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Walden Dissertations and Doctoral Studies

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The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes Jan 2023

The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes

Walden Dissertations and Doctoral Studies

AbstractPhysical activity (PA) is recognized as a treatment protocol for lung cancer patients that improves physical impairments and reduces symptoms of psychological stress. This qualitative interpretive phenomenological analysis (IPA) study was conducted to explore the lived experience of lung cancer patients and how PA is influenced by anxiety, depression, and fatigue. This study was guided by Bandura’s self-efficacy theory and Engel’s biopsychosocial model. In-depth semi structured interviews were conducted with seven lung cancer participants over Zoom and in person. The data were analyzed using manual hand coding. The analysis revealed themes in patients’ experiences about how PA participation is influenced …

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Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian Jan 2023

Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian

Walden Dissertations and Doctoral Studies

Health care worker shortage is a global problem and is challenging for human resources managers. Human resource managers need more strategies to recruit and retain healthcare workers in rural areas to decrease healthcare worker shortages, unemployment rates, patient morbidity, and mortality rates. Grounded by Maslow’s hierarchy of needs theory, the purpose of this qualitative multiple case study was to explore strategies human resource managers use to recruit and retain healthcare workers in rural areas. The participants were three managers from Southern Louisiana rural area medical facilities with at least 5 years of experience developing and implementing successful recruitment and retention …

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Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

Many individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …

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Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell Jan 2023

Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell

Walden Dissertations and Doctoral Studies

AbstractThis project sought to enhance the care offered in a local clinic to individuals with an intellectual and developmental disability (IDD) during the COVID-19 pandemic. Individuals with IDD are faced with the challenges of coping with some social conditions. Mainly waiting for extended periods in a doctor’s office can be challenging. To reduce this population’s waiting time, a staff education program was developed to address this concern. Currently, this local clinic did not have a prescreening exercise that would meet the needs of this population. This DNP project aimed to develop a staff education program for staff in a primary …

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Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte Jan 2023

Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …

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Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones Jan 2023

Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones

Walden Dissertations and Doctoral Studies

Underrepresentation is a significant issue for Black female nurses to secure nurse leadership positions in healthcare facilities. Leadership by Black female nurses is needed to provide culturally appropriate quality of care, to have a more diverse workplace, and to ensure that the needs of diverse patient populations are met. The purpose of this quantitative study was to explore the barriers and challenges faced by Black female nurses who failed to achieve their advancement goals into leadership roles.Using the National Sample Survey of Registered Nurses (NSSRN) database, the independent variables used were interpersonal differences with colleagues or supervisors, lack of good …

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How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez Jan 2023

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …

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Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin Jan 2023

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

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Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande Jan 2023

Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande

Walden Dissertations and Doctoral Studies

AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …

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Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande Jan 2023

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

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Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby Jan 2023

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

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Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza Jan 2023

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

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Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

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Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr Jan 2023

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

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Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike Jan 2023

Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this study was to explore respiratory therapists’ (RTs') perceived roles and responsibilities in a COPD multidisciplinary care team, and how those roles and responsibilities were affected when RTs were monitored and evaluated by a team member. Accountability theory was used to guide the development of this study. The study’s goal was to provide needed information on the specific roles and responsibilities of RTs in a COPD multidisciplinary care team because RTs knowing their roles and responsibilities could improve the quality of care and enhance the delivery of healthcare services for patients with COPD. The study’s research method …

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Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder Jan 2023

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

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Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

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Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg Jan 2023

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

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Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons Jan 2023

Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons

Walden Dissertations and Doctoral Studies

Insurance based discrimination is a bias that has the potential to harm patients by limiting their access to care and widen health disparities between patients with private and public insurance. The purpose of this study was to examine whether there is a relationship between type of health insurance (private and public) and access to care factors (acceptability and availability) among African American males ages 25–64 with chronic conditions. The Andersen healthcare utilization model framework supported this research in focusing on the determinants that influences a patient’s ability to access to health care. The research questions examined whether a relationship existed …

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Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

AbstractMany individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …

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The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco Jan 2023

