Digital Commons Network^™

Accreditation As An Organizational Response: Exploring The Influence Of Leadership And Institutional And Task Environments On The Accreditation Process In Communication Sciences And Disorders Programs, Jeffrey Charles Adams

Theses and Dissertations

Influences on the accreditation process in communication sciences and disorder (CSD) programs were examined using a cross case comparative qualitative analysis among four successfully accredited academic departments in the southern United States. Program chairs, CSD administrators, clinic directors and faculty were interviewed. Four institutional sites were selected for the case studies based upon the outcome of the program’s most recent accreditation site visit, the date of the accreditation site visit, number of available faculty, and institutional type. The four institutions included one master’s granting private institution, one master’s granting (larger) program, one doctoral/research medical university, and one doctoral/research university (very …

Nurse Managers, Work Environment Factors And Workplace Bullying, Joy Parchment

Electronic Theses and Dissertations

The purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States. Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that contribute to nurse managers being recipients of workplace bullying either, downward from their leaders, horizontally from their nurse manager peers, and upwards from their clinical nurses were not identified. …

Diffusion Of Technology In Small To Medium Medical Providers In Saudi Arabia, Ziad Hisham Arnaout

Walden Dissertations and Doctoral Studies

The Saudi ministry of health reported that government health care spending doubled from 2008 to 2011. To address increased demand, the government encouraged small to medium enterprise (SME) growth. However, SME leaders could not leverage technology as a growth enabler because they lacked strategies to address operating inefficiencies associated with technology. Only 50% of hospitals fully implemented information technology. The purpose of this phenomenological study was to explore lived experiences of SME leaders on strategies needed to accelerate technology implementation. This exploration drew on a conceptual framework developed from Wainwright and Waring's framework addressing issues of technology adoption. Data were …

The Effects Of A Concept-Based Curriculum On Nursing Students' Nclex-Rn Exam Scores, Patricia Allen Edwards

Walden Dissertations and Doctoral Studies

The Institute of Medicine and the National League of Nursing have called for curricular reform that promotes high first-time pass rates on the National Counsel of Licensure Examination for Registered Nurses (NCLEX-RN). A campus in the southeastern region of the United States implemented a concept-based curriculum; however, the effect on the first-time NCLEX-RN pass rates was unknown. The purpose of this comparative study was to determine if the concept-based curriculum improved student scores on the NCLEX-RN. Dreyfus' model of learning guided this study because of the andragogy tenets, which in turn supported the concept-based curricula. The research questions examined the …

Development Of Mentors To Facilitate Evidence-Based Practice In A Nurse Residency, Susan Annette Breit

Walden Dissertations and Doctoral Studies

Evidence-based practice has resulted in better patient outcomes, higher patient satisfaction, and effective patient-centered care. Leadership of a large teaching hospital determined that new nurses lacked the education and experience to design and implement an evidence-based project at the bedside, which was an expected outcome for completion of the established nurse residency program. The purpose of this project was to develop a design-only project in which Masters of Science in Nursing-prepared mentors were added to the residency program to establish the required evidence-based project. A mentor workshop was developed to guide the mentors in this role using Benner's novice to …

Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian

All ETDs from UAB

ABSTRACT Patient experience scores have become important indicators of value in healthcare. This study was the first of its kind to examine CEO gender, tenure, and education in relationship with patient experience scores and all other value based purchasing scores, such as outcome, efficiency, clinical process of care, and total performance scores. This study suggested that hospitals with certain types of CEOs may perform better with respect to patient experiences and other value based purchasing scores. The primary analysis of this study was to examine the impact of hospital CEO characteristics (tenure, education, gender) on patient experience scores. A supplementary …

Safety Culture And Patient Harm, Alfonso Gatmaitan

All ETDs from UAB

SAFETY CULTURE AND PATIENT HARM EVENTS: A CONTINGENCY THEORY PERSPECTIVE IN THE CONTEXT OF COMPLEX ADAPTIVE SYSTEMS ALFONSO GATMAITAN ADMINISTRATION-HEALTH SERVICES ABSTRACT This study examines the correlation between a Culture of Patient Safety as measured by hospital staff surveys and actual patient harm attributed to hospital performance. It is generally accepted by health care management leaders that the presence of a strong culture of patient safety has become a critical component in reducing patient harm. However, little empirical evidence within multiple hospitals over time exists to support this belief. Healthcare managers can utilize this evidence in formulating patient safety improvement …

Hospital-Based Skilled Nursing Facilities: Predictors Of Survival And Performance, Shivani Gupta

