Digital Commons Network^™

Employee Commitment Among Direct Care Professionals In An Intermediate Health Care Facility, Sharron Theresa Nicholson-Mccall

Walden Dissertations and Doctoral Studies

Lack of employee commitment affects the overall practice in healthcare organizations and can cause a disruption in the lives of people with intellectual disabilities who are receiving care. Researchers have demonstrated that increasing employee commitment and decreasing employee turnover are related to employee commitment in healthcare organizations. The purpose of this single case study was to explore strategies that leaders of an intermediate care facility for individuals with intellectual disabilities in the northwestern United States used to enhance employee commitment. Meyer and Herchovitch's model of employee commitment was the conceptual framework for this study. Data were collecting from semistructured interviews …

A Thematic Analysis On How Forensic Psychologists Conduct Personal Injury Evaluations, Denise M. Autret

Walden Dissertations and Doctoral Studies

Psychological evaluations administered by forensic psychologist in personal injury cases are surrounded by complex issues. Although empirically-based research has legitimized that psychological damages do exist in personal injury cases there is a missing link in the way forensic psychologists are conducting these evaluations. Prior researchers suggested that some personal injury evaluations had been dismissed or overlooked due to a lack of a standard of care. Addressing the current literature, this study examined how a diverse group of 14 licensed forensic psychologists, operating in different judicial jurisdictions (Daubert, Frye, and Independent) were conducting personal injury evaluations and their perspectives on the …

Preventing Catheter-Associated Urinary Tract Infections With Education On Using The Catheter Bundle, Diana Elizabeth Carlson

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention, the Joint Commission, and the Agency for Healthcare Research and Quality recognized the importance of reducing health-care-associated infections (HAIs) and catheter-associated urinary tract infections (CAUTIs) for the safety of all patients. The U.S Department of Health and Human Services has focused on approving a plan to address HAIs in the health care setting with an emphasis on CAUTIs. The purpose of this project was to decrease CAUTI rates on a long-term care and rehab unit by educating staff about using the CAUTI bundle and CAUTI maintenance tool kit. The theoretical framework that guided …

Relationship Between Senior Leadership Style And Patient Satisfaction In The Inpatient Rehabilitation Facility, Amy Elder

Walden Dissertations and Doctoral Studies

Patient satisfaction has a significant role in the healthcare industry, as high patient satisfaction can improve quality outcomes. Hospital leadership is responsible for the culture, outcomes, and patient experience, which can involve different leadership styles. The purpose of this quantitative study was to examine the relationship between leadership style of senior leaders and patient satisfaction in inpatient rehabilitation facilities (IRFs). Through the theoretical framework of transformational and transactional leadership theories, the research questions were designed to determine whether a statistically significant relationship existed between leadership style (transformational, transactional, and laissez-faire leadership) and patient satisfaction. The Multifactor Leadership Questionnaire was administered …

Staff Education On Metabolic Syndrome In Patients Taking Antipsychotic Medications, Juliana Ifeoma Omile

Walden Dissertations and Doctoral Studies

Second-generation antipsychotics (SGAs) are prescribed for treatment of psychosis. A major side effect of SGAs is an increased risk of metabolic syndrome (MetS) with symptoms of hypertension, hyperlipidemia, hyperglycemia, and truncal obesity. A clinic in the northeastern United States was not screening patients for MetS when being treated with SGAs. The purpose of this project was to educate staff on MetS risk factors, signs, symptoms, and patient management with a goal to improve their knowledge of MetS. Lewin's change theory provided a conceptual framework for the project. The project question explored the development and evaluation of an educational module on …

Impact Of The Prophecy Job Fit Predictor On New Graduate Nurse Satisfaction, Joi Alesha Johnson

Walden Dissertations and Doctoral Studies

Research has shown that job satisfaction influences retention of nurses, and policies focused on nursing satisfaction are more beneficial for retaining new nurses than adjusting work hours and wages. The prophecy job fit predictor is a quality improvement initiative designed to identify where a nurse should be assigned based on behavior, clinical capabilities, and personality assessment. The practice-focused question for this project focused on whether satisfaction rates of recently graduated registered nurses were influenced by their unit placement. The conceptual frameworks that guided this project were the plan, do, study, and act method and Herzberg's 2-factor theory. Data were obtained …

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …

Impact Of A Healthcare Workplace Violence Prevention Module On Staff Knowledge, Michelle Leigh Arroyo

Walden Dissertations and Doctoral Studies

The healthcare sector experiences violence 4 times as much as any other civilian domain, including law enforcement and corrections facilities. The clinical practice problem addressed in this project was the lack of adequate healthcare workplace violence (HWV) prevention in a not-for-profit community hospital. The purpose of this project increase awareness of HWV prevention through the use of an education module. Rogers’ diffusion of innovation model served as the foundation for analysis of scores from pre- and posteducation tests. The practice-focused question asked if a module on HWV prevention based on current clinical practice guidelines and peer-reviewed literature would improve staff …

Implementation Of A Trauma-€Informed Care Program For The Reduction Of Crisis Interventions, Renae Denise Hale

Walden Dissertations and Doctoral Studies

Childhood trauma is the primary reason children and adolescents display behavioral issues that require hospitalization. Implementation of a trauma-€informed care (TIC) program was the intervention chosen at a child and adolescent behavioral health hospital to decrease physical holds and seclusion rates for patients aged 3 to 17 and to reduce the risk of retraumatization of children needing psychiatric care. Six core strategies from the National Association of Mental Health Program Directors was the framework for this project. The number of crisis interventions before and after implementation were 440 and 259, respectively. The number of seclusions before implementation was 215, and …

Employee Retention Strategies For Executive Operation Leaders In An Academic Nursing Environment, Polly Castro Ramos

Walden Dissertations and Doctoral Studies

Employee attrition affects organizations in the form of lower productivity, decreased profitability, and reduced sustainability. In 2014, business owners lost over $11 billion in tangible and intangible assets due to the inability to retain employees. Using the social exchange theory as the conceptual framework, the purpose of this multiple case study was to explore effective employee retention strategies used by business leaders in an academic nursing environment. The study encompassed participants from 3 of the United States: Texas, Kentucky, and Florida. Participants were purposefully selected because of their experience in implementing effective employee retention strategies. Data were collected via semistructured …

An Educational Intervention For Skin Cancer Prevention With Hospital Staff: A Pilot Project For System Change, Amy Fran Bruce

Graduate Theses, Dissertations, and Problem Reports (ETD)

PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017).

METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention …

The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette

Walden Dissertations and Doctoral Studies

The profession of physicians' assistant was introduced in the 1960s to assist with physician shortages in the United States of America. Since then, some countries have introduced this profession to fill the gaps that exist in the physician shortages problem in their health care system. Yet, in many countries like Trinidad and Tobago, this role remains absent from the health care system. The objective of this study was to assess how professionalization supports the introduction of the physicians' assistant role in Trinidad and Tobago. Using the theory of profession as a theoretical framework, and through an evaluation of institutional, regulatory, …

Leadership Strategies To Improve Nurse Retention, Floyd Jordan Colwell

Walden Dissertations and Doctoral Studies

The nursing shortage and high turnover rates are a problem in the United States. The purpose of this multiple case study was to explore leadership strategies that hospital senior nurse managers in the Rocky Mountain states use to improve nurse retention. Participants were 6 hospital senior nurse managers including 3 chief nursing officers, 1 assistant chief nursing officer, and 2 directors who had demonstrated effective leadership strategies in retention of nurses. The leadership-motivated excellence theory was the conceptual framework. Semistructured interviews with open-ended interview questions were used to collect data; organization websites and documents were used to help corroborate evidence …

Successful Billing Strategies In The Hospital Industry, Samirah Merritt

Walden Dissertations and Doctoral Studies

Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and …

Nurse Faculty Perceptions Of Role Stress And Faculty-To-Faculty Incivility, Anne Kraft Kleinhesselink

Walden Dissertations and Doctoral Studies

The purpose of this study was to determine the relationship between nurse faculty perceptions of role stress and faculty-to-faculty incivility using the stressor-emotion model of counterproductive work behaviors. A convenience sample of 79 nurse faculty from 39 undergraduate nursing programs in Iowa responded to an online survey. The survey consisted of two instruments: Workplace Incivility Civility Scale and Role Strain Scale. Findings revealed 76 participants perceived incivility as a problem and identified stress (n = 64) and demanding workloads (n = 54) as contributing factors. Pearson correlation results revealed a positive relationship between experienced incivility and nurse faculty perceptions of …

Parents' Knowledge Of Child-Passenger Safety And Child-Passenger Restraint Usage, Amanda Cadore

Walden Dissertations and Doctoral Studies

Although occupant protection laws exist, limited research has been conducted on how current child passenger safety (CPS) issues and CPS marketing strategies relate to child passenger safety seat (CPSS) usage. The purpose of this cross-sectional study was to analyze the relationship between parents' perception and knowledge of CPS issues and CPSS usage rates. The diffusion of innovation and the social marketing theories provided the frameworks for this study. The overall research question for the study examined the correlation between parents' knowledge of CPS issues and CPSS usage. Data (participants' surveys, car seat check-up information, and observational statistics) were collected from …

