A Quality Improvement Study On Missed Appointment Management In Primary Care, Aunye' Dina Amos

Dissertations

Abstract

Problem: Patients who miss appointments have poorer health outcomes and increase costs for medical care. The purpose of this quality improvement study was to evaluate the effects of missed appointments on patients’ outcomes for diabetes mellitus, and resulting financial losses to a private primary care practice.

Method: A quality improvement initiative with a retrospective review of patients over a six-month period in 2018 (before) and 2019 (after a missed appointment fee was implemented). All adult patients, aged 18-92 years, were included. For those with diabetes, a HbA1c for each patient who kept or missed their appointment was recorded.

Results: …

Task-Based Estimation And Planning For Application Development Projects And Resources: Models, Methods And Applications, Chidambaram Subbiah

Dissertations

This dissertation takes a new approach to software development effort estimation from the perspective of design patterns at an organization. A new estimating tool is developed to provide bottom up estimates based on the design patterns of the organization. The research also offers guidelines for extracting the unique design patterns specific to an organization that are used to obtain baseline task level estimates in the Estimating Tool. In addition, the tool provides a suite of seven estimates using predictive analytics to estimate the labor hours required for a project using historical data, a bottom-up estimate that is rooted in the …

Towards Completely Automated Glycan Synthesis, Matteo Panza

Dissertations

Carbohydrates are ubiquitous both in nature as biologically active compounds and in medicine as pharmaceuticals. Although there has been continued interest in the synthesis of carbohydrates, chemical methods require specialized knowledge and hence remain cumbersome. The need for development of rapid, efficient and operationally simple procedures has come to the fore. This dissertation focuses on the development of a fully automated platform that will enable both experts and non-specialists to perform the synthesis of glycans. Existing automated methods for the synthesis of oligosaccharides are highly sophisticated, operationally complex, and require significant user know-how. By contrast, high performance liquid chromatography (HPLC) …

African-American Baccalaureate Nursing Students' Perceptions Of Nursing Programs And Factors That Support Or Restrict Academic Success, Sharon Marie Mills-Wisneski

Dissertations

The nursing literature is limited in reporting African-American nursing students' perceptions of nursing programs and factors that are viewed as supportive of or restrictive to academic success in this selected population. Bean and Metzner's (1985) conceptual model of Nontraditional Student Attrition proposed that there are four sets of variables that have a direct affect on whether nontraditional students will persist in their educational endeavors: (1) background and defining variables, (2) academic variables, (3) environmental variables, and (4) psychological outcomes. The National agenda to increase workforce diversity and leadership succession is critical to improving access for a culturally diverse society. The …

Quality Of Life Of Adults With Congenital Heart Disease, Lynn M. Simko

Dissertations

Adults with Congenital Heart Disease (CHD) are a new and growing population of patients who pose a challenge to both medicine and nursing. Medical and surgical advances have increased the number of adults with CHD. These advances may create Quality of Life (QOL) issues which were not previously considered. The purpose of this study was to collect data describing the QOL of adults with CHD in order for health professionals to develop appropriate information, counseling, and anticipatory guidance. This study was a case-control study design utilizing a QOL assessment tool, the Sickness impact Profile (SIP), along with a demographic questionnaire.

What Does Time Management Mean To You? Exploring Measures Of Time Management And Group Differences., Allison Burrus

Dissertations

For centuries people have been trying to find ways to effectively manage their time. Meanwhile, research in this area has lagged and provided inconsistent results about the outcomes (i.e., well-being and job performance) of the use of time management behaviors. A potential reason for the inconsistent results is the lack of a universal conceptualization of time management making it difficult to compare results. Further, it may be that certain groups use and/or interpret time management behaviors in different ways. This study investigated three of the most popular measures of time management concurrently. First, the measures were examined for statistical artifacts, …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Supervisory Working Alliance As A Predictor For Counselor Burnout: The Potential Mediating Role Of Supervisee Nondisclosure, Amanda Bohnenstiehl

Dissertations

Clinical supervision sometimes lacks the elements necessary for a rigorous, helpful, and meaningful experience for the supervisee. The purpose of this study was to examine the relationships between the supervisory working alliance, supervisee nondisclosure (i.e., when a supervisee does not communicate information that would otherwise be shared with the supervisor), and counselor burnout, specifically in a sample of counselors, social workers, and psychologists pursuing their original state licenses. Nondisclosure was examined to determine if it was a mediator of the relationship between the supervisory working alliance and burnout. Participants (n = 288) completed a demographic questionnaire, the supervisee form …

Accessibility To Resources For Homeless Documented Immigrant Families: A Case Study, Antaniece P. Carter

Dissertations

This study seeks to explore the experience of a homeless documented immigrant family attempting to access school and community resources. Research has shown that due to disadvantages including but not limited to lack of economic mobility, employment access, lone parent families, and cultural background, some immigrant families may face challenges accessing services (Arnold, 2004). Difficulty accessing services then can inhibit adjustment and may lead to homelessness.

