Public Health Commons^™

Response And Rebuttal To "Comment On: Risk Factors For Workplace Encounters With Weapons By Hospital Employees" In Public Health In Practice; 3 (2022) 100256 By Chidinma Okani And Carmen Black, James D. Blando, Chalsie Paul, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

No abstract provided.

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

The Relationship Between Insurance And Health Outcomes Of Diabetes Mellitus Patients In Maryland: A Retrospective Archival Study, Soo-Hoon Lee, Samuel L. Brown, Andrew A. Bennett

Management Faculty Publications

Background

Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants of health disparities were associated with variabilities in health outcomes. However, improving access to healthcare, such as health insurance, should mitigate negative health outcomes. The aim of the study was to explore the association between four types of health insurance, namely, Medicare Fee-For-Service (FFS), Medicare Managed Care (MC), Private FFS, and Private MC plans, and the health outcomes of DM patients, controlling for patients’ social determinants of health.

Methods

This is a retrospective cross-sectional archival record study to explore the relationships between types of …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Innovative Framework For Academic And Public Health Departments' Partnership On Preparing Future Practitioners- Preliminary Data, Michele Kekeh, Muge Akpinar-Elci, Myngoc Nguyen, Nancy Welch

Community & Environmental Health Faculty Publications

This article presents a model to respond to current public health challenges and transform knowledge into preventive strategies. It also presents an innovative way for academic institutes and public health departments to focus on public health workforce development. Academic institutes partnership with public health departments have started fostering service-learning opportunities to engage students in public health with an emphasis on the specific public health outcomes. However, the benefit of service–learning projects on the health departments and the populations served is largely unknown. Recently, these service-learning opportunities are becoming less sustainable due to the inability of preceptors to provide the necessary …

Strategies For Controlling Violence Against Healthcare Workers: Application Of Fuzzy Analytical Hierarchy Process And Fuzzy Additive Ratio Assessment, Fazel Rajabi, Mehdi Jahangiri, Farnaz Bagherifard, Sean Banaee, Payam Fahadi

Community & Environmental Health Faculty Publications

Objective: The present study aimed to identify and prioritize control measures of violence against Healthcare Workers (HWs) using the Fuzzy Analytical Hierarchy Process (FAHP) and Fuzzy Additive Ratio Assessment (F-ARAS).

Background: Occupational violence is a pervasive problem in healthcare centers. Reducing violence against staff is one of the challenges for healthcare managers.

Method: At the first stage, the most common criteria and control options for violence against HWs were identified and extracted using a review of previous studies. At the next stage, criteria for selection of control measures were prioritized using the FAHP. Finally, control measures of workplace violence were …

Survey Of Workplace Violence Perception, Prevention, Strategies, And Prevalence Of Weapons In Healthcare Facilities, James D. Blando, Marilyn Lou Ridenour, Daniel Hartley

Community & Environmental Health Faculty Publications

No abstract provided.

Risk Factors For Workplace Encounters With Weapons By Hospital Employees, James Blando, Chalsie Paul, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Objective:The specific aim of this study was to determine which risk factors were associated with frequent weapons confiscation in a healthcare facility. This study investigated the hypothesis that hospital-related factors impact the frequency of weapons confiscation.

Study design:Cross-sectional.

Methods:A cross-sectional survey was administered on-line to hospital security directors and assessed the associations of organizational factors with the frequency of weapons confiscation.

Results:It was found that hospitals with metal detectors were more than 5 times as likely to frequently confiscate weapons, suggesting this intervention is effective. It was also found that hospitals with psychiatric units were more likely to have frequent …

Workplace Violence And Hospital Security Programs: Regulatory Compliance, Program Benchmarks, Innovative Strategies, James D. Blando, Maryalice Nocera, Marilyn L. Ridenour, Daniel Hartley

Community & Environmental Health Faculty Publications

The authors describe the issue of workplace violence in hospitals, a New Jersey state law and regulations regarding workplace violence in healthcare, and some innovative strategies that are being utilized to help reduce the occurrence and risk of violence. The authors also discuss compliance with the New Jersey regulations.

A Test Of The Behavioral Model Of Health Services Use On Non-Emergent Emergency Department Use, Moira Crosby Mcmanus

Health Services Research Dissertations

Even though emergency departments (EDs) were created to treat trauma and emergent cases, there has been an increase in emergency department (ED) utilization for non-emergent reasons over the past half of a century. As non-emergent utilization grows as a result of the ED becoming a prevalent substitute for primary care, overcrowding of the ED and increased wait times will continue. Additionally, unnecessary cost to both the ED and the patient will be incurred. Previous research has examined and determined various reasons and risk factors driving non-emergent ED use, among them the influence of living location and the number of non-emergent …

Microbiological Contamination Of Mobile Phones Of Clinicians In Intensive Care Units And Neonatal Care Units In Public Hospitals In Kuwait, Mohammed Heyba, Mohammad Ismaiel, Abdulrahman Alotaibi, Mohamed Mahmoud, Hussain Baqer, Ali Safar, Noura Al-Sweih, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background: The objective of this study was to explore the prevalence of microbiological contamination of mobile phones that belong to clinicians in intensive care units (ICUs), pediatric intensive care units (PICUs), and neonatal care units (NCUs) in all public secondary care hospitals in Kuwait. The study also aimed to describe mobile phones disinfection practices as well as factors associated with mobile phone contamination.

Methods: This is a cross-sectional study that included all clinicians with mobile phones in ICUs, PICUs, and NCUs in all secondary care hospitals in Kuwait. Samples for culture were collected from mobile phones and transported for microbiological …

Modeling Solutions For Prevention Of Medicare Insolvency For The Baby Boomer Generation (Born 1946 - 1964), Gregory Thomas Scott

Health Services Research Dissertations

Medicare, a United States social insurance program operated by the United States federal government, began operating in a deficit in the year 2010. More funding was expended than revenue received for medical care, creating significant shortfalls for the Medicare Trust Fund. This study examined possible initiatives to describe Medicare funding related to issues as financial shortfalls utilizing mathematical modeling and simulation. The Park Conceptual Model is a framework created to identify internal and external changes that influence bankruptcies related to municipalities, and this Model served as the theoretical basis for this study.

The following study addressed insolvency as negative cash …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

An Examination Of Factors Affecting Non-Urgent Use Of Emergency Department Services By Patients With "Universal" Healthcare, Gregory Smith Feltenberger

Health Services Research Dissertations

The purpose of this research is to examine the factors affecting non-urgent utilization of emergency department (ED) services by individuals with "universal" healthcare using the Behavioral Model of Health Services Use. Since Air Force Medical Service beneficiaries have free and unlimited use of the full-range of healthcare services, they are ideally suited for this study. The findings of this research may also apply to other populations with free or low-cost access to healthcare (i.e., universal or single-payer healthcare). Using secondary data extracted from the Air Force Medical Service's electronic health record system at several military hospitals, this study will present …

Early Diagnosis Of Pulmonary Embolism: Review And Cost-Effectiveness Analysis, Efstathios Polychronopoulos

Health Services Research Dissertations

Pulmonary embolism (PE) is a serious, life-threatening thrombotic disease, which results in considerable health and economic consequences each year for the United States. These consequences include a toll of 83,000 deaths and an economic impact between 1,5 and 5 billion. Approaches to strategy selection by physicians and other health-care specialists are based mainly upon cost, technology availability, and cultural tolerance regarding radiation exposure. The purpose of this study was to determine the most cost-effective diagnostic strategy with patients suspected of PE among several strategies currently used by examining their detection failure rates. This objective was met by (a) assessing parameter …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

The Relationship Of Financial Performance, Quality Indicators, And The Role Of Nurse Executives In Virginia Nursing Homes, Jeany V. Murphy

Health Services Research Dissertations

Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, …

Test Of A Multidisciplinary Health Behavior Model Of Medicare Elders' Antihypertensive Acquisitions, Ann Marie Kopitzke

Health Services Research Dissertations

This study examined the relative utility of the enhanced Health Belief Model as compared to the proposed Pharmaceutical Acquisition Model for Medicare Elders (PAMME) in describing antihypertensive acquisition with usage intentions for Medicare elders (65 years or older) in Southeastern Virginia. Data collection included record reviews to identify hypertensive Medicare elders. Consenting Medicare elders were randomly selected for invitation, with consenting Medicare elders contacted by telephone or in-person interviews. The survey instrument utilized open and closed ended questions. The target population for this study is Southeastern Virginia Medicare elders enrolled in a Part D plan and prescribed at least one …

Patient Satisfaction Among Users Of The After Hours Program, Helen L. Larocco

Community & Environmental Health Theses & Dissertations

The problem of increasing health care costs and decreasing access to health care services is a major crisis in the U.S. today. One factor contributing to the rising cost of health care is the inappropriate use of emergency rooms, (ERs). In response to escalating costs a local health care corporation implemented a telephone triage program called the After Hours Program, (AHP). The goal of the program was to reduce inappropriate utilization of emergency rooms, and to educate patients to recognize and treat specific health problems independently, i.e., home treatment.

