Medicine and Health Sciences Commons^™

Development Of A Staff Education Project On Managing Patients With Nonmalignant Pain, Gerald M. Mcclain

Walden Dissertations and Doctoral Studies

Opioids, once considered the cure-all for most pain ailments (acute or chronic), have developed into one of the current largest epidemics. Many contributing factors have led to the opioid crisis, but providers have played a significant role in creating this epidemic. Therefore, this project involved constructing a staff education program for providers to present evidence-based practices (EBPs) that are less addictive pharmacological and nonpharmacological methods for managing nonmalignant pain in an ambulatory clinic. The adult learning theory was used to facilitate the learning process, and logic models were used to guide the process. The topics in the education program included …

Correlations To Financial Performance In The Pharmaceutical Industry, Fred Mcclellan

Walden Dissertations and Doctoral Studies

There exist conflicting priorities for leaders when considering ethical leadership behaviors and organizational financial performance. The purpose of this quantitative study was to examine correlations between top manager ethical leadership levels and organizational financial performance, within the pharmaceutical industry. The Ethical leadership theory was used to frame the study. Relationships between top managers’ perceived ethics levels and organizational financial performance were studied, as well as, whether top managers’ practices, purposes, and virtues acted as mediators. A goal of 184 participants were recruited from 338 pharmaceutical companies. Five top managers and 17 of their direct report team members took part in …

Advanced Practice Registered Nurses And Their Knowledge Regarding The Hindrance Of Obesity, Crystal Rainey

Walden Dissertations and Doctoral Studies

Advanced Practice Registered Nurses and Their Knowledge

Regarding the Hindrance of Obesity

by

Crystal N. Rainey

MSN, Walden University, 2014

BSN, University of Arkansas in Little Rock, 2011

AASN, Southeast Arkansas College, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2020

A Systematic Review Of Structured Communication Among Interprofessional Teams, Angeleta Zipporah Robinson

Walden Dissertations and Doctoral Studies

A leading cause of errors in health care settings is failure of interprofessional teams to communicate effectively. Ineffective communication has been associated with delays in treatment, omission of care, readmissions, and adverse and sentinel events. These incidents cost billions of dollars per year and with current reimbursement processes, health care organizations are now incurring the cost of such errors. The purpose of this project was to promote effective communication between nurses and physicians to reduce errors by standardizing the interaction among team members during interdisciplinary rounds and patient handoffs to increase the nurse communication HCAHPS scores, the physician communication HCAHPs …

Human Resource Strategies Used To Retain Millennials In Hospitals, Thomas F. Turner

Walden Dissertations and Doctoral Studies

Lead hospital human resource managers (HRMs) experience new recruitment, retention, and training costs for Millennial employees to close the skill gaps and address challenges from Baby Boomer employees retiring. The median turnover rate of 3 years for Millennial workers in hospitals is more than 3 times higher than older workers at hospitals. The purpose of this qualitative multiple case study was to identify retention strategies hospital HRMs use to address the retention of millennial generational employees beyond 3 years. Transformational leadership theory was the conceptual framework for the study. The data collection process included semistructured interviews and a review of …

Factors Associated With Prostate Cancer Screening Among African American Men In California, Frank Ibe Agodi

Walden Dissertations and Doctoral Studies

In Los Angeles County, California, prostate cancer (PC) is the second primary cause of cancer-related death in men. Previous studies have focused on sociodemographic factors influencing racial and ethnic inequalities in health in the United States. However, research was lacking regarding if and to what extent social-ecological factors predict PC screening, specifically among African American men residing in Los Angeles County. The purpose of this quantitative study, using a cross-sectional design, was to identify the factors that may align with PC screening among African American men living in Los Angeles. African American men aged 45 and older were the targeted …

Decision Making Process And Contralateral Prophylactic Mastectomy, Hala Alameddine

Walden Dissertations and Doctoral Studies

The increased rate of contralateral prophylactic mastectomy (CPM) among women with early stage unilateral breast cancer has raised concerns particularly with the lack of evidence for a survival benefit related to the CPM procedure and with the low risk of developing contralateral breast cancer among women with early stage sporadic breast cancer. The purpose of this quantitative cross-sectional study, using normative decision theory as the framework, was to assess the influence of the partner, physician, and media on the decision of women with unilateral breast cancer who decided to undergo CPM. Women with stage 0 to III early stage unilateral …

The Impact Of Digital Self-Scheduling On No-Show Event Rates In Outpatient Clinics, Karen M. Marhefka

Walden Dissertations and Doctoral Studies

The failure of patients to keep scheduled appointments results in significant loss of revenue due to decreased administrative efficiency, expensive clinical resource time, disruptive continuity of care between the patient and the provider, and reduced quality of care. The purpose of this quantitative study was to explore the use of digital self-scheduling as an emerging alternative to traditional office-assisted scheduling methods and determine if its use has an impact on reducing the occurrence of no-show events. The theoretical framework used for the study was the Consumer Behavior Theory. Three years of de-identified secondary data were collected from a large, adult …

Self Reported Cardiovascular Disease Risk Factors Among Deaf Users: A Communication Barrier, Dr. Jolene Ayres Ogunjirin

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the number one cause of mortality worldwide, and may disproportionately affect the Deaf and Hard of Hearing (DHOH) subpopulation in the United States. It has been suggested that communication barriers among the DHOH subpopulation contribute to the high prevalence of CVD risk factors. To assess this claim, this quantitative study utilized a cross-sectional data set of 400 DHOH and 400 non- DHOH participants taken from the National Health and Nutrition Examination Survey (NHANES) database. The differences of being told by a health professional of having specific CVD risk factors were assessed between the two groups and …

