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Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua
Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua
Walden Dissertations and Doctoral Studies
Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …
Understanding The Lived Experiences Of Counselors Who Have Been Assaulted By Clients, Cynthia S. Ellison
Understanding The Lived Experiences Of Counselors Who Have Been Assaulted By Clients, Cynthia S. Ellison
Walden Dissertations and Doctoral Studies
Assault of community-based mental health professionals is a worldwide phenomenon, and current extant literature examines the prevalence of client assault on counselors, social workers, and psychiatric personnel. While there is significant quantitative scholarship on the incidence of this phenomenon on social workers and psychiatric personnel, there are limited statistical data on client-perpetrated violence against community-based counselors and no qualitative studies found that examined how these professionals experience this occupation risk. Therefore, the purpose of this study was to explore how counselors who work in community-based settings make sense of these experiences. Through semi structured interviews, 6 community-based counselors living in …
Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera
Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera
Walden Dissertations and Doctoral Studies
The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …
Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush
Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush
Walden Dissertations and Doctoral Studies
Hospital systems in the United States are facing a dilemma regarding capacity management in the emergency department (ED) and the inpatient care setting. The average wait time in EDs across the United States exceeds 98 minutes, which is also the point at which patients begin to abandon healthcare treatment. The purpose of this quantitative study was to examine the use of queueing theory in capacity management on length-of-stay (LOS) rates, left-without-being-seen (LWBS) rates, and boarding rates in the ED and inpatient setting. The boarding rates represent the rate in which patients were roomed in the ED but required inpatient care. …
The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong
The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong
Walden Dissertations and Doctoral Studies
U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …
Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee
Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee
Walden Dissertations and Doctoral Studies
High no-show rates in the ambulatory setting lead to underutilized resources, decreased clinic revenue, and lower productivity. The purpose of this single case study was to explore strategies that administrators used to maintain acceptable no-show rates and maintain the sustainability of the healthcare practice. The target population for this study included local chapter members of a professional healthcare organization that provided access to practice managers and administrators in the Las Vegas, Nevada regional area where there are a large number of practices that are not part of a health system; the sustainability of these practices is dependent on allocation of …
Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack
Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack
Walden Dissertations and Doctoral Studies
Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2 factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel …
Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell
Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell
Walden Dissertations and Doctoral Studies
The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …
Mobile Technology Deployment Strategies For Improving The Quality Of Healthcare, Won K. Song
Mobile Technology Deployment Strategies For Improving The Quality Of Healthcare, Won K. Song
Walden Dissertations and Doctoral Studies
Ineffective deployment of mobile technology jeopardizes healthcare quality, cost control, and access, resulting in healthcare organizations losing customers and revenue. A multiple case study was conducted to explore the strategies that chief information officers (CIOs) used for the effective deployment of mobile technology in healthcare organizations. The study population consisted of 3 healthcare CIOs and 2 healthcare information technology consultants who have experience in deploying mobile technology in a healthcare organization in the United States. The conceptual framework that grounded the study was Wallace and Iyer's health information technology value hierarchy. Data were collected using semistructured interviews and document reviews, …
A Delphi Study Analysis Of Best Practices For Data Quality And Management In Healthcare Information Systems, Olivia L. Pollard
A Delphi Study Analysis Of Best Practices For Data Quality And Management In Healthcare Information Systems, Olivia L. Pollard
Walden Dissertations and Doctoral Studies
Healthcare in the US continues to suffer from the poor data quality practices processes that would ensure accuracy of patient health care records and information. A lack of current scholarly research on best practices in data quality and records management has failed to identify potential flaws within the relatively new electronic health records environment that affect not only patient safety but also cost, reimbursements, services, and most importantly, patient safety. The focus of this study was to current best practices using a panel of 25 health care industry data quality experts. The conceptual lens was developed from the International Monetary …
Effective Nurse Recruitment Methods For Long-Term Care Facilities, Keith Laprade
Effective Nurse Recruitment Methods For Long-Term Care Facilities, Keith Laprade
Walden Dissertations and Doctoral Studies
Nurse recruitment is a challenge for long-term care (LTC) leaders. Some owners of LTC businesses lack knowledge of how to attract, market, and hire qualified nurses to help ensure success. The purpose of this multiple case study was to explore the methods and strategies LTC leaders used to recruit nurses. The target population consisted of leaders of 3 LTC facilities who were responsible for recruiting nurses. This selection was based on findings that organization leaders experienced a downsizing of more than 20% of their personnel. The conceptual framework was the motivation-hygiene theory. Working conditions were influenced by Herzberg's 2-factor principles …
Successful Demand Forecasting Modeling Strategies For Increasing Small Retail Medical Supply Profitability, Arica Watkins
Successful Demand Forecasting Modeling Strategies For Increasing Small Retail Medical Supply Profitability, Arica Watkins
Walden Dissertations and Doctoral Studies
The lack of effective demand forecasting strategies can result in imprecise inventory replenishment, inventory overstock, and unused inventory. The purpose of this single case study was to explore successful demand forecasting strategies that leaders of a small, retail, medical supply business used to increase profitability. The conceptual framework for this study was Winters's forecasting demand approach. Data were collected from semistructured, face-to-face interviews with 8 business leaders of a private, small, retail, medical supply business in the southeastern United States and the review of company artifacts. Yin's 5-step qualitative data analysis process of compiling, disassembling, reassembling, interpreting, and concluding was …
Utilization Of Preventative Care Services By African Americans Post-Affordable Care Act, Madalyn Mcknight
Utilization Of Preventative Care Services By African Americans Post-Affordable Care Act, Madalyn Mcknight
Walden Dissertations and Doctoral Studies
Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and …
Improving Gonorrhea Result Notification And Response Among African American Women, Lashonda Ouk
Improving Gonorrhea Result Notification And Response Among African American Women, Lashonda Ouk
Walden Dissertations and Doctoral Studies
Previous research has shown that 45% of malpractice claims are due to insufficient and late follow-up of test results and limited communication methods provided to patients. This study explored the preferred communication methods between a patient and a healthcare provider. The technology acceptance model served as the conceptual framework. A quantitative research design was used to examine patients’ perceived usefulness, attitude, perceived ease of use, and adaptability regarding mobile technology. The primary means of data collection was the use of a survey questionnaire. Participants included a random sample of 118 women seen in a local health department in the women’s …
Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers
Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers
Walden Dissertations and Doctoral Studies
Most organizational change initiatives fail because managers lack effective change management strategies. The purpose of this single case study was to explore change management strategies that outpatient care facility managers used to positively affect process improvements. The population consisted of 6 managers who completed change initiatives at a military, outpatient medical facility in Texas and 6 of their team members. Data were collected using semistructured interviews and organization documents, then analyzed based on the conceptual framework of Lewin’s change theory. Rowley’s 4-step process for analysis—organizing; getting acquainted with; classifying; coding and interpreting; and presenting and writing up the data—was used …
The Relationship Of Nurse Manager’S Leadership Styles In Maintaining A Just Culture, Aida Solomon
The Relationship Of Nurse Manager’S Leadership Styles In Maintaining A Just Culture, Aida Solomon
Walden Dissertations and Doctoral Studies
Healthcare leaders must establish a just culture to mitigate preventable medical deaths that occur at 250,000 per year, making medical errors the 3rd leading cause of death in the United States. However, there is a gap in knowledge regarding the attributes of nurse manager leadership styles that contribute to promoting a just culture at the unit level. Guided by the full range leadership theory and the just culture model, the purpose of this descriptive correlational study was to determine the relationship between nurse manager transformational, transactional, and laissez-faire leadership styles and unit level just culture perceptions and the differences between …
Relationship Between Hospital Size, Staff Communication, Physician Communication, And Patient Experience Scores, Cheryl Marie Layton
Relationship Between Hospital Size, Staff Communication, Physician Communication, And Patient Experience Scores, Cheryl Marie Layton
Walden Dissertations and Doctoral Studies
Healthcare leaders who struggle to understand the importance of interactions between patients, staff, and physicians can result in poor patient experience. Healthcare care leaders who understand the importance of patient experience can develop customer service training modules and tutorials to improve organizational outcomes. The purpose of this correlational study was to examine the relationship between staff communication, physician communication, size of the hospital, and patient experience. House's path-goal theory was used to frame the study. Secondary data were collected from hospitals in Northeastern Ohio, that reported patient experience scores through the Centers for Medicare and Medicaid's Hospital Consumer Assessment of …
Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri
Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri
Walden Dissertations and Doctoral Studies
Social workers are uniquely positioned to facilitate early intervention services that minimize the impact and burden of Type 2 diabetes. There is little evidence on the specific role that social workers play in addressing the psychosocial factors that exacerbate the condition or impact treatment outcomes. The purpose of the study was to examine the role of social workers in facilitating early interventions for clients with Type 2 diabetes. The theories of role and organizational systems provided the conceptual framework. Data was collected from interviews with eight participants with Master's degrees in Social Work in a large Southwestern state in the …
Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young
Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young
Walden Dissertations and Doctoral Studies
Approximately 25% of those hospitalized with congestive heart failure are readmitted within 30 days after discharge. Because researchers and policy makers consider hospital readmission within 30 days for patients with heart failure to be a quality of care issue, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital's Medicare revenue for 1 year for excessive readmissions, potentially impacting the financial sustainability of some organizations. The purpose of the study was to address the research gap regarding the outcome quality measure of hospital admissions from the emergency department (ED) and 2 each …
Strategies Outpatient Health Care Executives Use To Reduce Physician Turnover, Maureen A. Onyenacho
Strategies Outpatient Health Care Executives Use To Reduce Physician Turnover, Maureen A. Onyenacho
Walden Dissertations and Doctoral Studies
Some outpatient health care executives experience high physician turnover leading to increased costs. To retain highly productive physicians, outpatient health care executives need to understand the best strategies for reducing physician turnover. Grounded in Herzberg 2-factor theory as the conceptual framework, the purpose of this multiple case study was to explore the strategies outpatient health care executives used to reduce physician turnover. Data were collected from semistructured interviews of 4 outpatient health care executives and the review of proprietary documents from 2 outpatient health care facilities in the Southern California metropolitan area. Data analysis comprised compiling and disassembling the data …
Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon
Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon
Walden Dissertations and Doctoral Studies
Extended hospital length of stay (LOS) causes increased health care costs and incidence of never events, such as hospital-acquired infections, pressure ulcers, and falls, which are not reimbursed by Medicare. This study examined if there would be a statistically significant decrease in the LOS of patients after the implementation of a discharge process improvement initiative (DPII), The model for improvement and small tests of change concept were used to guide the DPII at a hospital in northern California. Sources of data included archival data obtained from the hospital's quality improvement department that showed LOS prior to and after the implementation …
Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez
Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez
Walden Dissertations and Doctoral Studies
African American men are more likely to have diagnosed or undiagnosed diabetes than non-Hispanic White Americans and are less likely to adhere to treatment. Culture in the African American community plays a key role in how this community copes with illness and the health care system. The purpose of this study was to examine the lived experiences of social and cultural determinants of Type 2 diabetes self-management among African American men. Bandura's social cognitive theory provided the theoretical framework for the study. The research question sought to identify cultural and social factors that contribute or protect how African American men …
Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey
Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey
Walden Dissertations and Doctoral Studies
