Medicine and Health Sciences Commons^™

Evaluation Of Inappropriate Use Of Antibiotics In The Long-Term Care Community, Charlene A. Hughes

Walden Dissertations and Doctoral Studies

The number of antibiotics prescribed in the 65 and older population significantly increased related to the diagnosis of urinary tract infections (UTIs). Although empiric treatment is necessary at times, it can lead to antibiotic resistance; therefore, clinical symptomology with an active infection verified by diagnostic testing is the requirement for the treatment of a UTI. This project addressed the practice-focused question of how the implementation of an evidenced-based antibiotic stewardship program (ASP) in a nursing home on the East Coast may impact the overuse of antibiotics in that clinical setting. The project, guided by the theory of planned behavior, was …

The Relationship Between Sense Of Coherence And Coping With Stress Among Emergency Room Physicians, Melina Masihi

Walden Dissertations and Doctoral Studies

Physicians face different stressful situations daily when caring for patients in the emergency room (ER). The individual ER physician’s ability to cope with stressful situations varies considerably and affects patient care. Developing a sense of coherence (SOC) is thought to be one of the significant strategies for self-regulation in stressful conditions like those in the ER. The purpose of this research was to examine the relationship between SOC and coping abilities among emergency physicians in the United States. The study used a quantitative, cross-sectional design to assess physicians’ SOC and coping skills using an SOC scale and a coping scale, …

Improving Care Of Patients With Asthma Through Staff Education, Nicholas Moscatelli

Walden Dissertations and Doctoral Studies

Chronic asthma is a health epidemic and an increasing problem in the pediatric population. The purpose of this project was to raise nursing staff awareness of symptom recognition, treatment protocols, preventive measures, and detrimental effects of asthma for children. Adult learning theory provided the framework to support the staff education program on asthma. The project site stakeholders and the DNP student identified educational opportunities to assist staff in meeting caregiver needs, improving symptom recognition, and improving asthma outcomes. Prior to presentation of the educational program to the clinic nursing staff, it was reviewed by an expert panel including the clinic …

Patient Risks And Clinical Care Disruptions In Rural Hospital Mergers, Gabriel Muzanenhamo

Walden Dissertations and Doctoral Studies

Over 440,000 U.S. citizens are dying annually from avoidable, hospital-associated adverse events, with rural inhabitants experiencing more significant health threats than any other group in the United States. The trend of large health systems acquiring and consolidating rural hospitals (RHs) to improve the coordination of clinical care is backfiring, and accumulating patient safety risks. Although arguments for supporting hospital mergers in the past have focused on efficiency and presented a chance for struggling RHs with a financial survival mode, limited research has explicitly examined the impact of rural hospital mergers (RHMs). This study was constructed to explore the relationship between …

Public Health Leadership In The Philippines: Effective Approaches In Malaria Surveillance, Gethro Nullan

Walden Dissertations and Doctoral Studies

Leadership traits that affect and shape cost-effective practices ensure the long-term

growth and success for any organization. The purpose of this single case study was to explore leadership traits that may contribute to cost-effective approaches in a malaria surveillance program in the Philippines. The National Health Service Leadership Framework provided the conceptual framework for this study. The participants included 12 public health leaders/managers who have worked or been involved in malaria surveillance programs with budgetary oversight. Data were collected through in-depth interviews and document analysis. Values coding was used for data analysis, in which participants’ perspectives were coded using the …

Fall-Related Patient Education: An Essential Feature Of A Fall Prevention Program, Immaculata Okonkwo

Walden Dissertations and Doctoral Studies

This project documented the evaluation of a voluntary patient falls prevention education

program (VPFPEP) of a rehabilitative facility in a Mid-Atlantic US state and ascertained

its sustainability. The project was designed using the customized Moore et al. evaluation

model and Lippitt’s planned theory of change to encourage patient engagement in

physical activity (PA) through fall prevention education to allay patients’ fear of falling.

