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Articles 21781 - 21810 of 23775
Full-Text Articles in Medicine and Health Sciences
Successful Strategies To Sustain Practice Changes In Healthcare, Erin Gable
Successful Strategies To Sustain Practice Changes In Healthcare, Erin Gable
Walden Dissertations and Doctoral Studies
Healthcare managers implement evidence-based practice to meet the growing needs of aging populations. However, many healthcare leaders fail to sustain newly implemented practices. Grounded in the promoting action on research implementation in health services conceptual framework, the purpose of this qualitative interpretative descriptive study was to explore strategies healthcare leaders use to sustain practice changes to meet increasing demands for quality care of the aging population. The participants included eight healthcare managers from Canada and the United States who led strategies to sustain practice change. The four themes that emerged using semistructured interviews and thematic analysis were staff buy-in, staff …
Law Enforcement Officers' Experience Of Crisis Intervention Team (Cit) Training, Jessica Yolanda Goings
Law Enforcement Officers' Experience Of Crisis Intervention Team (Cit) Training, Jessica Yolanda Goings
Walden Dissertations and Doctoral Studies
AbstractThe decline in mental health services has led to an increased role of law enforcement officers (LEOs), who are often the first to respond to mental health crisis incidents. Despite the specialized training that officers receive, there continues to be a public consensus that LEOs lack proficiency when handling a mental ill individual and have a deficiency in communication skills. The purpose of the research was to explore the experience of Crisis Intervention Team (CIT) training for LEOs and then describe how their experience ensued once deployed to the field to handle mental health encounters. Evaluations of CIT training have …
Continuity Of Care For Adult Offenders With Severe And Persistent Mental Illnesses: An Action Research Study, Lakeshia C. Gonzalez
Continuity Of Care For Adult Offenders With Severe And Persistent Mental Illnesses: An Action Research Study, Lakeshia C. Gonzalez
Walden Dissertations and Doctoral Studies
For decades, the representation of adults with severe and persistent mental illnesses (SPMI) in the criminal justice system has steadily grown despite public recognition and increased federal implementation of mental health courts and diversion programs. Though more is known about risk factors associated with psychiatric and criminal recidivism among this population, a gap in the literature remains on collaborative interventions and continuity of care between inpatient mental health and criminal justice facilities. Grounded in resilience theory, the purpose of this qualitative study was to examine challenges social workers faced when attempting to facilitate discharge planning between inpatient mental health facilities …
Blood Stream Infections Related To Hemodialysis Catheter Use, Patricia Goodman
Blood Stream Infections Related To Hemodialysis Catheter Use, Patricia Goodman
Walden Dissertations and Doctoral Studies
Abstract Hemodialysis is a life-sustaining procedure for patients diagnosed with end-stage renal failure. Most of these patients initiate hemodialysis with a tunneled central venous catheter, with some depending on its use for long-term treatment due to poor vascularity. Catheter-related bloodstream infections in hemodialysis patients are a complication of hemodialysis catheter use with a high morbidity and mortality rate. A quality improvement (QI) project was conducted to answer the practice-focused question of whether the use of chlorhexidine swabs and caps for central venous catheter dressing changes decreased the rate of hemodialysis catheter-related bloodstream infections. Resolution to this problem would benefit the …
Chronic Kidney Disease And Depressive Disorders Among Adult Non-Hispanic African Americans And Whites In Georgia, Omatola Gordon-Rose
Chronic Kidney Disease And Depressive Disorders Among Adult Non-Hispanic African Americans And Whites In Georgia, Omatola Gordon-Rose
Walden Dissertations and Doctoral Studies
Chronic kidney disease (CKD), depressive disorders, and mental health are significant health issues in the United States. The purpose of this study was to examine the association of CKD and depressive disorders and days of poor mental health in adults living in Georgia, controlling for race/ethnicity, socioeconomic status, gender, age, diabetes mellitus status, high blood pressure status, marital status, and number of adults in the household. The study was a descriptive, quantitative, cross-sectional design with secondary data analysis, and the framework used was Wilson and Cleary health-related quality of life measures. The 2019 Behavioral Risk Factor Surveillance System Survey weighted …
Factors That Predict Prescription Opioid Misuse By Type Of Healthcare Insurance Coverage, Keon Green
Factors That Predict Prescription Opioid Misuse By Type Of Healthcare Insurance Coverage, Keon Green
Walden Dissertations and Doctoral Studies
The opioid epidemic remains one of the leading causes of unintended deaths in the United States and is still one of the focal points of the public health field. Previous research has increased awareness of the opioid crisis and has focused on sociodemographic factors that may cause or predict prescription opioid misuse. The purpose of this study was to investigate sociodemographic factors that may predict prescription opioid misuse while controlling for healthcare insurance. The theoretical foundation for this secondary data analysis project was the socioecological model using the 2019 National Survey on Drug Use and Health. The population was 56,136 …
Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove
Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove
Walden Dissertations and Doctoral Studies
Healthcare organizations’ leaders' lack of strategies to effectively deploy and monitor departments’ productivity goals affect overall organizations’ performance. Healthcare leaders who fail to deploy and monitor departmental productivity strategies effectively are limited to enhancing healthcare organizations’ performance outcomes. Grounded in transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies healthcare organizations’ leaders use to effectively identify, deploy, and monitor departments’ goals for improving their overall organization's performance. The participants were 20 healthcare leaders who successfully demonstrated success in improving their organizations’ departmental-specific productivity performance. Data were collected using semistructured interviews and a review of …
Holistic Health Among African American Women Remaining In A Marriage After Infidelity, Nena Evette Harris
Holistic Health Among African American Women Remaining In A Marriage After Infidelity, Nena Evette Harris
Walden Dissertations and Doctoral Studies
Infidelity has been noted as a major reason married women experience stress and seek therapy. Infidelity is a social problem that results in adverse outcomes for individuals, families, and society. Health disparities are noted in women who have experienced infidelity. Studies have been conducted on marital status and health, but little has been studied on the holistic health experiences of married African American women who stay in their marriage after a spouse’s infidelity. The purpose of this generic qualitative study was to explore how the experience of marital infidelity affects the holistic health of heterosexual African American women in the …
Clinical Guidelines For Identifying Early Warning Signs Of Deterioration In Rehabilitation Patients, Tchaiko Abiola Hicks
Clinical Guidelines For Identifying Early Warning Signs Of Deterioration In Rehabilitation Patients, Tchaiko Abiola Hicks
Walden Dissertations and Doctoral Studies
Failure to recognize early warning signs of clinical deterioration can cause critical complications and a sentinel event with legal implications. These complications are preventable if nurses have evidence-based guidelines to guide their critical thinking to identify early warning signs. The purpose of this project was to close this gap by developing a Clinical Practice guideline for identifying early warning signs of clinical deterioration for the rehabilitation center. The clinical practice question addressed what evidence supported the development of a clinical guideline for nurses to recognize early warning signs of a deteriorating patient improve the quality of care of patients at …
Risk Factors Of Malnutrition In Children Under 5 In Nigeria, Itanwan James
Risk Factors Of Malnutrition In Children Under 5 In Nigeria, Itanwan James
Walden Dissertations and Doctoral Studies
Malnutrition in children under 5 years remains an important public health challenge as it spurs child mortality and morbidity in developing countries, including Nigeria. The purpose of this quantitative cross-sectional study was to explore the risk factors of malnutrition in children under 5 years of age in Akwa Ibom State, Nigeria. Socioecological and health belief models were applied to examine risk factors of malnutrition among these children. This study used a secondary dataset of 1,235 participants obtained from Akwa Ibom State Demographic and Health Survey database. Pearson’s chi-square test and binary logistic regression were adopted for the analyses. The results …
Mental Health Professionals And Family Burden: Ways To Improve Training And Treatment, Johnnie Lee Jenkins, Iii
Mental Health Professionals And Family Burden: Ways To Improve Training And Treatment, Johnnie Lee Jenkins, Iii
Walden Dissertations and Doctoral Studies
During deinstitutionalization, schizophrenia treatment shifted from state facilities to communities and families. This change stressed families. This study investigated mental health professionals' (MHPs) knowledge and training about this stress also called family burden (FB). The study had three research questions. These addressed MHPs’ view of FB, what barriers exist in treating FB, can multiple viewpoints define FB, and if these views influence MHPs to reduce it. This grounded theory study used 22 MHPs in seven focus groups (FGs). The participant recruitment process included email, list serves, phone calls, and one state conference. The participants were MHPs licensed for 3 years …
Predictors Of Health Literacy Scores In The Adolescent Oncologic Population, Amber N. Jenkins
