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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 …
Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun
Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun
Walden Dissertations and Doctoral Studies
AbstractLike other individuals from diverse backgrounds, nurses who work in nursing homes are susceptible to becoming overweight. The way that others see and respond to the overweight person also may vary and even result in some level of discrimination. The purpose of this study was to explore the perspective of nurse managers about obese staff in the workplace. A qualitative phenomenological descriptive study design was used, guided by the theory of interpersonal relations and the relational leadership framework, to examine the lived experiences of managers working with obese nurses in nursing home settings in a large metropolitan region in the …
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 …
Hospital Ownership And Type As Predictors Of 30-Day Psychiatric Readmissions And Follow-Up, Zacquia Mckinley
Hospital Ownership And Type As Predictors Of 30-Day Psychiatric Readmissions And Follow-Up, Zacquia Mckinley
Walden Dissertations and Doctoral Studies
Studies have suggested that differences in hospital ownership structures impact the rates of 30-day hospital readmission and 30-day hospital follow-up in patients with psychiatric diagnoses. The purpose of this quantitative study was to examine the relationship between hospital ownership, hospital type, rates of 30-day psychiatric readmission, and rates of 30-day follow-up for psychiatric patients. This study drew on Donabedian's conceptual model of hospital quality assessment and used ANOVA testing for the four research questions concerning whether there is a significant relationship between 1) hospital ownership and inpatient psychiatric patient readmission within 30 days of discharge, 2) hospital type, and inpatient …
Effects Of Covid-19 On Maternal And Child Health In Haiti, Abbi M. Lee
Effects Of Covid-19 On Maternal And Child Health In Haiti, Abbi M. Lee
Walden Dissertations and Doctoral Studies
Haiti has a history of natural disasters that have played a part in the country’s weak infrastructure, poor quality health care, and short life expectancy. The purpose of this qualitative case study was to understand the experiences of health care professionals providing prenatal, perinatal, and postpartum health care services before and during the COVID-19 pandemic in Haiti to gain an understanding of the gaps in disaster response in reproductive health care. The theoretical bases for this study were community resilience theory and reproductive justice theory. Data were collected from interviews with 10 health care professionals working in Haiti providing reproductive …
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 …
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 …
Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan
Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan
Walden Dissertations and Doctoral Studies
Ineffective strategies to contain the costs of medical supply inventory can result in financial loss and are a significant challenge for hospital leaders. Grounded in complex adaptive systems theory, the purpose of this qualitative single case study was to explore the cost-containment strategies that private hospital business leaders use to reduce the expense of pharmaceutical inventory. The participants comprised six private hospital business leaders in one healthcare organization in Myanmar. Data were collected from semistructured interviews, internal company documents, and publicly available annual reports. Four themes emerged from Yin’s five-step data analysis method: (a) management controls, (b) specialist engagement and …
Predictors Of Medication Alternative Cost-Saving Strategies Among Adults With Type 2-Diabetes, Olaseni Solomon Oduwaye
Predictors Of Medication Alternative Cost-Saving Strategies Among Adults With Type 2-Diabetes, Olaseni Solomon Oduwaye
Walden Dissertations and Doctoral Studies
Adults with type 2 diabetes (T2D) in the United States experience a significant financial burden in managing their condition due to prescription medication, higher out-of-pocket (OOP) costs, number of prescribed medications, and health insurance status to stay compliant with their medications. This study examined the association between the alternative medication cost-saving strategies, including obtaining free samples from doctors or patient assistance programs, splitting pills or changing dosage frequency, purchasing from other countries, purchasing over the internet, and the three independent variables among adults diagnosed with T2D. Reasoned action approach theory helped guide how external factors may influence an alternative medication …
Association Between Staff Patient Safety Grade Mean Rating Score, The Person And Community Engagement Domain Score, And The Hospital Value Based Purchasing Total Performance Score, Tamara Lynn Awald
Walden Dissertations and Doctoral Studies
AbstractIt is essential for hospitals to focus on improving indicators that positively influence patient experience and clinical outcomes and thereby improve clinical and financial organizational outcomes. The purpose of the study was to examine the association between the staff Patient Safety Grade Mean Rating Score, Person and Community Engagement Domain Score, and the Value Based Purchasing Total Performance Score. The theoretical framework used in this study is the Donabedian model specifically regarding providing structure, process, and outcomes framework relative to the evaluation of care. The research questions examined the association between staff Patient Safety Grade Mean Rating Score, the Person …
Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter
Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter
Walden Dissertations and Doctoral Studies
Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …
The Role Of Self-Efficacy Against Workplace Stress, The Intent To Leave, And Burnout In Nursing, Alexis Collier
The Role Of Self-Efficacy Against Workplace Stress, The Intent To Leave, And Burnout In Nursing, Alexis Collier
Walden Dissertations and Doctoral Studies
Healthcare administrators must sustain the nursing workforce by minimizing workplace stress, the intent to leave, and burnout while maintaining a safe, accessible, high-quality, patient-centered care environment. This quantitative study examined the relationship between the independent variable of self-efficacy and the dependent variables of nurse burnout, workplace stress, and the intent to leave. The theory that grounded this study was the theory of self-efficacy. The research questions were formatted to determine the correlation between the self-efficacy levels of nurses and burnout, workplace stress, and the intent to leave. A quantitative, nonexperimental, cross-sectional (analytical) design addressed the research questions. The secondary data …
Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore
Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore
Walden Dissertations and Doctoral Studies
Fraudulent business activities have the potential for adverse business outcomes. Speech pathology business owners who lack a robust fraud prevention strategy may subject their practices to severe civil and criminal penalties. Grounded in Wilhelm’s eight-stage fraud management lifecycle theory, the purpose of this qualitative multiple case study was to explore strategies speech pathologist business owners used to prevent Medicare claims fraud. The participants were five speech pathologist business owners from three practices in a western U.S. state who successfully implemented fraud prevention strategies. Data were collected using semistructured interviews and reviewing organization policies and procedures manuals. Three themes emerged using …