The sample included patients who opted into the facility’s VPFPEP. Evaluation was

performed using run charts to visually and quantitatively monitor trends and patterns of

fall incidents over time. Run charts also facilitated comparison of injuries sustained …

Program Evaluation Of A Black Barbershop Health Outreach Campaign, Berkina Denise Porter

Walden Dissertations and Doctoral Studies

Black-owned barbershops in the Black community lack barber administered interventions to provide education and health screenings to Black men. Increasing knowledge of health assessments in a black barbershop setting increases the number of health screenings and preventative care among Black men. Grounded in general systems theory, the purpose of this qualitative summative program evaluation was to explore the extent to which a nonprofit Black barbershop health program aligns with the Health Research (HR) program objectives. The evaluation was performed for a nonprofit organization located in Maryland, 6 years after the organization implemented the HR Program Network of barbers and salon …

Predictors Of Condom Use Among High School Students In North Carolina, Danielle Cierra Robinson

Walden Dissertations and Doctoral Studies

The spread of sexually transmitted diseases is a major ongoing public health issue in North Carolina. Adolescents between the ages of 13 and 19 years have consistently contributed to this trend. Researchers have found that condom use among high school students has decreased. High school students continue to engage in sex with multiple partners, with lack of knowledge about sexually transmitted diseases, even though sex education and prevention programs have been recommended. The purpose of this quantitative study was to evaluate the predictors of condom use among adolescents. The socioecological model theoretical framework was applied to guide this research involving …

Socioeconomic And Sociocultural Factors Associated With Parenting Choice And Fertility Experience Among Lesbian And Nonlesbian Women, Annette Silvia

Walden Dissertations and Doctoral Studies

Minorities including lesbians may face disparities that contribute to minority stress, which leads to adverse health outcomes. The purpose of this social epidemiology study was to examine the association between insured status, perceived stress, and parental status among lesbians and nonlesbians. The theoretical foundation was minority stress, and the design was quantitative with a convenience sample of women aged 18 years and older. Data on demographics, perceived stress, fertility quality of life, and lesbian identity disclosure were collected via online survey. Among the 314 respondents, 102 self-selected as lesbian (49% parents), and 212 self-selected as nonlesbian (73.1% parents). More than …

Primary Payer Status And 30-Day Readmission Rates Among U.S. Diabetes Patients, Christina Marie Swilling

Walden Dissertations and Doctoral Studies

Diabetes is a leading cause of hospitalization and readmission in the United States. The 30-day readmission rate for diabetic patients represents substantial costs to the nation’s health care system. The purpose of this quantitative study was to examine the relationship between primary payer status and hospital readmission rates among individuals whose primary or secondary reason for admission was Type 2 diabetes mellitus (T2DM). Secondary data from the Healthcare Cost Utilization Program Nationwide Database of the 2015 National Readmission Database was analyzed. Participants in the data set included 41,068 diabetes patients, 53.8% of whom were female. The average age was 67.26, …

The Impact Of Faculty Bullying On Associate Degree Nursing Students, Angela M. Vitale

Walden Dissertations and Doctoral Studies

Bullying is prevalent in the profession of nursing, impacting the quality of health care and health care costs. The foundation of bullying, in the profession of nursing, may be attributed to bullying behaviors in nursing academia among nursing faculty and nursing students. Using Bandura’s social learning theory, the purpose of this study was to determine the relationship between bullying behaviors of nursing faculty and bullying behaviors of nursing students in associate degree nursing programs. Seventy-one randomly selected registered nurses who graduated from associate degree nursing programs in the past 5 years completed an online Incivility in Nursing Education-Revised survey. Spearman’s …

Faculty Members’ Perceptions Of Organizational Culture And Implementation Of Interprofessional Education, Cynthia Voyce

Walden Dissertations and Doctoral Studies

A disparity exists between what is known about the benefits of interprofessional education (IPE) and implementation of IPE at the university under study. The World Health Organization called on institutes of higher education to provide IPE in the education of health professionals to improve the healthcare workforce’s capacity to provide quality care. The purpose of this qualitative study was to understand the perceptions of health professions faculty members (HPFMs) about IPE and how those perceptions might be influenced by the organizational culture at the site. Informed by Hofstede’s dimensions of culture theory, the research questions addressed HPFMs’ understanding of and …

Association Between Metabolic Syndrome And Second Primary Cancer Among Colorectal Cancer Patients, Olukayode Ayodeji Agbeyomi

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third most common diagnosed cancer in both women and men in the United States. The gradual increase of incidence of second primary cancer (SPC) among CRC individuals has been a concern in recent times. Many CRC survivals have been forced back to be hospitalized for life-threatening cancers that are nonmetastatic cancers of CRC. Literature has suggested that there may be a relationship between metabolic syndrome (MetS) and CRC cases. The importance of early surveillance, detection, and treatment of SPC in CRC patients is significant to achieve better survival rates. The aim of this retrospective quantitative …

Obesity And Overweightness Among African-American Adolescent Population And Health-Related Quality Of Life, Emmanuel Anene

