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Articles 1 - 30 of 80
Full-Text Articles in Medicine and Health Sciences
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Walden Dissertations and Doctoral Studies
High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …
Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp
Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp
Walden Dissertations and Doctoral Studies
Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …
Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson
Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson
Walden Dissertations and Doctoral Studies
Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …
Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins
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
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 …
Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey
Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey
Walden Dissertations and Doctoral Studies
A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of …
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 …
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Walden Dissertations and Doctoral Studies
Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …
Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster
Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster
Walden Dissertations and Doctoral Studies
Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and …
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Walden Dissertations and Doctoral Studies
Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use …
Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon
Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon
Walden Dissertations and Doctoral Studies
Clinical supply chain managers who do not apply effective employee turnover strategies could negatively affect team performance, employee morale, employee well-being, patient outcomes, productivity, profitability, and the sustainability of organizational activities. The purpose of this multiple case study was to explore strategies that supply chain managers used to decrease employee turnover in clinical logistics organizations. The targeted population consisted of 6 clinical logistics supply chain managers working in 6 community hospitals located in Maryland who had experience implementing successful strategies to decrease employee turnover. The servant leadership theory served as the study's framework. Data collection included semistructured interviews and a …
Strategies To Reduce Hospital-Acquired Conditions, Steven G. Littleson
Strategies To Reduce Hospital-Acquired Conditions, Steven G. Littleson
Walden Dissertations and Doctoral Studies
Hospital-acquired conditions cause harm to patients and increase mortality. In addition to lowering the quality of patient care, hospital-acquired conditions also negatively affect financial performance, which makes them a business problem for hospital administrators. The purpose of this single case study, which was grounded in the theory of high reliability, was to explore strategies used to reduce the number of hospital-acquired conditions. The sample consisted of 13 senior leaders of a large academic medical center in the southeastern United States, who shared successful strategies used to reduce hospital-acquired conditions. Data collection took place through semistructured interviews and a review of …
Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado
Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado
Walden Dissertations and Doctoral Studies
Early avoidable 30-day post discharge readmission among patients diagnosed with chronic obstructive pulmonary disease (COPD) is associated with poor transition care processes. The purpose of this project was to analyze organizational system processes for admission and discharge transition care of patients diagnosed with COPD to identify key intervention strategies that could decrease the rate of 30-day post-discharge readmission by 1%. The project used the transitional care model as the framework to target specific care transition needs and create patient-centered, supportive, evidence-based relationships among the patient, the providers, the community, and the health care system to identify key intervention strategies for …
Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris
Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris
Walden Dissertations and Doctoral Studies
There is a growing need for healthcare teams within the Veterans Administration (VA) healthcare system to effectively collaborate and communicate to improve patient outcomes. The need to improve patient care in the Patient Aligned Care Team (PACT) has been well established. The scholarly literature does not provide evidence whether using the primary care PACT model on communication and teamwork by an interdisciplinary medical team ameliorates these communication breakdowns. Bronstein's design for interdisciplinary collaboration provided the overarching framework for this study. The purpose of this qualitative case study was to investigate the use of the PACT model on communication and teamwork …
Participant Experiences In Christian-Based Recovery, Joshua Mjolsness
Participant Experiences In Christian-Based Recovery, Joshua Mjolsness
Walden Dissertations and Doctoral Studies
Health care leaders are challenged with addressing addiction and the treatment of addiction. Many studies have been conducted around addiction treatment; however, no studies have been conducted on Christian-based recovery programs that use the same approach regardless of the addiction. The purpose of this phenomenological study was to explore the experiences of participants in a Christian-based recovery program that uses the same approach for all addictions. The social learning theory provided the framework for this study. Data were collected by interviewing participants of the Christian-based recovery program Free Grace Recovery (FGR). Eight participants selected had a variety of reasons for …
Nurses' Lived Experiences Of Oppression And Power Dynamics In The Hospital Setting, Khadijatu A. Leary
Nurses' Lived Experiences Of Oppression And Power Dynamics In The Hospital Setting, Khadijatu A. Leary
Walden Dissertations and Doctoral Studies
