Digital Commons Network^™

Examining Nurse Satisfaction With A Bedside Handover Report Process, Imelda C. Principe

Walden Dissertations and Doctoral Studies

Nurses' job satisfaction affects work performance at the point of care in hospitals. The incoming nurses who are able to receive a comprehensive patient report at shift change are more prepared in comparison to incoming nurses who are not able to receive a comprehensive patient report to provide care that is safe. The purpose of this project, guided by the theory of organization change, was to explore whether the use of a bedside handover process impacts nurses' satisfaction in an adult postoperative orthopedic and spine unit. A post-implementation survey of the bedside handover process was conducted after one month and …

Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans

All ETDs from UAB

This three-paper dissertation sought to examine the existence of strategic groups in the home health industry, the application of Porter’s generic strategies (cost leader, differentiator, “stuck-in-the-middle” and both cost leader/differentiator) in identifying these groups, and the association of group membership with agency performance. The findings of this study will provide researchers and managers with a highlight of the current strategic makeup of the home health industry and its relationship with quality and financial performance. The results of this dissertation provide some evidence that strategic groups do exist in the home health industry and can be described along the basis of …

Interprofessional Education: Theoretical And Practical Considerations For Occupational Therapy Educators, Mary K. Arvin, Lorrie A. George-Paschal, Jennifer S. Pitonyak, Sandee M. Dunbar

Journal of Occupational Therapy Education

Interprofessional education (IPE) is an integral part of occupational therapy education as programs across the United States incorporate IPE into existing courses and develop new, innovative curricula. The American Occupational Therapy Association (AOTA) Commission on Education (COE) proposed in its 2015 position paper on IPE in occupational therapy curricula, that IPE is imperative for effective and ethical practice in today’s healthcare environment. Through participation in a Scholarship of Teaching and Learning program focusing on IPE, the authors examined broad constructs and practical implementation of IPE in occupational therapy education. As occupational therapy educators explore opportunities to collaborate with a diverse …

Leadership Styles And Leadership Effectiveness Of Outpatient Physical Therapy Clinic Managers, Adedolapo Ibiyemi Oyefeso

Walden Dissertations and Doctoral Studies

Outpatient physical therapy clinics (OPTC), like many other healthcare organizations, face an array of challenges in meeting the needs of the growing elderly population. The leadership behavior of OPTC managers is a key component to secure employee loyalty, accommodate increased patient demand, and implement positive organizational change. The purpose of this nonexperimental quantitative survey designed study was to investigate the relationship between the leadership styles perceived by OPTC healthcare managers and nonmanagerial employees, as measured by the Multifactor Leadership Questionnaire Short. The primary research question examined the difference between the OPTC managers' self-perceived leadership style and the nonmanagerial subordinates' perceptions …

Barriers To Transition Of Care For Heart Failure Patients, Catherine Mary Murray

Walden Dissertations and Doctoral Studies

Heart failure (HF) is an escalating chronic disorder that impacts patients, families, and society. HF necessitates efficient transition of care and complex self-care knowledge in a population often burdened with low health literacy and high readmission rates. The purpose of this project was to improve transition of discharged HF patients from a Level 1 trauma system in a mostly rural area of South Carolina to its affiliated nurse-led HF clinic. The no-show rate for initial visits to the health care system's outpatient HF clinic by postdischarge patients was 59%. Using Henderson's need theory and Stevens's knowledge transformation model for theoretical …

Evaluation Of A Gender-Relevant Physical Activity After-School Program, Vianay Lopez

Open Access Theses & Dissertations

Background: Physical activity rates have decreased in the past 30 years. Physical activity rates decline further among girls as they reach adolescence, yet studies suggest girls are more inclined to participate in moderate-to-vigorous physical activity (MVPA) while among peers. When in close social networks, girls who have more physically active friends report being more active themselves. Several mentor-based programs throughout the United States have increased physical activity among preadolescent girls, indicating that gender-relevant physical activity programs may reverse their declining rates of physical activity.