Walden Dissertations and Doctoral Studies

Obesity and overweightness are a significant public health problem and a risk factor for many chronic diseases. The purpose of this study was to find the associations between gender, race, physical activity, and health-related quality of life (HRQOL) among obese and overweight African American adolescents aged 12 to 19 years. An improved understanding of the health issues could help this population live a longer quality life and prevent serious health implications in adulthood. A quantitative approach with a sample size of 331 was used. The control variables were age and household income, the dependent variable was HRQOL, and the independent …

Mothers’ And Community Stakeholders’ Perspectives About The Vitamin A Supplementation Program In Nigeria, Olufolakemi Mercy Anjorin

Walden Dissertations and Doctoral Studies

Vitamin A deficiency (VAD) affects about one third of children under the age of five in Nigeria. There is low uptake of biannual Vitamin A supplementation (VAS) used since year 2010 as the national response to addressing VAD among children 6 to 59 months. Yet, there is limited research on barriers or facilitators to uptake of VAS. The purpose of this study was to examine the perspectives of stakeholders about the VAS program in Nigeria. The theoretical underpinning was the social marketing framework. The central question related to the views of stakeholders toward the VAS program, and their perception about …

Leadership And End-Of-Life Planning Among Elderly Patients With End-Stage Renal Disease, Elizabeth R. Armstrong-Fears

Walden Dissertations and Doctoral Studies

More than 8-million people in the United States possess no kidney function. The purpose of this quantitative casual-comparative research study is to examine the relationship between ethnicity status of African American and European American patients suffering from end-stage renal disease, and advanced care planning and end-of-life decision-making among patients who are 55 years of age and older. The health belief model is the selected explanatory framework used to examine (a) whether ethnicity status is a significant predictor of whether decedents had written end-of-life care instructions, (b) whether ethnicity status is a significant predictor of whether treatment decisions were made, and …

The Lived Experience Of Child Marriage And Its Health Effects Among Young Mothers In Nigeria, Anastasia Iliwo Ashi

Walden Dissertations and Doctoral Studies

Child marriage has life-threatening implications for the mental, physical, and psychological development of the girl-child. In Sub-Saharan Africa, and other resource poor settings, child brides and very young mothers undergo various negative experiences including economic hardship and health challenges such as obstetric fistulas, birth complications, and even death. The purpose of this phenomenological study was to describe the lived experiences of child marriage and its effect on maternal health among young mothers in Nigeria. The social ecological model provided the conceptual framework for this study. Ten young women ages 18-24 years who had been child brides when age 12-16 years …

Faculty Evaluation Of Underperforming Nursing Students In Clinical Settings, Melody Lynn Bethards

Walden Dissertations and Doctoral Studies

Difficulty in evaluating underperforming nursing students in clinical settings is a problem for many nursing programs. The subjective nature of evaluations and faculty reluctance to provide negative evaluations have implications for subsequent patient care. A descriptive single case study research design was used to explore the experiences of clinical faculty evaluating underperforming nursing students in clinical settings at a U.S. Midwest community college. Gagné's learning outcomes and the National League for Nursing (NLN) Clinical Nurse Educator Core Competency: Implements Effective Clinical Assessment and Evaluation Strategies provided the conceptual framework for the study. The research questions focused on how nursing faculty …

Leadership Strategies To Achieve Organizational Excellence, Cherron Lakisha Blakely

Walden Dissertations and Doctoral Studies

Inadequate quality management tools and processes can lead to inefficient hospital operations and poor organizational performance. Community hospital leaders who fail to improve operations and organizational performance risk negatively impacting patient care and profitability. Grounded in the theory of high-performance work systems (HPWS), the purpose of this qualitative single case study was to explore strategies community healthcare leaders use to effectively employ quality management approaches to improve operations and achieve organizational excellence. The participants comprised 5 community healthcare leaders in the northeast United States who effectively used quality management approaches to improve operations and achieve organizational excellence. Data were collected …

Hispanic Nursing Students’ Perspectives On Student-Clinical Instructor Relationships And Learning, Inela Brito

Walden Dissertations and Doctoral Studies

Non-Hispanic students are more likely to be successful in their nursing school studies than Hispanic students. Facilitators and barriers to classroom success for Hispanic students has been studied; however, few studies have addressed the academic clinical experience and the clinical instructor’s role in Hispanic students’ success. The purpose of this descriptive phenomenological study was to explore the perspectives of undergraduate senior Hispanic nursing students regarding how student-instructor interactions in the clinical setting influenced students’ ability to learn and succeed in completing their studies. The research questions were guided by an adapted institutional support model and were used to explore how …

Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and …

Managing Energy As Experienced By Female Federal Senior Managers, Gwendolyn Jones Crimiel