Evaluating The Effectiveness Of Clinical Education On Critical Care Practice, Sara Ellen Salen

Walden Dissertations and Doctoral Studies

In 2016, the targeted temperature management (TTM) nursing protocol was updated and implemented at a large hospital in South Carolina. Development of a comprehensive evaluation program became a priority project due to reports that 75% of TTM cases during a 2-year period did not meet national benchmarks for quality and safe care for TTM patients. Therefore, this project answered the questions about whether the development, implementation, and standardization of ongoing TTM education would bridge the gap between knowledge and practice (transference of education). The purpose of this project was to evaluate the effectiveness of the education program launched regarding TTM …

Provider Education Increasing Recommendation For Human Papillomavirus Vaccination, Tiffany Charest Skinner

Walden Dissertations and Doctoral Studies

Human Papillomavirus (HPV) was the most common sexually transmitted disease in the United States in 2018 according to the Centers for Disease Control and Prevention (CDC). The CDC established the Healthy People 2020 initiative for HPV vaccination uptake of 80% to effectively eliminate HPV associated cancers. The project site, a rural multispecialty clinic in the Mid-Atlantic United States reported a 3% vaccination compliance rate, well under the national average and the benchmark of 80% recommended by the CDC. The practice-focused question for this project was to determine how education of primary providers will increase recommendation rates for vaccination of HPV. …

Student Perceptions Of Academic Integrity In An Online Psychiatric Nurse Education, Anne Burlington

Walden Dissertations and Doctoral Studies

This study explored student perceptions of academic integrity at an online nursing college with a high rate of plagiarism in Western Canada. Social cognitive theory and the theory of student cheating and plagiarism were used as the conceptual framework for this case study. Participants from a second-year cohort were sent a survey gauging their interest in participation. The ten students were interviewed to better understand what decision making they used to ensure academic integrity during their program of study. Employing a qualitative exploratory case study approach, each interview was taped and transcribed. The interview data were coded by numeric identifiers …

Use Of Spanish Audio Podcast To Educate Visually Challenged Hispanics With Diabetes, Baiju Issac

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among the Hispanic population, requiring solutions at the individual, community, and population levels. Self-management helps to manage diabetes and prevent complications, but it is a challenge in nursing practice. Health care providers use printed information to teach patients about self-management of diabetes. However, patients with visual impairment are not able to use these resources. Limited English proficiency, low health literacy, and visual challenges result in the underutilization of health care services within Hispanic communities. Therefore, the purpose of this study was to develop a Spanish audio podcast and lesson plan as teaching tools …

Mitochondrial Oxidative Phosphorylation Complex Regulates Nlrp3 Inflammasome Activation And Predicts Patient Survival In Nasopharyngeal Carcinoma, I. Che Chung, Lih Chyang Chen, Ngan Ming Tsang, Wen Yu Chuang, Tzu Chieh Liao, Sheng Ning Yuan, Chun Nan Ouyang, David M. Ojcius, Chih Ching Wu, Yu Sun Chang

All Dugoni School of Dentistry Faculty Articles

© 2020 Chung et al. We previously reported that tumor inflammasomes play a key role in tumor control and act as favorable prognostic markers in nasopharyngeal carcinoma (NPC). Activated inflammasomes frequently form distinguishable specks and govern the cellular secretion of IL-1β. However, we know little about the biological and biochemical differences between cells with and without apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC) speck formation. In this study, we used proteomic iTRAQ analysis to analyze the proteomes of NPC cells that differ in their ASC speck formation upon cisplatin treatment. We identified proteins that were differentially over-expressed in cells …

Immune Response Against Chlamydia Trachomatis Via Toll-Like Receptors Is Negatively Regulated By Sigirr, Mufadhal Al-Kuhlani, Graham Lambert, Sukumar Pal, Luis De La Maza, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

Copyright: © 2020 Al-Kuhlani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Chlamydia trachomatis is the most common bacterial sexually-transmitted infection and the major cause of preventable blindness worldwide. The asymptomatic nature of many infections along with uncontrolled inflammation leads to irreversible damage in the upper genital tract and the tarsal conjunctivae, with the major complications of infertility and chronic pelvic pain, and blindness, respectively. Inflammation must, therefore, be tightly regulated to …

Possible Role Of Tryptophan And Melatonin In Covid-19, Musthafa Mohamed Essa, Hamdan Hamdan, Saravana Babu Chidambaram, Buthainah Al-Balushi, Gilles J. Guillemin, David M. Ojcius, M. Walid Qoronfleh

All Dugoni School of Dentistry Faculty Articles

No abstract provided.

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 …

The Dietary Decision-Making Process Of Women In Nigeria, Gachomo Joanne Mapis

Walden Dissertations and Doctoral Studies

Nigerians have been opting for a more processed Western diet. These changes in dietary choices have aligned with obesity and undernutrition, attributable to micronutrient deficiencies or malnutrition. Many scholars have presented varying intervention strategies ranging from consumption of a variety of foods containing the necessary micronutrients to food fortification. The purpose of this grounded theory study was to explore the perceptions of women in an urban city in Nigeria on indigenous foods and Western dietary influences to determine social interactions, the consequence of the interactions, and the women’s current perceptions of food choices. The social-ecological model was used to explore …

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 …

Racial Differences In Hospital Readmission And Reimbursement Rates For Patients With Congestive Heart Failure, Catherine Talongwa

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a …

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 …