All ETDs from UAB

This three-paper dissertation examined the organizational and market factors predicting the response of hospital-based skilled nursing facilities (HBSNFs) to the changes in their environment such as the implementation of prospective payment system in 1998 and their role in coordination of care for patients in transition from acute care to home or a post-acute care facility. In the first study, population ecology of organizations framework was used to evaluate the organizational and market factors associated with HBSNFs’ closure after 1998. The event histories of all acute-care hospitals which had an open HBSNF in 1998 were examined across 15 years (1998-2012) to …

Effect Of A Cardiology Nurse Practitioner Service On The Reduction In Length Of Stay For Low Risk Chest Pain Patients, Marcia Andrea Reid

Walden Dissertations and Doctoral Studies

Healthcare organizations are responding to changes in reimbursements by redesigning and re-evaluating existing programs to improve patient outcomes. .One such intervention at the project setting was the re-evaluation of the treatment of patients with low risk for chest pain and implementing a cardiology nurse practitioner (NP) service focusing on the reduction of length of stay (LOS) with the goal of improving patient outcomes. The purpose of this doctor of nursing practice project was to evaluate the effectiveness of a nurse practitioner-led service on the reduction of LOS of patients with low risk for chest pain. An established evidenced-based guideline developed …

Examining The Impact Of Accreditation On A Primary Healthcare Organization In Qatar, Alia Ghareeb

Walden Dissertations and Doctoral Studies

Although a modest body of literature exists on accreditation, little research was conducted on the impact of accreditation on primary healthcare organizations in the Middle East. This study assessed the changes resulting from the integration of Accreditation Canada International's accreditation program in a primary healthcare organization in the State of Qatar. The study also investigated how accreditation helped introduce organizational changes through promoting organizational learning as well as quality improvement initiatives. Pomey's Dimension of Change framework and questionnaire was used to measure the effect of Accreditation Canada International standards on the perceived quality performance and the progress towards organizational learning. …

Health And Stress Symptoms In University Professors And Their Relationship With The Process Of Obtaining A Permanent Position, Irene Concepcion Carrillo-Saucedo

Open Access Theses & Dissertations

This research study used a quantitative, correlational method to examine health and stress symptoms in university professors and their relationship with the process of obtaining a permanent position and participation in a merit pay program. The Stress Profile Inventory (PEN) was used to measure professors’ health habits, social support network, Type A behavior, cognitive hardiness, coping styles and psychological well-being. An original measure with a Likert-type scale was used to measure health status. The questionnaires were distributed to 104 professors from the Universidad Autónoma de Ciudad Juárez (UACJ) who provided voluntary participation. Based on the results of the study, certain …

Chronic Care Model Staff Education And Adherence With End-Stage Renal Disease Patients, Emilia K. Addo

Walden Dissertations and Doctoral Studies

The management and treatment of chronic diseases, such as end-stage renal disease, is often unproductive because of patients' poor adherence to treatment. The chronic care model toolkit is an Agency for Healthcare Research and Quality supported framework, associated with improved outcomes in patients living with chronic disease. The purpose of this project was to develop and plan an educational program using the chronic care model toolkit for the interdisciplinary clinical staff of a renal hemodialysis center. The goal of this project was to adapt team building between patients and their clinicians through the use of the chronic care model in …

Relational Coordination: An Exploration Of Nursing Units, An Emergency Department And In-Patient Transfers, Mary Coffey

Theses and Dissertations

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to …

Toward Transforming Health Systems: A Practice Study Of Organizing And Practical Inquiry In Academic Medicine, Thomas A. Ellison

Antioch University Dissertations & Theses

Transformation of health care systems will be grounded in new professional relations and collective, cross-disciplinary actions to impact care delivery. Organizing such relations and actions involves practical inquiry rather than applying professional knowledge. This dissertation presents an exploratory, performative study of the initial organizing of the Health Systems Innovation and Research (HSIR) Program in Health Sciences at the University of Utah. The HSIR program was conceived principally to catalyze cross-disciplinary innovation and health services research and enhance care delivery changes by documenting care improvements and publishing research. This study includes a composite narrative of the organizing and practical inquiry work …

Is There An Economic Case For Investing In Nursing Care – What Does The Literature Tell Us?, Diane E. Twigg, Helen Myers, Christine Duffield, Margaret Giles, Gemma Evans

Research outputs 2014 to 2021

Aim

To determine the cost effectiveness of increasing nurse staffing or changing the nursing skill mix in adult medical and/or surgical patients?

Background

Research has demonstrated that nurse staffing levels and skill mix are associated with patient outcomes in acute care settings. If increased nurse staffing levels or richer skill mix can be shown to be cost-effective hospitals may be more likely to consider these aspects when making staffing decisions.