Walden Dissertations and Doctoral Studies

Senior managers experience a drain on personal energy while trying to meet the demands of work. The purpose of this hermeneutic phenomenological study was to explore how female senior managers describe lived experiences of managing and renewing personal energy while at work. The theoretical framework included conservation of resources theory and effort recovery theory. Data were collected from semi-structured interviews with 14 female senior managers who experienced managing and renewing their personal energy at work. Data analysis involved coding to capture the essence of the experiences and to identify common themes. Findings indicated that insufficient energy affected participants’ mental and …

Strategies For Automating Pharmacovigilance Adverse Event Case Processing, Mythily Easwar

Walden Dissertations and Doctoral Studies

Business leaders who fail to implement innovative technology solutions in their companies face economic distress in these organizations. Guided by the task technology fit model as the conceptual framework, the purpose of this qualitative single case study was to explore strategies used by pharmacovigilance (PV) systems leaders to implement innovative technology solutions. The participants were 4 PV systems managers working in a pharmaceutical company in the Boston area of Massachusetts, United States, who used successful strategies to implement innovative technology solutions to automate adverse events case processing. Data were collected using semistructured interviews and company documents. The collected data were …

Prevention Of Care Of Catheter-Associated Infections In Long Term Care, Maureen Edozie

Walden Dissertations and Doctoral Studies

The incidence of catheter-associated urinary tract infections (CAUTI) in long-term care settings ranges from 1.5 to 3.3 per 1,000 catheter days for adult. Over 380,000 nursing home residents are hospitalized due to infections each year. Staff education using Agency for Healthcare Research and Quality (AHRQ) practice guidelines showed knowledge gained. The use of an evidence-based practice guideline developed AHRQ has been shown to significantly reduce the rate of CAUTI in the long-term care residents. The clinical practice problem was a CAUTI rate higher than the national average in the long-term care facility of interest due, in part to inconsistent nursing …

Group Education Program To Increase Obesity Knowledge In Cardiac Care Nurses, Ethel Emenogu

Walden Dissertations and Doctoral Studies

Obesity increases the severity of cardiac disease, leading to increased mortality and morbidity. The need to address obesity is critical in reducing obesity-associated complications such as heart failure, strokes, heart attacks, and even death. Obesity is also a risk factor for many chronic diseases such as heart disease, cancer, diabetes, hypertension, and depression. Evidence has shown that obese individuals with cardiac disease are at increased risk of developing complications. The practice-focused question for this doctoral project asked whether a group educational program could increase obesity knowledge among cardiac care clinic nurses. The purpose of this DNP project was to provide …

An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane

Walden Dissertations and Doctoral Studies

Medical laboratory professionals have faced more than 20 years of workforce shortages. The causes of these workforce shortages include poor retention of new professionals and an insufficient number of new graduates who enter the workforce. The purpose of this qualitative case study was to explore the strategies that are used by managers in hospitals for the retention of laboratory professionals. The theoretical framework comprised Mobley’s theory of turnover and Porter’s organizational commitment theory. The research questions for this study addressed what managers perceived as the biggest challenges for the retention of laboratory professionals and what effective strategies they thought could …

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

Strategies To Implement A Material Management Information System For Medical Device Recalls, Paul Leo Lafrance

Walden Dissertations and Doctoral Studies

Health care business executives lack strategies to implement material management information systems (MMIS) related to medical device recalls. Lacking sufficient MMIS, health care business executives face insufficient product tracking related to medical devices affecting operational efficiency. Grounded in the conceptual frameworks of the technology acceptance model and diffusion of innovation, the purpose of this qualitative single case study was to explore health care business executives’ strategies for implementing an MMIS related to medical device recalls. The participants were 6 health care executives who implemented an MMIS in an urban hospital in the northeast region of the United States. Data were …

Instructor Perspectives On Case-Based Learning And Student Engagement In Occupational Therapy Curriculums, Pamela Lewis-Kipkulei

Walden Dissertations and Doctoral Studies

Students who are not engaged in the classroom become clinicians who are not successful in clinicals and entry-level work. This prompted occupational therapy (OT) educators to explore active teaching and learning strategies that have proven successful in various professional programs. This study explored OT instructors’ perceptions and experiences of case-based learning (CBL). This single case, qualitative study utilized content and thematic analysis to analyze interviews, brainstorming activities, and reflective journals from eight participants. Participants were OT professors who utilized CBL strategies. First and second cycle coding was used to categorize data then codes were reviewed for emerging themes. Content analysis …

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …