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The Benefits Of Evidence Based Practices In Public Administration: Does Therapeutic Listening Training Increase Emotional Intelligence To Affect Change Management Outcomes In Public And Private Sector Organizations, John Sillup

West Chester University Doctoral Projects

Abstract

This doctoral dissertation considers change management as it relates directly to evidence-based practices in public administration. The problem under study was the lack of scholarly research on the effect of an administrative leader’s emotional intelligence (EI) has on follower self-efficacy during change management. This study provided findings on the effect of therapeutic listening training as a means to increase emotional intelligence to potentially affect change management outcomes in public and private sector organizations. Change management is a systematic and structured process of developing and implementing strategies and interventions for organizations transitioning from current state to a desired state. The …

Appreciative Inquiry Of A Non-Profit Organization Transitioning To Teletherapy, Claudia Herrera

Department of Family Therapy Dissertations and Applied Clinical Projects

Mental health professionals have been required to make a transition to delivering services using technology during the COVID-19 pandemic. The non-profit agency participating in this study had already listed on its strategic plan the delivery of teletherapy. In 2020, due to the pandemic, the agency decided to expedite the delivery of teletherapy services. This study explored the experiences of the agency’s team, to determine what worked well while making this transition, as well as future dreams regarding the delivery of teletherapy. Appreciative inquiry was used as the method of data collection. Findings indicated the agency’s clinicians found keeping a positive …

Reducing Recidivism Of Psychiatric Inpatient Clients In Behavioral Health Facilities, Cottrell Jacobs

Walden Dissertations and Doctoral Studies

AbstractResearch shows readmitting clients to inpatient psychiatric facilities within 30 days to one year of discharge can be costly for an organization and may represent less than optimal quality care for clients. The purpose of this study was to obtain an in-depth understanding of practices and barriers to reducing inpatient readmissions by completing a qualitative case study of readmission reduction strategies used by a large inpatient psychiatric facility in the southern United States. The Baldrige excellence framework was used to guide the assessment of the organization. Data collection consisted of five semi-structured interviews with organizational leaders, evaluation of internal archival …

Improving The Patient Experience With Case Management Follow Up Phone Calls: A Quality Improvement Project Evaluation, Karen Jarrell

Walden Dissertations and Doctoral Studies

In January of 2020, a follow-up phone call quality improvement initiative was implemented by the case management department of an acute care facility located in the Mid-Atlantic region of the United States, to improve the patients’ healthcare experience. The intent was to improve the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores. This quality improvement (QI) project was conducted using the Plan-Do-Check-Act Cycle along with the Kotter’s 8-step change model. The purpose of the QI project evaluation was to determine if a QI initiative using follow up phone calls had a positive effect on increasing CAHPS survey scores. The …

Implementing A Hospital-Acquired Pressure Ulcer Intervention In The Icu, Audrey Gross

Doctor of Nursing Practice Projects

Background: Hospitals had been confronting greater incentives to prevent Hospital-Acquired Pressure Ulcers (HAPUs). HAPU rates had increased in the Intensive Care Unit (ICU) at an academic hospital over the past six months, especially regarding device related HAPUs.

Objectives: The primary purpose of this project’s implementation was to decrease the number of HAPUs in the ICU by 50% within a three-month timeframe. Secondary objectives were to achieve scores of 100% in terms of compliance with the Registered Nurse (RN) education module, post-test scores, and documentation.

Methods: This was a Quality Improvement (QI) project involving adult patients in the ICU of an …

Rap1a Overlaps The Age/Rage Signaling Cascade In Type 2 Diabetes Mellitus, Stephanie Burr

Electronic Theses and Dissertations

Diabetic individuals have an increased risk for developing cardiovascular disease due to stiffening of the left ventricle, which is thought to occur, in part, by increased AGE/RAGE signaling. Advanced glycation end products (AGEs) accumulate within the body over time, and under hyperglycemic conditions, the formation and accumulation of AGEs is accelerated. AGEs exert their effect by binding to their receptor (RAGE) and can induce myofibroblast differentiation, oxidative stress, cell-extracellular matrix contraction, and cell migration. Previous findings from our lab have demonstrated that preventing the production of Rap1a, a Ras-like GTPase signaling protein, in cardiac fibroblasts will decrease type 2 diabetes …

Student Registered Nurse Anesthetist Perspective On The Impact Of A Clinical Mentoring Program, Sheila M. Mccarley

Doctor of Nursing Practice Projects

There is a competitive push for recruiting and retaining the Student Registered Nurse Anesthetist (SRNA) graduate. Retention efforts begin with their first clinical experience. Mentoring in the clinical setting is a critical factor in influencing the student nurse anesthetist's retention to practice. The purpose of this project was to assess whether mentoring in the local setting noted similar findings. The method involved a survey of student nurse anesthetists queried about perspectives on a clinical-based mentorship program. Certified Registered Nurse Anesthetist (CRNA) faculty members vetted the survey instrument before implementation. The project focused on students presently enrolled in their first-year clinical …

Clinical Practice Guidelines For Assessing And Reporting Workplace Violence Against Nurses, Janice Lynn Canfield

Walden Dissertations and Doctoral Studies

AbstractWorkplace violence consists of physically and psychologically damaging actions while on duty. In healthcare, under a cloak of secrecy concerning workplace violence, an underreported epidemic exists. This problem is important to address because workplace violence can affect the quality of care delivered and patient care outcomes.. The purpose of this project was to develop a nursing clinical practice guideline (CPG) to assist hospital-based nurses to identify risk factors for workplace violence, identify strategies to mitigate violence, and report workplace violence. This CPG can be an effective tool for nurses to better understand the scope and nature of violence in the …

Examination Of Nurses’ Perceptions, Beliefs, And Conceptions Related To Rapid Bedside Implementation Of Prone Therapy During The Covid-19 Pandemic, Alyssa Poghen, Emily La Riviere

Doctor of Nursing Practice Projects

The COVID-19 pandemic of the SARS-CoV-2 virus created significant challenges for healthcare agencies and front-line healthcare workers. The SARS-CoV-2 virus has demonstrated a unique propensity to induce severe lung injury in the form of acute respiratory distress syndrome (ARDS). High rates of COVID-19 illness in the initial months of the pandemic in the United States led to a rapid influx of patients admitted to critical care units (CCUs) for ARDS. Prone positioning therapy (PPT) has shown substantial promise in treating refractory hypoxemia in people with severe ARDS but historically received poor acceptance as a first-line therapy. With the onset of …

The Development Of A Survey Instrument To Assess Racial And Cultural Inclusiveness: A Case Study Of Staff, Jolene Rios

All Master's Theses

Background:

The hierarchy of the medical system and its lack of racial and cultural inclusiveness has created systematically inequitable healthcare with direct outcomes to health disparities. Inequitable non-inclusive healthcare perpetuated and negatively impacted health disparities among minorities and has been a major preventable public health problem. Research studies have established a correlation between racism and various adverse health outcomes, including higher mortality, lower rates of cancer screening, elevated blood pressure, higher C-reactive protein levels, substance use, and mental health conditions (Shavers et al, 2012). Measuring exposure to racism has been essential to establishing racism’s influence on equitable, inclusive healthcare and …

A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes

Walden Dissertations and Doctoral Studies

Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …

Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan

Walden Dissertations and Doctoral Studies

Balanced diversity in health care promotes patient satisfaction and enhances innovation. Obtaining a culturally balanced workplace requires recruitment strategies that encourage inclusiveness among team members from various backgrounds. The purpose of this doctoral study was to explore the issue of lack of diversity in a behavioral health organization’s (BHO’s) student intern program and identify strategies for creating greater diversity in the workplace. The Baldrige excellence framework, the conceptual framework that guided the research, was designed to help BHOs to improve their overall business performance to accomplish goals and increase organizational sustainability. Three themes emerged from the data analysis: diversity training, …

Health Care Leaders Strategies And Patient Satisfaction, Aaronn Haerr

Walden Dissertations and Doctoral Studies

Ineffective patient satisfaction strategies can negatively impact patient satisfaction scores and overall organizational performance. Health care leaders who struggle to increase patient satisfaction are at high risk of diminished organizational performance and long-term sustainability. Grounded in the transformative learning theory, the purpose of this qualitative single case study was to explore strategies health care leaders implemented to improve patient satisfaction. The participants were five health care leaders in Ohio who effectively implemented strategies to increase overall patient satisfaction. Data were collected from semistructured interviews, organizational documents provided by the participants, and the company website. Yin’s five-step method was used to …

The Strategic Orientation Of Skilled Nursing Facilities, Jennifer R. Palazzolo

Theses and Dissertations

Since the early 2000s, skilled nursing facilities (SNFs) have operated in an environment made uncertain by changes in health care policy, growth in substitutes for nursing care, and increasing demand for services. To better understand how SNFs are strategically positioning themselves to survive and thrive, this study develops a taxonomy of strategic groups of SNFs.

A conceptual framework is based in Strategic Management Theory and classification of SNFs is based on scope of business decisions including length of stay, complexity of patients, and referral networks with hospitals. Two-step, hierarchical cluster analysis finds six strategy groups of SNFs: Post-Acute Care Focus …

Promotion Of Most Forms Through Education About Importance Of Advance Care Planning In Seriously Ill Patients, Nidhi More

DNP Projects

Abstract

Purpose: To establish the importance of early Advance Care Planning (ACP) and improve the utilization of Medical Orders for Scope of Treatment (MOST) forms in seriously ill patients by educating providers and nurses to identify patients who meet specified criteria. The goals of this intervention are reduction of readmissions and better quality of life for this patient population.

Methods: A quasi-experimental design was used for evaluation of an Educational intervention to promote MOST forms, Advance Directives (AD) and Palliative Care (PC) consults. A retrospective and prospective chart review was conducted to determine the number of patients who met criteria …

Improving Multidisciplinary Adherence To A Daily Goals Checklist In The Icu: A Quality Improvement Initiative, Chelsea Mccarty

DNP Projects

Abstract

Background: In November 2019, the University of Louisville Hospital merged and assumed operations of all KentuckyOne facilities. During the transition, a spike in hospital acquired infection rates ensued at Jewish Hospital, notably amongst the critical care units. In January 2020, a daily checklist was introduced to the critical care department. A Daily Checklist is a tailored communication tool designed to reduce communication error and improve adherence to patient safety measures. There continues to be a gap in adherence to the U of L daily checklist from both nurses and providers. Purpose: The purpose of this project was to improve …

The Impact Of A Change In Leadership, Taylor Collins

DNP Projects

Abstract

Background: Unmitigated stress in nursing results in moral distress, burnout, turnover and poor patient outcomes. Authentic leaders can improve the nurses’ work environment and satisfaction by improving communication and implementing supportive measures.

Purpose: The purpose of this study was to determine whether a change in executive leadership at BSW Grapevine Medical Center reduced nursing job stress as evidenced by improved nurse satisfaction, nurse retention, nurse engagement, patient satisfaction and care outcomes.

Conceptual Framework: Watson’s Theory of Human Caring

Design: This study is a quantitative, descriptive retrospective measurement of two points in time, before and after …

S.A.F.F.E.R. Airway Management: Evaluating The Effectiveness Of Checklist Implementation On Reducing Peri-Intubation Complications In An Air Medical Transport Service, Rachael M. Croley

DNP Projects

Background: Advanced airway management via endotracheal tube placement in the critically ill and injured is tenuous and presents a multitude of challenges that threaten patient safety. The potential for procedure-associated hypoxia, hypotension, and cardiac arrest during the peri-intubation period can be detrimental to overall patient outcomes. Purpose: The purpose of this project is to evaluate the effectiveness of the Standardized Airway Flow For Engineered Resuscitation (S.A.F.F.E.R.) checklist in reducing peri-intubation complications and provider perception of checklist implementation when performing advanced airway procedures.

Methods: A case-control analytical observational design study which included retrospective and prospective electronic medical record review to determine …

Evaluating The Sustainability Of A Colorectal Cancer Screening Improvement Intervention, Kimberly Bastin

DNP Projects

Background: Sustainability is a domain or characteristic of quality in healthcare that is not just about what may be delivered to patients today, but what can continue to be delivered to patients in the long term. Evidenced based interventions and quality improvement (QI) initiatives have led to major advancements in health care and have become expected in every clinical setting. Despite the amount of QI work taking place, there is limited evaluation of the sustainability of initially successful quality improvement efforts and a lack of evidence supporting best strategies and measures to ensure that improvement of goals and outcomes are …

Validation Of An Evidence-Based Dietetic Practice Instrument And The Association Between Level Of Education And Use Of Evidence-Based Dietetic Practices Among Registered Dietitian Nutritionists, Leslie Thompson Van Horn

UNF Graduate Theses and Dissertations

Evidence-based practice (EBP) is associated with improved and consistent patient care and reduced healthcare costs. While dietetic didactic and practice requirements emphasize EBP, there is a lack of a valid and reliable instrument that measures both objective and subjective knowledge of EBP among registered dietitian nutritionists (RDNs). Content validity was conducted with 11 experts and resulted in a 38-item survey that included ten items assessing objective knowledge of EBP. Items were deemed clear and appropriate for the survey goals and intended audience based on a face validity review among 16 RDNs with varying backgrounds. A pilot evaluation (n = …

Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah

Walden Dissertations and Doctoral Studies

In the United States, the registered nurse turnover rate was 17.2% in 2018, a 0.4% increase from 2017. The nursing turnover rate at a small out-patient clinic in the northeast United States was 19.1% in 2019 and has not improved to date. The administrator at the out-patient clinic further indicated that the turnover rate has been approximately two nurses per month for the last 6 months and that the facility did not have a formalized nurse orientation program. Nursing orientation is one of the strategies for increasing the confidence levels and retention of newly hired nurses. The purpose of this …

Meaningful Use Criteria And Staff Accountability In An Office Setting, Marcia Ionie Pender

Walden Dissertations and Doctoral Studies

Proper documentation for meaningful use (MU) criteria within electronic health records (EHRs) was identified as an issue for office staff at a local primary care office in a metropolitan area of Central Florida. The project question addressed the local gap in knowledge about MU standards necessary to ensure correct documentation of EHRs. The purpose of this doctoral project was to provide an educational program for staff to ensure compliance with the HITECH Act of 2009. Lewin’s Change Theory and Knowles Theory of Adult learning were the conceptual foundations for the educational program. The project question was to determine whether a …

Effects Of Differing Education Levels On Respiratory Therapy Hiring Decisions In Pennsylvania, Ronald Curtis Aumiller

Walden Dissertations and Doctoral Studies

Many healthcare professions struggle with knowing what the entry-level educational requirement should be for their profession. This study looked at the educational level of hiring managers for respiratory therapy and whether that affected their decisions on hiring associate or baccalaureate degree graduates in the state of Pennsylvania. The quantitative internet-based questionnaire surveyed respiratory therapy hiring managers in hospitals in Pennsylvania. The power theory, with the use of expert power, organizational culture and change, and ethnographic principle, was used to examine how hiring managers choose their employees. An invitation was sent to 70 respiratory hiring managers in Pennsylvania to participate on …

A Lebanese Health Care Organization’S Strategies To Secure Sustainable Funding, Dania Mahmoud Al Assadi

Walden Dissertations and Doctoral Studies

Fundraising and donations are the main sources of revenue for behavioral health care nonprofit organizations (NPOs) worldwide. Economic, political, social, or health crises impact fundraising and donation sources for behavioral health care NPOs. This qualitative case study addressed strategies that senior leaders of a Lebanese behavioral health care NPO could use in times of crisis. The study also addressed the behavioral health leaders’ experience managing a funding crisis. The Baldrige conceptual framework was used to assess the organization’s effectiveness in seven key areas. Interviews with the senior leaders and analysis of the organization’s archival data were used to inform the …

Inhaled Insulin, Afrezza, Educational Module For Health Care Providers, Sara Lynn Doolin-Thompson

Walden Dissertations and Doctoral Studies

Abstract Inhaled Insulin, Afrezza, Educational Module for Health Care Providers

bySara Doolin-Thompson

MSN, Walden University, 2014 BSN, University of Phoenix, 2004 ASN, Kentucky Wesleyan College, 1994

Project Submitted in Partial Fulfillmentof the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021 Abstract Diabetes is on a global rise and there is a definite gap in providing care for the diabetic population. Two of the largest contributors to this gap in care are the lack of collaboration between health care professionals and the lack of education for health care providers on the evolution of diabetes treatment plans. …

Staff Education To Promote Postpartum Depression Screening, Melony Stokes

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is the most frequent cause of maternal morbidity in the United States. PPD is far more prevalent than reported. The literature suggests that more than half of women experiencing PPD are untreated and unrecognized. PPD affects the health of mothers and their newborns and is associated with long-term psychological and socioeconomic implications. Varying factors may influence PPD, and it is often difficult for patients to recognize the symptoms making it critically important for health care staff to screen for PPD. The aim of this project was to determine whether an education program for nurses in an obstetrical …

Merger And Acquisitions: Effects Of Cultural Adaptation On Burnout Over Time Among Middle Managers, Perian Nora Stavrum

Walden Dissertations and Doctoral Studies

Merger and acquisition (M&A) actions are common; however, research on cultural adaptation over time leading to burnout is scarce. The purpose of this quantitative, nonexperimental study was to evaluate the relationships between independent variables defined as organizational and group adjustment, and the criterion variables operationalized as emotional exhaustion and cynicism, and to determine if the adjustment factors and time interact, affecting burnout in middle managers working in a target organization of U.S.-based M&As. The theoretical framework used was organizational socialization, conceptualized as newcomer adaptation, suggesting that individuals must traverse through an adjustment period regardless of the context of the change. …

Territoriality As A Factor In Nursing Incivility, Carolyn Wright

Walden Dissertations and Doctoral Studies

AbstractIncivility and hazing in health care results in unsafe environments, not only for the nurse but also for the client, facility, and other health professionals. The project site, a privately owned medical clinic, has a high employee turnover rate with exit interviews indicating bullying and incivility from long-term nursing staff toward new employees as critical reasons for employee resignation. The literature offers minimal information regarding territoriality, a concept associated with aggressive (i.e., alpha) behaviors in animals and humans and incivility in nursing. The purpose of the project was to identify whether territoriality was a behavioral factor that may have contributed …

Effective Postdischarge Communication From Nursing Staff To Mental Health Patients, Paula Renee Garrison

Walden Dissertations and Doctoral Studies

AbstractMental health patients have a history of decreased follow-up appointments, poor diet, and medication noncompliance after discharge from inpatient facilities in addition to multiple co-morbidities, making a return to the community difficult. The practice problem was an increase in hospital readmissions of mental health patients within 30 days postdischarge due to inadequate post-discharge education and follow-up communication. Using Rodgers’s recovery on mental health theory and Revan’s action learning theory, a staff education program was developed to educate 10 nursing staff and two social workers on how to effectively implement postdischarge communication at 3 days and 30 days after discharge from …

An Investigation Of Strain And Support Needs Of Caregivers Of Older Adults With Delirium And Allied Health Promotion Interventions, Jasmine Vickers

All ETDs from UAB

Delirium, or the sudden onset of confusion, is common, highly distressing, debilitating, and deadly among hospitalized older adults and is associated with adverse outcomes for their family caregivers. As people are living longer with more complex conditions, more people will face the task of caregiving for older adults with delirium. Family caregivers can make meaningful contributions to delirium care, but high distress, insufficient knowledge, and lack of skills often seen in caregivers can lead to maladaptation and negative health outcomes. A few studies have focused on distress in caregivers from witnessing delirium episodes; however more research is needed to understand …