The persistent and chronic nursing shortage presents an urgency to understand the root causes of nurses' increasing mobility and movement within and outside of the nursing workforce. A key to understanding nurses' dissatisfaction is to explore the work environment in which they practice. The purpose of this heuristic, phenomenological study was to understand nurses' experiences of oppression and the power dynamics in the hospital setting, which may provide insight to nursing turnover. The conceptual framework was Harvey's civilized oppression theory. Data were collected from semistructured interviews of 9 registered nurses by phone that met inclusion criteria of having more than …
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, …
An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon
An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon
Walden Dissertations and Doctoral Studies
A global epidemic of metamorphosed, conglomerated health care systems changed the face of public health care organizations. The problem is, public health care organizations merge into new systems, but the culture for each merged organization has not been formed under the new system. Public administrators, health care workers and the Department of Health and Human Services are affected when there are issues in health care behavioral practices and performance outcomes. Research found that employee motivation is hard to achieve when there are issues within the internal structure of a new system. Using Herzberg's motivation-hygiene and Tajfel and Turner's social identity …
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 …
Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward
Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward
Walden Dissertations and Doctoral Studies
Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Walden Dissertations and Doctoral Studies
Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and …
Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern
Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern
Walden Dissertations and Doctoral Studies
No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …
Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai
Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai
Walden Dissertations and Doctoral Studies
Every year, 2 million patients in the United States suffer with at least 1 hospital-acquired infection resulting in an estimated 99,000 deaths annually. The purpose of this exploratory single case study was to explore strategies healthcare managers in U.S. hospitals used to reduce hospital-acquired infections. The study included face-to-face, semistructured interviews with 5 healthcare managers from a hospital in Maryland who were successful in reducing these infections. The conceptual framework was human capital theory. Field notes, hospital documents, and transcribed interviews were analyzed to identify themes regarding strategies used by healthcare managers. The data analysis and coding process resulted in …
Strategies To Improve Employee Ethical Conduct In Health Care Organizations, Shannon La'vone Hill
Strategies To Improve Employee Ethical Conduct In Health Care Organizations, Shannon La'vone Hill
Walden Dissertations and Doctoral Studies
Organizational leaders face challenges related to implementing ethical standards, which influence performance, organization sustainability, and culture. The purpose of this single case study was to explore ethics strategies that health care business leaders used to improve employees' ethical conduct. Data were collected through face-to-face, semistructured interviews with a purposive sample of 7 business leaders of a health care organization located in central Georgia and a review of organization documents. The conceptual framework was Brady's Janus-headed model of ethical theory. Using a priori coding during the data analysis process provided 3 thematic categories: policy strategies for the improvement of employee ethical …
Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie
Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie
Walden Dissertations and Doctoral Studies
The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization …
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Walden Dissertations and Doctoral Studies
Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These …
Development Of Nursing Education For An Observation Unit, Donna Mckinney
Development Of Nursing Education For An Observation Unit, Donna Mckinney
Walden Dissertations and Doctoral Studies
As healthcare continues to face scrutiny related to the cost and quality of patient care, organizations are challenged with providing the right care to patients in the right setting. Some healthcare organizations are implementing observation units to provide appropriate care to a specific subset of patients. The purpose of this project was to develop education for nursing staff who will work on the dedicated observation unit and are unfamiliar with the care requirements. Benner's novice-to-expert theory was used as the framework for the project. This theorist posits that nurses transitioning to a new area require new knowledge and skills to …
Intraoperative Neurophysiological Monitoring Reimbursement Post International Classification Of Diseases-10, Cindy A. Akkerman
Intraoperative Neurophysiological Monitoring Reimbursement Post International Classification Of Diseases-10, Cindy A. Akkerman
Walden Dissertations and Doctoral Studies
International Classification of Diseases the 10th Revision (ICD-10) was implemented October 1, 2015, and there was little knowledge how the transition to ICD-10 would impact the revenue cycle for intraoperative neurophysiological monitoring medical practices in Oklahoma. This correlational quantitative study examined the changes in dependent variables of reimbursements due to the change from ICD-9 to ICD-10 for independent variables of intraoperative neurophysiological monitoring procedure codes. The reimbursements from 2014 were compared to reimbursements from 2016. Prices were adjusted for inflation to 2016 dollar values. Annual reimbursements decreased for all intraoperative neurophysiological monitoring procedures examined except the remote monitoring code. The …
The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez
The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez
Walden Dissertations and Doctoral Studies
The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …
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 …