Medicine and Health Sciences Commons^™

Sleep Deprivation And Neurological Disorders, Muhammed Bishir, Abid Bhat, Musthafa Mohamed Essa, Okobi Ekpo, Amadi O. Ihunwo, Vishnu Priya Veeraraghavan, Surapaneni Krishna Mohan, Arehally M. Mahalakshmi, Bipul Ray, Sunanda Tuladhar, Sulie Chang, Saravana Babu Chidambaram, Meena Kishore Sakharkar, Gilles J. Guillemin, M. Walid Qoronfleh, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

Sleep plays an important role in maintaining neuronal circuitry, signalling and helps maintain overall health and wellbeing. Sleep deprivation (SD) disturbs the circadian physiology and exerts a negative impact on brain and behavioural functions. SD impairs the cellular clearance of misfolded neurotoxin proteins like α-synuclein, amyloid-β, and tau which are involved in major neurodegenerative diseases like Alzheimer's disease and Parkinson's disease. In addition, SD is also shown to affect the glymphatic system, a glial-dependent metabolic waste clearance pathway, causing accumulation of misfolded faulty proteins in synaptic compartments resulting in cognitive decline. Also, SD affects the immunological and redox system resulting …

Effects Of Electronic Cigarette Aerosol Exposure On Oral And Systemic Health, Cássio Luiz Coutinho Almeida-Da-Silva, Harmony Matshik Dakafay, Kenji O'Brien, Dallin Montierth, Nan Xiao, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

Conventional cigarette smoke harms nearly every organ of the body and is the leading cause of death in the United States and in the world. Decades of research have associated conventional cigarette smoke with several diseases and death. Heavily marketed, electronic nicotine delivery systems such as electronic cigarettes (e-cigarettes) are available in a variety of flavors and high nicotine concentrations. In 2019, a severe lung disease outbreak linked to e-cigarette use led to several deaths, which was called electronic-cigarette or vaping product use-associated lung injury (EVALI). Even though the trend of e-cigarette use among teens continues to increase, information on …

Potential Impacts Of Artificial Intelligence On Spine Imaging Interpretation And Diagnosis, David Howard Durrant

Walden Dissertations and Doctoral Studies

Spine and related disorders represent one of the most common causes of pain and disability in the United States. Imaging represents an important diagnostic procedure in spine care. Imaging studies contain actionable data and insights undetectable through routine visual analysis. Convergent advances in imaging, artificial intelligence (AI), and radiomic methods has revealed the potential of multiscale in vivo interrogation to improve the assessment and monitoring of pathology. AI offers various types of decision support through the analysis of structured and unstructured data. The primary purpose of this qualitative exploratory case study was to identify the potential impacts of AI solutions …

Pertussis Resurgence In Europe: Incidence And Epidemiologic Cycles In Immunization Required And Non-Required Countries, Sheryl Ann Duquet

Walden Dissertations and Doctoral Studies

Although pertussis vaccines have been available for over 7 decades, countries are experiencing a pertussis resurgence. This study sought to establish a relationship between the European pertussis immunization schedule designs (with and without the inclusion of adolescent boosters) and the immunization requirement (recommended or required), which potentially influences immunity waning, and thus the incidence rate and epidemiologic cycles of pertussis. The theoretical foundation for this study was the theory of herd immunity. A quantitative research method was used, supported by a secondary data source. The statistical analysis included the use of linear regression to evaluate the relationship between the requirement …

Staff Education: Prediabetes Lifestyle Modification Toolkit, Vivian Elege

Walden Dissertations and Doctoral Studies

Prediabetes patients are at a high risk of developing Type 2 diabetes. The purpose of this project was to educate the medical staff of the project site clinic on lifestyle modifications that can help patients prevent prediabetes from progressing to Type 2 diabetes. The project took place at an outpatient clinic in the Southwestern United States. The clinic patient population is mostly African American, a population at risk for diabetes. The theoretical framework to support the project was the Iowa model of evidence-based practice. Staff education on patient diabetes prevention was the goal of the project. The project question focused …

The Impact Of Human Resources On Nurses' Turnover Intention, Anita Estell Jackson

Walden Dissertations and Doctoral Studies

Nurse retention is of great concern to healthcare organizations including hospitals. With so many countries reporting a shortage in nursing personnel, healthcare organizations are now seeking ways to reduce this shortage. It is known that job satisfaction and turnover intention impact nurses' continued employment. However, the role of human resources (HR) impact on nurses' job satisfaction and turnover intention is unknown. The theoretical basis of this study came from the work of Bowen and Ostroff who argued the strength of HRM system regulates employee perceptions and outcomes within an organization. Therefore, the purpose of this study was to evaluate the …

Enhancing The Resilience Of Acute Care Psychiatric Nurses Through A Brief Gratitude Intervention, Patricia D. Sullivan

