Digital Commons Network^™

Patient Portal Use In A Community Medical Group: A Healthcare Improvement Project, Pamela S. Kallmerten

Doctoral Dissertations

The American Recovery and Reinvestment Act (ARRA) of 2009 included the Health Information Technology for Economic and Clinical Health Act (HITECH) to provide stimulus for the provision of electronic access for consumers as a way to improve patient engagement. As described by the act, meaningful use of a tethered personal health record called a patient portal was theorized to improve patient engagement and result in improved clinical outcomes, reduced cost and increased patient satisfaction. Accordingly, financial incentives and penalties were to be awarded the eligible provider (EP) demonstrating meaningful use according to various stages with corresponding deadlines. A community medical …

Knowledge-Based Medication Administration: Program Evaluation And Optimization, Elizabeth Evans

Doctoral Dissertations

It has been reported by members of The Institute of Medicine that a patient is at risk for one medication administration error per day when hospitalized, thus prevention of medication administration errors is a priority patient safety goal. One recommendation to reduce the prevalence of medication administration errors is the use of barcoded medication administration (BCMA) systems. While there are many benefits to BCMA, there are also issues with existing systems. Suboptimal BCMA design and implementation has resulted in medication administration workarounds. A hospital located in southern New Hampshire, implemented a Knowledge Based Medication Administration (KBMA) system in January 2014. …

The Impact On The Family Of Long-Term Caregiving In The Home, Holley Spangler Gimpel

Doctoral Dissertations

Families provide care in ever-increasing numbers for chronically and terminally ill family members. Previous empirical measurement of caregiver strain was generally limited to one type of care recipient population (e.g., elderly), with samples drawn primarily from metropolitan centers (and often support groups), and confined to individual assessment (i.e., primary caregiver), with outcomes of depression and anxiety. This study sought to address some of the research gaps in previous research.

In-depth caregiver and family-member interviews using both quantitative and qualitative research methods were conducted during a 10-month period throughout an entire state, composed mostly of rural and small-town populations. Examination was …

Changes By Accident Or Design: An Analysis Of Trends In American Nursing From A Feminist Perspective (1870-1988), Gloria Giaveno Straughn

Doctoral Dissertations

This exploratory study analyzed trends in American nursing from 1870-1988. The study used three kinds of graphical analysis (timeplots, scatterplot matrices and residual plots) to informally test fifteen hypotheses regarding nurse supply. Nurse supply was broken into two categories: nurse requirement, or the actual number of nurses employed in nursing at any one point in time; and nurse availability, or the potential number of new nurses needed to be produced or recruited. The hypotheses focused on two broad empirical research questions: "How many nurses are there?" and "How many nurses are enough?" Feminist conceptual frameworks were employed to inform the …