalizations, Crystal Spring Bowens

Walden Dissertations and Doctoral Studies

Readmission of skilled nursing facility (SNF) residents has become a financial and quality-of-care concern for facility leaders. SNF administrators do not know whether nurse staffing levels are impacting readmission rates. The Affordable Care Act included measures to monitor and improve quality and to penalize SNFs that have high readmission rates. The purpose of this quantitative correlational study was to examine the relationship between SNF nurse staffing levels and readmission rates using the Skilled Nursing Facility Readmission Measure (SNF RM). The theoretical framework for the study was Donabedian's structure, process, outcome model. The research questions addressed the relationship between nurse staffing …

Work Engagement, Job Satisfaction, And Nurse Turnover Intention, Yolanda Marie Edwards-Dandridge

Walden Dissertations and Doctoral Studies

In the United States, the high turnover rate of registered nurses and indications of a future shortage of registered nurses is detrimental to healthcare organizations. The purpose of this correlational study was to examine whether, in hospitals, work engagement and job satisfaction predicted registered nurse turnover intention. The theoretical framework was Fishbein and Ajzen's theory of reasoned action. Probability sampling was used to identify 155 participants, all full-time registered nurses with 2 or more years of employment in New York hospitals. Data, obtained from surveys, were analyzed via multiple linear regression. The results revealed that only job satisfaction predicted turnover …

Barriers To Timely Activation Of Rapid Response Teams, Lajuanah Jean Herdrich

Walden Dissertations and Doctoral Studies

Timely activation of the rapid response team (RRT) depends on the nurse's willingness

and ability to make a rapid decision. The practice-focused questions for this DNP project

sought to identify barriers that contribute to delays in activating the RRT when needed in

medical-surgical patients. The self-efficacy theory was the guiding theory and was used

to examine self-confidence and performance along with Donabedian's health care model.

Qualitative data were obtained through focus groups and identified 2 prominent thematic

barriers among nurses with less than 3 years' experience: a lack of self-confidence and

the of lack of knowledge and experience. Results of …

Surgical Perioperative Leadership: The Association Between Leadership Style And Team Job Satisfaction, Corey Louise Jamison

Walden Dissertations and Doctoral Studies

Abstract

The perioperative operating room (OR) is a highly complex, fast-paced environment where countless transactions must be executed with efficiency, speed, and accuracy, and where mistakes of any kind could lead to adverse patient outcome, injury, or death. The surgeon, as leader of the procedure and the OR team, sets the overall climate of the OR and determines how willing (or unwilling) team members are to speak up about potential errors or unsafe patient conditions. This exploration of the relationship between perioperative surgeon leadership style and OR team member job satisfaction fills a gap unaddressed in the literature using items …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

Accelerated Online And Hybrid Rn-To-Bsn Programs: A Predictive Retention Algorithm, Melissa Knight

Walden Dissertations and Doctoral Studies

Predicting retention and time to graduation within accelerated online and a hybrid RN-to-BSN programs are significant elements in leveraging the pipeline of qualified RNs with BSN degrees, but the literature lacks significant accounts of retention and time to graduation outcomes within these programs and predictive algorithm developments to offset high attrition rates. The purpose of this study was to quantitatively examine the relationships between pre-entry attributes, academic integration, and institutional characteristics on retention and time to graduation within accelerated online RN-to-BSN programs in order to begin developing a global predictive retention algorithm. This study was guided by Tinto's theories of …

A Phenomenological Examination Of Resilience In Adult Children Of Alcoholics, Marcy Martens

Walden Dissertations and Doctoral Studies

Researchers have identified adult children of alcoholics (ACOAs) as being susceptible to substance abuse, intimate partner violence, mental health instability, and a myriad of psychosocial inadequacies. Growing up within an adverse childhood environment has also imprinted an unwanted stigma among ACOAs. Although there are many studies on the ACOA population, there is a significant gap in the literature between ACOAs exhibiting resilience and those who succumb to the negative characteristics of growing up within an adverse environment. The purpose of this hermeneutic, phenomenological study was to examine the lived experiences of adult children of alcoholics who have succeeded despite their …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

The Cost Of Treating Human Papillomavirus-Related Oropharyngeal Cancer, Karla Smalley Houston