Design

A systematic review of the literature on economic evaluations of nurse staffing and patient outcomes was conducted to see whether there is consensus that increasing nursing hours/skill mix is …

Strategy For Improvement Of Maternal Health In Nepal, Gehendra Mahara, Xiuhua Gua, Wei Wang

Research outputs 2014 to 2021

Maternal death is a public health problem in like Nepal. Still women have been facing the pregnancy related problems due to inaccessible and poor quality health service as well as a less available health service from skilled health workers. This is due to lack of essential knowledge about pregnancy and its complications. The main aim of this article is to evaluate and synthesize the current public health issues of maternal health of women in Nepal. Syntheses the problems, challenges and issues regarding maternal health and what can be done for the improvement of those problems with the evidence base practice. …

Leadership Skills For Nursing Unit Managers To Decrease Intention To Leave, Michael R. Roche, Christine M. Duffield, Sofia Dimitrelis, Belinda Frew

Research outputs 2014 to 2021

Aim: To examine specific elements of nursing leadership linked to intention to leave, in public acute care hospitals. Background: Nurse turnover is a global issue receiving widespread attention due to prolonged and projected workforce shortages. Nurse management and leadership qualities have been associated with intention to leave and turnover of nurses. The role of the nurse unit managers in the retention of nurses is becoming increasingly important, particularly because of their strong influence on the quality and stability of the work environment. Methods: Data were collected from 6 2 medical, surgical, and mixed units across eleven public acute care hospitals …

Documenting Perceived Effectiveness Of Community-Based Health Promotion Coalitions: A Grounded Theory Approach, Alyssa Brooke Mayer

USF Tampa Graduate Theses and Dissertations

Introduction: Community coalitions with public health-related missions are formal, semi-permanent, action-oriented partnerships comprised of community members, representatives of government agencies, policymakers, and academic partners. Despite their potential to promote sustainable change, coalitions have had mixed success in effecting long-term improvements in community health. There is a need to assist them in developing strategies for improving and sustaining their functionality. The purpose of this study was to improve understanding of the elements of coalition success and sustainability that are vital to health-related community-based participatory research.

Methods: Although the literature describes coalition functions for effecting sustainable programs and policies, most research reports …

Early Alert Referral Program, Roslana D. Gray

Regis University Student Publications (comprehensive collection)

Early recognition of academically at-risk nursing students by faculty plays an important role in increasing retention rates. The main objective of the early alert referral program is to systematically detect early students who are academically for failure and refer at-risk students to faculty or support services, to increase nursing retention rates. The Early Alert Referral Project is a quantitative design in terms of purpose and methodology. The program was held in a classroom in a rural community college in Alabama during the summer semester (May, June, July, August) 2014. All practical nursing students currently enrolled in summer 2014 cohort were …

Transitional Care Services: A Nurse-Led Quality Improvement Project, Debra Conroy-Mccue

Doctor of Nursing Practice (DNP) Projects

With the implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA) and a national requirement for health care providers and systems to deliver care that is safe, outcome driven, and cost effective, Dignity Health (DH) as part of the hospital engagement network (HEN) launched an initiative called the “No Harm” campaign to reduce all-cause avoidable hospital readmissions. The project, led by a Doctorate of Nursing Practice (DNP) student and readmission team, sought to achieve a 20% reduction in preventable readmissions by December 2014. After having achieved initial success in implementing transitional care services for patients with heart …

Implementation And Evaluation Of An Oral Hygiene Program In Long-Term Care, Lawrence P. Lemos

Doctor of Nursing Practice (DNP) Projects

A review of the literature focusing on oral care within long-term care (LTC) suggests positive resident care outcomes occur when standardized practices are employed. Studies of staff education programs, trained oral hygiene aides, and dental hygienists working within LTC, have linked regular oral hygiene practices to decreased pneumonia rates. While these studies make the connection between good oral hygiene and reducing risk for pneumonia, best practices focused on implementing and sustaining an oral hygiene program in LTC facilities are lacking. The aim of this quality improvement project was to ensure that dependent residents in LTC receive assistance with daily oral …

Employee Engagement In The Pacu, Michelle Spadaro

Master's Projects and Capstones

A clear vision is a powerful tool that can help advance employee engagement within nursing units. There is a great need for a compelling vision for the operation of a safe, efficient, equitable, effective, and patient centered healthcare delivery system. It is crucial to identify what actions are needed to achieve this vision and what realistic strategies are necessary for success. The purpose of this vision statement is to achieve excellence in nursing by establishing a common identity and direction that responds to an ever-changing healthcare environment. The project was conducted on a 25 bed peri-operative and post anesthesia care …

Patient Satisfaction Related To Noise In The Coronary Care Unit, Anjanette S. Dominguez

Master's Projects and Capstones

Background The CCU staff recognized a department trend for low patient-satisfaction score related to environmental noise levels. Based on the Press Ganey score, the patient-satisfaction score plummeted in relation to noise level beginning in March 2014.

Purpose To improve patient satisfaction regarding noise level in the CCU to 100% by November 21, 2014.

Methods Senior & Fleming’s Hard System Model of Change guided this literature search of CINAHL and Fusion for articles published from 2009 to 2014. Specific terms used were noise, critical care, and sleep promotion. From September to November 2014, earplugs were offered to all alert/oriented patients entering …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Sensory Abnormalities In Focal Hand Dystonia And Non-Invasive Brain Stimulation, Angelo Quartarone, Vincenzo Rizzo, Carmen Terranova, Demetrio Milardi, Daniele Bruschetta, Maria Felice Ghilardi, Paolo Girlanda

Publications and Research

It has been proposed that synchronous and convergent afferent input arising from repetitive motor tasks may play an important role in driving the maladaptive cortical plasticity seen in focal hand dystonia (FHD).This hypothesis receives support from several sources. First, it has been reported that in subjects with FHD, paired associative stimulation produces an abnormal increase in corticospinal excitability, which was not confined to stimulated muscles. These findings provide support for the role of excessive plasticity in FHD. Second, the genetic contribution to the dystonias is increasingly recognized indicating that repetitive, stereotyped afferent inputs may lead to late-onset dystonia, such as …

Leadership Styles Of Clinical Coordinators And Clinical Instructors In Physical Therapy Clinical Education, Allison Kellish

Seton Hall University Dissertations and Theses (ETDs)

The APTA has identified the roles of the CCCE and CI as leaders in physical therapy clinical education. In the literature there appears to be an absence of studies examining the CCCE and CI leadership style and its impact on the preparation for clinical instruction, extra effort, job satisfaction and effectiveness of quality clinical education. The purpose of this study was to examine the leadership styles of CIs and CCCEs and to discern if there was a correlation between CI’s and CCCE’s perceptions of leadership style and perceptions of leadership effectiveness based upon three leadership outcomes. The second purpose of …

Disrupting Faculty Service: Using Technology To Increase Academic Service Productivity, Perry Burnett, Kenneth Shemroske, Mohammed Khayum

Administrative Issues Journal

Scholarly attention regarding faculty involvement has primarily focused on faculty opinions of shared governance and faculty influence on institutional decision-making. There has been limited attention given to academic service productivity and the effectiveness of traditional approaches toward the accomplishment of faculty service requirements. This paper discusses disruptive technological change as a subset of disruptive innovation and proposes a technology-based framework for increasing service productivity while maintaining effort with regard to faculty service requirements in academic institutions. Specifically, a social networking tool is used to approach academic service projects with organic involvement and measured progress. It is suggested that such an …

Healthcare Expansion Of Scope, Steve Adkins

Learning Showcase 2014

The healthcare system of OhioHealth has a reputation for providing quality care. As with any healthcare system, there are some populations who are underserved. There are several changes OhioHealth can make to enlarge its customer base. Some of the techniques OhioHealth can use involve increasing its scope of practice in these areas: complementary and alternative medicine (CAM), long-term care, men’s bone health, and social media. The need for long-term care will continue to increase as the population ages. OhioHealth can merge with a long-term care company to provide OhioHealth with the facilities. This strategy is more likely to be successful …

Improving Community Health Through Hospital-Public Health Collaboration: Insights And Lessons Learned From Successful Partnerships, Lawrence Prybil, F. Douglas Scutchfield, Rex Killian, Ann Kelly, Glen P. Mays, Angela Carman, Samuel Levey, Anne Mcgeorge, David W. Fardo

Health Management and Policy Faculty Book Gallery

From the introduction:

Health care expenditures in the United States currently consume over 17 percent of the nation’s gross domestic product, a much larger share than other developed nations. Yet, despite this large investment, studies by Commonwealth Fund, the Institute of Medicine, and other organizations show the USA lags behind other developed nations on multiple metrics of population health such as infant mortality and life expectancy. Moreover, there is extensive evidence of disparities in access, cost, and quality of health care services.

Thus, we are confronted by a striking paradox: the USA spends a large and growing proportion of our …

The Role Of Leadership In Creating A Strategic Climate For Evidence-Based Practice Implementation And Sustainment In Systems And Organizations, Gregory A. Aarons, Mark G. Ehrhart, Lauren R. Farahnak, Marisa Sklar

Frontiers in Public Health Services and Systems Research

There is a growing impetus to effectively implement evidence-based practices (EBPs) in health and allied health settings in order to improve the public health impact of such practices. To support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups (3). This article identifies two relevant types of leadership for implementation and recommends steps that leaders can take in developing a strategic climate for EBP implementation and sustainment within the outer and inner contexts of health …