The purpose of this study is to investigate the issue of homelessness as experienced by immigrants within an urban community. A case study will highlight the experience of a homeless immigrant family, as defined …

Can Free College Programs Level The Playing Field? An Exploratory Study Of Understanding Non-Economic Persistence Barriers For Low-Income Students, Alan Byrd

Dissertations

The rising cost of higher education has created substantial access and persistence barriers for low-income students. Consequently, gaps in educational attainment between low-income students and their middle- and high-income peers have continued to widen over the last few decades. Colleges and universities have taken notice of these growing disparities, and several institutions have responded by developing need-based financial aid programs to close unmet need gaps for Pell Grant recipients. These last-dollar financial aid programs have opened doors for more low-income students to attend selective institutions, but it is unclear how these programs will influence their persistence and completion rates. The …

The Effect Of Union Affiliation On Salary For Female Community College Faculty, Kathleen Kanz White

Dissertations

There is a substantial pay disparity between the highest and lowest paid full-time community college faculty members, more so for women. Faculty unions, which are common at community colleges, are believed to increase pay equity, although research on unions is limited. This study provided evidence addressing gaps in the literature regarding the community college workforce and unionization in higher education. No previous research has been conducted at the community college level examining specific union affiliation and the role it plays in salary.

The purpose of the study was to examine salary variables for female community college faculty members employed in …

Selected African American First-Time Teenage Mothers' Perceptions Of Nurse Caring Behaviors During The Postpartum Period, Danita R. Potter

Dissertations

Nurse caring behaviors are essential to improving health outcomes. However, there has been little research conducted that has investigated nurse caring behaviors during the postpartum period, particularly behaviors directed toward African American first-time teenage mothers. The purpose of this study was to explore and describe African American first-time teenage mothers' perceptions of nurse caring behaviors during the postpartum period. Watson's (1985) Theory of Human Caring was the conceptual basis of this study. Data were collected using the Caring Behaviors Assessment (CBA) instrument, a 63-item questionnaire that included two open-ended questions that were used to identify themes, and a 9-item demographic …

Compensation Of Staff Nurses Employed In United States Hospitals From 1960 To 1990, Pamela Frances Cipriano

Dissertations

Compensation for registered nurses employed as staff nurses in nonfederal hospitals from 1960 to 1990 was studied. Significant events of hospital financing, professional efforts to improve wages and working conditions, and the changing demand for nurses were also examined. Historical method was used to gather and interpret data, construct a salary time series, and describe events affecting the interaction of supply, demand, and wages in the nurse labor market.

When The Injured Nurse Returns To Work: An Institutional Ethnography, Laurie Clune

Dissertations

Nursing is a high risk profession for injury. A Canadian survey reports many nurses are in poor physical and emotional health; they sustain more musculoskeletal and violence related injuries than other occupational groups. In Ontario, an injury management approach called Early Return to Work (RTW) requires injured workers, including nurses, to go back to work before full recovery. The Workplace Safety and Insurance Board cite this approach as beneficial to both the employer and employee. This study uses an institutional ethnographic approach to examine critically the RTW process from the standpoint of injured registered nurses. Through interviews and mapping activities …

Social Support, Psychological And Physical States Among Japanese Women With Breast Cancer, Reiko Makabe

Dissertations

In Western cultures, it has been reported that social support has effects on health outcomes among women with breast cancer. However, little is known about social support and the effects on health outcomes among Japanese women with breast cancer. In addition, there are no instruments with established reliability and validity to measure social support specific to Japanese populations giving consideration to cultural differences. A cross-sectional study was designed incorporating quantitative and qualitative approaches for the purposes of: (1) testing the reliability and validity of instruments developed to measure social support with Western populations when used with Japanese women with breast …

Perceived Social Support, Coping, And Psychological Distress In Advanced Cancer Patients, Adelaida Zabalegui

Dissertations

The purpose of this study was to examine the extent to which perceived social support and coping mechanisms contribute to explaining psychological distress in advanced cancer patients receiving chemotherapy. The Lazarus and Folkman stress and coping model (1984a) provided the framework.

Peripherally Inserted Central Catheters (Picc) And The Efficacy Of Tip Placement Confirmation With Ecg Ultrasound-Guided Technology And Chest Radiography, Elizabeth A. Morrell

Dissertations

The aim of this study was to appraise the efficacy of peripherally inserted central catheters (PICC) tip placement confirmation using a fully-integrated magnetic tracking system and ECG ultrasound-guided insertion technology performed at the patients' bedside by venous access nurses and validated by the post-insertion chest radiography (CXR) report. Labor costs and time were compared with the interventional radiology (IR) team and the venous access nurses to determine if there was a noteworthy cost difference with PICC insertions. PICCs have gained popularity due to improved ECG ultrasound-guided tip navigation technology. Real-time ECG ultrasound-guided technology is the safest, most accurate method of …

Preferences For Information And Self-Care, Stress And Coping With Outpatient Surgery: A Descriptive Correlational Study, Linda Marie Caldwell

Dissertations

Outpatient surgery is a rapidly growing phenomena in the health care field; however, little is known about the stressful aspects of the experience of how patients cope with this type of surgery. The purposes of this descriptive, correlational study were: to identify what aspects of the outpatient surgical experience are appraised as stressful and how patients cope with these stressful experiences, and to examine the influence of preferences for information and self care on stress and coping. The study was based on the theory of stress and coping as proposed by Lazarus. Data were collected from a convenience sample of …

Development Of An Instrument To Measure Quality Of Nurses' Worklife, Beth A. Brooks

Dissertations

This study reports the development process and factor structure of a questionnaire to measure quality of nursing work life for registered nurses in hospital settings. Included is information on item generation, content validation, initial pilot testing, and results from the full study.

Assessing The Impact Of Practice Transition On Advance Practice Registered Nurse's Job Stress And Job Satisfaction., Patricia E. Hendrickson

Dissertations

The impact of the transition to full practice authority (FPA) on job satisfaction and job stress has not been previously described in the literature.

Job satisfaction, job stress, and practice transition stress data was collected from a sample of 33 Advance Practice Registered Nurses (APRN) working at the VA St Louis Health Care System using Misener Nurse Practitioner Job Satisfaction Survey (MNPJSS), National Institute of Occupational Safety and Health Generic Job Stress Questionnaire (NIOSH-GJSQ), and student-developed practice transition stress questionnaire during the initial phase of FPA transition.

Maternal Attitudes, Feeding Practices And Child Weight-For-Length Percentiles: Maternal Participation Vs. Non-Participation In A Prenatal Infant Nutrition Education Session, Connie S. Lewis

Dissertations

Obesity has reached epidemic proportions nationally and internationally. All ages are affected resulting in physiological and psychological health consequences. Obesity-related habits that begin in childhood may continue into adulthood suggesting the need for developmentally targeted approaches. Efforts to reduce obesity should begin early in life with interventions targeting infants and young children. Is there a difference in infant feeding attitudes, the initiation of breastfeeding practice, the introduction of solid foods practice, and child weight-for-length percentiles at 12, 18, and 24 months between mothers who participated in a prenatal infant nutrition education session and mothers who did not participate? The purpose …

Decision-Making Between Nurse-Midwives And Clients Regarding The Formulation Of A Birth Plan, Mary Ellen Doherty

Dissertations

This descriptive qualitative study examined the interaction between nurse-midwives and clients during prenatal visits in the third trimester as they formulated a birth plan. The study was concerned with decision-making and the participative behaviors exhibited by the participants while engaged in the process. The theoretical framework undergirding the study was Kim's (1983b, 1987b) theory of collaborative decision-making in nursing practice. This field study was conducted using the participant observation approach of Schatzman and Strauss (1973) and the analytic ethnography perspective of Lofland (1995).