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is a sexually transmitted infection contributing to 70% of oropharyngeal cancers in the United States. The incidence of HPV-related oropharyngeal cancers is greater in Kentucky's population than in any other state. Research has demonstrated the cost of treating oropharyngeal cancer on a national level, but little information exists as to state-specific costs. The purpose of this quantitative study was to examine radiation therapy costs for treating HPV-related oropharyngeal cancer in Kentucky in relation to age, gender, race, and insurance. A theory by Aday and Andersen was applied to explain the relationship between the independent and dependent variables. …

Clinical Nursing Faculty Competency, Christine Lee Kalt

Walden Dissertations and Doctoral Studies

Nursing faculty are responsible for graduating competent students and being competent themselves; however, the required competencies of clinical nursing faculty who instruct students in the clinical area are unidentified. The practice problem addressed in this project was the lack of a structured, organized process for identifying initial and ongoing competencies of a clinical nursing facility. The purpose of this project was to explore nursing faculty clinical competency and provide a multimethod, multispecialty approach for implementing clinical nursing faculty competency. The target population was clinical nursing faculty (n= 30) in an academic setting. This project explored the impact of a multimethod, …

Determinants Of Cervical Cancer Screening In Hiv-Positive Young Women In Swaziland, Marianne Calnan

Walden Dissertations and Doctoral Studies

In Swaziland, cases of cervical cancer among Human Immunodeficiency Virus (HIV)-positive adolescent girls and young women (AGYW) are increasing, but there is low uptake of cervical cancer screening. This study was conducted using the systems thinking theory to explore the relationships between the uptake of cervical cancer screening among HIV-positive AGYW in Swaziland and the availability of trained health providers, cervical screening services, and the provision of referrals for cervical screening. The study also investigated any differences in uptake of cervical screening based on age group. For this quantitative cross-sectional study, secondary HIV program data that were collected routinely between …

Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai

Walden Dissertations and Doctoral Studies

Every year, 2 million patients in the United States suffer with at least 1 hospital-acquired infection resulting in an estimated 99,000 deaths annually. The purpose of this exploratory single case study was to explore strategies healthcare managers in U.S. hospitals used to reduce hospital-acquired infections. The study included face-to-face, semistructured interviews with 5 healthcare managers from a hospital in Maryland who were successful in reducing these infections. The conceptual framework was human capital theory. Field notes, hospital documents, and transcribed interviews were analyzed to identify themes regarding strategies used by healthcare managers. The data analysis and coding process resulted in …

Effects Of High-Fidelity Simulation On The Critical Thinking Skills Of Baccalaureate Nursing Students, Janine Roth Blakeslee

Walden Dissertations and Doctoral Studies

This project study addressed the decline in successful passing rates for the National Licensure Exam for Registered Nurses (NCLEX-RN) in a nursing program at a private university in the Midwestern United States. There is support from the literature for a connection between critical thinking skills of nursing students and successful passing of the NCLEX-RN. The purpose of this quantitative study was to examine whether significant differences existed in mean critical thinking skill scores across time within groups (pretest to posttest) and between groups (simulation versus written case studies), as measured by the Health Science Reasoning Test. Cognitive learning theory as …

A Systematic Review Of The Effectiveness Of The Nln Jeffries Simulation Framework, Angela Feeler

Walden Dissertations and Doctoral Studies

Simulation theoretical frameworks serve as guidelines for the development, planning, implementation, and evaluation phases during nursing simulation activities. Simulation frameworks provide a substantive foundation for research, education, and practices that contribute to the science of nursing education. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to recommend the National League for Nursing (NLN) simulation education framework for simulation activities. The Academic Center for Evidence-Based Practice star model of knowledge transformation and descriptive theory were used as frameworks to guide this systematic literature review. The practice question for this systematic literature …

Incorporation Of The Caring Moment In Scripting, Anita E. Barker

Walden Dissertations and Doctoral Studies

A large healthcare system in Texas mandated scripting as way to improve patient satisfaction. The purpose of this project was to incorporate a caring moment into scripting by the nursing staff to improve patient satisfaction. The project was guided by Watson's caring theory, the adult learning theory, and Lewin's planned change theory. All 35 nurses from the primary care and specialty care outpatient clinics of the Texas healthcare system participated in a staff development training to learn how to incorporate a caring moment into their script. Of these 35 nurses, 13 (37%) chose to complete the pre-education and postproject surveys. …

Staff Education Project Using The Stop Elderly Accidents Deaths And Injuries (Steadi) Toolkit, Carla Fisher

Walden Dissertations and Doctoral Studies

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change …