Examining Nationality, First Generation Status and Academic Identity Status as a Lens into Student Achievement

This study investigates the relationship between academic identity statuses and academic achievement at a U.S. northeastern college where 55% of the population is first-generation students. Using Was and Isaacson’s (2008) Academic Identity Measure, I assessed four identity statuses (achieved, foreclosed, diffused, and moratorium) among 424 students. Multiple linear regression analysis revealed that achieved identity status had the strongest positive effect on grade-point average (GPA), while diffused identity status showed the most significant negative impact. Additionally, birthplace and mother’s educational status emerged as significant demographic predictors of academic achievement. The findings suggest that students with foreclosed or diffused identities struggle with decision-making and often employ ineffective academic strategies. These results underscore the need for targeted interventions to help students develop an achieved academic identity while considering their social identity intersections

Effective Health Care Management Strategies for Increasing Employee Engagement and Productivity

Ineffective strategies to increase employee engagement and productivity can negatively impact business operations. Human resources (HR) and business leaders in the health care industry who lack effective strategies to increase employee engagement and productivity risk business stability. Grounded in self-determination theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies HR and business leaders in health care use to increase employee engagement and productivity. The participants were six health care HR and business leaders who had effectively implemented strategies to increase employee engagement and productivity. Data were collected by conducting semistructured interviews. Thematic analysis yielded five themes: (a) communication and meetings, (b) performance management, (c) learning and development, (d) recognition and rewards, and (e) job satisfaction surveys. A key recommendation is for HR and business leaders to be fully engaged to recognize and respond in an appropriate and timely manner to the needs of their employees. This project has implications for positive social change in that a fully engaged workforce that brings their entire selves to work and has meaningful work they are proud of can potentially encourage other community members to achieve similar results for themselves. Having meaningful work may promote strong communities where employees are actively employed, contributing to society, and serving as upstanding pillars of their communities

Relationship Between Years of Experience, Age, Teamwork, and Medical-Surgical Nurses’ Intentions to Stay

The United States is currently experiencing a nurse staffing crisis that is significantly impacting the medical-surgical (MS) nursing workforce. With MS nurses providing the most care for inpatient beds, hospital administrators must identify strategies that support MS nurse retention to preserve access to care for patients and support patient safety. The purpose of this study, guided by the complex adaptive systems theory, was to understand the relationship between teamwork, age, years of experience, and MS nurses’ intentions to stay in their roles in acute care hospitals. MS nurses were recruited via invitations from the chief nursing officer of a system or social media recruitment flyer. The final sample consisted of 82 MS nurses with at least 6 months of experience who responded to questions from the Nursing Teamwork Survey and the Organizational Commitment Questionnaire. Likert scale responses were analyzed quantitatively using linear and multiple regression analyses. The findings of this cross-sectional survey revealed a statistically significant relationship, with a medium effect, between teamwork (R2 = 0.22, p \u3c 0.001), mature age (R2 = 0.32, p = 0.003), and MS nurses’ intentions to stay in their acute care roles in a hospital. Future research using a longitudinal design and a larger sample size is recommended. The findings of this study may raise awareness among MS administrators and nurse leaders to develop strategies that promote teamwork in acute care hospital MS nursing staff and promote research on the impact of teamwork and age on MS nurses’ intentions to stay in their roles in acute care hospitals, which results in increase in nursing staffing and impacts positive social change

A Disparities Analysis of Cancer Patients’ Access to Depression Treatment by Health Insurance Status and Type

Research has demonstrated that comorbid conditions like depression in cancer patients reduce quality of life, prolong recovery, and reduce survival time of the cancer patient. Although other studies have investigated the issue of depression among cancer patients, there is a dearth of studies looking at differences in taking depression medication with health insurance as a source of disparity. Using survey data from the National Health Interview Survey (NHIS), and the health belief model as the theoretical framework, this study had two purposes. The first was to determine if there were differences in the likelihood of taking medication for depression based on health insurance status (not having vs. having health insurance) among adult breast, colorectal, skin, prostate, and/or lung cancer patients. The second was to determine whether there were differences in the likelihood of taking medication for depression based on type of health insurance (public vs. private) among those same patients who had health insurance. Although bivariate logistic regression analyses found no statistically significant differences, multivariate logistic regression analyses controlling for gender, race, and age found that those with health insurance were 2.128 times as likely to take depression medication as those without health insurance, and that among those with health insurance, those with public insurance were 2.168 times as likely to take depression medication as those with private insurance. The study\u27s findings underscore the need for targeted interventions, culturally competent care, and enhanced screening to ensure equitable access to depression treatment for all cancer patients, regardless of insurance status, particularly for underserved racial populations, in oncology practices

