Medicine and Health Sciences Commons^™

Effectiveness Of Virtual Reality On Reducing Pain In Burn Patients, Jillian R. Carr

Honors Undergraduate Theses

Burn patients undergo excruciating levels of pain throughout their treatment in the hospital. Pain levels increase during medical procedures, such as wound care and debridement. As a part of the treatment plan, traditional pharmacologic interventions are provided. Over time, patients become tolerant of pain medications, specifically opioids. The developed tolerance contributes to more pain felt by the patient. Medical providers limit the number of opioids prescribed to prevent addiction and other adverse effects, contributing to the challenge in treating burn pain. Virtual reality (VR) has been studied as an intervention across various settings to alleviate distressing symptoms in patients. Many …

Home-Based Interventions To Lower Neonatal Mortality Rates In Developing Countries, Josee Sarah Etienne

Honors Undergraduate Theses

Aim: To evaluate Home-based interventions to lower neonatal mortality rates in developing countries.

Background: A developing country is a country that is lacking in the services and facilities enjoyed by people in developed countries, such as personally owned automobiles and homes with indoor plumbing and water-carried sewage disposal systems. The difference in resources compared to developed regions, has been evident to the correlation of the increase neonatal mortality rates.

Method: An electronic, systematic review of four databases were used to retrieve 209 articles initially, later filtered to 42 articles utilized in this review. The following databases used are as listed: …

Facilitation Of Enviromental Factors To Reduce Sound Decibels In The Neonatal Intensive Care Unit: A Literature Review, Cassandra Hanlon

Honors Undergraduate Theses

This literature review investigates nursing interventions to reduce decibel levels in the neonatal intensive care unit (NICU). The secondary purpose of this review was to evaluate if the interventions to reduce noise in the NICU had different outcomes for normal weight premature infants and infants afflicted with neonatal abstinence syndrome. The data bases for completing this review were Google Scholar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus), PubMed, and Elton B. Stephens Co. (EBSCO). The key search words included ‘NICU and decibels', ‘reducing decibels', ‘neonatal abstinence syndrome' ‘decibels', ‘preterm infants' and 'normal weight preterm infant*'. The …

Use Of Mechanical Pronation Beds In Acute Respiratory Distress Syndrome In The Intensive Care Unit: An Integrative Review Of The Literature, Amanda St. John

Honors Undergraduate Theses

The increasing rate of Acute Respiratory Distress Syndrome (ARDS) reinforces the need for additional resources to assist clinical staff with an individual's care and recovery. Pronation therapy involves physically rotating an individual from the posterior position to the prone position. Pronation therapy has successfully been used for individuals diagnosed with ARDS in Intensive Care Units for decades. However, manual pronation maneuvers by staff members poses risks for those who are critically ill and risk of physical injury to caregivers. Mechanical pronation beds have revolutionized the art of pronation therapy, minimizing risks, and decreasing possibility of kinking or pulling out life …

Race-Based Adjustment In Egfr Algorithms: An Integrative Literature Review, Leah E. Utt

Honors Undergraduate Theses

Background: There is a 3-fold risk of developing end stage kidney disease in Non-Hispanic African Americans compared to Non-Hispanic White Americans (Centers for Disease Control and Prevention, 2017). Estimated glomerular filtration rate (eGFR), one of the fundamental algorithms for coordinating treatment for kidney disease which factors in age, race, gender, and levels of creatinine, may pose an issue in this vulnerable population. Currently African Americans receive a correction factor between 1.21 and 1.16 to their eGFR to adjusting the value higher, potentially impacting appropriate kidney disease classification, and delaying beneficial interventions (National Kidney Foundation, 2020).

Methods: A systematic literature search …

Long-Term Assessment Of The Effects Of Covid-19 And Isolation Care On Survivor Disability And Anxiety, David Brett-Major, David S. Cates, James V. Lawler, Chad Vokoun, Angela L. Hewlett, Daniel W. Johnson, Elizabeth R. Schnaubelt, Michael C. Wadman, Christopher J. Kratochvil, M. Jana Broadhurst

Journal Articles: Epidemiology

We conducted an assessment of disability, anxiety, and other life impacts of COVID-19 and isolation care in a unique cohort of individuals. These included both community admissions to a university hospital as well as some of the earliest international aeromedical evacuees. Among an initial 16 COVID-19 survivors that were interviewed 6-12 months following their admission into isolation care, perception of their isolation care experience was related to their reporting of long-term consequences. However, anxiety and disability assessed with standard scores had no relationship with each other. Both capture of the isolation care experience and caution relying on single scoring systems …

Multiplex Qpcr Discriminates Variants Of Concern To Enhance Global Surveillance Of Sars-Cov-2, Chantal B. F. Vogels, Mallery I. Breban, Isabel M. Ott, Tara Alpert, Mary E. Petrone, Anne E. Watkins, Chaney C. Kalinich, Rebecca Earnest, Jessica E. Rothman, Jaqueline Goes De Jesus, Ingra Morales Claro, Giulia Magalhães Ferreira, Myuki A. E. Crispim, Brazil-Uk Cadde Genomic Network, Lavanya Singh, Houriiyah Tegally, Ugochukwu J. Anyaneji, Network For Genomic Surveillance In South Africa, Emma B. Hodcroft, Christopher E. Mason, Gaurav Khullar, Jessica Metti, Joel T. Dudley, Matthew J. Mackay, Megan Nash, Jianhui Wang, Chen Liu, Pei Hui, Steven Murphy, Caleb Neal, Eva Laszlo, Marie L. Landry, Anthony Muyombwe, Randy Downing, Jafar Razeq, Tulio De Oliveira, Nuno R. Faria, Ester C. Sabino, Richard A. Neher, Joseph R. Fauver, Nathan D. Grubaugh

Journal Articles: Epidemiology

With the emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants that may increase transmissibility and/or cause escape from immune responses, there is an urgent need for the targeted surveillance of circulating lineages. It was found that the B.1.1.7 (also 501Y.V1) variant, first detected in the United Kingdom, could be serendipitously detected by the Thermo Fisher TaqPath COVID-19 PCR assay because a key deletion in these viruses, spike Δ69-70, would cause a "spike gene target failure" (SGTF) result. However, a SGTF result is not definitive for B.1.1.7, and this assay cannot detect other variants of concern (VOC) that lack …

The Quantification Of Training Load In Professional American Soccer Players, Drew S. Dejohn

College of Graduate Studies: Theses & Dissertations

Training load (TL) has become a common tool to measure the exertion of athletes over the course of a session or season. However, there is still limited understanding of the load placement throughout training weeks within American professional soccer. The purpose of this study was to quantify potential differences in the external [duration, total distance (D_T), explosive distance (D_E), sprint distance (D_S), maximum speed (Speed_Max) and number of sprints (#S)] and internal [session rating of perceived exertion load (S-RPE Load), average heart rate (HR_Avg), peak heart rate (HR_Peak), …

The Association Of Demographic Characteristics And Social Vulnerability With Covid-19 Outcomes, Gloria D. Boone

College of Graduate Studies: Theses & Dissertations

The Association of Demographic Characteristics and Social Vulnerability With COVID-19 Outcomes

by

Gloria Boone

(Under the Direction of Gulzar Shah)

ABSTRACT

This research explored 102 Illinois counties' COVID-19 data to determine whether demographic characteristics and social vulnerability are associated with increased vulnerability to COVID-19 infections and deaths. COVID-19 is disproportionately impacting vulnerable groups and has been deadlier for African American and Hispanic people. The findings of this research will contribute to the knowledge base regarding social vulnerability and assist public health officials in targeting resources and designing interventions. This study used a retrospective cross-sectional design to assess demographic characteristics of …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Faith Leaders’ Perceived Role In Mental Health Promotion In Impoverished Communities, Kelly L. Cornish

Walden Dissertations and Doctoral Studies

The use of faith-based organizations (FBO) for health promotion in vulnerable communities has the potential to improve mental health outcomes by providing resources to community members. The purpose of this generic qualitative study was to explore how faith leaders perceived their role in mental health promotion as a resource to improve access to mental health care in impoverished communities. The health belief model and theory of planned behavior were used as the conceptual framework. Purposeful and snowball sampling was used to recruit eight faith leaders who led a FBO and resided in Cumberland County, NJ. Data were collected using semistructured …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

State Consent Policies And The Meaningful Use Of Electronic Health Records Among Nonfederal Acute Care Hospitals In The United States, Adetoro Kafilat Longe

Walden Dissertations and Doctoral Studies

The less-than-nationwide use of electronic health record (EHR) systems to send, receive, and integrate (SRI) patient summary of care (PSC) records limits the ability of hospital administrators to maximize efficiency and improve quality in the continuum of care. Despite obvious differences in state health information exchange (HIE) consent policies, there is no known research that has determined if and what aspects of state-level HIE legislation affect the use of EHR systems to SRI PSC records. Guided by the unified theory of acceptance and use of technology (UTAUT), the purpose of this quantitative cross-sectional research study was to examine the relationship …

Unmet Needs Of Children With Special Health Care Needs When Transitioning To Adult Services, Kiara Monee Moseby

Walden Dissertations and Doctoral Studies

Health care transition planning could help decrease health care disparities among those who identify as an individual on the autism spectrum; however, less than a quarter of the adolescent population living with autism spectrum disorder receive transition planning. Decreasing health care disparities could lead to an increase in health care quality and longevity. The purpose of this study was to analyze if there was a relationship between (a) the number of physician visits, (b) if the physician treats only children, (c) if the physician talks about the child seeing physicians who treat adults, (d) if the physician worked with the …

Health Care Manager Electronic Medical Record Systems Implementation Strategies To Improve Patient Outcomes, Mcarthur Bruno Damis

Walden Dissertations and Doctoral Studies

Ineffective implementation of electronic medical record systems (EMRS) among health care outpatient clinics results in substantial financial loss. Health care managers (HCMs) in outpatient clinics who fail to implement EMRS adversely affect employee usage and performance. Grounded in fayolism theory, the purpose of this qualitative multiple case study was to explore the strategies health care managers used to implement EMRS in their organizations. The participants were six HCMs in a U.S East Coast city. Thematic analysis was used to analyze the data from semistructured interviews and internal company documents. Five themes emerged: internal communication, overcoming barriers, time management, compensation improving …

The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo

Walden Dissertations and Doctoral Studies

AbstractSub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their lives. Starting in early 2000, Congolese HIV+ patients have undergone a variety of inputs designed to decrease HIV risk behaviors among people. The purpose of this inquiry was to understand the impact of those actions within the community. Data grounded on the socioecological model were collected regarding any changes in (1) behavioral rejection of condoms, (2) Kintwidi phenomenon, (3) levirate and (4) sororate marriage, (5) sexual …

Impact Of A Standardized Situation, Background, Assessment, And Recommendation Tool On Satisfaction And Communication In The Perioperative Area, Salomy Abraham

Walden Dissertations and Doctoral Studies

AbstractEffective communication among health care providers is critical to maintain patient safety during the handoff of care. Communication breakdown during handoff can lead to medical errors and sentinel events. The perioperative area is a vulnerable area that is prone to communication errors due to the involvement of providers from various disciplines and the nature of the quick patient turnovers within the perioperative area. To ensure proper communication during the handoff in the perioperative area, a unit-specific handoff tool is required. The focus of the project was to implement a standardized situation, background, assessment, and recommendation (SBAR) communication tool in the …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

The Power Of Exogenous Variables In Predicting West Nile Virus In South Carolina, Christopher Lee Glaze

Walden Dissertations and Doctoral Studies

Despite the availability of medical data, environmental surveillance tools, and heightened public awareness, West Nile Virus (WNv) remains a global health hazard. Reliable methods for predicting WNv outbreaks remain elusive, and environmental health managers must take preventive actions without the benefit of simple predictive tools. The purpose of this ex post facto research was to examine the accuracy and timeliness of exogenous data in predicting outbreaks of WNv in South Carolina. Decision theory, the CYNEFIN construct, and systems theory provided the theoretical framework for this study, allowing the researcher to broaden traditional decision theory concepts with powerful system-level precepts. Using …

The Relationship Between Hospitals’ Electronic Health Records Maturity And Excess Readmission Ratio, Cynthia Saint-Ulysse

Walden Dissertations and Doctoral Studies

Since the Health Information Technology for Economic and Clinical Health Act was enacted in 2009, a majority of U.S. hospitals have adopted electronic health records (EHR) to improve quality of care. However, variations exist in the technology's capability and maturity, making it difficult for researchers to analyze the full impact. The purpose of this quantitative study was to explore the relationship between hospitals' EHR maturity and the quality measure of excess readmissions, as well as the relationship between hospital characteristics, specifically, hospital location and the number of licensed beds in Medicare hospitals (N = 1,006). Both the chi-square statistical test …

Behavioral Health Audit Tool Implementation And Health Care Documentation, Stephanie Lou Weatherly

Walden Dissertations and Doctoral Studies

Quality documentation is a foundational element in healthcare. This QI project was conducted to examine the extent to which the implementation of a standardized behavioral health audit tool influenced compliance with required documentation elements. The context, input, process, product evaluation model was used to support the need for documentation compliance in behavioral health. A new audit tool was developed and implemented. Retrospective audit data were gathered from 86 locations over a period of 3 years, reflecting quarterly corporate audits and monthly program self-audit results. The first five quarters exhibited the widest variation in scoring; 28 locations required action plans for …

Perceived Learning Needs Of High School Teachers Regarding Suicide Prevention, Miranda Lynne Bevilacqua

Walden Dissertations and Doctoral Studies

Suicide is the second leading cause of death among youth in Canada. Though school-aged youth are surrounded by teachers, mentors, and school mental health nurses (SMHN), little is known about what teachers want to know regarding suicide and whether the teachers have the knowledge to recognize youth at risk. The purpose of this generic exploratory qualitative study, guided by the health belief model, was to explore the perceived learning needs of high school teachers in northwestern Ontario (NWO) regarding suicide prevention. The data collection process involved semistructured virtual interviews with 14 high school teachers in NWO recruited via social media. …

Nurse Executives’ Intuitive Decision Making And Leadership Personality Styles During Organizational Change, Chaudron Carter Carter Short

Walden Dissertations and Doctoral Studies

Within the complex and multifaceted health care environment, nurse executives are challenged to effectively make decisions and lead organizations through change. How nurse executives make those decisions is determined in a variety of ways, one being through intuitive decision making. The purpose of this quantitative correlational study, guided by the dual process theory, was to examine nurse executives’ intuitive decision making and leadership personality styles during organizational change. The Agor Intuitive Management Survey and the Multifactorial Leadership Questionnaire were administered to 70 nurse executives recruited by direct email obtained from public hospital organizations’ websites and social media platforms. Regression analysis …

Relationship Between Social Media Screen Time, Sedentariness, And Bmi Among Young Adults, Helen Golod

Walden Dissertations and Doctoral Studies

Obesity has quickly become an epidemic that affects adults and youth not only in the United States, but also increasingly elsewhere in the global community. Research suggests that most children and adolescents spend a significant amount of time indulging in screen-based leisure, especially on social media. Such behavior may also be linked to sedentary lifestyle, which can impact an individual’s body mass index (BMI). There is a lack of understanding concerning how sedentary behavior moderates the relationship between screen time spent on different types of social media and BMI among young adults in the United States. To address this research …

Noncompetitive Subordinate Employees’ Descriptions Of Adaptive Performance Following An Internal Promotion, Yemisi Milledge

Walden Dissertations and Doctoral Studies

Employees’ views on internal promotions tend to influence outcomes such as support given to the promoted employee, employee organizational commitment, and employee job satisfaction. Research on the influence of internal promotions has focused primarily on the reactions of competitive non-promoted internal candidates and those of the promoted individuals. This qualitative study investigated how employees who did not compete for a promotion adapted to a coworker being promoted to become their supervisor and how the employees described the coworker’s adaptation to the promotion. A taxonomy of adaptive performance and generic qualitative research formed the conceptual frameworks, and the leader-member exchange theory …

Healthcare Leader Strategies For Leveraging Electronic Heath Records, Danessa Thomas

Walden Dissertations and Doctoral Studies

AbstractHealthcare organizations may incur significant losses of productivity and profit because of the absence or incomplete implementation of Electronic Health Records (EHRs). EHRs are important to healthcare leaders because they enhance communication between providers and patients, reduce unnecessary costs, and increase adherence to clinical guidelines. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies that some successful healthcare leaders used to leverage EHRs in their organization to increase profit and productivity. The participants were nurse managers from four healthcare organizations that successfully implemented an EHR system in Georgia. Thematic analysis was …

Educating Pediatric Emergency Department Nurses On Autism Spectrum Disorder, Melanie Lynn Cardona

Walden Dissertations and Doctoral Studies

Caring for patients with autism spectrum disorder (ASD) that present to a pediatric emergency department (ED) poses many challenges for nurses. The multifaceted characteristics and needs exhibited by a child with ASD presenting to an ED has the potential to lead to poor patient outcomes. The purpose of this doctoral project was to increase registered nurses’ knowledge and confidence level for caring for patients with ASD in a pediatric ED. The practice-focused question for this doctoral project explored whether the implementation of an ASD educational intervention increase registered nurses’ knowledge and confidence level for caring for patients with ASD in …

Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham

Walden Dissertations and Doctoral Studies

AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …

Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton

Walden Dissertations and Doctoral Studies

Falls among hospitalized, geriatric patients are a leading cause of injury. Geriatric patients with psychiatric illnesses are at an even greater risk of falls. The project site was experiencing an increase in the number of patient falls and identified a need for staff education on fall risk assessment and implementation of interventions specific to the hospitalized, geriatric, psychiatric patient. Thus, the practice-focused question for this project was whether an educational program on evidence-based assessment and fall prevention strategies would improve nurses’ knowledge and skills to assess risk for falls and implement appropriate interventions for inpatient, geriatric, psychiatric patients. Knowles’s adult …