Digital Commons Network^™

Strategies For Increasing Employee Engagement In The Service Industry, Tonia Ann Walker

Walden Dissertations and Doctoral Studies

The annual loss to U.S. organizations consequential to a lack of employee engagement was approximately $300 billion in 2013. Employee engagement is vital to the business sustainability of an organization. The purpose of this qualitative single case study was to explore successful strategies that business leaders of a service organization used to increase employee engagement. The conceptual framework guiding this study was the behavior engineering model theory developed by Gilbert. A purposeful sample of 6 engineering managers was selected based on their success in creating strategies resulting in increased employee workplace engagement in a monopoly service organization in Connecticut. Semistructured …

Perceptions Of Female Sexual Pathology: The Role Of Racial Biases In Clinical Decision Making, Jerusha Sanjeevi

All Graduate Theses, Dissertations, and Other Capstone Projects

Diversity issues such as multicultural competence and sexual health competence have received increased but separate academic attention in recent years. Although empirical support has been found for the presence of racial biases in the diagnoses of mental health disorders, there is no evidence to date regarding the role of racial biases in the diagnoses of female sexual pathology. In the present study, 101 pre-doctoral psychology interns across the United States assessed the symptom severity of a fictional client via online vignettes in which client race was experimentally manipulated. Participants did not report significantly different symptom severity ratings between the vignettes …

What Works For Successful In-Home Family Therapists Working At Community-Based Agencies, Aleyah R. Yasin

Department of Family Therapy Dissertations and Applied Clinical Projects

Resiliency is an important characteristic of successful therapists (Aponte, 1991; Aponte & Carlsen, 2009; Aponte & Winter, 2000; Clark, 2009; Hamel & Laraway, 2004; Kuiper, 2012; Protinsky & Coward, 2001; Rosenburg & Pace, 2006; Wolgien & Coady, 1997), especially those in entry-level positions that tend to involve high stress and turnover (Acker, 2004; Clark, 2009; Davis, 2013; Greenson, Guo, Barth, Harley, & Sission, 2009; Grosch & Olsen, 1994; Gupta, Peterson, Lysaght, & Zweck, 2012; Horan, 2002; Maslach & Leiter, 1997; Negash & Sahin, 2011; Rosenburg &Pace, 2006; Skovolt &Trotter Mathison, 2011). This study explored the perspectives of six therapists providing …

Determining The Relationship Among Change Fatigue, Resilience, And Job Satisfaction Of Hospital Staff Nurses, Robin Brown

Electronic Theses and Dissertations

Purpose: The purpose of the study was to determine if there is a relationship among change fatigue, resilience, and job satisfaction of hospital staff nurses and if differences exist between novice and experienced staff nurses.

Background: Healthcare is typified by change. Organizational changes have a negative impact on nurses and the effects of organizational change are being overlooked and under researched. Change fatigue is a result of constant organizational change and has not been researched with nurses.

Methods: The study utilized a descriptive correlational design. Participants completed an online survey, using three tools: Change Fatigue Scale, Connor-Davidson Resilience Scale (CD-RISC), …

Impact Of Health Information Technology Patient Education With "Teach-Back" On Patient Satisfaction And Hospital Readmissions, Judi Dunn

DNP Projects

Background: With the advances in medical care, patients are being asked to manage more complicated self-care regimens, and there is often a gap between what the nurse teaches and what the patient understands. This can lead to re-hospitalizations that are burdensome for patients and are costly to the American healthcare system. The Department of Health and Human Services (DHHS) challenged healthcare organizations to leverage technology that engages patients in self-management support and encourages clinician use of patient-centered communication techniques, such as teach-back.

Purpose: The purpose of this project is to evaluate the use of health information technology along with an …

Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan

All ETDs from UAB

The purpose of this dissertation was to examine the antecedents and outcomes of hospital vertical integration into Sub-Acute Care (SAC). Using a sequential quanqual mixed methods design, we examined why hospitals adopt a vertical integration strategy and the relationship this strategy has to performance. Findings from this dissertation are important to hospital administrators as they seek to find ways to respond to the changing payment structures established during the Affordable Care Act. The results of this dissertation suggest that not all market and organizational factors are associated with vertical integration strategies toward SAC. They also suggest that vertical integration into …

Patient Portals: Achieving Technology Acceptance And Meaningful Use In Independent Physician-Managed Practices, Kimberly W. Bartholomew

CCAC Theses and Dissertations

As the bulk of medical health records shift from paper-based file systems to electronic formats, the promise of the transformation process called healthcare reform included adding efficiencies to medical practice workflows, lower costs, improved quality of care and most important, and the freeing of patient information from traditional propriety silos. With this incoming largess of protected health information data now viewable through online patient portals, patients can be empowered to become educated and active in their own health care decisions, but only if they have admission to their information. A digital divide currently exists in many medical practices where only …

Hurricane Sandy : Public Health Staff Perceptions Of Impact And Recommendations For Future Preparedness, New York State, Asante Shipp Hilts

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Improving The Identification, Delivery Of Care, And Outcomes Of Hospital-Acquired Sepsis, Nicholas James Welker

DNP Projects

Sepsis syndromes that develop among a hospital inpatient population can be difficult to differentiate from other disease processes that share systemic inflammatory response syndromes. A bedside nurse-driven screening process was developed at Baptist Health Lexington to aid with early sepsis identification and foster prompt goal-directed therapy. This retrospective study of 26 patients identified over a 6 month period measures intensive care length of stay, mortality, and sepsis severity. Exclusion criteria were pregnancy and Do Not Resuscitate orders.

Screening compliance was poor at 23.1 percent (n=6). Complete compliance with goal directed therapy was 7.7 percent, though some components of therapy such …

The Impact Of African-Centered Psychotherapy On Depressive Symptoms And Africentric Worldview In African Americans, Larae Tillis

Walden Dissertations and Doctoral Studies

Depression is a prominent issue in the African American community. However, there are significant gaps in the literature on the delivery and outcomes of culturally relevant mental health psychotherapy to African Americans. Cultural variables, such as worldview, have been noted to impact an individual's overall psychosocial functioning and have significant implications for mental health service delivery. The purpose of this study was to use archival data to analyze the impact of African-centered therapeutic services on depressive symptoms and on Africentric worldview among African Americans. Archival data on 38 African American adults, recorded from 2012-2015, were obtained from a community mental …

Organizational Culture And Organization Based Self- Esteem As Predictors Of Spirit At Work, Zeynep Merve Ünal, Tülay Turgut

Khazar Journal of Humanities and Social Sciences

This study aims to investigate the relationships between organizational cultures, spirit at work, and organization based self-esteem among academicians, and whether organization based self-esteem mediates the relationship between organizational culture and spirit at work. A cross-sectional design was employed, and data were collected through a questionnaire-based survey. Based on the convenience sampling, 417 academicians answered the questionnaire in public and private universities located in Turkey. To analyze the data descriptive statistics, Pearson coefficient, simple and multiple regression analyses were conducted. Feminine organizational culture has more positive contribution on experiencing spirit at work than masculine organizational culture. Moreover, organization based self-esteem …

Meeting Meaningful-Use Requirements With Electronic Medical Records In A Community Health Clinic, Tony Andrew Richardson

Walden Dissertations and Doctoral Studies

Small nonprofit medical practices lack the technical expertise to implement electronic medical records (EMRs) that are consistent with federal meaningful-use requirements. Failure to comply with meaningful-use EMR requirements affects nonprofit community health care leaders' ability to receive reimbursement for care. Complexity theory was the conceptual framework used in this exploratory single case study. The purpose of the study was to explore the strategies nonprofit community health care leaders in Washington, DC used to implement EMRs in order to comply with the meaningful-use requirements. Data were collected via in-depth interviews with 7 purposively-selected health care leaders in a nonprofit clinic and …

An Exploration Of Bullied Nurses, Witnesses, And A Hospital's Bottom Lline, Brenda Kay Williams

Walden Dissertations and Doctoral Studies

Nurses experiencing bullying or witnessing other nurses bullied may choose to vacate their hospital positions. Nurse attrition negatively impacts a hospital's bottom line, which can lead to insolvency and a lack of access to healthcare by patients. The purpose of this phenomenological study was to understand the choices nurses made regarding their careers after experiencing or witnessing bullying and to calculate a hospital's cost of loss. Freire's oppressed group theory provided the conceptual framework for the study. The basis of the research questions was to understand how the nurse felt when bullied or observing a coworker bullied, the actions taken, …

