Medicine and Health Sciences Commons^™

Emergency Department Operational Strategies, Joyce W. Davis

Walden Dissertations and Doctoral Studies

AbstractEmergency Department Operational Strategies by Joyce W. Davis MBA/MHA, Pfeiffer University, 2011 BS, North Carolina A&T State University, 1980

Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration

Walden University December 2022

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 …

How Social Workers Contribute To Outcomes Of Adolescent Participants In Wilderness Programs, Tracy Dockler

Walden Dissertations and Doctoral Studies

The wilderness environment has become recognized as a viable treatment modality for addressing the psychosocial and behavioral needs of treatment-resistant adolescents. Even though social workers provide services in these specialized programs, little is known about how they perceive the contributions they make to the outcomes of the adolescent participants. The conceptual framework of wilderness treatment with a focus on the wilderness experience, as well as on the physical, social, and psychosocial aspects of participant functioning guided this study. In this qualitative study, a semistructured interview guide was used to elicit the thoughts of five master’s level social workers (MSWs) regarding …

The Correlation Between Staffing Hours And Nursing Home Resident Fall Rate, Nduka Ikpo Eke

Walden Dissertations and Doctoral Studies

AbstractHealthcare administrators and researchers have had the burden of determining best practice protocols that minimize falls among older adults living in nursing homes for several years. Several studies have investigated, and identified intrinsic and extrinsic factors that lead to falls among other adults and made recommendations along the lines of their findings. However, researchers are yet to establish the impact of staffing hours on nursing home resident fall rate. The purpose of this study was to determine the correlation if any, between nursing home residents fall rate and the staffing hours they receive daily from certified nursing assistants (CNAs), licensed …

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …

Predictors Of Radio Frequency Identification Adoption For Medication Administration In Hospitals, Sherita Freeman

Walden Dissertations and Doctoral Studies

Medication administration challenges within the United States hospital system have led to adverse drug events from medication errors among patients, resulting in 1.3 million emergency room visits and 350,000 hospitalizations annually. Radio frequency identification (RFID) has been identified as a useful tool within hospital systems; however, this technology has been slow to be incorporated to manage medication administration processes, necessitating exploration of predicting factors of RFID adoption. This quantitative, cross-sectional study explored the contributing factors of United States hospital’s adoption of RFID for medication administration using the technology-organization-environment framework as a foundation and secondary data from the Health Information Management …

Successful Strategies To Sustain Practice Changes In Healthcare, Erin Gable

Walden Dissertations and Doctoral Studies

Healthcare managers implement evidence-based practice to meet the growing needs of aging populations. However, many healthcare leaders fail to sustain newly implemented practices. Grounded in the promoting action on research implementation in health services conceptual framework, the purpose of this qualitative interpretative descriptive study was to explore strategies healthcare leaders use to sustain practice changes to meet increasing demands for quality care of the aging population. The participants included eight healthcare managers from Canada and the United States who led strategies to sustain practice change. The four themes that emerged using semistructured interviews and thematic analysis were staff buy-in, staff …

Lived Experiences Of Crisis Counselors With Repeat Exposure To Mental Health Crises, Emily Genever

Walden Dissertations and Doctoral Studies

Due to the potentially traumatic content that crisis counselors face, members of the counselor education community must understand the psychological implications of repeated exposure to mental health crises to fulfill their responsibility of properly training, supervising, and supporting crisis counselors. The purpose of this qualitative phenomenological study was to explore the lived experiences of crisis counselors who had worked full-time with a variety of mental health emergencies. A hermeneutic design and constructivist self-development theoretical lens allowed for the illumination of the perceived positive and negative consequences of crisis work. Purposive sampling strategies were employed to recruit seven crisis counselors for …

Help-Seeking Behaviors For Depression Among Native Hawaiian Women In The Western Region Of The United States Mainland, Marlana Glover

Walden Dissertations and Doctoral Studies

Help-seeking for depression, as with other mental illnesses is contingent upon stigmas that one perceives. Although causes for depression differ among indigenous populations, native Hawaiians suffer from the Western acculturation and colonization of their homeland. With lack of trust in the U.S. healthcare system, many native Hawaiians are reluctant to seek help for depression. Furthermore, research has shown that most studies on native Hawaiians are conducted in their native environment when many Hawaiians relocate to the U.S. mainland. Because of the current depression crisis, it is critical to explore depression among native Hawaiians, particularly women on the mainland to see …

Continuity Of Care For Adult Offenders With Severe And Persistent Mental Illnesses: An Action Research Study, Lakeshia C. Gonzalez

Walden Dissertations and Doctoral Studies

For decades, the representation of adults with severe and persistent mental illnesses (SPMI) in the criminal justice system has steadily grown despite public recognition and increased federal implementation of mental health courts and diversion programs. Though more is known about risk factors associated with psychiatric and criminal recidivism among this population, a gap in the literature remains on collaborative interventions and continuity of care between inpatient mental health and criminal justice facilities. Grounded in resilience theory, the purpose of this qualitative study was to examine challenges social workers faced when attempting to facilitate discharge planning between inpatient mental health facilities …

Fully Automated Life Support Training Effects On Inpatient, Cardiac Arrest Survival Rates, Adessa D. Goss

Walden Dissertations and Doctoral Studies

In the United States, more than 200,000 adult patients die annually from inpatient cardiac arrest with survival rates stagnated at 22%–25% nationally. Recently, the adoption of fully automated life support training modalities by health care organizations has become widespread with limited literature available showing the effects on inpatient, cardiac arrest survival. The purpose of this quantitative study was to investigate the effects of fully automated life support training on inpatient, cardiac arrest survival. Applying Bloom’s mastery learning theory, the impact of the Resuscitation Quality Improvement (RQI) quarterly training and hospital unit compliance on inpatient cardiac arrest return of spontaneous circulation …

Christian U.S. Army Female Combat Veterans Diagnosed With Ptsd Experiencing A Moral Injury Of War, Kathaleen Graham-Young

Walden Dissertations and Doctoral Studies

Warzone exposure potentially impacts the mental and physical health of veterans who receive a diagnosis of PTSD. There is limited research addressing the adjustments of the potentially morally injurious event(s) (PMIEs) experienced by Christian U.S. Army female combat veterans diagnosed with PTSD who returned home from Iraq and Afghanistan warzones post - 9/11. To better understand the impact of PMIEs experienced by the target population, a study of the integration of the transpersonal-existential meaning-based model was used. A general qualitative research design was selected to understand the complex social phenomena. In-depth telephone interviews were conducted to gather viable data. These …

Intersectional Invisibility Of Black Lgbtqia+ Client Strategies For Bias And Discrimination Prevention, Dr. Tonya Y. Griffith

Walden Dissertations and Doctoral Studies

Abstract Those who identify as members of lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual (LGBTQIA+) communities have been victims of bias and prejudicial attitudes. Because LGBTQIA+ people embody all cultures, races, religious convictions, and socioeconomic statuses, this creates additional barriers for some community members who identify as both Black and LGBTQIA+. The purpose of this qualitative study was to explore social workers’ perceptions of intersectional invisibility when working with Black LGBTQIA+ clients and the strategies that social workers identify as beneficial in averting discrimination and bias when working with this community. Implicit bias theory and intersectionality theory …

The Role Of Health And Diet In The Development Of Metabolic Syndrome Stratified By Race, Sex, And Age, Michael D. Harada

Walden Dissertations and Doctoral Studies

Obesity is now recognized as a disease in need of treatment by the medical profession and is associated with other chronic diseases including hypertension, hyperglycemia, hypertriglyceridemia, insulin-resistance, and reduced levels of high density lipoproteins. Metabolic syndrome (MetS) occurs when a combination of at least three of these chronic conditions are comorbid with each other. The purpose of this quantitative cross-sectional study was to find significant health and nutritional predictors of MetS status across race, sex, and age. The evolutionary mismatch hypothesis and health belief model provided the framework for this study. Data were collected from 2,303 participants from the 2015-2016 …

Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove

Walden Dissertations and Doctoral Studies

Healthcare organizations’ leaders' lack of strategies to effectively deploy and monitor departments’ productivity goals affect overall organizations’ performance. Healthcare leaders who fail to deploy and monitor departmental productivity strategies effectively are limited to enhancing healthcare organizations’ performance outcomes. Grounded in transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies healthcare organizations’ leaders use to effectively identify, deploy, and monitor departments’ goals for improving their overall organization's performance. The participants were 20 healthcare leaders who successfully demonstrated success in improving their organizations’ departmental-specific productivity performance. Data were collected using semistructured interviews and a review of …

Holistic Health Among African American Women Remaining In A Marriage After Infidelity, Nena Evette Harris

Walden Dissertations and Doctoral Studies

Infidelity has been noted as a major reason married women experience stress and seek therapy. Infidelity is a social problem that results in adverse outcomes for individuals, families, and society. Health disparities are noted in women who have experienced infidelity. Studies have been conducted on marital status and health, but little has been studied on the holistic health experiences of married African American women who stay in their marriage after a spouse’s infidelity. The purpose of this generic qualitative study was to explore how the experience of marital infidelity affects the holistic health of heterosexual African American women in the …

Clinical Guidelines For Identifying Early Warning Signs Of Deterioration In Rehabilitation Patients, Tchaiko Abiola Hicks

Walden Dissertations and Doctoral Studies

Failure to recognize early warning signs of clinical deterioration can cause critical complications and a sentinel event with legal implications. These complications are preventable if nurses have evidence-based guidelines to guide their critical thinking to identify early warning signs. The purpose of this project was to close this gap by developing a Clinical Practice guideline for identifying early warning signs of clinical deterioration for the rehabilitation center. The clinical practice question addressed what evidence supported the development of a clinical guideline for nurses to recognize early warning signs of a deteriorating patient improve the quality of care of patients at …

Lead Toxicity, Attention–Deficit Hyperactivity Disorder, And Gun Violence Among Young African American Men, Gwendolyn Hooker-Mcintosh

Walden Dissertations and Doctoral Studies

Violence among adolescents and young adults is a major public health concern in the United States, but it disproportionally affects African Americans. This racial disparity is especially concerning in New Orleans, Louisiana, where fatal and nonfatal shootings have been consistent since 2010 for young African American men. Also, Louisiana ranks third in the nation in prevalence of attention–deficit hyperactivity disorder (ADHD) among children. African Americans in New Orleans have lived in areas known to have greater concentrations of lead in the soil, and African American children and their parents have a lower level of awareness of lead toxicity. The purpose …

Risk Factors Of Malnutrition In Children Under 5 In Nigeria, Itanwan James

Walden Dissertations and Doctoral Studies

Malnutrition in children under 5 years remains an important public health challenge as it spurs child mortality and morbidity in developing countries, including Nigeria. The purpose of this quantitative cross-sectional study was to explore the risk factors of malnutrition in children under 5 years of age in Akwa Ibom State, Nigeria. Socioecological and health belief models were applied to examine risk factors of malnutrition among these children. This study used a secondary dataset of 1,235 participants obtained from Akwa Ibom State Demographic and Health Survey database. Pearson’s chi-square test and binary logistic regression were adopted for the analyses. The results …

Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara

Walden Dissertations and Doctoral Studies

Ethnic diversity in the U.S. nursing workforce had not been well researched. This aspect of nursing is important to the advancement of the profession because ethnic diversity of nursing helps reduce health care disparities. The purpose of this quantitative correlational study was to examine the possible relationship between the perceived ethnicity of nurse leaders and the engagement of bedside nurses. Culture of care theory was the theoretical foundation for this study. The Utrecht Work Engagement Scale with additional demographic questions was used to survey 53 bedside nurses with 2 or more years of experience. Simple regression was used to analyze …

Water/Sanitation, Hygiene, And Risk Factors Associated With Under-5 Mortality In Côte D’Ivoire, Ouda Kamagate

Walden Dissertations and Doctoral Studies

Despite remarkable progress in children’s survival since 1990, the global burden of the under-5 mortality rate (U5MR) remains immense. According to the World Health Organization, about 5.2 million children below 5 died in 2019, with 14,000 dying each day. Literature reveals that the lack and limitation of water, sanitation, and hygiene (WaSH) are linked to deaths in childhood. Cote d’Ivoire still lags behind expectations with 79 per 1000 live births in 2019 rather than 25 and below, so there is a need to uncover to what extent the U5MR is affected by WaSH. Through a cross-sectional design guided by the …

Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …

Evidence-Based Discharge Planning For Assisted Living Facility Residents, Annick Sheron Kelly

Walden Dissertations and Doctoral Studies

AbstractLack of staff knowledge is one of the leading challenges contributing to ineffective discharge planning from assisted living facilities. Recognizing that appropriate discharge planning is essential to the well-being of residents, the purpose of this doctoral project was to develop a staff education program based on current evidence-based discharge planning procedures for residents of an assisted living facility. Knowles’s adult learning theory; Lewin’s change theory; and the analysis, design, development, implementation, and evaluation model guided development of the staff education program. According to a review of the literature, evidence-based strategies for resident discharge planning included early discharge planning; tailored support, …

Gender And Risk Behaviors Association With Hepatitis-B Infections Among Liberia Military Personnel, Joseph B N Kowo Jr

Walden Dissertations and Doctoral Studies

The increasing number of hepatitis B-related deaths in the Armed Forces of Liberia was due to the lack of understanding of the associated risks with the disease. Gender, substance use, and condom use have been researched as related risk factors for hepatitis B virus infection (HBV). The goal of this study was to determine if gender (male or female) and risk factors (substance use, alcohol abuse, and condom use) predicted hepatitis B infections after adjusting for age, marital status, education, and military rank among Liberia military population. The theory that grounded this study was Bronfenbrenner’s socio-ecological model (SEM) which posits …

Mental Health-Medical Crisis Team Impact On First Responder Outcomes On Persons With Mental Illness, Mary Josephine Lakey

Walden Dissertations and Doctoral Studies

Persons with mental illness (PMIs) are 16 times more likely to experience harm when interacting with police than individuals without mental illness. This inequity has recently become prominent in American discourse due to the ubiquitous use of cell phones and social media, where videos of incidents between police and PMIs circulate. In this generic qualitative research, members of a collaborative mental health and emergency medical service professionals (EMSPs) team in an urban area were interviewed to assess the team members’ perceptions of the impact of the program on frequency of adverse outcomes during interactions with PMIs. The theoretical framework for …

Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah

Walden Dissertations and Doctoral Studies

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It …

Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender

Walden Dissertations and Doctoral Studies

Substance use disorder continues to be a major health crisis in the United States. Thousands of people die yearly due to substance use and related criminal activity. Substance abuse treatment is a remedy to the disorder and treatment centers admit thousands of patients yearly to address the dilemma. Throughout the years retention has been an ongoing barrier to successful treatment. This study explored significant obstacles to retention: motivation and engagement. The Baldrige Excellence Framework was utilized to assess the training, supervision, procedures, and leadership roles at an intensive outpatient substance abuse treatment center. This study utilized a qualitative approach case …

Examining Health Care Utilization Among Adult Heart Disease Patients With Self-Reported Depressive Symptoms, Courtney R. Lockett

Walden Dissertations and Doctoral Studies

Health care costs are most commonly concentrated among small groups of high-cost patients, or high utilizers. Many of these patients receive unnecessary and ineffective care and often critical health care needs can go unmet, even when substantial care from multiple sources is received. Thus, there is a need to look into high utilizing patients for not only quality improvement but also effective resource allocation. The operational problem for health care administrators is managing resources and improving quality of care by targeting specific medical conditions that may be high utilizers of medical resources. The purpose of this study was to identify …

Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall

Walden Dissertations and Doctoral Studies

Managed care leaders of independent physician associations (IPAs) lack strategies for allocating existing funds to avoid business closure. Medical providers are concerned with the quality of care for patients if the allocation of funding is not executed correctly. Grounded in the competing values framework (CVF), the purpose of this qualitative single case study was to explore strategies managed care leaders of IPAs use to allocate funds to avoid business closure. Participants were six executive leaders of an IPA in Los Angeles, the United States, who successfully managed the allocation of funds in a managed healthcare system. Data were collected from …

Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka

Walden Dissertations and Doctoral Studies

Low health literacy can adversely affect individuals and groups without access to health information. Health insurance leaders who lack strategies to decrease low health literacy may lose their ability to provide quality health services and control care costs. Grounded in the health belief model and the Andersen health service model, the purpose of this qualitative multiple case study was to identify the strategies private health insurance leaders use to increase medical utilization to reduce healthcare costs. The three participants were from two private insurance companies in Las Vegas, Nevada. Data were gathered through semistructured, open-ended interviews via videoconferencing, a review …