Medicine and Health Sciences Commons^™

Evaluation Of Nurse-To-Nurse Handoff With The Use Of A Tablet, Maria Bessie Ziegenfuss

Walden Dissertations and Doctoral Studies

According to recent studies, many medical errors are caused by ineffective hand-off communication, which leads to patient harm and poor outcomes. Researchers have demonstrated that accurate and timely communication improves patient outcomes. The purpose of this quality improvement project was to evaluate the necessity, planning, implementation, outcomes, and transferability of the site quality improvement project, “Improving Nurse-to-Nurse Handoff With the Use of a Tablet.” The context/input/process/product model was used to provide a systematic approach to the evaluation of the site quality improvement project. A paired t test was used to analyze the pre- and post-survey results and demonstrated improvement in …

Familial Caregivers’ Perceptions Of Alcohol Use Among Mature Adults Residing In Assisted Living Communities, Lemeshia Meshana Agee Chambers

Walden Dissertations and Doctoral Studies

Research suggests that alcohol abuse is among the 8 primary causes of death for mature adults, which includes individuals age 65 and older. Alcohol use is a growing, unaddressed, public health concern among this referent population. Additionally, as mature adults enter the retirement phase of their lives, many of them transition to residing in assisted living communities. The purpose of this study was to explore mature adults’ alcohol use in assisted living communities and how such use, as perceived by the familial caregivers, affected the mature adults’ ability to age successfully. The population under study consisted of 8 familial caregivers, …

Staff Instruction On Patient Health Questionnaire And Collaborative Care Model In Primary Care, Jennifer Carton

Walden Dissertations and Doctoral Studies

The DNP project examined the effectiveness of the Patient Health Questionnaire-9 (PHQ-9) and the Collaborative Care Model (CCM) as a practice protocol for patients suffering from depression in primary care to address the problem of a shortage in mental health specialists. Research reveals an increase in Americans suffering from depression. Many primary care clinics do not have a practice protocol in place to screen and manage depression. The project's purpose was to develop a lesson plan to instruct staff on the PHQ-9 and CCM to implement into their practice. The project questions were if the lesson plan developed by the …

Healthcare Organizational Design Strategies To Improve Performance, Katherine Madonna Chubbs

Walden Dissertations and Doctoral Studies

Business leaders are exploring ways to improve organizational performance through organizational design, including reviewing the structures of their organization. Grounded in McKinsey’s 7S framework, the purpose of this qualitative single case study was to explore organizational design strategies healthcare leaders used to improve organization performance. Participants were 6 leaders within a healthcare organization in Alberta, Canada, who successfully developed and implemented organizational design strategies to improve organizational performance. The data collection techniques included a review of internal and external documents, a reflective journal, and semistructured interviews. I used methodological triangulation and thematic analysis to complete the data analysis. The data …

Best Practices For Screening And Early Treatment For Hiv In The Hispanic Community, Juliana Deboviel

Walden Dissertations and Doctoral Studies

The Hispanic community is among the ethnic minorities that are adversely affected by HIV/AIDS in the United States. HIV transmission rates and rates of death are high among Hispanic communities because of delays in HIV testing and late participation in HIV treatment, especially in the state where this study was conducted. However, advanced practices for screening and early treatment of HIV can improve patient outcomes and inform practice. Thus, this systematic review was conducted to identify the best available evidence for HIV screening and care in the Hispanic population in the Western United States that shares a border with Mexico. …

Impact Of Demographic Characteristics And Therapy On Tuberculosis Incident Cases, Iliedor Garcon

Walden Dissertations and Doctoral Studies

For more than two decades, tuberculosis (TB) has ranked second among the top killers of infectious diseases, with an estimated 10.4 million incident cases in 2018. Demographic characteristics and drug susceptibility influence TB incidence worldwide. Using a retrospective cohort design, the purpose of this quantitative study was to investigate whether race/ethnicity, age, sex (gender), therapy completion within one year (COT), and testing for isoniazid and rifampin susceptibility (TIRS) were predictors of 672 cases of TB in New York-Newark-Jersey City from 1993 to 2017. Guided by the epidemiological triad theory, this research was conducted using a secondary TB dataset from the …

Educating Staff On The Benefits Of Vitamin D Therapy For Multiple Sclerosis, Cheniece Harris

