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Nigerian Hospital-Based Interprofessional Collaborative Patterns And Organizational Implications, Osaeloka Christiandolus Ekwueme Jan 2018

Nigerian Hospital-Based Interprofessional Collaborative Patterns And Organizational Implications, Osaeloka Christiandolus Ekwueme

Walden Dissertations and Doctoral Studies

Interprofessional collaboration is recognized as the innovative, evidence-based strategy that strengthens health systems and improves performance and health outcomes. While resource-rich countries have benefited much from the implementation of this initiative, literature is scarce regarding sub-Sahara Africa. This quantitative cross-sectional descriptive study described the extent of interprofessional collaborative practice at the tertiary care level in Nigeria and its implications on patient health outcomes, professionals' performance, satisfaction, and healthy practice environment. The relational coordination theory (RCT) provided the conceptual framework for the study. Key research questions were on the association between the extents of interprofessional practice and each of the outcome …


Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper Jan 2018

Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper

Walden Dissertations and Doctoral Studies

The introduction of federal initiatives and incentives regarding health information technology fostered a movement towards the adoption of electronic health records (EHR). Implementation of EHRs sparked discussions among healthcare providers, patients, and others about the benefits or challenges of the move from the traditional paper method to the electronic version in healthcare settings. A knowledge gap in research involving the usefulness of EHRs and their impact to the delivery of care in other settings exists. The purpose of this qualitative study was to explore public health providers' perceptions of the meaningful use of EHRs in a disaster setting. Study participants …


A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson Jan 2018

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …


Perceived Usefulness And Perceived Ease Of Use Impact On Patient Portal Use, Dasantila Sherifi Jan 2018

Perceived Usefulness And Perceived Ease Of Use Impact On Patient Portal Use, Dasantila Sherifi

Walden Dissertations and Doctoral Studies

Patient portals are web-based tools that provide patients with access to their health records and enhance communication with providers. Despite the efforts in expanding their use and patients interest in using them, patient portal usage remains low. Higher use of portals is associated with greater patient engagement and better healthcare quality and outcomes. This study investigated the impact of perceived usefulness (PU) and perceived ease of use (PEU) on patient portal usage. The conceptual framework was based on the Technology Acceptance Model, which suggests that PU and PEU of a system affect attitude and behavioral intention toward using the system, …


Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun Jan 2018

Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun

Walden Dissertations and Doctoral Studies

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …


Cost-Effectiveness Analysis Of Preimplantation Genetic Screening, William Andrew Moye Jan 2018

Cost-Effectiveness Analysis Of Preimplantation Genetic Screening, William Andrew Moye

Walden Dissertations and Doctoral Studies

In vitro fertilization (IVF) is used to help infertile couples achieve a live birth. Clinical studies have suggested that multiple, consecutive cycles of IVF can increase live birth rate significantly. Others have documented improved live birth rates from the use of new laboratory techniques for preimplantation genetic screening (PGS). This genetic screening technique seeks to determine the ploidy of the embryo prior to implantation into the woman. To date, no study has examined the cost-effectiveness of using IVF in conjunction with PGS compared to that of IVF alone for 3 consecutive cycles in achieving a live birth. This study compared …


Streamlining Hospital Administrative Procedures To Reduce Costs, Dr. Claret Onukogu Jan 2018

Streamlining Hospital Administrative Procedures To Reduce Costs, Dr. Claret Onukogu

Walden Dissertations and Doctoral Studies

Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. …


Hypertension Awareness And Health Care Access/Use In Black Women With Hypertension, Marlène Trusiak Jan 2018

Hypertension Awareness And Health Care Access/Use In Black Women With Hypertension, Marlène Trusiak

Walden Dissertations and Doctoral Studies

Black women in the United States have a high prevalence of hypertension and suffer the most complications of cardiovascular disease. Black women, though aware of the dangers associated with hypertension, have limited opportunity to access health care and or change their lifestyles. The purpose of this quantitative cross-sectional study was to test if there was a significant difference in hypertension awareness, health care access/use, and lifestyle modifications in Black women prior to and post implementation of The Patient Protection and Affordable Care Act, as compared to women of other races. The behavior modification theory guided this study. Secondary data from …


Strategies To Prevent And Reduce Medical Identity Theft Resulting In Medical Fraud, Junior V. Clement Jan 2018

Strategies To Prevent And Reduce Medical Identity Theft Resulting In Medical Fraud, Junior V. Clement

Walden Dissertations and Doctoral Studies

Medical identity fraud is a byproduct of identity theft; it enables imposters to procure medical treatment, thus defrauding patients, insurers, and government programs through forged prescriptions, falsified medical records, and misuse of victim's health insurance. In 2014, for example, the United States Government lost $14.1 billion in improper payments. The purpose of this multiple case study, grounded by the Health Insurance Portability and Accountability Act as the conceptual framework, was to explore the strategies 5 healthcare leaders used to prevent identity theft and medical identity fraud and thus improve business performance in the state of New York. Data were collected …


Implications Of An All Bsn Workforce Policy, Mary Clifford Jan 2018

Implications Of An All Bsn Workforce Policy, Mary Clifford

Walden Dissertations and Doctoral Studies

Discussion continues about requiring a Bachelor of Science in Nursing (BSN) as the minimum requirement for entry into registered nursing practice. A Magnet-® recognized hospital located in the Northeast United States is requiring all registered nurses without a BSN (n=284 or 28%) to obtain their BSN by 2022 as a condition for employment. The purpose of this project was to quantify the potential number and rationale of nurses who are not planning to return to school. The 2 practice focused questions are (a) What is the rationale for nurses who do not plan to pursue their BSN degree and (b) …


Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston Jan 2018

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …


Successful Project Management, Tomomi M. Horning Jan 2018

Successful Project Management, Tomomi M. Horning

Walden Dissertations and Doctoral Studies

High project failure rates result in billions of wasted dollars each year. Project failure does not discriminate by type of project or the industry from which they originate. The purpose of this qualitative single case study was to explore strategies that leaders at a health care organization located in Pennsylvania use to manage projects successfully. This population was selected due to the health care organization's reputation for successful project completion. The conceptual framework for this study was Fiedler's contingency theory. Data were collected by conducting semistructured interviews with 9 project leaders and reviewing project documents provided by study participants. Interviews …


Leadership Communications Strategies For Enhancing Virtual Team Performance, Rachel Oludolapo Agbi Jan 2018

Leadership Communications Strategies For Enhancing Virtual Team Performance, Rachel Oludolapo Agbi

Walden Dissertations and Doctoral Studies

The fast-growing trend of using virtual teams comes with challenges including the lack of knowledge by some virtual team leaders for managing virtual teams. The purpose of this single case study was to explore the communication strategies that leaders use to manage virtual teams in real time to enhance team performance. The sample was composed of 4 successful virtual team leaders of a multinational accounting firm whose headquarters is in the northeastern region of the United States of America. The conceptual framework that guided this study was Tuckman's small group developmental model. Data consisted of semistructured interviews and the review …


Hospital Executive Succession Planning Strategies, Janet Tingling Jan 2018

Hospital Executive Succession Planning Strategies, Janet Tingling

Walden Dissertations and Doctoral Studies

Approximately 50% of New York City hospitals lack succession planning as baby boomers transition out of the workforce into retirement. The potential loss of knowledge capital could affect leadership development and corporate stability. Guided by the transformational leadership theory, the purpose of this single site case study was to explore successful strategies executive-level leaders used to facilitate succession planning within their hospital. Three hospital executive-level leaders from a single site location participated in a semistructured face-to-face interview and provided data that assisted the analysis. Four themes emerged from the data analysis through a word cloud format that showed the most …


Exploring Management Practices Of The Health Care System For Contractors, Gary L. Williams Jan 2018

Exploring Management Practices Of The Health Care System For Contractors, Gary L. Williams

Walden Dissertations and Doctoral Studies

Researchers have found that military members serving in war experienced changes in physical and mental health. Military members' healthcare is managed by the Department of Defense. The problem was that management practices of the system for providing long-term healthcare for employees of a contracting company working in foreign combat zones is either minimal or nonexistent. The purpose of this case study was to explore ways that contractor managers and government managers can work together to provide healthcare for those contract employees who will be deployed with the U.S. military. The primary research question was to determine what managers of contractors …


Management Of Inappropriate Behaviors By Healthcare Risk Managers, Sahar Ebrahim Zadeh Jan 2018

Management Of Inappropriate Behaviors By Healthcare Risk Managers, Sahar Ebrahim Zadeh

Walden Dissertations and Doctoral Studies

Medical errors are the 3rd leading cause of death in the U.S.. The problem is timely recognition and management of inappropriate healthcare worker behaviors that lead to intimidation and loss of staff focus, eventually leading to errors. The purpose of this qualitative modified Delphi study was to seek consensus among a panel of experts in hospital risk management practices on the practical methods for early detection of inappropriate behaviors among hospital staff, which may be used by hospital managers to considerably mitigate the risk of medical mishaps. High reliability theory guided the research process, utilizing the conceptual framework of fair …


Predictive Relationships Between Electronic Health Records Attributes And Meaningful Use Objectives, Solomon Nii Koppoe Jan 2018

Predictive Relationships Between Electronic Health Records Attributes And Meaningful Use Objectives, Solomon Nii Koppoe

Walden Dissertations and Doctoral Studies

The use of electronic health records (EHR) has the potential to improve relationships between physicians and patients and significantly improve care delivery. The purpose of this study was to analyze the relationships between hospital attributes and EHR implementation. The research design for this study was the cross-sectional approach. Secondary data from the Health Information and Management Systems Society (HIMSS) Analytics Database was utilized (n = 169) in a correlational crosssectional research design. Normalization Process Theory (NPT) and implementation theory were the theoretical underpinnings used in this study. Multiple linear regressions results showed statistically significant relationships between the 4 independent variables …


Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline Jan 2018

Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline

Walden Dissertations and Doctoral Studies

Researchers have predicted that by 2020 the United States will experience a severe shortage of registered nurses. The purpose of this correlation study, using the National Sample Survey of Registered Nurses 2008, was to investigate the relationship between nurse job satisfaction and its effect on nurse retention nationwide. Secondary data sets from the 2008 National Sample Survey of Registered Nurses and examining relationships between the variable of nurse retention and job satisfaction. Bivariate (correlation coefficient, chi squares, and simple linear regression) and multivariate (logistic regression) analyses identified and connected associations and examined measurement levels between the dependent and independent variables, …


Workplace Violence Among Nurses And Nursing Assistants In Texas, Tamala Norris Jan 2018

Workplace Violence Among Nurses And Nursing Assistants In Texas, Tamala Norris

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) is ranked as one of the leading causes of occupational injury in the United States and is common in health settings. Nurses have the highest rate of violent victimization reported in the U.S., thus presenting a significant issue for healthcare leaders. Various researchers focus on prevalence rates of WPV among nurses discussing types of violence, location, and the setting where the WPV occurred. Less information exists regarding time taken off work and factors associated with WPV among nurses versus nursing assistants (NAs). This information is important due to the impact on safe work environments for nursing employees. …


Patient Experience And Readmissions Among Medicare Shared Savings Programs Accountable Care Organizations, Benjamin Michael Anderson Jan 2018

Patient Experience And Readmissions Among Medicare Shared Savings Programs Accountable Care Organizations, Benjamin Michael Anderson

Walden Dissertations and Doctoral Studies

In 2011, Medicare patients represented the largest share of total readmissions and health costs when compared to all other patient categories. Because patient-centered care drives the use of health services, the U.S. Patient Protection and Affordable Care Act outlined improving the patient experience to reduce readmission rates; however, the relationship between patient experience and readmissions is not well understood. Grounded in systems theory, the purpose of this correlational study was to determine if the relationship between patient experience and readmission rates in Medicare Shared Savings Program accountable care organizations. Data from the Consumer Assessment of Healthcare Providers and Systems survey …


Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist Jan 2018

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …


Socioeconomic Status And Cancer Risks In Employer-Insured Cancer Survivors, Christine Clinton Jan 2018

Socioeconomic Status And Cancer Risks In Employer-Insured Cancer Survivors, Christine Clinton

Walden Dissertations and Doctoral Studies

Chronic illnesses such as cancer continue to be among the costliest for employers who provide health insurance to their employees. Despite efforts to incorporate health improvement programs in the workplace, there are concerns about the effectiveness of these programs that do not always deliver a positive return on investment. Little is known about the specific socioeconomic status of employees for whom these workplace health improvement programs are designed for. Guided by the social-ecological model, this study sought to understand the relationship between cancer health risks about socioeconomic factors among cancer survivors in the employer-insured population. Data were extracted from the …


Creation Of A Diabetic Health Literacy Program For Staff Of A Rural Federally Qualified Healthcare Center, Cathy Jones Jan 2018

Creation Of A Diabetic Health Literacy Program For Staff Of A Rural Federally Qualified Healthcare Center, Cathy Jones

Walden Dissertations and Doctoral Studies

Adult residents in rural communities have a higher incidence of chronic diseases. This fact coupled with low health literacy and a lack of primary and specialty care services makes the management of diseases such as diabetes difficult. The purpose of this doctoral project was to develop a diabetic health literacy program for staff of a rural federally qualified health care center (FQHC) that is the largest primary care center within a 5-county area in a rural mid-Atlantic region of the United States. Most residents have difficulty understanding diabetic information as it is presented to them, which leads to an increase …


Toward Excellence: Exploring Leader Strategies In Chronic Wound Care Centers, Geraldine Rosol Jan 2018

Toward Excellence: Exploring Leader Strategies In Chronic Wound Care Centers, Geraldine Rosol

Walden Dissertations and Doctoral Studies

The number of chronic wounds is rising in the United States, and health leaders face the economic and health burdens these wounds pose to the U.S. health care system. Many investigators have documented the importance of leadership in promoting excellence and reducing health care costs in chronic disease. Yet, the literature lacks information regarding leader strategies used to promote wound treatment cultures of excellence directed toward improved quality and reduced health costs. This study examined leader strategies used to promote excellence in chronic wound treatment to address the problem of the economic and health burdens associated with chronic wounds. The …


Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth Jan 2018

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …


The Survival Of Healthcare In Rural Texas, Destin Cook Jan 2018

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …


Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck Jan 2018

Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck

Walden Dissertations and Doctoral Studies

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to …


Leveraging Artificial Intelligence To Improve Provider Documentation In Patient Medical Records, Evangeline C. Ozurigbo Jan 2018

Leveraging Artificial Intelligence To Improve Provider Documentation In Patient Medical Records, Evangeline C. Ozurigbo

Walden Dissertations and Doctoral Studies

Clinical documentation is at the center of a patient's medical record; this record contains all the information applicable to the care a patient receives in the hospital. The practice problem addressed in this project was the lack of clear, consistent, accurate, and complete patient medical records in a pediatric hospital. Although the occurrence of incomplete medical records has been a known issue for the project hospital, the issue was further intensified following the implementation of the 10th revision of International Classification of Diseases (ICD-10) standard for documentation, which resulted in gaps in provider documentation that needed to be filled. Based …


Accountable Care Organization Success Strategies: The Importance Of System Changes, Shelly Pierce Jan 2018

Accountable Care Organization Success Strategies: The Importance Of System Changes, Shelly Pierce

Walden Dissertations and Doctoral Studies

Accountable care organizations (ACOs) are a new health care reform initiative that has been highlighted as one of the most important organizational structures that could lead to quality improvements and cost savings in the United States through shared savings. The inability of health care managers to successfully implement ACOs could result in financial losses, reduced patient access to health care, and poor patient outcomes. Grounded by von Bertanlaffy's general systems theory, the purpose of this multiple case study was to explore the system change strategies health care managers used to implement an ACO to meet ACO quality and cost standards. …


Strategies To Sustain A Physician-Led Primary Care Practice, Ashley Polidori Jan 2018

Strategies To Sustain A Physician-Led Primary Care Practice, Ashley Polidori

Walden Dissertations and Doctoral Studies

Since 2008, physician-led primary care practices have decreased as physician's encounter sustainability challenges because of government regulations and the requirements of the Affordable Care Act. The problem is that some physician-led primary care practice leaders lack strategies to sustain a medical practice longer than 5 years. The purpose of this study was to explore strategies primary-care practice leaders use to sustain a practice longer than 5 years. This study followed a case study design, including a purposeful sampling of 3 physician-led primary care practice leaders in southern Indiana. Open-ended semistructured interviews were conducted and triangulated with company policies and procedures …