Purpose: To evaluate if participation in a gender-relevant physical activity after-school program influenced participants' aerobic fitness, …

A Systems Approach To Moral Distress In Long Term Care, Margaret Lemley

Electronic Theses and Dissertations

Abstract: The question that this dissertation seeks to answer is whether or not a Systems Approach to Moral Distress can serve to positively address issues of moral distress within the Long-Term Care setting. Because moral distress has largely been understood as a phenomenon of the individual, efforts to address and reduce incidents of moral distress have focused almost entirely on the individual and his or her reaction to specific triggers. Building upon the existing literature this dissertation argues that previous efforts to understand moral distress within the healthcare setting have been limiting in two very important aspects. The first …

Prevalence And Factors Associated With Sexual Activites Among High School Students In Kendal Regency, Indonesia, Ekha Rifki Fauzi

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: The risk of sexual activities among adolescents is high in globally. Unwanted pregnancy, sexual transmitted infections, and HIV are still the big problem in adolescents. This study was involved to exam the prevalence and factor associated with sexual activities among high school students. Methods: A cross-sectional study was conducted around 145 male students and 315 female students. The total populations was 460 students with multistage random sampling technique. A self-reported questionnaire was used including Illustrative Questionnaire for Interview-Surveys with Young People, Sexual Activity Scale and Sex Education Inventory. Descriptive statistics, Chi-square test, and multivariate logistic regression were used to …

Developing Psychiatric Nursing Competencies On An In-Patient Hospital-Based Psychiatric Unit, Beverly J. Sedlacek

Doctor of Nursing Practice Projects

Problem Statement

Offering staff development training for psychiatric nurses has not kept pace with the advances in psychiatric knowledge and skills in nursing. Purpose: The purpose of this quality improvement doctor of nursing (DNP) project was to implement a competency-based staff development program on a community hospital-based inpatient psychiatric unit to determine if the psychiatric/mental health nursing knowledge, nurse patient relational skills, and attitudes of the nurses would improve or change.

Methods

A mixed method of quasi-experimental, non-randomized pre-test/post-test and semi-structured interview design was used, which utilized a convenience sampling approach. Data were collected in two phases. Three domains of …

Be Well: A Systems-Based Wellness Intervention Using Mindfulness In The Workplace – A Case Study, Kate M. Levett, Sharyn Coughlan, Sharon Longridge, Violet Roumeliotis, Jon Adams

Medical Papers and Journal Articles

Introduction: Healthy work environments are essential in determining improved well-being of Australians. Job stress has been identified as a significant factor in psychological distress. This study evaluated the effect of introducing a systems-based workplace wellness programme using mindfulness in the workplace.

Methods: The programme ‘Be Well’ was introduced as part of a systems-based approach to workplace health promotion, and evaluated using sick leave as a proxy for workplace stress, and the stress satisfaction offset score to determine the degree of change in stress and satisfaction.

Results: There was significant reduction in sick leave (2014 vs. 2012) (p<.001), and significant improvement in stress satisfaction offset score (p<.05). Logistic regression analysis identified the programme components most predictive of reduced stress and higher job satisfaction.

Conclusion: The impacts …

Concept Of Self: Approach To Behaviors In Mental Health, The Tapout Program, Tina Goodrow

Walden Dissertations and Doctoral Studies

Violence in mental health care continues to be a problem. The incidence of violent episodes in healthcare settings with aggressive behavior of patients aimed at staff members or other patients is almost four times greater in healthcare than in other industries. Reducing violent episodes enhances the quality of care and improves safety for staff members and for patients. The project focused on development of a staff education program exploring the practice-focused question: Will this program effectively guide staff member approaches to mental health patients with challenging behaviors? The purpose of this project was to address the identified gap in practice …

Relationships Between Interprofessional Teamwork And Clinical Management Of, Jacqueline G. Stephens

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a highly prevalent chronic disease that affects 29 million people in the United States including over 2 million veterans who receive care through the Veterans Administration. Patient-aligned care teams (PACTs) are an interprofessional teamwork system designed to improve outcomes of chronic illness, but empirical explorations of the efficacy of the PACTs have been insufficient. Utilizing the chronic care model, the purpose of this retrospective study was to determine if PACTs have been efficient in the diabetic management of veterans receiving care through a Southeastern VA. Medical records for 114 veterans with type 2 DM were randomly …