Walden Dissertations and Doctoral Studies

Clinical competency is an important factor when delivering care to those with chronic conditions such as multiple sclerosis. Vitamin D therapy through diet, supplements, and sunlight may decrease physical complications. The gap in practice this doctoral project addressed is the lack of education provided to healthcare professionals to promote the benefits of vitamin D. The project examined whether registered nurses who are provided education on the benefits of vitamin D therapy can apply the knowledge into the plan of care for patients with MS within 6 months versus those provided no education. Paradigms and models that were used include the …

Promoting The Recognition Of Depression In The Geriatric Population, Rose L. Hodge

Walden Dissertations and Doctoral Studies

Depression is a chronic condition that has both physical and mental consequences, complicating the elderly’s health status and interfering with daily functioning. Depression is not a normal part of aging and the elderly frequently seek mental health care in outpatient clinical settings where there is need for effective screening and prompt recognition leading to decreased morbidity and mortality. It is critical for psychiatric care settings to provide the most effective screening tools for recognizing depression as quickly as possible. This Doctoral Nursing Project quality improvement (QI) evaluation project resulted from observation of lack of a tool for recognizing depression in …

Positive Behavior Support-Based In-Home Services For Traumatic Brain Injury, Charles Jack

Walden Dissertations and Doctoral Studies

Researchers have demonstrated the effectiveness of positive behavior support (PBS) services in the in-home (IH) setting but few studies examined its use with traumatic brain injury (TBI) clients, and most of these were small sample cases. Additional research on IH PBS services for TBI clients was recommended, in particular using larger samples. The purpose of this study was to address that need by examining the effectiveness of IH PBS services in treating TBI-related challenging behaviors on a larger sample. The theoretical foundations for PBS, behaviorism, cognitive constructivism, social learning theory, and the biopsychosocial model of behavior, are described. The research …

Comparison Of Health Factors And Outcomes Between Accredited And Nonaccredited Health Departments, Deborah Koester

Walden Dissertations and Doctoral Studies

The launch of the Public Health Accreditation Board in 2012 established national public standards. This study examined possible correlations between the accreditation status of local health departments and specific indicators for health, including communicable disease, disease prevention and health promotion, and maternal child health factors, and outcomes of premature death and infant mortality. The population for the intervention group included all 212 local health departments accredited from September 2012 through December 2017. Accredited health departments were matched with nonaccredited health departments based on population, rurality, agency type, governance authority, and state public health structure. Linear regression analysis was performed on …

Nurse Directed Palliative Care Discussions In The Emergency Department, Shannon Lorince Landefeld

Walden Dissertations and Doctoral Studies

Emergency department (ED) nurses are in a unique position to discuss with patients who have life-limiting illnesses. However, due to lack of training, ED nurses are often reluctant to have these conversations. Although ED patients receive written information about advanced directives, there is a gap in practice with discussing palliative and end-of-life care, resulting in increased potential for patient isolation, inconsistencies in treatment modalities, and delayed opportunities for patient-centered goal setting. Therefore, the purpose of this project was to address what resources are available to guide evidence-based practice for ED nurses in a small inner city hospital to implement nurse-directed …

Barriers To Physical Activity Among Asian Indian Women In The United States, Anjana Mathews

Walden Dissertations and Doctoral Studies

Asian Indian women have a higher prevalence of cardio-metabolic diseases compared to women from other ethnicities and Asian Indian men in the United States. This is due to the lower level of physical activity behaviors among this population. The purpose of this study was to explore the perceived barriers to physical activity among Asian Indian women living in the United States. The theoretical framework that guided this study was Bandura’s social cognitive theory and the research design used was qualitative ethnographic approach. Participants were recruited from 2 Christian churches in Southern California using purposive and snowballing sampling strategies. Fifteen participants …

Factors Affecting Seatbelt Use Among The Deaf And Hard-Of-Hearing, Deidre G. Mott

Walden Dissertations and Doctoral Studies

In the United States, despite the proven significant economic, health, and social benefits of seatbelt use, millions of Americans do not use seatbelts. It is known that some factors, including obesity, reduce the rates of seatbelt use; however, a lack of research exists regarding whether individuals who are deaf or hard-of-hearing (HOH) have different rates of seatbelt use. The purpose of this study was to examine the difference in seatbelt use between deaf or HOH individuals and hearing individuals after adjusting for individual-level factors (BMI, marital status, education, and access to health care). The theoretical foundation for this study was …