Emerging Adults' Lived Experience Of Perinatally Acquired Human Immunodeficiency Virus, Angela Marie Wright

Dissertations

The purpose of this qualitative heuristic study was to explore the emerging adults' lived experience of PAHIV. The aim of this study was to determine if the emerging adults were meeting the benchmarks of their developmental stage as their unaffected peers and to elucidate their voices to understand their essence of the experience of PAHIV. This study answered the questions: What is the emerging adults' lived experience of perinatally acquired HIV (PAHIV)? What benchmarks of the developmental stage are the emerging adults with PAHIV meeting? Philosophical Underpinnings: This study utilized the qualitative research approach with interpretivism and constructivism as the …

Testing An Intervention To Decrease Catastrophizing In Persons With Fibromyalgia, Pamela Jean Nelson

Dissertations

The purpose of this study was to test the effectiveness of a brief psychoeducational nursing intervention to alter catastrophizing and improve coping with fibromyalgia, a syndrome of chronic, widespread pain. Catastrophizing is defined as a negative way of thinking about pain that interferes with the development of pain coping self-efficacy, the confidence a person has in their ability to manage pain. In fibromyalgia, catastrophizing has demonstrated a strong relationship to pain severity and daily functioning, but brief interventions targeting catastrophizing have not been tested. Theoretical framework. Bandura's social cognitive model emphasizing self-efficacy as a determinant of behavior was used as …

Community Schools In St. Louis Then And Now: Exploring The Influence Of Family, School, And Community Engagement On Student And Community Outcomes, Kimberly Ann Carothers

Dissertations

All children should have access to the American Dream by receiving a meaningful and equitable educational opportunity that prepares them to be successful in school and life thereafter. Today, many children are denied this dream over and over again. Minority and low-income children often face multiple barriers that stagnate their growth; resulting in equity and achievement gaps. Schools that implement the community schools strategy integrate resources and services from family, school, and community partners to prepare students for success in meeting the demands of the twenty-first century. Community schools are hubs with evening and weekend hours that bring together a …

The Role Of Bro Culture In Exploration Of Why Women Leave It, Ana Krasteva

Dissertations

The goal of this exploratory study is to investigate ways in which whether the phenomena called the ‘bro culture’ may influence on women in the information technology (IT) workforce. It specifically seeks to determine whether bro culture has an impact on why women in IT move from one IT company to another; leave IT for a non-technical field; or leave the workforce entirely.

Although there is a plethora of studies on why women leave positions in IT, less understood is the impact and influence of bro culture on the decision.

My findings suggest that bro culture in the workplace is …

The Impact Of Structural Supports On The Success Of Students Of Color In The K-16 Educational System, Brandis Jones, Sherry Holmes

Dissertations

Collective Abstract

This collective dissertation contains the efforts of two practitioners in the field of education who possess a shared vision for designing student experiences with the mission of preparing all students for success in secondary and post-secondary education. The researchers believed that by creating structural supports for students in underserved populations, these same students will increase their educational attainment and access to long-term career opportunities. With successful completion of postsecondary education and with increased career opportunities, students can improve their lives, their families’ lives and the lives of members of their community.

Many students struggled on their educational journeys …

A Comparative Study Analyzing Undergraduate Internship Participation And The Impact On Retention And Timely Degree Completion At A Four-Year, Private, Midwest Institution, Stefani Schuette

Dissertations

Declining enrollments, rising costs and increasing student debt have caused college administrators, potential students, and outside stakeholders to focus on certain student outcomes, including retention and timely degree completion. Colleges and universities are not only collecting data in these two areas, they are searching for strategies, which might have a positive effect. Research has provided a variety of factors, which contribute to retention and timely degree completion. High-impact practices, such as service learning, student faculty research and internships featured several characteristics that may contribute to retention and timely degree completion. Internships offer several advantages, such as preparation for future careers …

Implementation Of Oral Health Recommendations In Pediatric Primary Care, Kelly Lucash

Dissertations

Abstract

Problem: Early childhood caries (ECC) is the most common chronic disease of childhood and fluoride is key to prevention. A major barrier to dental care for children is lack of access to a dental provider. Current practice recommendations include the application of fluoride varnish (FV) in the primary care setting. The purpose of this quality improvement initiative was to evaluate the number of FV applications in a Midwestern, suburban pediatric primary care practice.

Methods: An observational, descriptive design utilizing retrospective medical record reviews for children aged 12-, 18-, 24-, and 36-months who experienced well-child visits between April 1^{st …}

Impact Of A Web-Based Instructional Module Of Alzheimer’S Disease Within Seven Content Knowledge Domains, Joyce Haynie

Dissertations

Abstract

Alzheimer’s Disease (AD) has been classified as the most common form of dementia. Primary health care providers are usually the first clinicians to whom individuals present with symptoms of dementia. By 2050, it is expected that as many as 13.8 million Americans will be living with AD, and millions more will be placed in the challenging role of providing care for these individuals. However, studies continue to show that dementia is often underdiagnosed and under detected. The purpose of the study was to systematically inquire about the impact of AD education on level of knowledge about AD among primary …