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Articles 1 - 30 of 94
Full-Text Articles in Medicine and Health Sciences
Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi
Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi
Walden Dissertations and Doctoral Studies
AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …
Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler
Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler
Walden Dissertations and Doctoral Studies
Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …
Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter
Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter
Walden Dissertations and Doctoral Studies
AbstractHistorically, the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community has reported low patient satisfaction for health care. The purpose of this quantitative study was to examine the statistical relationship between patient satisfaction among LGBTQ patients (independent variable) and patient volume and hospital revenue (dependent variables) in the U.S. state of Georgia. The study was grounded on Andersen's model of healthcare utilization. Two research questions guided this study related to the statistical relationship between hospital revenue and patient satisfaction within health systems and the statistical relationship between patient satisfaction and patient volume. The study included 567 members of the LGBTQ …
Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon
Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon
Walden Dissertations and Doctoral Studies
AbstractSome organizational leaders of home healthcare agencies (HHA) experience financial pressures to sustain within the changing regulatory landscape. Organization healthcare leaders who develop sustainability strategies remain competitive and employ the community. Grounded in the balanced scorecard framework, the purpose of this descriptive, qualitative multiple case study was to identify strategies home healthcare agency (HHA) leaders used to maintain sustainability. The participants were five organizational leaders of three HHA and two home health industry consultants in the Northeast United States who implemented sustainability. Data collected came from semistructured interviews, archival records, and organizational documentation. Three themes emerged from the thematic analysis: …
Website Accessibility Strategies, Gary W. Hrezo
Website Accessibility Strategies, Gary W. Hrezo
Walden Dissertations and Doctoral Studies
Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …
Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt
Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt
Walden Dissertations and Doctoral Studies
Physicians in residency training (PIRTs) in the United States are facing extreme burnout. The prevalence of burnout among physicians in residency training may cause adverse consequences such as medical malfeasance, alcoholism, or suicide due to physical and mental exhaustion. The purpose of this study was to analyze the servant leadership style of physician trainers and burnout among PIRTs in academic medical centers in the United States to ultimately increase wellness and thereby mitigate burnout. Servant leadership was the theoretical foundation for this study. This research investigated whether servant leadership characteristics of physician trainers played a statistically significant role in burnout …
Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts
Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts
Walden Dissertations and Doctoral Studies
A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …
Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia
Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia
Walden Dissertations and Doctoral Studies
Healthcare costs have continued to increase in the United States. The Centers for Medicare and Medicaid Services (CMS) have proposed policy changes to reduce inequities between hospital outpatient centers and independent freestanding facilities when reimbursing for the same service. The purpose of this quantitative study was to explore if there was a difference in the payments to the Outpatient Prospective Payment System between the years 2017 and 2018 to assist hospital administrators in preparing for Medicare reimbursement cuts. The study was grounded in the agency theory and aimed to determine the relationship among the provider, payer, and patient. The research …
Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick
Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick
Walden Dissertations and Doctoral Studies
The specific research problem that was addressed through this study is the low rate of postpartum visits among Medicaid-enrolled women, leading to increased postpartum complications and readmissions. The purpose of this quantitative study was to evaluate if hospital readmissions can be reduced by integrated care home visiting services relating to postpartum visit compliance. The research questions evaluated the relationships between postpartum visit compliance, hospital readmissions among Medicaid-enrolled women in Indiana, and an integrated care home visiting program. The Donabedian model for quality-of-care grounds this study and is based on structure, process, and outcome. Through this model, healthcare leaders can evaluate …
Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig
Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig
Walden Dissertations and Doctoral Studies
A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …
Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe
Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe
Walden Dissertations and Doctoral Studies