Personality, Job Satisfaction, And Turnover In Long-Term Care Nursing Assistants, Sarah Elizabeth Shanks

Walden Dissertations and Doctoral Studies

There is a clear association between nursing assistant (NA) turnover and resident outcomes which may be caused by poor compensation, organizational culture, and staffing mix. However, very limited literature is available exploring intrinsic variables of NAs, specifically personality, leading to turnover. Guided by the five-factor personality theory and Herzberg’s two-factor motivation hygiene theory, the purpose of this quantitative study was to examine the relationship between the five-factor personality traits of open-mindedness, conscientiousness, agreeableness, extraversion, and neuroticism; length of employment; and job satisfaction among NAs working in long-term care. The Nursing Home Certified Nursing Assistant Job Satisfaction Questionnaire was used to …

Bioterrorism: Exploring Factors For Improving Nurse Preparedness, Policies, And Practices, Leone Okey Tom-James

Walden Dissertations and Doctoral Studies

Ebola virus release/attack in New Jersey could go unnoticed but have immediate and long-lasting effects on the broader population and security. The risk underscores the need to prepare and enhance the state’s efforts to deal with a release and treat the confirmed cases. This descriptive single case research explored factors for improving nurses’ preparedness, policies, and practices for a bioterrorism release/attack. The epidemiological triangle conceptual framework was used descriptively in exploring, and developing a knowledge base of Ebola virus pathogenicity, characteristics, routes of transmission, and infection. The unit of analysis was Summit Ridge Genesis Healthcare Center. The theory of robust …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students, Lepani Waqatakirewa

Walden Dissertations and Doctoral Studies

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, …

Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman

Walden Dissertations and Doctoral Studies

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) …

The Complete Care Model: Improving Diabetic Patient Outcomes In Correctional Facilities, Chad Williams

Walden Dissertations and Doctoral Studies

Diabetes is a growing problem, becoming an increasing concern within prisons. Research suggests that as many as 4.9% of the inmate population is diagnosed with diabetes. To provide constitutionally required healthcare to the inmate population, corrections officials must identify a validated diabetes treatment modality geared toward improving diabetes outcomes. The purpose of this quantitative study was to evaluate the impact of a patient centered medical home (PCMH) based model of healthcare within the California Correctional Health Care Services (CCHCS) on diabetic prisoners. Using the social construct theory as the framework, the research questions were focused on determining whether there was …

Perception Of Breast Cancer Screening Among African Immigrant Women In Dallas., Phillipa Akuwa Anuwe

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of cancer-related deaths in women, and mammography is proven to detect breast cancer at its earliest stage; however, studies show that Black women have the lowest rate of breast cancer screening. The purpose of this descriptive, qualitative study was to explore the perceptions of African-born immigrant women about breast cancer screening. Data were collected by conducting individual interviews with 10 purposefully selected, African, immigrant women in Dallas, between 35 to 65 years old. Data were analyzed using NVivo software and coded based on the conceptual framework, which was the health belief model. Participants’ perception …

Mandibular Attachment Device Effects On African American Veterans With Heart Failure, Tracey T. F. Carter

Walden Dissertations and Doctoral Studies

Heart failure is a growing epidemic that affects people nationwide and is disproportionate to African Americans. The purpose of this quantitative repeated measures study was to determine whether mandibular attachment device (MAD) therapy impacts symptoms of heart failure in African American male veterans diagnosed with obstructive sleep apnea (OSA). The oxidative stress theory was applied in this study to assess whether MAD therapy received from Veterans Affairs (VA) dental clinics impacted heart failure symptoms, after controlling for patient body mass index (BMI) levels and smoking status. Research questions examined whether MAD had a significant effect on symptoms of heart failure …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

Revisions Of A Clinical Practice Guideline For Diabetes Management Protocol, Daniel O. Huston

Walden Dissertations and Doctoral Studies

Management of type 2 diabetes mellitus (T2DM) is essential from cost and treatment perspectives. In 2017, costs associated with diabetes management in the United States amounted to approximately $327 billion. The treatment of T2DM has been in a dynamic state for the past several years with the arrival of new classes of medications and new data supporting the use of diabetes medications to reduce risks from cardiovascular disease and slow the decline of renal function. This project explored the current evidence on treatment of T2DM to support changing either the flow of the current protocol algorithm or the medications identified …

