Digital Commons Network^™

Clinical Inertia In Type 2 Diabetes: A Retrospective Analysis Of Pharmacist-Managed Diabetes Care Vs. Usual Medical Care, Felix K. Yam, Aimee G. Adams, Holly Divine, Douglas Steinke, Mikael D. Jones

Pharmacy Practice and Science Faculty Publications

Background: Evidence suggests that patients with type 2 diabetes (T2DM) suffer from a high rate of “clinical inertia” or “recognition of the problem but failure to act.”

Objective: The aim of this study is to quantify the rate of clinical inertia between two models of care: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical Care (UMC).

Methods: Patients in a university based medical clinic with type 2 diabetes (T2DM) were analyzed in this retrospective cohort study. Patients were exposed to either PMDC or UMC. The difference in days to intervention in response to suboptimal laboratory values and time …

Generating Hypotheses About Care Needs Of High Utilizers: Lessons From Patient Interviews., Dawn B Mautner, Hauchie Pang, Jeffrey C Brenner, Judy A Shea, Kennen S Gross, Rosemary Frasso, Carolyn C Cannuscio

Department of Family & Community Medicine Faculty Papers

Informed by a largely secondary and quantitative literature, efforts to improve care and outcomes for complex patients with high levels of emergency and hospital-based health care utilization have offered mixed results. This qualitative study identifies psychosocial factors and life experiences described by these patients that may be important to their care needs. Semi-structured interviews were conducted with 19 patients of the Camden Coalition of Healthcare Providers' Care Management Team. Investigators coded transcripts using a priori and inductively-derived codes, then identified 3 key themes: (1) Early-life instability and traumas, including parental loss, unstable or violent relationships, and transiency, informed many participants' …

Bringing Functional Family Probation Services To The Community: A Qualitative Case Study, Denise Lynmarie Austin

Dissertations and Theses

In March 2011, Multnomah County's Juvenile Services Division (JSD) in Portland, Oregon implemented a new program model called Functional Family Probation Services, a case management model based on the principles of Functional Family Therapy. Under this model JSD Juvenile Court Counselors deliver Functional Family Probation Services to medium and high-risk youth on probation; both to the youth and their family in their home. This qualitative case study examined the extent to which the Juvenile Court Counselors and Community Justice Managers implemented Functional Family Probation Service's components and recorded their opinions regarding Functional Family Probation Services as a case management model. …

The Influence Of Organizational Culture On Affinity For Knowledge Management Practices Of Registered Nurses, Gregory Allen

Faculty Publications - George Fox Digital

This study addressed the problems of hospitals’ duplicated effort and ad hoc knowledge management (KM) practices. The purpose of this quantitative study was to examine the focus and type of organizational culture in order to describe and predict the relationship between organizational culture and the affinity for KM of nurses working in health care organizations in Portland, Oregon. Guided by the competing values framework and social capital theory, this research study was undertaken to illuminate the possible relationship between the affinity for and probable use of KM and organizational culture in Oregon hospitals. Data were collected from 93 registered nurses …

An Educational Approach: Increasing College Freshmen's Knowledge Regarding Sexually Transmitted Infections, Jennie Mcclain

Evidence-Based Practice Project Reports

According to the Centers for Disease Control (2009), young adults account for only 25% o fsexually active persons in the United States, but account for 50% of the newly diagnosed cases of sexually transmitted infections (STIs). Some young adults may not have received appropriate or credible information on sexual health by which to make knowledgeable decisions that may influence the rest of their lives. High schools are not required to offer comprehensive sex education. Therefore, some students may have received abstinence-only sex education. Risk reduction and disease prevention are important in college health. This evidenced-based practice project included the creation, …

Addressing Uncertainty During Workplace Change: Communication And Sense-Making, Richard Parsells

Administrative Issues Journal

Change is a commonplace occurrence in today’s organizations. In order to survive in an extremely competitive marketplace, organizations and their employees undergo change frequently. The ability to manage change and to learn from this experience is now viewed as a key competency for sustainable competitiveness in most business markets. However, while change management processes are employed and followed, a high percentage of change efforts are judged to be unsuccessful by upper management. Moreover, a number of scholars suggest that communication strategies during organizational change are an important element to the success of a change initiative, yet such strategies are not …

Healthcare Providers Monitoring Of Serum Potassium Levels In The Treatment Of Heart Failure, Sara Burwell, Megan Chaney, Corey Shoemaker

MSN Research Projects

The purpose of this study was to determine if patients older than 65 years of age received the influenza vaccine.

Influenza Vaccination Of The Older Adult Patient And Documentation By The Healthcare Provider, Sara Burwell, Megan Chaney, Corey Shoemaker

MSN Research Projects

The purpose of this study was to determine if patients older than 65 years of age received the influenza vaccine.

Interaction Between Human Resources Management And Ohs: Preparing Future Managers, Sylvie Gravel, Monique Lortie, Henriette Bilodeau, Jessica Dubé

Rapports de recherche scientifique

Plusieurs disciplines, dont l’ergonomie, la médecine, la toxicologie, l’andragogie et bien d’autres, ont contribué à l’avancement des connaissances en santé et sécurité au travail (SST). Malgré les avancées scientifiques, un défi demeure, celui de développer les habiletés des gestionnaires et de sensibiliser ces derniers à leur rôle dans la prise en charge des mesures correctrices et préventives en matière de santé et de sécurité. Une équipe de professeurs de l’Université du Québec à Montréal (UQAM) a proposé de relever ce défi en constituant une banque d’études de cas destinée à l’enseignement aux futurs gestionnaires. Les cas ont été élaborés à …

Effects Of A School-Based Education Intervention On Bmi And Physical Activity, Lauren M. Panner

Evidence-Based Practice Project Reports

In 2011, the CDC reported that there are 12.5 million obese children and adolescents living in the United States (U.S.). The financial burden of childhood obesity in the U.S. is estimated to be 14 billion dollars. The objective of this evidence-based practice (EBP) project was to answer the question: In school-aged children, how does school-based, structured, family-oriented physical activity education affect body mass index (BMI) compared to usual education over an eight week time period? The Stetler Model of EBP and the health belief model were used to guide this project in a rural, Northwest Indiana elementary school. For eight …

A Case Study On Pharmacy To Explore The Perceptions Of Pharmacy Leaders And Policy Makers On The Benefits, Risks, And Alternatives Of The Doctorate As The Entry Level Degree In Health Professions, Heidi Marie Crocker

Dissertations

The clinical doctorate is an emergent trend in many health profession disciplines. Collier (2008) projects continued momentum toward higher degrees for entry into practice and advancing the field in health professions. There has been minimal research on how the trend of doctoral education in health professions will affect health professions education, delivery of services, and interdisciplinary relationship among health care providers, or the wider society (Freburger, King, & Slifkin, 2008). This research focused on the transition to the clinical doctorate in one profession, Pharmacy, retrospectively examining the inception and enactment phase of the Pharm.D. The study provides important insight into …

Depression Screening Of Young Adult Freshmen Students, Marlee R. Steele

Evidence-Based Practice Project Reports

Depression is a mental health issue that requires prompt identification and treatment. According to the CDC, it is estimated that in the U.S .one in 10 adults suffer from depression (CDC, 2011) with 4.7% of young adults, 18-39 years, suffer from depression (CDC, 2006). Many young adults report that college life is often more stressful than anticipated and the demands placed not only academically, but also socially, adversely affect their psychological and physical health (Dyson & Renk, 2006). The purpose of this EBP project was to answer the PICOT question: How does a depression screening tool in combination with a …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Development And Implementation Of A Quality Improvement Initiative: Systematic Follow-Up Of Patients Who Have Spinal Cord Stimulator Implants, Irina Rajala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recent medical advances and the rising prevalence of chronic pain in the US population contribute to the use of spinal cord stimulator (SCS) implant as a treatment modality for chronic pain management. As the numbers of patients receiving SCS implants steadily increases, the challenge of managing this device grows and the need for SCS implants follow-up programs rises. Follow-up programs need to focus on implant longevity and efficacy to improve the quality of care outcomes.

This Doctor of Nursing Practice (DNP) quality improvement initiative was developed to provide systematic follow-up for patient with SCS implant. The project includes the creation …

Comparison Of Study/Article Characteristics And Methodological Quality Of International Nurse Workplace Violence Research Published Before And After The Joint Commission Sentinel Event Alert On Disruptive Behaviors, Terressa Margarette Stowell Love

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The majority of new nurses experience workplace violence from other nurses. The purpose of this study was to compare study/research characteristics and methodological quality of international nurse workplace violence research published before and after the 2008 release of the U.S. The Joint Commission (TJC) sentinel event alert on disruptive behaviors.