Self-Care Activities And Nurse Manager Well-Being, Gretchen Eileen Johnson

Walden Dissertations and Doctoral Studies

The role of the nurse manager is important in organizations and influences outcomes such as the safety and quality of care provided on a unit, satisfaction, turnover of nursing staff, and overall health of the work environment. Stressors for managing nurses can impair physical and emotional health and lead to poor patient and staff satisfaction, safety, and outcomes. The evidence-based practice project will explore nurse managers' well-being and self-care activities. The theoretical framework of the project is the Relationship-Based Care Model as well as Kotter's change theory. The literature suggests that self-care activities can reduce stress and improve well-being. A …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Predictors Of Excessive Alcohol Consumption Among U.S. Business Travelers, Jennifer Clore Barrickman

Walden Dissertations and Doctoral Studies

Excessive alcohol consumption (EAC) is an important public health problem. Several researchers have examined work-related influences on EAC, but few have investigated the predictors of EAC related to business travel. This study measured the association between EAC and frequency of business travel, duration of business travel, and job industry among U.S. business travelers. Research was conducted within the social-ecological theoretical framework. Snowball sampling was used to gather data from 187 business travelers. Data were evaluated using bivariate analysis to assess the association between measures of EAC and each independent variable. Multiple logistic regression was used to adjust for covariates. Respondents …

Return To Full Duty Work: Determining The Ideal Time To Refer Occupationally Isolated Acute Low Back Pain Patients To Physical Therapy, Aletha Mae Stephenson

Walden Dissertations and Doctoral Studies

Employees who develop and report nontraumatic acute low back pain that occurs while performing work duties, or shortly thereafter, are classified as having occupational isolated acute low back pain (OIALBP). The purpose of this project was to identify and implement an evidence- based time frame to refer occupational isolated acute low back pain patients (OIALBPPs) to physical therapy (PT) that returns them to full duty work (FDW) more quickly. The diffusion of innovation theory aided the project leader and health care providers to develop strategies to overcome barriers in implementing the project's results into the practice. A total of 932 …

Education And Mentoring Of Staff Nurses In Evidence Based Practice, Sherri L. Smith-Keys

Walden Dissertations and Doctoral Studies

Current gaps in nursing practice can decrease by the translation, implementation, and dissemination of evidence-based practice (EBP). The purpose of this project was to provide staff nurses with EBP education and mentoring in identifying and addressing nursing practice issues using EBP to manage patient care. The Advancing Research & Clinical Practice through Close Collaboration (ARCC) and the social cognitive theory were used as a framework to guide this project development, which addressed if medical surgical nurses receiving education in EBP practice led to improved use, implementation, and improved best practice outcomes. Seven randomly selected medical surgical nurses from a local …

Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown

Walden Dissertations and Doctoral Studies

Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies …

Strategies To Retain Employees In Clinical Laboratories, Amber Rose Phipps

Walden Dissertations and Doctoral Studies

With 30 million citizens gaining access to U.S. healthcare through the Affordable Care Act by 2016, healthcare managers need preanalytic employees to ensure quality healthcare services can be provided. The purpose of this qualitative single case study explored strategies used to retain preanalytic employees. The target population consisted of 10 clinical laboratory managers in a single community-based clinical laboratory in the mid-southern United States, selected because of prior success in improved employee retention strategies. The conceptual framework grounding this study was the theory of work adjustment. Data triangulation occurred from using semistructured interviews and company documents. All interpretations from the …

Preventive Health Education Media And Older Worker Health Literacy, Lori Michelle Williams-Johnson

Walden Dissertations and Doctoral Studies

The United States has experienced an increase in older workers as individuals born between 1946 and 1964 have remained in the labor force. Preventive health screening education, such as an immunization flyer, is necessary to avert preventable illness among older workers. Based on previous research, there is a gap regarding age-specific methods for educating the older worker about preventive health. Therefore, the purpose of this study was to explore the relationship between various media providing preventive health screening information and the assessed health literacy of the older worker. Based on the health belief model, a quantitative, cross-sectional method was used. …

Development Of Emotional Intelligence Training For Certified Registered Nurse Anesthetists, Rickey Don King

Walden Dissertations and Doctoral Studies

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Rickey King

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Marisa Wilson, Committee Chairperson, Health Services Faculty