Obesity, Physical Activity, And The Place Of Residence Among Latinos, Chanda Mcneal

Walden Dissertations and Doctoral Studies

Obesity is one of the most costly chronic, but preventable, diseases that has increased in prevalence in the United States. Obesity is known to be related to a lack of physical activity and the conditions in which people are born and live. Although adult Latino men and women have the second highest obesity rate in the United States, researchers have not explored place of residence as a factor in understanding Latinos’ health status. Therefore, the purpose of this correlational quantitative study was to determine if there is a relationship between obesity and Latinos’ place of residence and physical activity, and …

Qualitative Inquiry Of Resilience In Veterans Transitioning To Civilian Life, Brenda D. Nicholson

Walden Dissertations and Doctoral Studies

This qualitative phenomenological research focused on the resilience of 10 veterans transitioning back to civilian life. An increase in suicide rates among veterans over the last 10 years has become a major concern for the U.S. Congress and Department of Defense (DoD). The theoretical frameworks guiding the study are Durkheim’s suicide theory, Lindenberg and Frey’s social production function theory, and Diener’s deindividuation theory. Many veterans have no self-awareness of their need for psychological and transitional assistance, leaving them vulnerable during a time of potentially increased and unfamiliar stress. Understanding the need for effective psychological adjustment and resilience in military members …

The Relationship Between Practice Environment, Role Overload And Job Satisfaction Of Nurses In Canada, Olabisi Amao Olaniyan

Walden Dissertations and Doctoral Studies

Abstract

The shortage of nurses is a global phenomenon. The problem is particularly pronounced in rural areas and contributes to the health disparities experienced in the healthcare sector. Many factors had been shown to adversely impact the recruitment and retention of nurses, most especially in the rural areas. No study has examined how some factors such as the practice environment variation; geographical locations; and role overload impact job satisfaction of nurses. The Herzberg two-factor theory, with constructs of Motivation and Hygiene factors guided the study. In this quantitative, cross-sectional study, correlational approach was used to examine the association between the …

Mindfulness In Healthcare: Exploring The Gap Between Leadership Practice And Employee Burnout, Bryn Saunders

Walden Dissertations and Doctoral Studies

A healthcare employee’s ability to provide proficient, or quality, care to patients is impeded by burnout. Previous studies showed high levels of burnout is a common problem in healthcare, indicating there is a lack of support for employee health. The purpose of this quantitative study was to determine whether mindfulness training reduced burnout in healthcare professionals. The study focused on increasing knowledge between the leadership practices and programs used to improve healthcare proficiency by analyzing the relationship between mindfulness and three measures of burnout: sense of efficacy, depersonalization, and emotional exhaustion. The Western concept of mindfulness that emphasizes self-awareness and …

Association Between Childhood Secondhand Smoke Exposure And Inflammatory Bowel Disease Development, Stephanie Eve Walsh

Walden Dissertations and Doctoral Studies

Inflammatory bowel disease (IBD) is a group of diseases that affect the gastrointestinal tract. Environmental factors, such as smoking, have been shown to play a role in the development of IBD; however, minimal research regarding secondhand smoke (SHS) exposure and the development of IBD has been conducted. The purpose of this study was to examine whether there was a relationship between childhood SHS exposure and the development of IBD. Bronfenbrenner’s ecological systems theory was used in this study as a basis that the environment can aid in the development of disease. The research questions addressed the potential association between childhood …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Motivators And Barriers Affecting Physical Activity Participation In Online Graduate Students, Gloria Christine Bales

Walden Dissertations and Doctoral Studies

Physical inactivity is a major contributor to chronic diseases, especially coronary heart disease. The American College Health Association’s National College Health Assessment II showed that only 47.4% of college students are meeting suggested physical activity requirements. As the nontraditional student population increases, research is needed to identify motivators and barriers specifically for online graduate students. The purpose of this case study was to examine the relationships of barriers and motivators for physical activity in online graduate students at Walden University. The study addressed research questions on what physical activity barriers existed in this study sample, (b) what intrinsic motivators and …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …