Exemplary Chief Nurse Executives Leading Through Storytelling, Tricia Kassab

Dissertations

Purpose: The purpose of this phenomenological study was to understand and describe how exemplary human resources administrators use storytelling to lead organizations using Denning’s (2011) model. In addition, it was the purpose to understand how they use storytelling to create transformational change. Denning’s The Leader’s Guide to Storytelling highlights eight storytelling narrative patterns: to ignite action, to communicate who you are, to build your brand, to transmit values, to foster collaboration, to share knowledge, to tame the grapevine, and to share vision.

Methodology: This phenomenological qualitative study described the lived experiences of exemplary elementary chief nurse executives in California. The …

Insured And In Debt, Virginia Jeffries

Capstones

Many Americans with employer-sponsored health insurance are still going into debt to pay medical bills.

http://virginia-jeffries.com/cap/

"Rise And Shine" Early Ambulation In Surgical Patients, Bhapinder Thiara

Master's Projects and Capstones

Abstract

An assessment done in a hospital unit established low rates of early ambulation for patients in postoperative care. At the same time, early ambulation after surgery has been shown to improve clinical outcomes and patient satisfaction. Some of the factors for the low rates of early ambulation include inadequate nurse staffing, poor teamwork, and the inability to utilize technology effectively. Consequently, a project was designed to empower nursing staff, promote interprofessional collaboration, and obtain technologies for ambulation. It is expected that the project will improve rates of early ambulation and lower hospital length of stay.

Evaluating Preventative Care And Post-Hospitalization Primary Care Follow-Up In Adults With Intellectual And/Or Developmental Disabilities, Jason Xenakis

NYMC Student Theses and Dissertations

Post-Hospitalization Primary Care Follow-Up Abstract

Title: Characteristics that are associated with primary care follow-up and discharge summary receipt post-hospitalization in adults with intellectual and/or developmental disabilities.

Background: Transition from an inpatient to an outpatient setting is a high risk time for patients. Studies in the general population find that poor post-hospitalization primary care follow-up results in higher rates of readmissions – a widely used indicator of healthcare quality. There is no research that evaluates post-hospitalization primary care follow-up or discharge summary receipt in the IDD population.

Objective: To explore the demographic, socioeconomic, and clinical characteristics that are associated with whether …

Autonomy, Suffering, And The Practice Of Medicine: A Relational Approach, Michael A. Stanfield

USF Tampa Graduate Theses and Dissertations

In this project, I argue that the conventional view of personal autonomy that is operational in contemporary American culture, bioethics and medical practice places undue emphasis on individualism and a limited range of personal qualities and attributes (such as self-sufficiency). Instead, I argue in favor of a relational approach to autonomy which recognizes that each person that exists has certain minimal connections or relations to others, and these connections/relations are identity-forming. Unfortunately, current medical practices have tended to overemphasize individuality and choice (consistent with the conventional view) while minimizing or excluding these relational aspects. As a result, informed consent and …

Individual- And Community- Level Associations With Healthcare Utilization Among A Health System, Emergency Department Population, Carlene A. Mayfield

Theses and Dissertations

AIM: The primary aim of this study was to examine individual-level and community- level characteristics associated with ambulatory or primary care utilization, emergency department (ED) utilization, and ED charges among a sample of ED patients.

DESIGN AND SAMPLE: Data for this cross-sectional study were obtained from three distinct sources: (i) electronic medical records (EMR); (ii) billing records; and (iii) the 2013-2017 American Community Survey (ACS). The individual-level EMR and billing sample included all adults residing in Mecklenburg County, North Carolina who visited an Atrium Health ED in 2017. The ACS sample included population and demographic estimates from Mecklenburg County’s 27 …

Journey Of The State Budget, Karina Carmichael

Masters Theses/Capstone Projects

In attempts to make government fair and equitable, the process of any bill but especially the budget bill can be extremely convoluted and difficult to follow. I was able to learn how to navigate the system and understand the processes by which things happen at the statehouse.

The statehouse is filled with representatives of countless interest groups all fighting for their opinion of how things should be done. As demonstrated by this budget cycle, government can be a push and pull directed by politics, personal opinions, and countless other factors, which may result in nothing getting done.

Timely Access To Maternal, Neonatal And Child Healthcare For Rural Communities In Rwanda: The Role Of Community Health Workers, Jean Bosco Bigirimana

Electronic Thesis and Dissertation Repository

Abstract

Introduction: In Rwanda, although there has been some progress in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. Improving equitable access to quality healthcare services for maternal, neonatal and child healthcare (MNCH), community-based maternal, neonatal and child healthcare (CBMNCH) depends upon using “community health workers” (CHWs). Yet CHWs program faces difficulties that upset delivery of the quality of the comprehensive package of services. Unfortunately, little is known about CHWs` performance and job satisfaction in the provision of CBMNCH.

Goal: The study aimed to provide insight into …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

Tuberculosis, Jessica Puri

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a curable disease that claims the lives of millions each year. TB is an airborne disease spread by inhaling droplets of the tubercle bacillus. There are two different types of TB related conditions; latent TB infection and active TB disease. During latent TB, an individual inhales droplets of tubercle bacillus but the immune system can fight off this infection. However, once droplets of tubercle bacillus penetrate the alveoli, and colonization of droplets multiply, latent TB transitions into active TB disease (Katanekwa & Dahlback, 2016, p. 9). TB is typically found in the lungs but can also develop …

Implementation And Evaluation Of A Neonatal Chest Tube Simulation Lab For App Competency., Tracey Miller

Doctor of Nursing Practice Papers

Pneumothorax in the neonatal period is a potentially life threatening condition that requires Neonatal Advanced Practice Providers to respond rapidly and competently in order to prevent complications of morbidity and mortality. It has become increasingly difficult to establish initial competency as well as maintain competency in low volume high acuity emergency procedures such as chest tube placement. The purpose of this practice based quality improvement project was to implement a simulation based training program in chest tube placement for the Neonatal Advanced Practice Providers within Norton Children’s Neonatology. The goal was to have all Advanced Practice Providers (APP) be able …

Improving Access To Youth-Friendly Health Services In A Rural California Community, Elena Higley

Doctor of Nursing Practice (DNP) Projects

Adolescents and young adults experience relatively high rates of preventable morbidity and mortality due to injuries, mental health disorders, suicide, substance use, and reproductive health issues. It is paramount for healthcare providers to address risky behaviors early to thwart future adverse outcomes. Rural communities especially struggle with meeting the healthcare needs of their youth because there are fewer resources specifically dedicated to serving adolescents and young adults. This issue is evident in Grass Valley, California, a rural community in Nevada County, an area located in the foothills of the Sierra Nevada mountains. In response to limited access to youth-friendly healthcare …

Rural Or Underserved Practice Interest Among Doctor Of Physical Therapy Students. Do Clinical Education Experiences Change Opinions?, Brandon Godin, Trenton Poulson, Mac Neil Moresca, Tyler Satoshige

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: People living in rural and underserved areas are poorly served by our country's healthcare system. The Federal Office of Rural Health Policy reports that approximately 18% of people in the United States live in rural areas. Within the physician and nursing literature the largest reported predictor of rural practice is having a rural background. Mandated rural medical rotations during training have been shown to positively alter interest in rural practice and employment. While nursing and medical students have been thus studied, limited evidence exists for physical therapists. The objective of this study was to determine how rural …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell

Electronic Theses and Dissertations

Literature suggests there is a relationship between cultural competency and health outcomes as well as a perceived fear of discrimination LGBT individuals face when attempting to receive healthcare services. The aim of this study is to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC: postsecondary experience, relations with LGBT individuals, and religion using a sample of 57 different healthcare students in a faith-based university during …

Community-Based Healthcare | Interlace Of Biophilic Design In Outpatient Facilities, Joshua Robinson

Bachelor of Architecture Theses - 5th Year

This thesis questions how architects can redesign typical healthcare typology in response to the medical and sociological needs of the community while integrating the measures of wellness and biophilic design. By redefining architectural programs within a wellness clinic, this can allow the facility to prioritize the communities needs through non-medical determinants. The research will look at both the social and medical needs of a community, along with the Seven Standards of Wellness as defined by the Well Building Standard and The Fourteen Patterns of Biophilic Design as defined by the Terrapin Bright Green, to develop a connection between the facility …

Exploring Ways To Improve Healthcare Access For The Homeless Population In Merced County, Stella Nwasoka Adesokan

Doctoral Projects

Homelessness is a societal dilemma that affects people in the United States and around the globe. Homelessness relates to poor health conditions that affect the living conditions of individuals (Institute for Urban Initiatives, 2018). Chronic and acute illnesses are rampant in this group, most of these illnesses are treatable but accessing healthcare poses a challenge for this vulnerable population. Homeless persons are often unable to access healthcare due to fear and denial of ill health, difficulty in communicating health needs, and low self-esteem (Lamb & Joels, 2014).

In the study, questionnaires were administered to 25 homeless individuals through random sampling. …

Current Challenges Facing Physical Therapists In Urban Nebraska, Mark A. Carter

Theses/Capstones/Creative Projects

Previous research regarding the analysis of the current healthcare professional workforce has been done in the state of Nebraska in order to determine to magnitude of healthcare resource deficits among different counties and populations, and research has shown that deficits are severe in the field of physical therapy primarily in rural counties. Consequently, the flow of patients to more urban areas in order to receive care has challenged physical therapists with accounting for the deficits in rural Nebraska. It is known that these issues as well as challenges regarding insurance and lack of interprofessionalism has led to complications in patient …

Reflections On Healthcare Administration Practicum: My Journey With Ohiohealth Doctors Hospital, Anitha Guduri

Masters Theses/Capstone Projects

No abstract provided.

A Comparative Analysis Of Primary Care Practice Payment Models: Practice And System Level Implications, Travis Masood

Muskie School Capstones and Dissertations

EXECUTIVE SUMMARY

The purpose of this capstone was to (1) assess the likely effects of various primary care practice reimbursement models on quality of care and costs, (2) assess each reimbursement model’s applicability relative to practice size, and (3) analyze each model’s practice and system level implications. This was done through the conduction of a comparative analysis of current practice reimbursement models. The questions addressed in this analysis include:

• What are the primary, practice reimbursement models currently being used?
• What are the implications of these models on quality and costs?
• Are these reimbursement models applicable in all practice types (e.g. …

Expanding International Health Curriculum For The Internal Medicine Residency At Mmc, Brian King, Hassan Mahmoud, Anthony Pastore

Thinking Matters Symposium Archive

While internal medicine residents at Maine Medical Center provide care for many refugees and immigrants, there is not a formal international health curriculum to equip residents to care for this vulnerable population. Since 2002, 3,793 refugees have arrived in Maine for resettlement. Our aim was to survey residents about their interest in added international health instruction and design an educational curriculum for these physicians.

Emergency Departments And Care For Marginalized Populations, Irvin B. Harrell

Institute for the Humanities Theses

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider …

Respiratory Infections And Risk For Development Of Narcolepsy: Analysis Of The Truven Health Marketscan Database (2008 To 2010) With Additional Assessment Of Incidence And Prevalence, Darren Scheer

USF Tampa Graduate Theses and Dissertations

Background and Significance: Narcolepsy is a chronic neurological disorder. These patients experience various psychiatric and physical comorbid diseases and mortality at an increased rate compared to the general population. Additionally, patients with narcolepsy experience approximately a doubling of various annual healthcare related facility visits, transactions, and costs comparatively. Narcolepsy with cataplexy is generally believed to be more prevalent than narcolepsy without cataplexy. However, incidence and prevalence estimates of narcolepsy (with or without cataplexy) vary widely with few large epidemiological studies conducted worldwide and none in the U.S evaluating these proportions in both children and adults utilizing a large health care …

Human Trafficking Identification Among Nurse Practitioner Students During Objective Structured Clinical Examinations, Zoe Onyun

Dissertations

Problem: Human trafficking (HT) is a significant worldwide and domestic issue affecting all ages, races, and genders resulting in over 40 million victims globally. Nurse practitioners (NP) often unknowingly come into contact with victims of HT, however, few NP’s have had formal education on the topic and may fail to recognize signs and risk factors. The purpose of this study was to initiate HT training for NP students.

Methods: A quality improvement (QI) initiative for a university college of nursing (CON) utilizing a prospective, observational, descriptive, cohort design. A plan-do-study-act (PDSA) methodology was implemented. A written case study given …

Associations Among Healthcare Utilization And Binge Drinking, Ethan Grey, Chad Phalon, Anna Greene, Patricia Harmeyer, Kalyn Rosenberg, Cristine Griffing, Tom Delaney

Master of Public Health Culminating Projects

Objective. To examine associations among routine healthcare services and binge drinking in Vermont adults.

Methods. We analyzed a cross-sectional sample of randomly selected 6516 adults who participated in the self-reported 2017 Vermont Behavioral Risk Surveillance System survey. We estimated odds ratios for responses indicative of binge drinking in association with length of time since last routine checkup using a bivariate logistic regression model.

Results. Participants who reported binge drinking were 31% (OR = 0.69, 95% confidence interval [CI] = 0.56, 0.83) less likely to engage in a healthcare visit within the past year controlling for age, employment status, annual household …

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …

Impact Of A Healthcare Workplace Violence Prevention Module On Staff Knowledge, Michelle Leigh Arroyo

Walden Dissertations and Doctoral Studies

The healthcare sector experiences violence 4 times as much as any other civilian domain, including law enforcement and corrections facilities. The clinical practice problem addressed in this project was the lack of adequate healthcare workplace violence (HWV) prevention in a not-for-profit community hospital. The purpose of this project increase awareness of HWV prevention through the use of an education module. Rogers’ diffusion of innovation model served as the foundation for analysis of scores from pre- and posteducation tests. The practice-focused question asked if a module on HWV prevention based on current clinical practice guidelines and peer-reviewed literature would improve staff …