Engagement Strategies To Reduce Registered Nurse Turnover In Hospitals, Robert Neeley

Walden Dissertations and Doctoral Studies

Skilled and experienced registered nurse employees are critical to the organizational success and stability of hospitals, but an annual average registered nurse turnover rate of 14% can result in financial losses of millions of dollars annually for the typical hospital in the United States. The purpose of this multiple case study was to explore the engagement strategies hospital nurse managers use to retain registered nurses. The study population included 8 nurse managers employed by hospitals in West Central Florida who have successfully implemented engagement strategies to retain registered nurses. The conceptual framework for the study was based on systems theory …

The Soldier 360°Orgram: Strengthening Combat-Exposed, Noncommisioned U.S. Army Officers' Interpersonal Sensitivity, Anne Harper

Walden Dissertations and Doctoral Studies

Interpersonal sensitivity is a foundational component of interpersonal relationships. It encompasses an individual's self-concept and self-identity, which are formed as the individual develops. An individual's self-concept develops from the norms and mores of his or her society. Soldiers in the U.S. Army have been trained to form a repurposed self to engage in combat and work in combat-focused jobs. The consequence of this training in many cases has been diminished interpersonal sensitivity that has been detrimental to their interpersonal relationships. The Soldier 360° course is a comprehensive treatment program that takes a holistic approach to providing soldiers with self-empowering tools …

Perceptions Of Community-Based Participatory Research From Community And Academic Members, Ivonne G. Kanko

Walden Dissertations and Doctoral Studies

Community-based participatory research (CBPR) is an increasingly popular form of public health research. However, little is known about the application of CBPR and the levels of involvement for partners in specific phases of the partnership. This phenomenological study addressed the application of CBPR from the perspectives of 7 academic researchers and 6 community members experienced in CBPR. Arnstein's ladder of citizenship participation and the community coalition action theory provided the framework for the study. Semi-structured interviews addressed participants' levels of involvement in the CBPR process, as well as challenges, concerns, successes, and recommendations for improvement. Interview transcripts were analyzed by …

Leadership Practices That Improve The Workplace Safety Environment, Nathan Nomore Chikono

Walden Dissertations and Doctoral Studies

Inadequate leadership is the reason workplace accidents in the mining industry remain high, making the industry one of the most hazardous operational activities in the world. Unsafe leadership practices may result in death or injury to workers. A group of 30 mining company leaders from 3 gold mines in Zimbabwe revealed an exception to these hazardous practices, however, notable through their outstanding safety improvement records. To better understand what these practitioners were doing, this multicase study research design explored their strategies to improve the workplace safety environment in the mines. Data were collected using audio-recorded semistructured interviews and document analyses. …

Applying Clinical Guidelines To Curtail Opioid Overprescribing In Primary Care, Glenda Leflore

Walden Dissertations and Doctoral Studies

The purpose of this scholarly project was to evaluate an evidence-based quality improvement program implemented in 2016 in a clinical practice setting to curtail overprescribing of opioids for noncancer pain management. In 2001, the National Pharmaceutical Council and The Joint Commission on Accreditation and Hospital Accreditation initiated a standard of practice for opioid use in noncancer pain management that resulted in opioid overprescribing and a 200% increase in opioid-related deaths and incalculable societal costs. Primary care providers including nurse practitioners issue the greatest number of opioid prescriptions; therefore, to address the problem of opioid overprescribing, the 2016 Centers for Disease …

Hourly Rounding: A Fall Prevention Strategy In Long-Term Care, Robyn Mitchell

Walden Dissertations and Doctoral Studies

Falls and injuries related to falls are some of the most common and costly incidents that occur in the long-term care environment. Purposeful hourly rounding is a proactive way for nursing staff to identify patient needs and demonstrate positive fall prevention outcomes. This project examined a process improvement endeavor of a long-term care unit that experienced an increase in the number of falls over 3 months. The purpose was to evaluate whether staff education and implementation of an evidence-based hourly rounding program would affect the number of patient falls. The Johns Hopkins nursing evidence-based conceptual model, Kurt Lewin's change model, …

Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye

Walden Dissertations and Doctoral Studies

Billing inefficiencies represent 80% of wasteful healthcare administrative costs that are projected to reach $45 billion by 2018. Potentially, a reduced billing administrative cost is estimated to yield an annual savings of $60 billion that could fund other societal needs such as jobs, wage increases, and education. Through the conceptual framework of iceberg change management model, this single case study explored collaborative strategies 3 healthcare billing managers in Dallas, Texas successfully used to reduce billing administrative costs. Data were collected through semistructured interviews and the review of company documents. Using Yin's procedure of examining, comparing, categorizing, and coding data, the …

“Mental Health Day” Sickness Absence Amongst Nurses And Midwives: Workplace, Workforce, Psychosocial And Health Characteristics, Scott Lamont, Scott Brunero, Lin Perry, Christine M. Duffield, David Sibbritt, Robyn Gallagher, Rachel Nicolls

Research outputs 2014 to 2021

Aim

To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as ‘mental health days’.

Background

The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a ‘mental health day’ as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence.

Design

Online cross-sectional survey.

Methods

Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses …

Decreasing Primary-Care-Related Emergency Department Visits In The Hispanic Population Using Patient Navigators, Arthur Dominguez Jr.

Walden Dissertations and Doctoral Studies

Primary-care-related emergency department (PCR-ED) visits by Hispanic patients enrolled in a not-for-profit Medi-Cal and Medicare health plan resulted in longer wait times in the emergency department (ED) at a regional medical center in Southern California. This congestion decreased access for those with true emergencies, created capacity issues, increased ED length of stay, and resulted in potential safety risks. This project focused on decreasing PCR-ED visits in the Hispanic population using patient navigators in Southern California. Applying the health belief model and Lippitt's theory of change, this doctoral project involved the creation and implementation of a culturally appropriate, population-specific patient navigator …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

The Development, Implementation, And Evaluation Of A Transgender Health Resource Bundle, Lovejeet Kaur

Doctor of Nursing Practice (DNP) Projects

Transgender populations experience disproportionate social and health disparities that can negatively impact quality of life. Healthcare barriers due to gender based discrimination and lack of medical insurance and culturally competent providers contribute to low levels of access to preventative health care screenings, resulting in sub-optimal health outcomes. The unique health circumstances of transgender individuals have been understudied in the literature. As a result clinicians are often under-informed of their specific health maintenance needs and screening guidelines. To help address this disparity, a Doctor of Nursing Practice (DNP) student at the University of San Francisco facilitated the collaborative assessment, development, implementation …

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Electronic Communication Among Anesthesia Providers, Joseph K. Wells

Doctoral Projects

Facilities in the United States are utilizing electronic communication devices (ECDs) for their nursing staff on intensive care units, general medical-surgical floors, and chemotherapy floors, but it is underutilized in the operating room where seconds truly matter (Wu et al., 2012). Situations arise daily within operating rooms that require quick and decisive communication to avoid poor patient outcomes. The ultimate goal is to prevent poor patient outcomes by enhancing communication among anesthesia providers.

This doctoral project evaluated an anesthesia group in southeast Mississippi regarding their satisfaction with current devices used for communication. This anesthesia group utilized smart phones and public …

Principles Of Incorporating Spirituality Into Professional Clinical Practice, Thomas G. Plante

Psychology

Incorporating spirituality into contemporary professional clinical practice has become more common in recent years most notably with the popular interest of mindfulness meditation, mindfulness based stress reduction, and yoga in particular. However, many other spiritual and religiously based assessment and treatment approaches have also been successfully utilized with a great deal of evidence-based research to support their use and effectiveness. The purpose of this brief article is to outline several guiding principles for those professionals interested in integrating spiritual and religious wisdom and approaches into their professional clinical practices in the spirit of diversity and multiculturalism sensitivity and respect. Psychology …

Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman

Electronic Theses and Dissertations

As the nation’s healthcare system moves through the 21^st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.

This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to …

“In Principle We Have Agreement, But In Practice It Is A Bit More Difficult": Obtaining Organizational Buy-In To Patient-Centered Medical Home Transformation, Janelle Applequist, Michelle Miller-Day, Peter F. Cronholm, Robert Gabbay, Deborah S. Bowen

Communication Faculty Articles and Research

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis …