Medicine and Health Sciences Commons^™

The Flame, 2021-2022, Mennonite College Of Nursing

The Flame (1985-present)

The Flame is a newsletter of Illinois State University's Mennonite College of Nursing

Reimbursement Of Mental Health Service For Individuals Seeking Services At Primary Care Facilities, Keith Avant

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to explore the relationship between primary care services, mental health services, patient visits, and insurance reimbursement for individuals with a mental health diagnosis who visit primary care facilities. The theoretical integrated theory of health behavior changes has been vital in identifying the contributing factors to the relationship between primary care, mental health services, and insurance reimbursement. The research questions explored whether any relationship existed between mental health diagnosis and office visits, outpatient versus inpatient, the amount paid for treatment, and reimbursement of services. This study used a quantitative approach along with a Pearson …

The Predictive Relationship Of Allostatic Load In Asthma, Mohamed Mustafa Hassan

Walden Dissertations and Doctoral Studies

Research on populations emphasizes the influence of allostatic overload, a marker of biophysical and biochemical stress, in driving adverse health outcomes. Unknown is the impact of allostatic load and its cardiovascular, metabolic, and inflammatory components as they pertain to asthma prevalence in U.S. populations. Specifically, there is a need to understand the nature of the relationship between allostatic load and asthma in light of confounders such as socioeconomic status, race, education, and gender. Using Bronfenbrenner’s bioecological model as a theoretical underpinning and binary logistic regression as a statistical modality, the predictive relationship between allostatic load and asthma was examined in …

Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger

Walden Dissertations and Doctoral Studies

People who have not overcome childhood trauma and who have developed mental illnesses have difficulties dealing with life challenges. The purpose of this quantitative study used a correlational design to test any relationship between childhood trauma experience levels and resilience against life challenges in adulthood. The theoretical framework used for this study was Barnes’ social support theory. Data were collected from 104 participants over a 7-week period. Participants voluntarily answered the ACE questionnaire, 2-way support scale, and resilience scale. Key results indicate that people with mental illness who receive social support are positive impacted by that support. Receiving adequate levels …

Staff Education To Improve Pain Management In Skilled Nursing Patients, Keitta Evans

Walden Dissertations and Doctoral Studies

One of the key ethical principles in nursing is the promotion of health and wellness and ensuring that patients are free from unnecessary pain and suffering. It is estimated that at least 65% of patients in skilled nursing centers in the United States report the presence of pain, indicating that there are opportunities for improvement with effective pain management within this practice setting. A key factor that has been identified as an opportunity for improvement is education for clinical staff who practice within this setting. This Doctorate of Nursing Practice (DNP) project provided education to a group of clinical team …

Nursing Interventions For Reducing Falls Among Older Adults On Polypharmaceutical Agents, Kevin O. Onuekwusi

Walden Dissertations and Doctoral Studies

In the United States, the cost of treating a resident of a long-term care facility (LTC) after a fall with injury is between $10,000 and $26,000. Current nursing interventions for fall prevention among older adults aged 65 years and over at the local LTC do not address the risk of polypharmacy and are focused on environmental and intrinsic factors. The purpose of this systematic literature review was to find the nursing interventions that have been used to reduce falls in older adults aged 65 years and over in nursing homes and LTCs who are on polypharmaceutical therapy. Primary research articles …

Perspectives Of Key Court Personnel On The Prosecution Of Domestic Violence Cases, Crystal M. Schoeder

Walden Dissertations and Doctoral Studies

Domestic violence (DV) continues to be a public health and criminal justice problem. Several criminal justice system changes have been made to combat DV, such as mandatory arrest policies, no-drop prosecution policies, and specialized DV courts. Perspectives on these policies, DV, and the criminal justice system have been obtained from the victims, police officers, and victim advocates. However, perspectives from those within the criminal justice court system are missing. The purpose of this qualitative phenomenological study was to obtain the perspectives of key court personnel in small rural communities regarding the prosecution of DV cases. Narrative policy framework was used …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

Food Insecurity In Community College Students In The Central Valley Of California, Leah Carter

Walden Dissertations and Doctoral Studies

AbstractMany college students struggle with having enough money to pay for the costs of college and basic necessities, such as adequate food, which leads to food insecurity. Food insecurity results in a more challenging time focusing on studying and less success in school. This study addressed the lack of a profile of a food-insecure California community college student at Hiker’s Community College (HCC; pseudonym) in the Central Valley of California. The purpose of this quantitative study was to determine the profile of a food-insecure student and to determine relationships between food insecurity and ethnicity, gender, being a first-generation college student, …

Comparative Analysis Of Systemic Lupus Erythematosus Support Group Type On Quality Of Life, Mary Louise Giles

Walden Dissertations and Doctoral Studies

When individuals are diagnosed with systemic lupus erythematosus (SLE), they tend to go through emotional, psychological, and physical anguish that requires support. Studies have shown that a support group can provide SLE patients with an outlet in which they can share firsthand feelings and experiences and receive emotional support but it is not known if how the individual with SLE accesses online or face to face support makes a difference. The purpose of this study, guided by the Chronic Care Model, was to determine if there were differences in quality of life (QoL) for persons with SLE participating in an …

Increasing Access To Diabetic Self-Management Education Using Telehealth In Rural Kentucky, Gina Good

Walden Dissertations and Doctoral Studies

The lack of diabetic self-management education (DSME) can affect generations of families who have suffered from diabetes. More than 80% of Appalachian Kentucky counties lack access to DSME and care due to high incidence of diabetes. The purpose of this quality improvement project was to determine whether the use of telehealth increased patient access to DSME in Southeast Kentucky. Application of Peplau’s theory of interpersonal relations to patient relationships in nursing practice provided a framework for the project. De-identified retrospective data 6 weeks before intervention and 6 weeks postintervention were collected by the project facility for secondary data analysis to …

Creating A Pain Management Clinical Practice Guideline For Hospice Patients, Tiffany Ann Bowland

Walden Dissertations and Doctoral Studies

Current evidence-based research shows that pain in hospice patients is a growing problem. A gap in practice was identified as the current clinical practice guideline (CPG) in a hospice center in South Carolina was outdated and not being employed. A literature review revealed that updated CPGs provide better outcomes in pain management for end-of-life care. The project answered the practice-focused question: In the context of hospice, what are current evidence-based strategies for managing pain. The Stettler model and Kolcaba’s comfort theory guided the development of the CPG. Three nurse case managers and two physicians participated in the creation of CPG. …

Clinical Practice Guidelines For Assessing And Reporting Workplace Violence Against Nurses, Janice Lynn Canfield

Walden Dissertations and Doctoral Studies

AbstractWorkplace violence consists of physically and psychologically damaging actions while on duty. In healthcare, under a cloak of secrecy concerning workplace violence, an underreported epidemic exists. This problem is important to address because workplace violence can affect the quality of care delivered and patient care outcomes.. The purpose of this project was to develop a nursing clinical practice guideline (CPG) to assist hospital-based nurses to identify risk factors for workplace violence, identify strategies to mitigate violence, and report workplace violence. This CPG can be an effective tool for nurses to better understand the scope and nature of violence in the …

The Impact Of Inpatient Boarding In North Carolina Emergency Departments, Miracle Howard

Walden Dissertations and Doctoral Studies

Currently, emergency department overcrowding has negatively impacted hospitals' financial, operational, and organizational performance globally. A contributing factor to emergency department overcrowding includes the delay of the throughput process for patients who have a time-sensitive diagnosis and are admitted to the emergency department. This causes adverse hospital outcomes such as longer length of stays and increase hospitalization cost. This study utilized secondary data to address a relationship between admitted patients who have time-sensitive diagnoses such as chest pain and chronic obstructive pulmonary disease within North Carolina emergency departments and length of stay, utilization of services, and overall hospital cost. The conceptual …

Nurse-Patient Ratios And Falls In The Acute Care Setting: A Staffing Educational Program, Trinia Shawell Williams

Walden Dissertations and Doctoral Studies

AbstractThe correlation between patient falls and nurse-patient ratios in acute care has been a prevalent topic for decades. The lack of nurse-patient ratio guidelines to direct nurse staffing has restricted nursing leaders’ efforts to address this issue. The purpose of this staff education project was to educate nursing leaders on nurse-patient ratios and their association to patient falls. The practice-focused question centered on whether education would increase nursing leaders’ knowledge about appropriate staffing ratios and practices to reduce falls at a long-term acute care facility. Rogers’s diffusion of innovations theory was the change model used to guide this project. There …

Exploring The Effects Of Generation And Leadership Style On Nurses’ Organizational Commitment, Kim M. Hedley

Walden Dissertations and Doctoral Studies

There is an impending shortage of nurses; therefore, healthcare leaders must use strategies that promote staff nurses’ organizational commitment (OC) to retain a clinically competent workforce. The purpose of this quantitative descriptive cross-sectional study guided by the transformational leadership theory and generational theory was to determine whether OC differs according to generational cohort (GC) and leadership style (LS) and then explore the combined effects of GC and LS on staff nurses’ OC. One-hundred sixty acute care staff nurses in the United States responded to the survey that included the Multifactor Leadership Questionnaire 5x-Short and Three-Component Model Employee Commitment Survey. A …

Effects Of Education On Rural Emergency Department Preceptors’ Self-Efficacy And Knowledge, Katherine Marie Jasper

Walden Dissertations and Doctoral Studies

The Emergency Nurses Association recommends nurse preceptorship programs for emergency departments (EDs) to give nurses the skills needed for precepting new nurses; however, many rural areas do not have nurse education for preceptorship, and no standardized training is available for preparing preceptors for their roles. Rural ED preceptors therefore lack knowledge and skills needed for precepting new nurses. The purpose of this study, guided by Benner’s skill acquisition and self-efficacy theory, was to determine if there were significant differences in 33 rural ED nurse preceptors’ knowledge and self-efficacy after they completed an online informational PowerPoint presentation. The PowerPoint education program …

Black Mothers’ Birthing Center Experiences And Exclusive Breastfeeding Practices, Natashia King-Conner

Walden Dissertations and Doctoral Studies

The persistence of racial disparities in breastfeeding is associated with a range of interconnected factors, such as historical, cultural, social, social, and psychological. The current gap in the prevalence of exclusive breastfeeding among Black mothers and White mothers has led to rising concerns in the United States. A basic qualitative approach was used to conceptualize the multidimensional constructs of the social–ecological model to investigate the individual, interpersonal, institutional, and community-level structures and existing policies in birthing centers that inadvertently harbor biases that impede care for Black mothers. Data were gathered through purposeful sampling and semistructured interviews with 10 Black mothers …

A Systematic Review Of Tobacco Cessation Strategies Tailored For Military Personnel, Ni Ketut Supiyati

Walden Dissertations and Doctoral Studies

AbstractA Systematic Review of Tobacco Cessation Strategies Tailored for Military Personnel by Ni Ketut Supiyati

MS, Walden University, 2000

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021

The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease that can lead to many complications, is one of the leading causes of death. Obesity tends to increase the risk of diabetes. Nutritional therapy can not only control diabetes but also prevent it in some cases by decreasing weight. The ketogenic diet is a low-carbohydrate, high-fat diet that can prevent and control diabetes. The purpose of this study was to examine the recommendations of medical providers before and after the presentation of educational content on the ketogenic diet as nutritional therapy in prediabetic and diabetic patients. The practice-focused question addressed whether educating medical staff at a …

Emergency Department Utilization And Length Of Stay Among Sickle Cell Patients, Rushali Naik

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) utilize the emergency department (ED) frequently due to limited access to adult health care providers. Few providers are knowledgeable about caring for patients with sickle cell disease. This quantitative study’s purpose and research questions addressed whether there was a correlation between ED utilization and ED length of stay (LOS) pre- and post-enrollment in an adult comprehensive sickle cell clinic between the years of 2012 and 2017. The Donabedian framework was used to examine the structure, process, and outcomes related to the benefits of care in a sickle cell center. The independent variables of pre- …

Volunteer Motivation Of Individuals In Rural Pacific Northwest, Lenea Kindred Pierzchanowski

Walden Dissertations and Doctoral Studies

Volunteering is a selfless social action in which an individual chooses to participate through personal motivations. These actions of public service are a combination of need-based vacancies within organizations and unpaid compensation for filling those needs. The purpose of this research was to identify motivational attributes of individuals who volunteer in the identified rural area using one-on-one semi-structured interviews through the lens of the volunteer process model, in addition to the social identity, ecological, and social capital theories. The 15 participants for this study were over the age of 18, fluently spoke and read English, and had been a volunteer …

Relationship Between Media Coverage And Child Measles Vaccination Uptake, Tanika Ward

Walden Dissertations and Doctoral Studies

Childhood vaccines have been a source of heated debates between both opponents and proponents of vaccination. Childhood immunizations have proven to be effective and save lives, but antivaccine movements continue. The purpose of this retrospective cross-sectional quantitative study was to determine if there was a significant difference in child measles vaccine uptake based on provider facility type and census region, after adjusting for age and education of mother, for the years 2003–2012, pre-and-post 2007 media coverage deeming vaccines unsafe, and for the years 2013–2017, pre-and-post exposure to measles at Disneyland in 2014–2015 for children aged 19–35 months. The social ecological …

Prevalence Of Metabolic Risk Factors With Abnormal Obesity Measures Among The Tobagonian Adult Population, Joanne Cruickshank

Walden Dissertations and Doctoral Studies

AbstractAn increase of metabolic risk factors is a public health threat to the well-being of the population of Tobago; this increase is poorly documented and understood. According to a review of evidence-based research, studies linked metabolic risk factors to the high prevalence of obesity. However, there was a gap specific to the Tobagonian population. This cross-sectional quantitative study assessed the evidence of metabolic risk factors to determine whether obesity measures correlated with metabolic risk factors among a sample from Tobago. Guided by the social-ecological theory, a self-reported survey was used to collect primary data from 270 participants during a workplace …

Use Of Critical Thinking Strategies By Nurse Educators, Josephine Tundun Akintonde

Walden Dissertations and Doctoral Studies

AbstractNew graduate nurses often lack the clinical decision-making skills that are essential for developing clinical competency. Critical thinking abilities are essential for nursing excellence and professional competency. However, little is known about nurse educators' techniques and teaching practices for developing students’ critical thinking. The purpose of this phenomenological study, guided by constructivist learning theory, was to understand the lived experiences of nurse educators who used critical thinking teaching strategies in a baccalaureate nursing program to develop critical thinking skills in nursing students. Thirteen nurse educators from baccalaureate nursing programs were interviewed using open-ended questions. Interviews were transcribed and manually coded. …

Working With Sexually Violent Persons: Grit, The Supervisory Working Alliance, And Burnout, Stalina Harris

Walden Dissertations and Doctoral Studies

Clinicians who work with sexually violent persons (SVPs) are faced with various problems related to the nature of their job duties, job settings, and the specificity of the population they serve. Although researchers have investigated the phenomenon of burnout extensively over the last decade, research focusing on burnout among counselors who work with SVPs is insufficient. The purpose of this quantitative comparative survey study was to investigate differences in burnout among clinicians working with SVPs by examining their grit, the supervisory working alliance, and job settings. The Grit Short Scale (Grit-S), the Supervisory Working Alliance Inventory—Trainee version (SWAI-T), and the …

An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart

Walden Dissertations and Doctoral Studies

AbstractHealthcare-associated infections (HCAIs) threaten the quality and safety of the services provided. HCAIs are infections that occur while a patient is receiving treatment for another condition in any type of healthcare. The Centers for Disease Control estimates that approximately one in every 20 inpatients will become infected with an HCAI during their hospital stay. Proper hand hygiene is the most significant intervention in preventing HCAIs. Despite hand hygiene's effectiveness, evidence suggests that only 50% of healthcare workers are compliant with proper hand hygiene techniques. The purpose of this project is to increase nurse’s knowledge the via education. Kotter's eight-step change …

Staff Education Program On Smoking Cessation In Patients With Cardiovascular Disease, Jennifer Shipp

Walden Dissertations and Doctoral Studies

Cigarette smoking in the United States constitutes a public health crisis, with millions of people having cigarette-related diseases and comorbidities. Although there is an increased prevalence of uncontrolled smoking among patients with cardiovascular diseases, many healthcare facilities, including the project site, lack adequate screening for tobacco use among cardiovascular patients. The 5As (asking, advising, assessing, assisting, and arranging) model of behavioral change provided the framework for the project. The practice-focused question for this project addressed whether a staff education program specifically designed to instruct healthcare providers on using the 5As intervention with cardiovascular patients would increase their knowledge of smoking …

Parents’ Decision Making And Uptake Of Human Papillomavirus Vaccination Among Adolescent Males, Franklyn Penn

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) infections account for most oropharyngeal, anal, and penile cancers among men. Two vaccines have been recommended for boys 11 years of age or older to prevent HPV infection, but HPV vaccination rates are far below the Healthy People 2030 target goal. Some research indicates the role of the parent is vital in HPV vaccine uptake, but to what extent is unclear. Through quantitative secondary data analysis of the National Immunization Survey-Teen 2016 (NIS-Teen) data set (n = 43,271) that was grounded in the health belief model, chi-square, and logistic regression analyses revealed three key findings. First, male …

Social Media And Physical Activity Among African American College Women, Carmen Brown

Walden Dissertations and Doctoral Studies

Among African American (AA) college women, physical activity (PA) is decreasing, with less than 20% participating in moderate-intensity cardio or aerobic exercise. Physical inactivity can lead to increased morbidity and mortality from chronic conditions. There is a need for more research on AA women’s health practices to develop interventions that can lead to sustainable behavior change among this population. More than 70% of AA college women reported using some form of social media (i.e., Facebook, Twitter, Instagram, TikTok, and Snapchat) daily. Social networking sites (SNS) in particular can provide health information, advice, and an open forum for individuals with health …