Walden Dissertations and Doctoral Studies

Stressors affecting healthcare providers have accelerated in recent years, causing increasing rates of burnout and emotional exhaustion. Evidence suggests that improving general mental well-being of nurses could enhance their resilience and ability to cope in stressful situations. Psychiatric nurses are at risk by caring for involuntary and manipulative patients who can be violent and abusive. The purpose of this project was to improve psychiatric nurses' mental well-being through the implementation of a gratitude practice and examined the effect of this brief gratitude intervention on their mental well-being. Models informing this project were human caring theory, resilience theory, and positive psychology …

Comprehensive Evidence-Based Guidelines For Facet Joint Interventions In The Management Of Chronic Spinal Pain: American Society Of Interventional Pain Physicians (Asipp) Guidelines, Laxmaiah Manchikanti, Alan David Kaye, Amol Soin, Sheri L. Albers, Douglas Beall, Richard E. Latchaw, Mahendra R. Sanapati, Shalini Shah, Sairam Atluri, Alaa Abd-Elsayed, Salahadin Abdi, Steve Aydin, Sanjay Bakshi, Mark Boswell, Ricardo M. Buenaventura, Joseph A. Cabaret, Aaron K. Calodney, Kenneth D. Candido, Paul J. Christo, Lynn Cintron, Sudhir Diwan, Christopher Gharibo, Jay Grider, Myank Gupta, Bill Haney, Michael E. Harned, Standiford Helm, Jessica Jameson, Sunny Jha, Adam M. Kaye, Nebojsa Nick Knezevic

School of Pharmacy Faculty Articles

Background: Chronic axial spinal pain is one of the major causes of significant disability and health care costs, with facet joints as one of the proven causes of pain. Objective: To provide evidence-based guidance in performing diagnostic and therapeutic facet joint interventions. Methods: The methodology utilized included the development of objectives and key questions with utilization of trustworthy standards. The literature pertaining to all aspects of facet joint interventions, was reviewed, with a best evidence synthesis of available literature and utilizing grading for recommendations.

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Coping And Support Strategies Portrayed In Rheumatoid Arthritis Illness Blogs, Folasade Bolanle Alagbada

Walden Dissertations and Doctoral Studies

The symptoms of rheumatoid arthritis (RA), such as pain, fatigue, stiffness, and inflammation, limit individuals’ abilities to care for themselves, participate in social events, and complete tasks associated with gender norms. RA is a chronic and debilitating disease that people struggle to cope with physically, mentally, emotionally, socially, and financially, but many have not established effective coping and support strategies. The purpose of this hermeneutic phenomenological qualitative study guided by a combination of Orem’s theory of self-care and Watson’s theory of the human caring was to explore the coping mechanisms and support strategies of women and men with RA as …

Examining Health Care Providers' Perceptions Of The Bundled Payments For Care Improvement Initiative, Okey Felix Duru

Walden Dissertations and Doctoral Studies

AbstractThe goals of the modern health care system are in transition from volume of care to quality of care; as a result, the existing fee-for-service model may be outdated, and value-based systems such as bundled payment models should be evaluated. Accordingly, the purpose of the current study was to explore the perceptions of physicians and nurse practitioners regarding the effects of the Bundled Payments for Care Improvement (BPCI) initiative on the procedures for patient selection, care implementation, and quality measurement. The study was guided by a qualitative approach, a phenomenological design, three research questions, and the Donabedian framework for measuring …

Age At Diagnosis And Lung Cancer Presentation, Marida Gingras

Walden Dissertations and Doctoral Studies

Lung cancer is the leading cause of cancer-related mortality in the United States because of its lack of symptoms until late stages. It is noted that a 5-year relative survival rate can be improved by earlier cancer detection. The currently recommended age of screening by the U.S. Preventive Services Task Force may not be optimal, and the recommendations are only for smokers. The purpose of this cross-sectional study was to examine the association between the stages of presentation of lung cancer and age at diagnosis using quantitative research. Using the Surveillance, Epidemiology, and End Results (SEER-18) database, 63,107 records were …

Development Of A Clinical Practice Guideline For The Care Of Transgender Patients, Wayne Zeh Wellington

Walden Dissertations and Doctoral Studies

AbstractTransgender persons face stigma and discrimination while receiving health care services. The gap in nursing practice at a clinic serving transgender patients in the Southeastern United States was a lack of understanding by providers of evidence-based practices for the provision to patient-centered care. The purpose of this project was to develop a clinical practice guideline (CPG) for the care of transgender patients. The project question asked, based on current evidence, what CPG for patient-centered care should be recommended to providers in the clinic. The patient-centered care model developed around the Donabedian model of quality improvement was used to guide the …

Qualitative Evaluation Of A Hospital-Based Preceptor-Guided Clinical Orientation Program, Brian Eigelbach Martin

Walden Dissertations and Doctoral Studies

Effective preceptor-guided clinical orientation programs (PGCOP) help new graduate nurses (NGNs) across the theory-practice gap to provide safe, effective, and efficient patient care. This constructivist-designed qualitative program evaluation study explored NGNs’ and preceptors’ perceptions of a local hospital’s PGCOP as an effective transition vehicle. The conceptual framework combined Knowles’ andragogical process model for learning with the new world Kirkpatrick model evaluation model. The sample included 7 NGNs who graduated in the past year and had no prior orientation experience and 5 preceptors employed by the study site for at least 1 year. A goal-free approach guided data collection with face-to-face …

Use Of Simulations To Improve Clinical Judgment In New Graduate Nurses, Aaliyah Sabreen Franks

Walden Dissertations and Doctoral Studies

The goal of healthcare organizations across the world is to provide safe, efficient healthcare for patients and their families. The practice problem for this DNP Project, a staff education project, addressed simulation as a strategy to improve clinical judgment in new graduate nurses. Recent studies have shown that 23% of new nurses do not demonstrate entry-level competency and are not as effective as more experienced nurses when making clinical judgment decisions. This lack of efficacy poses a threat to patient safety. This was based on nurse’s progression through Benner’s five levels of competency and was designed to enhance new graduate …

Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus (DM) is a recognized cognitive impairment risk factor. Even with hyperglycemia being a modifiable risk factor in dementia, primary care is without an evidence-based screening tool to screen patients with diabetes for cognitive abilities. Current literature supports developing an evidence-based standardized guideline for early screening for cognitive impairment in elderly patients with DM. The purpose of this doctor of nursing practice (DNP) clinical practice guideline (CPG) project was to develop an evidence-based CPG for early screening of dementia in patients with DM, providing a means for early recognition of cognitive decline in these patients, making early intervention more …

Staff Education On American Diabetes Association Standards Of Medical Care For Diabetes, Christine Nsubuga

Walden Dissertations and Doctoral Studies

Diabetes is a commonly encountered chronic illness that leads to other lifelong comorbidities if left uncontrolled. Ranked as the seventh leading cause of death in the United States, diabetes affects over 29 million Americans. Although 90%-95% of all diabetes cases are preventable with proper planning and management, clinicians continue to be challenged as they strive to achieve the desired patient care goals. This Doctor of Nursing Practice (DNP) staff education project addressed the lack of standard evidence-based care for diabetic patients in the federally qualified health center look-alike practice for which this project was developed. Guided by the practice-focused questions …

Guiding Nurses To A Healthier Lifestyle, Margaret Yvonne Garcia

Walden Dissertations and Doctoral Studies

AbstractNurses provide continuous patient care around the clock. Nurses who work outside of the 9:00 a.m. to 5:00 p.m. hours are susceptible to fatigue and sleep deprivation that impair their attention to detail, ability to remain focused, information processing, and problem solving. This is especially prevalent among those who work the night shift. Nurses also find that their memory, reaction time, motivation, communication, mood, and empathy are affected with fewer hours of sleep. This project explored the sleepiness that night shift nurses experience and provides nurses with strategies to improve these symptoms. Nurses were provided with a PowerPoint presentation to …

Non-Pharmacological Interventions For Residents With Dementia, Jared Bielanski

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in persons with dementia has been shown to increase mortality in long-term care (LTC) patients. National guidelines recommend the use of nonpharmacological interventions when possible for LTC residents with dementia. Nurses who work in a local LTC facility are not regularly trained in effective nonpharmacological interventions and lack the knowledge to provide care for patients with dementia. To provide safe and effective alternative interventions to antipsychotic medication use, nurses and direct care staff must have current, evidence-based education available to them about alternative practices. The purpose of this staff education project, guided by Calista Roy’s …

Decreasing Thirty-Day Readmissions For Heart Failure Patients, Willybroad Che

Walden Dissertations and Doctoral Studies

Heart failure (HF) patients have a 20-25% hospital readmission rate within the first month of discharge. Patients experiencing HF often have a decline in health resulting in frequent hospitalizations and encumbering symptoms including dyspnea, fluid retention, and orthopnea. HF is a common condition in nursing homes and accounts for a significant proportion of resident transfers to emergency departments. HF is considered one of the costliest diagnoses in the United States, estimated to cost the healthcare system billions of dollars annually. The purpose of this systematic review was to provide a synthesis of evidence-based literature on the current recommendations and strategies …

Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston

Walden Dissertations and Doctoral Studies

Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …

Perceptions Of Physician Influence On Healthcare Accessibility, Samuel N. Jacobs-Abbey

Walden Dissertations and Doctoral Studies

A significant portion of the U.S. population across the country has limited access to quality healthcare; however, this situation is more pronounced in rural areas. One potential solution is for healthcare practitioners to move their services to underserved rural areas to improve healthcare coverage. No previous studies have explored the perceptions of practitioners regarding their influence on healthcare access, particularly the potential impact of moving healthcare services to underserved areas. Thus, the purpose of this research was to address this gap. A qualitative phenomenological approach was adopted. A sample of 24 participants was selected using purposive sampling, from the target …

Increasing Culturally Competent Care Of Lgbtq Patients By Providing Staff Education, Victoria Jacoby

Walden Dissertations and Doctoral Studies

The majority of health care professionals do not feel confident or competent to adequately care for a lesbian, gay, bisexual, transgender, and queer (LGBTQ) patient. Research has identified a link between poor preparedness of the provider/staff and poor patient outcomes. The purpose of this study was to evaluate the effectiveness of an in-person staff education module about providing culturally competent care to LGBTQ patients. The study focused on providers’ attitudes, preparedness, and confidence in caring for a LGBTQ patient. The Iowa and Kirkpatrick models were utilized to ground and evaluate the study. This study was a one-group pre- and posttest …

The Association Between Provider Cultural Competence And Type 2 Diabetes Health Behaviors, Bernadette Joyce Mejia-Tran

Walden Dissertations and Doctoral Studies

Provider cultural competence is poorly understood in relation to the outcome of Type 2 diabetes patient health behaviors. The purpose of this study was to examine the association between provider cultural competence and diabetes patient health behaviors. The chronic care model provided the conceptual framework for this study. The research questions were designed to determine whether 5 measures of provider cultural competence play a role in diabetes patient health behavior change. The research design of the study was a quantitative cross-sectional survey using the 2017 National Health Interview Survey. The 2,342 participants included in the study represent a national sample …

Prevention Practices And West Nile Virus Infection Among Ethnic Minorities, Texas, Bayabel Debebe Mengistu

Walden Dissertations and Doctoral Studies

Abstract

West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used …

Development Of Practice Guidelines Based On Need-Driven Dementia-Compromised Behavior Model, Amy Marie Nolan

Walden Dissertations and Doctoral Studies

People with dementia, who experience cognitive decline, memory loss, and reasoning difficulties, often exhibit compromised behaviors such as agitation or aggressive behavior that impact negatively upon the person’s quality of life and increase safety risks. The purpose of this project was to develop an evidence-based clinical practice guideline (CPG) to improve the use of effective evidence-based interventions by staff in a skilled long-term care nursing facility to manage the compromised behavior of residents with dementia. The Need-Driven Behavioral Model, which suggests that compromised behaviors occur when patient attempts to accomplish a goal or express a need, provided the framework CPG …

Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's

theory was …

Nursing Faculties’ Perceptions Of Teaching Students Who Speak English As Second Language, Natalia S. Ruiz Muniz

Walden Dissertations and Doctoral Studies

Nursing students who speak English as a second language (ESL) often struggle due to language barriers, the complexity of the medical vocabulary, and the knowledge base that they must develop in a short time. These struggles may be due in part to the preparation of nursing educators to meet the specific needs of the ESL student population. The purpose of this qualitative research study was to develop a greater understanding of nurse educators' perceptions when teaching ESL nursing students. The conceptual framework used was Cummins' framework for the development of language proficiency. Four research questions guided this basic qualitative research …

Relationship Between Burnout And Academic Teaching Level Among Nursing Faculty, Erica Lynn Sciarra

Walden Dissertations and Doctoral Studies

Nursing faculty function as healthcare providers, educators, mentors, advisors, and researchers, which contributes to the development of emotional exhaustion or burnout due to role overload. Symptoms of burnout may vary among nursing faculty depending on academic teaching level, tenure status, and educational preparation and may influence the physical and psychological health of nursing faculty, potentially affecting work productivity, career longevity, and the number of future nurses educated. The purposes of this study, guided by Maslach’s multidimensional burnout theory and the job demands resources model, were to determine (a) if there was a difference in level of burnout between graduate and …

Associate Degree Nursing Graduates’ Experiences Of The Transition From Student To Nurse, Katherine Margaret Slusser

Walden Dissertations and Doctoral Studies

Attrition among newly graduated nurses remains a top concern among nursing leaders in the United States. Many published studies about new graduate nurses focus on bachelors-prepared nurses or on mixed populations of nurses that include both associate and baccalaureate degree graduates. No published studies were located that focused specifically on the Associate Degree Nursing (ADN) graduate. The purpose of this qualitative, interpretive phenomenological study was to understand the experiences of transition after graduation and into professional nursing of newly employed nurses who graduated from an ADN program. The theoretical basis for this study was Meleis’s transition theory. The research question …