Many drug overdoses in the United States are from prescription drugs, most of which are classified as opioid pain relievers (OPRs) and commonly prescribed in emergency departments (EDs) to treat pain. OPR abuse and addiction is a major public health issue. Researchers have identified the role of various patient characteristics (race, gender, demographics, etc.) in the variation in OPR prescription rates, but the contribution of provider-type differences to that variation has not been exposed. The purpose of this study was to evaluate the strength of the association between provider type and the likelihood of an opioid prescription by ED providers …
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
Walden Dissertations and Doctoral Studies
Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …
Medicare And Medicaid Regulations' Financial Effects On Home Health Agencies' Performance, Binzie Roy Davidson
Medicare And Medicaid Regulations' Financial Effects On Home Health Agencies' Performance, Binzie Roy Davidson
Walden Dissertations and Doctoral Studies
Some owners of small to medium-sized managed care businesses lack strategies to address the effects of healthcare regulations on their businesses. The purpose of this multiple case study was to identify strategies that owners of small to medium-sized managed care businesses used to address the financial effects of healthcare regulations on their businesses. The conceptual framework for this study was profit maximization and adaptation in changing contexts. Data were gathered from company documents, observations, and semistructured interviews with 5 home healthcare business owners in Los Angeles County, California. Data were coded to identify themes from the narrative segments. Key themes …
Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover
Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover
Walden Dissertations and Doctoral Studies
The value-based purchase requirement of the Patient Protection and Affordable Care Act puts pressure on hospital leaders to control cost while improving quality of care. The resource dependency theory was the theoretical framework for this correlational study. Archival data from the Centers for Medicare and Medicaid Services collected from 166 acute care urban hospitals for the Fiscal Year 2016. Multiple linear regression analysis was used to determine the relationship between nursing salaries per patient day, cost of uncompensated care as a percentage of net patient revenue, percentage of net income from patient services, and overall patient satisfaction for quality of …
Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy
Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy
Walden Dissertations and Doctoral Studies
This qualitative multiple-case study sought to provide an in-depth understanding of how children living in broken families-due to the wrongful conviction of parent(s)-developed psychosocial issues. The theoretical frameworks applied to this study were the social learning theory, the social control theory, the role-modeling theory, and the general theory of crime. A purposeful sample of 13 adults who were children at the time of their parents’ wrongful incarceration were drawn for phone and in-person interviews. The data were transcribed and analyzed to code, sort, and organize; to analyze connections in the information, and to compare and contrast cases. The multiple-case study …
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Walden Dissertations and Doctoral Studies
Hospital readmissions within 30 days of discharge result in significant multimillion-dollar penalties to thousands of Medicare-eligible hospitals throughout the United States and are indicators of suboptimal patient healthcare leading to less than ideal health outcomes for previously hospitalized patients. The purpose of this correlation study was to examine the relationship between medication reconciliation, nursing workforce competency, timely and effective care, and Medicare-eligible hospital 30-day readmission rates. The sample of 269 hospitals came from the population of Medicare-eligible hospitals throughout the United States. Complexity theory and the general model of readmission were theoretical frameworks grounding this study. Secondary data were from …
Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster
Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster
Walden Dissertations and Doctoral Studies
Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …
Strategies Used By Healthcare Supervisors For Employee Retention, Serrita Chaney
Strategies Used By Healthcare Supervisors For Employee Retention, Serrita Chaney
Walden Dissertations and Doctoral Studies
Healthcare supervisors who lack effective employee retention strategies could negatively affect patient well-being, employee performance, and organizational functions. The purpose of this single case study was to explore strategies that healthcare supervisors used to improve employee retention in 1 health care organization in southeast Georgia. Vroom expectancy theory was the conceptual framework for the study. Data were collected from semistructured interviews with 5 healthcare supervisors in a medium-sized healthcare organization who had hiring responsibilities and a history of implementing successful strategies to improve employee retention. Data were analyzed using coding and word frequency to discern patterns. Three significant themes emerged …