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …

Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster

Walden Dissertations and Doctoral Studies

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …

Evaluating An Educational Initiative For Postsurgical Vascular Patients, Cynthia Ann Gillespie

Walden Dissertations and Doctoral Studies

The educational medium GetWellNetWork (GWNW) in a large magnet teaching facility offered few educational videos specific to vascular patients with a focus on leg elevation after lower extremity bypass surgery. Supplying patient-specific education has the potential for providing cost-effective nursing care to vascular patients and improving hospital reimbursement. Guided by the interactive care model, a storyboard was developed using best-practice evidence for vascular postoperative patients that could lead to the development of a video to address the educational needs of vascular patients upon discharge. The practice focused question asked if a video addressing the importance of leg elevation would improve …

Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes

Walden Dissertations and Doctoral Studies

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …

Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller

Walden Dissertations and Doctoral Studies

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …

Geographically Distributed Employees' Perceptions Of Employee Assistance Program Access, Davina Smith

Walden Dissertations and Doctoral Studies

Many investigators have documented high levels of stress in the U.S. workplace and the underutilization of employee assistance programs (EAP). Researchers in other studies have concluded that an employee's perception of a service influences participation and service use. However, the perceptions of geographically distributed employees, who represent a growing population, have not been sufficiently examined. The purpose of this study was to investigate geographically distributed employees' perceptions regarding access to EAP stress management services to address the problem of EAP underutilization. Organizational justice theory served as the theoretical framework. The study design was generic qualitative. A purposeful sample of 15 …

Home Health Aides' Performance And Home Health Clients' Quality Of Life, Ronny Terrell Smith

Walden Dissertations and Doctoral Studies

Home health aides' performance can help home health clients achieve quality of life. This quantitative, cross-sectional study examined which work-related factors of home health aides influence home health clients' quality of life. A socioecological perspective was used to understand influences on behaviors. Participants in this study were 400 home health clients who received services from home health agencies. A binary logistic model was used to determine the predictor variables of home health aides that contributed to home health clients' quality of life. Findings indicated that psychosocial skills were among the most predicted work-related performance of home health aides that lead …

Effective Strategies For Recognition And Treatment Of In-Hospital Strokes, Maryika Ivanova Gibson

Walden Dissertations and Doctoral Studies

In-hospital onset strokes represent 4% to 20% of all reported strokes in the United States. The variability of treatment protocols and workflows as well as the complex etiology and multiple comorbidities of the in-hospital stroke subpopulation often result in unfavorable outcomes and higher mortality rates compared to those who experience strokes outside of the hospital setting. The purpose of this project was to conduct a systematic review to identify and summarize effective strategies and practices for prompt recognition and treatment of in-hospital strokes. The results of the literature review with leading-edge guidelines for stroke care were corelated to formulate recommendations …

An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon

Walden Dissertations and Doctoral Studies

A global epidemic of metamorphosed, conglomerated health care systems changed the face of public health care organizations. The problem is, public health care organizations merge into new systems, but the culture for each merged organization has not been formed under the new system. Public administrators, health care workers and the Department of Health and Human Services are affected when there are issues in health care behavioral practices and performance outcomes. Research found that employee motivation is hard to achieve when there are issues within the internal structure of a new system. Using Herzberg's motivation-hygiene and Tajfel and Turner's social identity …

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

Hospital-Acquired Pressure Ulcer Prevention, Druscilla Willis Jones

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure ulcers (HAPUs) represent a significant challenge in the care provided for hospitalized patients. HAPUs impact morbidity, mortality, and quality of life. At the local practice site, the incidence of HAPUs increased in the perioperative setting. The practice-focused question for this project asked if an education program for staff nurses working in a perioperative care setting with high HAPU incidence can advance nurse knowledge regarding prevention, early assessment, symptoms, and treatment of HAPUs. The purpose of this educational project was to develop a pretest and posttest designed education program on HAPU prevention and care for perioperative nurses. The Iowa …

The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn

Walden Dissertations and Doctoral Studies

Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public …

Improving Access To Cancer Care For The Rural Community With Telehealth, Cheryl Ann Fiscelli

Walden Dissertations and Doctoral Studies

After a diagnosis of cancer, timely access to oncology care is a priority. For patients living in a rural community, there are many challenges such as proximity to cancer care, reduced access to state-of-the art therapies, lack of coordinated care, and limited access to clinical trials. A multidisciplinary consultation (MDC) via telehealth can improve access to care for rural oncology patients. The purpose of this project was to determine the effects of telehealth MDC on the time in days from diagnosis to the first treatment with the goal of persuading the project site to implement a telehealth MDC. The data …