Predictors Of Health Literacy Scores In The Adolescent Oncologic Population, Amber N. Jenkins
Walden Dissertations and Doctoral Studies
Recent research showed a relationship between low health literacy in adult oncology patients, poor communication with providers, misconceptions about disease and treatment options, and the inability to adhere to treatment plans. Comparative literature addressing adolescent health literacy contained insufficient evidence of these relationships. The purpose of this exploratory cross-sectional quantitative study, based on the health literacy skills framework, was to assess the health literacy of adolescents treated in the oncology department at an academic children’s hospital in Missouri to determine whether there was a significant relationship between individual health literacy scores of this population based on age, sex, number of …
Sociodemographic Factors As Predictors Of Low Influenza Vaccination In Chicago, Illinois, Ingrid L. Jeske
Sociodemographic Factors As Predictors Of Low Influenza Vaccination In Chicago, Illinois, Ingrid L. Jeske
Walden Dissertations and Doctoral Studies
Outbursts of seasonal influenza contribute to morbidity and mortality in the United States. Influenza is a contagious disease caused by influenza viruses. The main subtypes of the influenza virus are Type A and Type B. Influenza vaccines are among the most effective methods in preventing the spread of the influenza virus because they offer the best immune defense. However, health care providers face significant challenges due to low patient compliance with current vaccine recommendations and misinformation. Scholars have yet to expand and further explore the reasons for the gap in influenza vaccination between White individuals and minorities, such as the …
Micronutrient Deficiency After Bariatric Surgery, Naitte P. Jordan
Micronutrient Deficiency After Bariatric Surgery, Naitte P. Jordan
Walden Dissertations and Doctoral Studies
Abstract Bariatric surgery is the most clinically efficacious treatment for obesity and obesityrelated comorbidities. Many patients undergoing bariatric surgery have preexisting levels of nutritional deficiencies. The prevalence of micronutrient deficiencies may increase after surgery, and long-term nutritional monitoring and follow-up are essential factors for postoperative patient care; yet advanced practice nurses may not be accustomed to caring for patients or treating micronutrient deficiencies. The purpose of this systematic literature review was to collect and analyze clinical evidence to determine what can the APN with the best available evidence do for implementing protocols and procedures to prevent, detect, and monitor for …
Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara
Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara
Walden Dissertations and Doctoral Studies
Ethnic diversity in the U.S. nursing workforce had not been well researched. This aspect of nursing is important to the advancement of the profession because ethnic diversity of nursing helps reduce health care disparities. The purpose of this quantitative correlational study was to examine the possible relationship between the perceived ethnicity of nurse leaders and the engagement of bedside nurses. Culture of care theory was the theoretical foundation for this study. The Utrecht Work Engagement Scale with additional demographic questions was used to survey 53 bedside nurses with 2 or more years of experience. Simple regression was used to analyze …
Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga
Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga
Walden Dissertations and Doctoral Studies
AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …
Evidence-Based Discharge Planning For Assisted Living Facility Residents, Annick Sheron Kelly
Evidence-Based Discharge Planning For Assisted Living Facility Residents, Annick Sheron Kelly
Walden Dissertations and Doctoral Studies
AbstractLack of staff knowledge is one of the leading challenges contributing to ineffective discharge planning from assisted living facilities. Recognizing that appropriate discharge planning is essential to the well-being of residents, the purpose of this doctoral project was to develop a staff education program based on current evidence-based discharge planning procedures for residents of an assisted living facility. Knowles’s adult learning theory; Lewin’s change theory; and the analysis, design, development, implementation, and evaluation model guided development of the staff education program. According to a review of the literature, evidence-based strategies for resident discharge planning included early discharge planning; tailored support, …
Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan
Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan
Walden Dissertations and Doctoral Studies
Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …
Measuring Advance Directive Knowledge Gives Rise To Primary Care Nurses' Education Training, Arnell Corethia Kithcart
Measuring Advance Directive Knowledge Gives Rise To Primary Care Nurses' Education Training, Arnell Corethia Kithcart
Walden Dissertations and Doctoral Studies
AbstractPatients have the right to self-determine how and in what manner they desire to make end-of-life decisions. The use of advance directives (AD) is the focus of the Patient Self Determination Act (PSDA). The PSDA permits the use of legal documents to outline the patient’s end-of-life decision when they can no longer communicate to the medical community. Because individuals with chronic diseases are living longer the medical community must stay abreast on current laws and protocols to provide the care needed and address patient’s wishes for end-of-life needs. Nurses would be ideal to provide education on AD to patients upon …
Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott
Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott
Walden Dissertations and Doctoral Studies
Despite the 2009 mandate from the U.S. Government that healthcare organizations adopt and implement electronic medical records (EMR) systems to avoid fines and take advantage of the benefits EMR systems provide, adoption of EMR systems in the United States has been low. Since 2011, medical facilities have received incentive payments if they demonstrated “meaningful use” of certified EMR systems; however, medical facilities unable to demonstrate meaningful use beginning in 2015 have faced up to 5% penalties. Grounded in the diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies that hospital project managers use …
Gender And Risk Behaviors Association With Hepatitis-B Infections Among Liberia Military Personnel, Joseph B N Kowo Jr
Gender And Risk Behaviors Association With Hepatitis-B Infections Among Liberia Military Personnel, Joseph B N Kowo Jr
Walden Dissertations and Doctoral Studies
The increasing number of hepatitis B-related deaths in the Armed Forces of Liberia was due to the lack of understanding of the associated risks with the disease. Gender, substance use, and condom use have been researched as related risk factors for hepatitis B virus infection (HBV). The goal of this study was to determine if gender (male or female) and risk factors (substance use, alcohol abuse, and condom use) predicted hepatitis B infections after adjusting for age, marital status, education, and military rank among Liberia military population. The theory that grounded this study was Bronfenbrenner’s socio-ecological model (SEM) which posits …
An Integrated Care Transitions Program And 30-Day Readmission Rates For Heart Failure And Chronic Obstructive Pulmonary Disease, Kathryn J. Martinez
An Integrated Care Transitions Program And 30-Day Readmission Rates For Heart Failure And Chronic Obstructive Pulmonary Disease, Kathryn J. Martinez
Walden Dissertations and Doctoral Studies
The impact of hospital readmissions on an organization includes reimbursement penalties, elevated mortality and morbidity rates, increased health care expenditures, and poor quality of life for the community’s residents. This study examined the impact of an integrated care transitions program on the 30-day readmission rates for heart failure and chronic obstructive pulmonary disease (COPD) within an independent rural community health care organization in Middle America. The two research questions pertained to the relationships pre-and post-implementation of this program to the 30-day readmission rates for these two disease processes. The Donabedian model examined the structure and function of an integrated care …
The Lived Experience Of Individuals Thinking About Food And Coping With Stress, Tobi Martin
The Lived Experience Of Individuals Thinking About Food And Coping With Stress, Tobi Martin
Walden Dissertations and Doctoral Studies
Stress results in many people altering their eating patterns, often consuming food high in sugar and fat. Such behavior is a factor in the growing obesity epidemic and can potentially cause the development of chronic diseases, resulting in employment problems and billions of extra dollars spent on national health care programs. Researchers have focused on the concept of “emotional eating” while overlooking the overarching research question of this study, which was about exploring the experience of individuals using eating behavior as a coping mechanism to deal with stress. All responses were viewed through the lens of social cognitive theory. Interviews …
Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield
Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield
Walden Dissertations and Doctoral Studies
AbstractOpioid use accounts for many deaths each day in the United States. Although research has shown that retention in medication assisted treatment (MAT) programs increases quality of life for those individuals with opioid use disorder (OUD) and decreases premature death, there has been limited research on the perspectives of individuals with OUD in MAT programs and why they remained in or left the programs. The purpose of this qualitative phenomenological study, guided by Merleau-Ponty’s theory of perception, was to explore the lived experiences of those with OUD treated in a MAT program. An algorithm type interview was conducted to ask …
Student Nurses’ Senior Practicum Experience And Its Role In Transition To Practice, Trilla Mays
Student Nurses’ Senior Practicum Experience And Its Role In Transition To Practice, Trilla Mays
Walden Dissertations and Doctoral Studies
Newly graduated nurses (NGNs) are not prepared to transition to practice, often leaving practice within the first year. The purpose of this descriptive qualitative study, guided by Meleis’ transition theory, was to explore the NGN’s perceptions of their senior practicum experience and how the experience prepared them for transition to practice. The Covid-19 pandemic limited recruitment of participants. After extended recruitment efforts, three NGNs were recruited, interviewed using a semistructured interview guide, and recorded using Zoom, which was verified while listening to the recording. The Ravitch and Carl three-pronged coding approach and NVivo was used to assist with the manual …
Improving Nurses' Knowledge Of Patient Self-Management Of Sickle Cell Disease, Angel Amaura Mccullough
Improving Nurses' Knowledge Of Patient Self-Management Of Sickle Cell Disease, Angel Amaura Mccullough
Walden Dissertations and Doctoral Studies
Sickle cell disease (SCD) is a chronic illness affecting over 100,000 Americans annually. SCD causes severe pain, which may require frequent hospital admissions for pain control. A high level of patient self-care knowledge is needed to prevent readmissions. Patients usually receive self-care education at hospital discharge from nurses, who may not know about self-care in SCD. Inadequate patient education on self-management of SCD at hospital discharge can lead to hospital readmissions. There was a gap in knowledge among RNs regarding SCD self-care at the local facility. This doctoral project was intended to educate nurses about SCD self-management to increase their …
The Effects Of Stress Reduction For Healthcare Workers On Covid Units, Rosita Cynthia Mctaggart
The Effects Of Stress Reduction For Healthcare Workers On Covid Units, Rosita Cynthia Mctaggart
Walden Dissertations and Doctoral Studies
The rise of the COVID pandemic was a surprise to many. Since Florence Nightingale, society has suffered from various epidemic infectious diseases. This specific educational project was developed because of the stress and the aftereffects experienced by many healthcare workers coping with the working conditions related to COVID. This educational project is important because according to the World Health Organization, a healthy environment is a place for physical, mental, and social well-being, which supports optimal health and safety. Healthcare workers should be provided an educational program to assist them in minimizing stress. Havelock’s and Lewin’s theory of change was chosen …
The Effects Of Acculturative Stress On The Physical/Mental Health Of Immigrant Mexican Women, Maria Del Carmen Mendoza Griego
The Effects Of Acculturative Stress On The Physical/Mental Health Of Immigrant Mexican Women, Maria Del Carmen Mendoza Griego
Walden Dissertations and Doctoral Studies
AbstractImmigrants may experience acculturative stress as they adapt to their host country's dominant culture, which previous research has indicated may affect their physical and mental health. The purpose of this quantitative study utilizing a random sample was to examine the effect of acculturative stress and age on the mental and physical health of adult women of Mexican origin living in the United States, considering the moderation of perceived discrimination. The theoretical framework of acculturation by John W. Berry guided this study. The three research questions involved understanding whether immigrant Mexican women experienced a negative effect on their mental and physical …
Strategies To Improve Quality Of Care And Increase Medicare Payments In Hospitals, Emmanuel Mendoza
Strategies To Improve Quality Of Care And Increase Medicare Payments In Hospitals, Emmanuel Mendoza
Walden Dissertations and Doctoral Studies
The difficulty that nurse leaders experience in administrating quality of care while increasing Medicare payments threatens the hospital's patient well-being and financial stability. Health care administrators should be concerned about these issues to ensure their hospitals meet patient and community needs. Grounded in the performance improvement model, the purpose of this qualitative single case study was to explore strategies that hospital managers use to improve the quality of care and increase Medicare payments. The participants were six nurse leaders of a medium size hospital based in Houston, Texas. Data were collected using semistructured virtual interviews and a review of company …
Diabetes Self-Management Education For Nurses In The Primary Care Setting, Emilea Emade Mfortow
Diabetes Self-Management Education For Nurses In The Primary Care Setting, Emilea Emade Mfortow
Walden Dissertations and Doctoral Studies
AbstractDiabetes is a chronic disease that can be controlled by self-management to reduce the risk of acute or long-term complications. Healthcare might encounter many challenges for patients’ lack of adherence to diabetes self-management education. For this reason, lifestyle modification can be applied as a tool in the nursing field to manage adult patients with type 2 diabetes mellitus. This doctoral project addressed the gap in nursing practice for adult patients with type 2 diabetes regarding diabetes self-management education. This project focused on improving the nursing staff’s knowledge to promote evidence-based diabetes self-management education with their patients. The goal was to …