Allostatic Load and Incident Dementia Among Older Adults in the United States

Allostatic load (AL), the cumulative physiological burden of chronic stress, is a significant health problem, and it has been associated with adverse health outcomes, including cognitive functioning. There is a paucity of literature examining associations between AL and incident dementia in the United States. This quantitative study used data from the United States Health and Retirement Study cohort (2016-2020) to examine the association between AL quartile and incident dementia among participants who were aged 56 and older at baseline. Dementia status was determined measuring immediate and delayed recall, serial seven subtraction, and backward count, as well as self-report conditions for dementia status and Alzheimer’s disease. A composite score of 20 biomarkers from neuroendocrine, immune, metabolic, and cardiovascular systems was used to create a quartile of AL. The Cox regression model was used to examine the association between AL quartile and incident dementia. Of the 7,003 participants, 342 (4.9%) experienced dementia by the end of 5 years. In the unadjusted model, incident dementia was higher in the highest AL quartile than the lowest Al quartile (HR = 2.55, 95% CI [1.74, 3.71], p \u3c .001). In a fully adjusted model, the hazard ratio was attenuated (HR = 1.46, 95% CI [1.0, 2.14], p = .05), but the overall test of AL quartile was not significant. Race/ethnicity and apolipoprotein did not modify the association. Findings highlight the relationship between AL and incident dementia, and further study regarding social determinants of health is needed. Findings may inform health professionals to develop strategies to reduce stress stimuli and monitor biomarkers, reducing AL, delaying dementia onset, and improving quality of life

Clinical Practice Guideline for Nurse Practitioners: Diabetes Type Two Self-Care Management

This project was a clinical practice guideline (CPG) for nurse practitioners regarding evidence-based guidelines for type 2 diabetes (T2DM) self-care management at a primary care practice in Ohio. The practice problem of T2DM is a prevalent disease affecting approximately 37.3 million people. T2DM can lead to complications of kidney disease, heart disease, diabetic neuropathy, eye damage, foot damage, and infections. Self-care in T2DM can improve outcomes and decrease complications. However, evidence-based guidelines are lacking to guide practitioners in self-care management of T2DM at this site. The practice-focused question was, “Does the evidence support development of a self-care, T2DM, CPG for primary care providers, that receives a quality score of 70% or greater by an expert panel using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) Instrument and receives approval for use in practice by end users?” A comprehensive literature review and synthesis of 20 current articles on T2DM management using the Johns Hopkins Model supports the project. A panel of three experts assessed the CPG via the AGREE II Instrument. Domain scores ranged from 100% to 92%. Two global domain scores were 100% each, resulting in end users\u27 approval for the use of this CPG in practice. The results indicate a quality CPG. This self-management, T2DM CPG may help reduce inequalities in healthcare by ensuring that all patients, regardless of their social or ethnic background, have access to the same high level of care. An important aspect of this project is the integration of principles of positive social change, diversity, equity, and inclusion into the approach to treatment

Female Students with Disabilities’ Perceptions of Science, Technology, Engineering, Mathematics Education

The demand to increase enrollment in science, technology, engineering, and mathematics (STEM) education programs has intensified globally since the early 21st century. Researchers have concentrated on the gender divide with limited research on female students with disabilities (FSwDs). The purpose of this qualitative study was to explore FSwDs’ perceptions of their successes and challenges with accessibility, inclusion, and support experienced in STEM education programs, as well as their recommendations for improving policies and practices in STEM higher education. The study was grounded in social identity and social learning theories. For this basic qualitative design, semistructured interviews were conducted with nine FSwDs who were engaged in STEM activities or enrolled in STEM education courses at three local colleges and had their disabilities on file with the institution. Axial coding produced the following four themes: 1) appreciation for fostering innovation and motivation, 2) dedication to growing better communication networks, 3) commitment to promoting enrichment and understanding, and 4) supporting structural enhancements. These results could lead to positive social change by enriching the learning environment and academic settings, by streamlining the communication between the disability department and STEM teachers, by strengthening the support services, and by making structural enhancements, such as updating the building infrastructure to accommodate accessible entry at all points of entrance. By providing FSwDs access to STEM education and supporting their academic success, a critical shortage of highly qualified workers in STEM fields can be addressed

Educating Substance Use Treatment Nurses on Patient Pain Assessment and Management

The inconsistent application of evidence-based pain assessment strategies continues to be a significant challenge in nursing practice. Due to gaps in nurses’ knowledge and the variability in implementing best practices, patients with substance use disorders (SUDs) often experience inadequate pain management. These deficiencies exacerbate patient suffering, impair functioning, and usually lead to prolonged hospitalizations. Addressing these challenges is vital because nurses’ pain assessment and management knowledge can enhance patient pain outcomes. I conducted this project to strengthen the knowledge of nursing staff in pain assessment and management through an evidence-based educational intervention for nurses working with patients with SUD. I used the analyze, design, develop, implement, and evaluate (ADDIE) model to ensure clear objectives and effective learning outcomes in the educational intervention. The program was based on evidence from quasi-experimental studies, randomized controlled trials, and systematic reviews from peer-reviewed journals that I found in reputable databases, such as CINAHL and MEDLINE, accessible through the Walden University Library. Data analysis of the pre-posttest scores revealed 35% increased knowledge levels among participants, indicating the effectiveness of the evidence-based educational intervention. This project emphasized knowledge enhancement, continuous education, and evidence-based practice in nursing. My further recommendations stress the importance of applying the knowledge gained in clinical practice to improve patient care while advancing positive social change, diversity, equity, and inclusion

Strategies U.S. Hospital Leaders Use to Recruit, Hire, and Retain Physicians to Sustain Profitability

Poor physician retention negatively impacts the quality of community healthcare, leading to financial losses and increased operational costs for hospitals. Hospital administrators and the governing boards are particularly concerned with addressing this issue to ensure sustainable healthcare delivery. Grounded in the Hertzberg’s two factor theory, the purpose of this qualitative pragmatic inquiry was to explore strategies that hospital administrators can utilize to improve physician retention. The participants included eight high-ranking hospital administrators within the geographic region of North Carolina who had an active role in provider retention. Data was collected using semistructured interviews, identify five critical themes: (a) implement mentorship, (b) promote competitive salaries, (c) ensure clear communication, (d) foster work life balance, and (e) apply progressive leadership. A key recommendation that emerged from this study is for hospital administrators to implement mentorship programs throughout the organization. The potential implications for positive social change include improved public health outcomes and increased health equity by ensuring consistent access to well-trained physicians. Additionally, enhancing physician education on emerging disease states and preventive care strategies can optimize community health, ultimately reducing hospitalizations and lowering healthcare costs for individuals and society

Staff Education on the Use of GAD-7 to Screen for Anxiety

Summary This staff education project aimed to implement the Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety screening during routine patient visits. Integrating such tools into nursing practice is essential for early identification and timely intervention of anxiety disorders. The project investigated the effectiveness of staff education on the use of GAD-7 in enhancing the identification and management of anxiety in patients during routine visits. Its purpose was to equip providers with the skills to use the tool effectively, improving their ability to manage anxiety disorders. The practice focus question “Will an interactive educational program improve the knowledge of the use of the GAD-7?” Data on the NPs\u27 knowledge, attitudes, and self-reported practices regarding anxiety screening pre and post the intervention were collected. The findings showed that all 15 nurse practitioners acknowledged the value and effectiveness of using the GAD-7 for anxiety screening after the educational sessions, with a significant increase in their confidence, 16.99%, and competence, 25%. The findings suggest that staff education enhances the use of screening tools in clinical practice, suggesting that similar initiatives should be implemented across different healthcare settings to foster early anxiety disorder detection. This approach benefits nursing practice by improving patient outcomes, strengthening nurse-patient. relationships, optimizing resource use, and promoting equitable mental health care, which helps reduce health disparities and supports holistic patient care