The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco

Walden Dissertations and Doctoral Studies

The clinical laboratory plays a crucial role in aiding physicians to diagnose disease. With numerous studies on “Speak Up” culture well-documented among providers and nurses surrounding patient safety, gaps in literature exist concerning “Speak Up” culture that address team effectiveness and organizational performance within the clinical lab setting. The purpose of this quantitative correlation study was to investigate the relationship between “Speak Up” culture level, team effectiveness, and organizational performance among health care workers employed in the clinical lab. The high-performance work practices model was utilized as the conceptual framework to ground this study. Research questions assessed the link between …

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Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte Jan 2023

Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …

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Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu Jan 2023

Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu

Walden Dissertations and Doctoral Studies

Nurse turnover is a significant problem that hospital managers and administrators face in delivering high-quality patient care while ensuring organizational profitability. In the United States, the average cost of replacing a nurse ranges from $40,000 to $100,000. Hospital managers are significantly challenged to reduce nurse turnover and keep costs down. Grounded in the Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore the strategies hospital managers use to reduce nurse turnover. The participants included five hospital managers at five medical centers in Arizona with successful experience in reducing nurse turnover. Data were collected from semistructured interviews …

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Trauma-Informed Practices For Behavioral Health Leaders Serving Sex-Trafficking Survivors And Personnel, Evelyn Cordero Molina Jan 2023

Trauma-Informed Practices For Behavioral Health Leaders Serving Sex-Trafficking Survivors And Personnel, Evelyn Cordero Molina

Walden Dissertations and Doctoral Studies

Trauma-informed practices are essential to successful treatment outcomes and employee wellness in the context of sex trafficking clinical intervention. This single case study described the trauma-informed practices developed in a residential program for biologically-female sex trafficking survivors in the Southwest United States. The Baldrige excellence framework and the trauma-informed framework informed the study to comprehend organizational key factors and principles in the context of the residential program. Data were collected through semistructured interviews with four leaders at the senior and middle management levels, and internal documentation such as procedures, protocols, strategic plans, and yearly reports were included in the analysis. …

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The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire Jan 2023

The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire

Walden Dissertations and Doctoral Studies

AbstractHospital readmissions have continuously been a concern to healthcare providers and policymakers because of their negative impacts on the economy and the well-being of patients. A gap in knowledge exists in the understanding of the factors that have led to increased readmissions due to chronic cardiovascular diseases (Heart Failure) and respiratory diseases (chronic obstructive pulmonary disease [COPD] and Asthma). The aim of this study was to examine the relationship between poverty rate and hospital readmission rates for patients with COPD, Heart Failure, and Asthma in the United States using secondary data from the Healthcare Cost and Utilization Project’s (HCUP’s) Nationwide …

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Impact Of Pulmonary Embolism Response Teams On Patient Quality Ratings, Sabrina Renee' Simpkins-Morris Jan 2023

Impact Of Pulmonary Embolism Response Teams On Patient Quality Ratings, Sabrina Renee' Simpkins-Morris

Walden Dissertations and Doctoral Studies

AbstractLeaders of health care organizations have limited evidence of the impact of pulmonary embolism response teams (PERTs) on quality outcomes for patients with an intermediate and high-risk pulmonary embolism (PE). The purpose of this quantitative study was to determine whether there was any significant difference in patient HCAHPS linear mean scores for instructions given about medication and overall care between acute care hospitals with and without PERT teams. Donabedian’s framework for assessing health care quality was used as the theoretical foundation for this research. Survey data collected by the Centers for Medicare and Medicaid, as part of its Hospital Consumer …

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Using Multi-Theory Model (Mtm) To Predict Intention To Promote Physical Activity By Primary Care Providers, Shirley Mcclendon Jan 2023

Using Multi-Theory Model (Mtm) To Predict Intention To Promote Physical Activity By Primary Care Providers, Shirley Mcclendon

Walden Dissertations and Doctoral Studies

Physical inactivity persists as a public health concern worldwide and results in more than a million deaths per year. This modifiable behavior can result in improved health when primary care providers (PCPs) communicate recommendations to patients and behavior change is supported. In this study, a quantitative cross-sectional design was used to investigate the intentions of PCPs in providing physical activity counseling, using the constructs of the multi-theory model (MTM) of health behavior change as the theoretical framework. An anonymous 37-item electronic survey was administered to participants practicing primary care and family medicine from rural areas in the Southeastern region of …

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Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks Jan 2023

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …

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Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande Jan 2023

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Go to article

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

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