Methods: Thirty-nine quantitative nurse workplace violence research articles published between 2001 and 2012 were assessed and divided into two groups: articles published (a) before the 2008 TJC sentinel event alert or the same year, i.e., 2001-2008 (BTJC) and (b) after the 2008 TJC sentinel event alert, i.e., 2009-2012 (ATJC). …

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

The Effects Of A Violence Assessment Checklist On The Incidence Of Violence For Emergency Department Nurses, Sarah Knapp

Evidence-Based Practice Project Reports

Workplace violence (WV) is commonplace in American culture, and nurses working in emergency departments (ED) are not immune to its effects. Violence against emergency department nurses is prominent in current nursing literature, and a cause for major concern. Regrettably there is no consistent tool being used to assess for potential patient violence specific to the emergency department. Current assessment tools have been developed and are commonly used in the mental health arena. This evidence-based practice project concentrated on answering the clinical question of whether or not a violence risk assessment checklist reduced the incidence of violence and increased perception of …

The Clinical Education Experience Of Student-Physiotherapists Within A Transformed Model Of Healthcare, Serela Ramklass

Internet Journal of Allied Health Sciences and Practice

Purpose: The democratisation of the health system was a cornerstone of post-apartheid South Africa. Primary healthcare (PHC) was adopted for increased access, broader participation, and equity in health. Hereafter, physiotherapy and other health sciences curricula, research function, and teaching staff would have to be re-oriented towards enabling implementation and sustainability of the new model. This is an important consideration for the design of clinical education programmes, a learning trajectory within professional curricula that is fundamental to the education, training, and professional socialisation of emerging healthcare personnel. This study explored how student-physiotherapists experienced clinical education practice within the model of PHC. …

Nurses’ Perceptions Of Sustainability Of Magnet® Efforts, Heather Vartanian, Kathleen Bobay, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Magnet® designation and redesignation efforts are time and resource intensive. The results of a survey of nurses’ perceptions about 4 components of sustainability indicate differences between Magnet and non-Magnet hospitals. Evaluating nurses’ perception of the sustainability of Magnet efforts will help nurse executives determine where to commit financial, time, and human resources.

Development Of A Lateral Workplace Incivility Nurse Liaison Position In The Psychiatric Healthcare Setting, Christopher L. Brown

Nursing Theses and Capstone Projects

Workplace incivility is becoming commonplace in all work environments including health care. Research highlights the dangerous, distressing, and costly side effects of lateral workplace incivility (LWPI) including nursing staff's overall health, organizational commitment, and intent to stay. Historically, organizations have been considered safe work environments but LWPI has increased over the last several decades. There has also been limited research related to LWPI as it affects psychiatric healthcare staff and no study recommending a needs assessment or developing a position to educate and assist victims. The purpose of this project was to assess psychiatric healthcare staff's understanding and exposure to …

Nurses' Perceptions Of Shared Medical Appointments, Kristin Monza

Nursing Theses and Capstone Projects

With the increased economic burdens placed on Americans in recent years, the topic of healthcare has been in the forefront. As healthcare reform embraces the country, healthcare organizations are forced to re-examine their business structure more accurately to reflect the changing culture and patient population. The Shared Medical Appointment (SMA) is a model in the chronic disease setting, and many of the benefits and proficiencies have been studied but no studies have assessed nurse experiences or perceptions of SMAs. The purpose of this study was to determine the Registered Nurses's experience with and perception of SMAs. A descriptive exploratory design …

A Pilot Intervention To Engage Nurses To Lead Transformation Of The Workplace, Molly Patton

Theses and Dissertations

The often toxic work environment in which nurses practice contributes to decreased well-being, job dissatisfaction, and poor retention rates, while negatively impacting quality and patient safety. Most leadership programs and resources target nurses in formal leadership positions and are exclusive of the bedside nurse. The purpose of this research utilization project was to determine immediate and short-term outcomes of an educational leadership workshop for nurses, including intent to change the work environment and subsequent action to change the work environment. The goal was to develop, deliver, and evaluate an evidence-based educational intervention to empower nurses at all levels of care …

Examining Generational Differences Across Organizational Factors That Relate To Turnover, Kimberly Asuncion

All Graduate Theses, Dissertations, and Other Capstone Projects

Turnover continues to pose a problem for all organizations across industries. This study examines the complex nature of turnover, by examining the relationship of turnover intentions with perceptions of distributive justice, procedural justice, growth opportunities, and recognition across age groups. Age groups will be used as a proxy for generational cohort membership. Results of the study confirm previous research that generational differences do exist; however, those differences are fairly small. Perceptions of distributive justice, procedural justice, growth opportunities, and recognition were found to be significant predictors of turnover intentions regardless of the age group.

Evaluating Discharge Readiness Of Patients At A Primary Stroke Center, Amanda Green

DNP Projects

The diagnosis of stroke is very prevalent in healthcare and it is estimated that someone in the United States suffers from a stroke every 40 seconds (Lloyd-Jones et al., 2009). In order to optimally prepare these patients for discharge and improve patient outcomes, it is important to understand the needs of the patient and caregiver and to meet these needs. In order to evaluate this, the focus of this project was to evaluate the discharge readiness of patients at a primary stroke center. “Discharge Needs of the Stroke Patient and Caregiver” focuses on a review of the literature in order …

Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm

All ETDs from UAB

The purpose of this research was to examine the relationship between Patient-Centered Medical Homes (PCMH) practice capabilities and costs. Complexity science theory was used to develop a theoretical framework to address three primary and twelve secondary hypotheses. Secondary data from a consortium of physician organizations participating in Blue Cross Blue Shield of Michigan's Physician Group Incentive Program and Blue Cross Blue Shield of Michigan's administrative claims data were used to test hypothesized relationships using fixed effects panel regression models. It was found that higher levels of aggregated PCMH practice capabilities were negatively associated with certain costs, specifically average readmission costs. …

Translating The Values Of Clinical Pedagogy Across Generations, Alistair E. Newbern

Vanderbilt Law School Faculty Publications

Clinical teaching is a Baby Boomer. After an extended infancy, it came of age in the 1960s. It challenged the entrenched isolation and aloofness of law school by questioning the very methods by which law is taught. Channeling the Boomers' cultural tenets of dismantling hierarchy, fostering collaboration, and advocating for social change, it shook off legal academia's suit and tie and rolled up its sleeves, bringing the community into the classroom and putting the university to work. These Boomer-era values are reflected in clinical teaching's enduring core principles of non-directive teaching, reflective practice, close and immediate supervision, learning from experience, …

Hospital Financial Performance: A Look At Governance And Hit Strategies, Taleah Collum

All ETDs from UAB

Taken together, the purpose of the three papers included in this dissertation is to provide empirical evidence on the relationship between strategies employed by hospital managers and hospital financial performance. The findings of these studies are important to managers as they search for ways to sustain and improve hospital financial performance in light of environmental changes that have taken place over the last three decades. The results of this dissertation suggest that to improve financial performance hospital leaders (e.g. management, board of directors) should choose strategies that are more amenable to their control. Specifically, having BOD members that are independent …

The Role Of Agency In Community Health Outcomes: Local Health Departments And Childhood Immunization Coverage Rates, James Anthony Ransom

Antioch University Dissertations & Theses

Organizational culture is defined as a system of shared meaning held by members of an organization that distinguishes it from other organizations. How organizational culture is experienced in the public sector, particularly local health departments (LHDs), is not well understood. The purpose of this study was to determine whether LHD organizational culture impacts childhood immunization coverage rates. I used a modified organizational culture survey tool, the Organizational Management Survey, to quantify organizational culture and determine whether an LHD's organizational culture helps explain variations in childhood immunization coverage rates. In addition, qualitative data from an earlier study of LHD immunization staff …

An Innovative Approach To Action Research In Family Violence Prevention, Linnaya M. Graf, Nancy K. Rea, William M. Barkley

Journal of Sustainable Social Impact

Violence prevention remains a priority in the current public health agenda because of continuing high rates and debilitating effects of violence that exist across the globe (U.S. Department of Health and Human Services, Administration on Children, Youth and Families [USDHHS-ACF], 2009; World Health Organization [WHO], 2013). This article presents the use of an innovative qualitative study developed from community action research methods in the area of family violence. By applying the combined framework of force field analysis (Lewin, 1958) and the public health model (Centers for Disease Control, 2002; Knox & Aspy, 2011), the current study identified factors that positively …