A program evaluation was completed in which different dimensions of patient …

A Cipp Evaluation Of The Administrative Associate Training Program Through Sentara, Patricia A. Criswell

Community & Environmental Health Theses & Dissertations

Hospitals are facing change in today's environment. In order to meet these growing challenges, they are responding by providing value added services. Value added services have been defined as reducing inefficiencies and improving quality and service. Operational restructuring in the form of a new concept called patient-focused care has become the paradigm shift and structural revamping at several hospitals across the nation. Sentara Hospitals have adopted this program to improve the clinical and service quality delivered to the patient. An integral component of this new approach is the multiskilling of staff to reduce duplication, inefficiencies, and improve the quality provided …

The Relationship Of Locus-Of-Control And Altruism To Prehospital Emergency Medical Care Providers Universal Precaution Practices, Joanne L. Wakeham

Health Services Research Dissertations

The purpose of this study was to determine the relationship between locus of control, altruism, occupational risk, and personal factors to the frequency of universal precautions practices of prehospital emergency medical care providers. The effects of OSHA's Occupational Exposure to Bloodborne Pathogens; Final Rule on reducing prehospital emergency medical care providers occupational exposure to bloodborne pathogens were also examined. Prehospital emergency medical care providers from municipal and private EMS agencies in the Tidewater Emergency Medical Services region participated in this study. Prehospital emergency medical care providers self-reported perceptions of locus of control, altruism, occupational risk, and universal precautions practices were …

An Analysis Of Quality Assessment Efforts In Health Care, Margaret M. Curran

Community & Environmental Health Theses & Dissertations

The purpose of this research was to determine whether consensus could be reached by experts in the field of quality assurance on the most important indicators of health care quality and to determine whether cause and effect relationship could be attributed to the process and outcome indicators suggested in our survey. We invited participation by a representative sample of experts in a Delphi Panel to address these issues. There were 49 respondants to our Round One Questionnaire and they evaluated the relative importance of 50 process and 50 outcome indicators. Panelists were asked to establish cause and effect relationships between …

Identification And Ranking Of Stressors In Nuclear Medicine Technology, Scott R. Sechrist

Community & Environmental Health Theses & Dissertations

The purpose of this study was to identify the most significant stressors in the field of nuclear medicine technology. A sample of convenience of 25 nuclear medicine technologists was used to generate a list of 35 stressors specific to the occupation. Sixty-three randomly selected nuclear medicine technologists responded to a mailed questionnaire which asked the technologist to assess the relative stressfulness of each of the 35 items on a scale of "0 to 1000". Data from the 59 valid responses indicated that equipment malfunctions, add on exams, uncooperative physicians, lack of staff, and uncooperative patients were the most significant stressors …

Preferred Provider Organizations: Developmental Indicators, Marcia Anne Guida

Community & Environmental Health Theses & Dissertations

The purpose of this research was to determine what factors, if any, led to the development of a preferred provider organization and if these factors were related to sponsorship. A survey instrument was developed and mailed to a random sampling of 90 existing preferred provider organizations' executive directors for their completion. A Two-Factor Contingency Table Analysis was compiled. Chi-square, and the Contingency factor, C, were computed and tested at the .05 level of significance. First and second preference analyses were done on the responses to developmental indicators. Mean percentages were tallied for: sponsorship, tax status, alternative delivery systems in the …

Correlates Of Knowledge And Locus Of Control On Burden In Professional Caregivers Of Alzheimer's Disease Victims In Three Institution Types, Ruth A. Manning-Gay

Community & Environmental Health Theses & Dissertations

In assessing professional caregivers of Alzheimer's Disease victims, this study tested whether, 1) knowledge would influence perceptions of burden in providing care to such patients, and if 2) individual locus of control would influence perceptions of burden in caring for; Alzheimer's I patients. Professional nurses (BSN's, RN's, and LPN's) from nursing banes, hospitals and psychiatric facilities were asked to complete a three part survey. Three instruments were utilized in this study: the Burden Self-Interview by Zarit, Reeves and Bach-Peterson and adapted for professional caregivers, a 15 item knowledge quiz and the North Carolina Internal External scale (short form) by Schopler, …