Emergency departments (EDs) are experiencing an influx of patients with opioid-related which result in increased opioid misuse, abuse, and overdoses. The purpose of this study was to examine the relationship between opioid-related ED visits and financial liability of hospitals by evaluating if an increase in opioid-related ED visits leads to an increase in average ED visit costs. The framework used for this study was Reason’s theory of failures, which involves improving healthcare maturity in terms of risk management, achieved through enhanced efficiency. The analyzed research questions included analysis between the number of opioid-related ED visits and financial liability of hospitals …
U.S. Military Treatment Facility Reform: Decision-Based Plan Of Action And Milestones, Sean E. Marshall
U.S. Military Treatment Facility Reform: Decision-Based Plan Of Action And Milestones, Sean E. Marshall
Walden Dissertations and Doctoral Studies
In 2017, the U.S. Congress mandated a specific reorganization and centralized approach in military medicine. The Air Force developed a medical reform construct to organize military treatment facilities (MTFs). The leaders of each unit are required to comply with the reorganization using internal resources with no additional funding or personnel. The purpose of this study was to deliver a plan of action and milestones (POAM) suitable for workgroup implementation to achieve the mandated health unit integration at a medium-sized MTF. The practice-focused question asked how a POAM road map guides effective decision-making. A consultancy approach was used to assist leadership …
Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen
Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen
Walden Dissertations and Doctoral Studies
AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …
Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin
Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin
Walden Dissertations and Doctoral Studies
Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …
Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli
Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli
Walden Dissertations and Doctoral Studies
AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …
Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler
Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler
Walden Dissertations and Doctoral Studies
AbstractThe Centers for Medicare and Medicaid Services implemented the Hospital Readmission Reduction Program in 2012. Ten years later, hospitals across the United States have had negligible improvement in reducing preventable 30-day hospital readmissions for COPD patients. Healthcare, specifically the hospital setting, consists of complex processes and procedures. Not one process or procedure is the sole cause of correcting excessive preventable 30-day readmissions of patients with COPD. The essential elements of provider communication were studied using the Complex Adaptive Systems theory in this quantitative study. Each fundamental element of provider communication was the independent variable, and the preventable 30-day COPD excessive …
Exploring African American Women’S Experiences With Breastfeeding Support In Health Services, Jennifer Johnson
Exploring African American Women’S Experiences With Breastfeeding Support In Health Services, Jennifer Johnson
Walden Dissertations and Doctoral Studies
Breastfeeding provides complete nutrition to infants and reduces the risk of many chronic diseases among infants and their mothers, yet disparities exist. African American mothers have the lowest breastfeeding rates compared to other ethnic groups in the United States. There is limited qualitative research on health services support from the African American mother’s perspective. Understanding health behaviors may improve programming, reduce racial and ethnic disparities, and address social determinants of health. The purpose of this study was to explore African American women’s beliefs, experiences, perspectives, and opinions around breastfeeding support provided in healthcare settings by healthcare professionals. From a conceptual …
Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro
Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro
Walden Dissertations and Doctoral Studies
AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …
The Relationship Between Team Engagement And Physician Engagement, Lynne Miles
The Relationship Between Team Engagement And Physician Engagement, Lynne Miles
Walden Dissertations and Doctoral Studies
AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …
Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell
Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell
Walden Dissertations and Doctoral Studies
Readmissions for chronic obstructive pulmonary disease (COPD) are a major contributor to healthcare costs and patient outcomes. The Hospital Readmissions Reduction Program (HRRP) by the Centers of Medicare and Medicaid was implemented to decrease high rates of readmissions for serious medical problems, including COPD. The purpose of this study was to determine whether HRRP resulted in reductions in readmissions and costs for COPD patients. The Donabedian model was used as the theoretical framework to investigate three research questions concerning whether there are statistically significant differences in terms of readmission rates, total charges, and primary type of insurance payment before and …
Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo
Walden Dissertations and Doctoral Studies
Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …
Strategies Nursing Managers Use To Prevent And Address Workplace Conflicts, Ifeanyi Emmanuel Ezeani
Strategies Nursing Managers Use To Prevent And Address Workplace Conflicts, Ifeanyi Emmanuel Ezeani
Walden Dissertations and Doctoral Studies
Workplace conflicts negatively impact organizational performance. Health care leaders are concerned that workplace conflicts lead to stress and low performance by nurses and negatively affect the delivery of care to patients. Grounded in the social exchange theory, the purpose of this qualitative multiple case study was to explore strategies health care nursing managers use to address workplace conflict. Data were collected through semistructured interviews with five nursing managers from multiple healthcare organizations in the Western region of the United States who have successful strategies to address workplace conflict. The data analysis using Yin’s five-step approach identified four main themes: perception …
Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar
Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar
Walden Dissertations and Doctoral Studies
Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …
Development And Validation Of A Clinical Practice Guideline For Telemedicine, Jennifer Johnell Upton
Development And Validation Of A Clinical Practice Guideline For Telemedicine, Jennifer Johnell Upton
Walden Dissertations and Doctoral Studies
Access to healthcare necessitated the utilization of telemedicine during the international pandemic of COVID 19. Telemedicine use surged in family practice in 2020 with limited resources for appropriate telemedicine patients. The problem identified for this DNP project was the lack of resources for telemedicine guidelines in family practice. The purpose of this project was to create a clinical practice guideline (CPG) to initiate screenings for appropriate patients for telemedicine. The Plan, Do, Study, Act (PDSA) concept and framework were utilized to develop the CPG. The project question identified was whether the development of a CPG on telehealth delivery in a …
California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga
California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga
Walden Dissertations and Doctoral Studies
A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied; however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The …
Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike
Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike
Walden Dissertations and Doctoral Studies
Nurses play a significant role in mobility management, an essential element of care for critically ill adults. However, the current practice of mobility management comes from patient orders without the adoption of an evidence-based physiologic assessment guide to support safe patient mobility resulting in unreliable outcomes. Physiologic stability may change during mobility and unsafe patient mobilization can result in negative patient outcomes that increase patient recovery time. The purpose of this systematic review was to look at the current practice of physiologic assessment measures and then use the findings to influence safe patient mobility practices in intensive care units. The …
Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson
Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson
Walden Dissertations and Doctoral Studies
This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …
The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson
The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson
Walden Dissertations and Doctoral Studies
Home dialysis is a cost-effective and efficient means of treating end-stage renal disease. Under-utilization of home dialysis results in higher than necessary Medicare spending and loss of quality of life for patients. The purpose of this study was to understand the relationship between a nephrologist's length of time in practice, a nephrologist's belonging to a Joint Venture (JV) financial arrangement with a home modality program, and the use of home dialysis and home modality education using a quantitative, correlational design. Roger's diffusion of innovation theory explains the varying willingness of individuals to accept innovation. Secondary data were collected from Medicare …
Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant
Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant
Walden Dissertations and Doctoral Studies
The United States lacks postdischarge services, which can negatively impact hospital readmissions within 30 days. It is important for case managers to effectively leverage outpatient services to enhance patient care and reduce readmission rates. Grounded in the practice change model framework, this qualitative single case study explores the perspectives of case managers involved with postdischarge services for patients diagnosed with coronary artery disease (CAD). Participants included 13 case managers from two metropolitan hospitals in Atlanta, Georgia. To address the research problem and study purpose, data collection techniques included semi-structured interviews, case management discharge summaries, and reflective journal notes. The thematic …
Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies
Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies
Walden Dissertations and Doctoral Studies
Performance related to patient satisfaction is becoming a significant factor in determining reimbursement for hospital-based services. Furthermore, consumers are increasingly accessing publicly available quality and patient experience information to make decisions about where to receive care. Understanding which hospital characteristics influence patient satisfaction is critical to the healthcare administrator to ensure the financial viability of the organization and to meet the needs and expectations of the community. Many studies have examined the relationship between a single performance characteristic and patient satisfaction. This secondary data quantitative study used regression analysis to analyze the relationship between three hospital performance characteristics (i.e., the …