Dr. Murielle Beene, Committee Member, Health Services Faculty

Dr. Deborah Lewis, University Reviewer, Health Services Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2015

Abstract

Development of Emotional Intelligence Training for Certified Registered Nurse Anesthetists

by

Rickey King

MSNA, Gooding Institute of Nurse Anesthesia, 2006

BSN, Jacksonville …

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …

Evaluation Of Early Mobilization Strategies In The Mechanically Ventilated Patient Population, Katherine B. Stewart

DNP Projects

Purpose

This practice inquiry project was designed to evaluate current mobility practice and identify associations between mobility practice and specific patient characteristics in a cardiovascular intensive care unit.

Population and Setting

The sample consisted of electronic medical records of adult patients that required mechanical ventilation in a 16-bed cardiovascular intensive care unit in a private, urban hospital in Southern U.S. Of the selected participants, 48 were male and 52 were female with an average age of 64.49 (SD = 14.58).

Inclusion Criteria

Inclusion criteria for this study were patients who 1) were aged 18 and older; 2) were mechanically ventilated …

Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay

All ETDs from UAB

RURAL HOSPITAL CLOSURES IN ALABAMA: POST ACA DENNIS O. MCCAY HEALTH SERVICES ADMINISTRATION ABSTRACT Rural hospitals differ from their urban counterparts with regard to two main areas. First, rural hospital patients are usually older, of lower income, and less healthy than those in urban areas. Second, their facilities tend to be smaller, older, and more prone to staff shortages than those in an urban environment. Rural hospitals have been closing at higher rates than their urban counterparts for a number of years, but more so since the implementation of the Affordable Care Act in 2010. The objective of this research …

Providing Optimal Nutrition In Critical Care, Jo Anne Foley

Walden Dissertations and Doctoral Studies

Malnutrition among hospitalized patients is prevalent and associated with adverse outcomes. At the health care facility for which this quality improvement (QI) initiative was developed, patients were not consistently fed within the nationally recommended 48 hours. The purpose of this project was to facilitate the early initiation of enteral feedings to prevent malnutrition in a vulnerable patient group by development of an evidence-based enteral feeding policy, algorithm, and nursing education module. The find, organize, clarify, understand, select, plan, do, check, and act model provided a systematic approach for development of the project. Validation of the QI initiative was through the …

Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson

Walden Dissertations and Doctoral Studies

Military health care organizations need competent frontline managers with knowledge and skills to manage health care complexity and ensure evidence-based practice. With systematic, planned turn over of military managers, more civilian managers are needed to fill permanent positions in military hospitals. The purpose of this project was to provide a better understanding of the competencies perceived by nurse managers at a military medical center and whether they differed by military or civilian status. The American Organization of Nurse Executives competency model and framework provided the theoretical framework for the project. The design was nonexperimental, with an observational, descriptive, cross-sectional approach. …

Evaluating Key Predictors Of Employee Response To Change In The Pharmaceutical Industry, Otis S. Johnson

Walden Dissertations and Doctoral Studies

This study addressed the factors that predict employee response to large-scale change in the United States pharmaceutical industry. When poorly executed, major organizational changes such as mergers and acquisitions are often disruptive and costly to organizations and demoralizing to employees. Although employee responses to change have been studied in several industries, employee responses during change execution in the pharmaceutical industry have not been subject to study. The purpose of this correlational study was to reduce the knowledge gap related to organizational change in the pharmaceutical industry by evaluating key predictors of employee response to large-scale change. The theoretical framework consisted …

Leading By Design: Physicians In Training And Leadership Awareness, Meridithe Anne Mendelsohn

Antioch University Dissertations & Theses

Patient-centered care requires robust physician leadership in all aspects of healthcare in order to lead organizations to this ideal.Programs in Graduate Medical Education provide inconsistent and limited exposure to formal leadership development experiences for physicians in their final year of residency training.Literature addressing leadership training for residents focuses on the scarcity of effective programs that deliver adequate training and provide measurable outcomes.The purpose of this study was to explore how chief medical and surgical residents develop leadership awareness and experience training in leadership and engage chief residents, faculty mentors, and program administrators in a collaborative process, developing a leadership training …

Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger

Walden Dissertations and Doctoral Studies

This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume …