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Articles 31 - 60 of 101
Full-Text Articles in Medicine and Health Sciences
Practice Size And Geographical Location And Annual Merit-Based Incentive Payment System Scores In Dermatology, Issam H. Harmouch
Practice Size And Geographical Location And Annual Merit-Based Incentive Payment System Scores In Dermatology, Issam H. Harmouch
Walden Dissertations and Doctoral Studies
Despite the transition to value-based care in the healthcare industry using the Merit-Based Incentive Payment Systems (MIPS), small and rural physician practices still score in the poor category annually. These poor performances negatively impact funding for staffing and service availability; further, little research has focused on the factors behind these poor performance scores. The purpose of this study was to examine the relationship between practice size and organization geographical location on annual MIPS scores among dermatologists in the South-Central United States. The Donabedian model was used as the theoretical framework for this study that focused on the three qualities of …
Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd
Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd
Walden Dissertations and Doctoral Studies
AbstractHealthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in …
Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow
Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow
Walden Dissertations and Doctoral Studies
AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …
Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr
Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr
Walden Dissertations and Doctoral Studies
AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …
The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins
The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins
Walden Dissertations and Doctoral Studies
AbstractPatient satisfaction has been utilized to measure healthcare quality and outcomes, which affects reimbursement. Some claim such measures could be biased as they do not consider the patient’s socioeconomic status. Measuring the quality of care, Area Deprivation Index (ADI), and patient experience has been captured and publicly reported; and the measuring indicator Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS), however, hospitals serving patients in low ADI areas generally score poorly. Grounded in the theory of Donabedian, the purpose of this quantitative correlational study was to examine the relationship between patient experience associated with socioeconomic disparities and how patients …
Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice
Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice
Walden Dissertations and Doctoral Studies
Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …
Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg
Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg
Walden Dissertations and Doctoral Studies
Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …
Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons
Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons
Walden Dissertations and Doctoral Studies
Insurance based discrimination is a bias that has the potential to harm patients by limiting their access to care and widen health disparities between patients with private and public insurance. The purpose of this study was to examine whether there is a relationship between type of health insurance (private and public) and access to care factors (acceptability and availability) among African American males ages 25–64 with chronic conditions. The Andersen healthcare utilization model framework supported this research in focusing on the determinants that influences a patient’s ability to access to health care. The research questions examined whether a relationship existed …
Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti
Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti
Walden Dissertations and Doctoral Studies
Hospital-acquired infections (HAIs), specifically clostridioides difficile (CDI) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia, increase mortality and length of stay and cost the United States billions of dollars each year. Though preventable, continued incidence demonstrates that infection prevention interventions remain challenging for health system administrators. The purpose of this quantitative study was to identify whether there was a significant difference between Magnet accreditation and non-Magnet accreditation and the frequency of HAIs, specifically, CDI and MRSA bacteremia. The independent variable was Magnet accreditation status; the dependent variables were CDI and MRSA bacteremia. The foundation of the study focused on Donabedian’s framework of …
Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker
Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker
Walden Dissertations and Doctoral Studies
Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …
Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker
Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker
Walden Dissertations and Doctoral Studies
Hospital admissions and readmissions among Medicaid patients significantly impact increased healthcare costs for the state of Louisiana and are associated with poor quality of care. The specific research problem under study was the relationships, if any, between mental health outpatient services in Louisiana, either individual therapy or home and community-based services post-hospital discharge, gender of the patient, and age of the adolescent patient with the number of hospital readmissions over 1 year. Secondary quantitative data analysis was performed using the Island Peer Review Organization Annual External Quality Review Technical Report and data from the managed care organization in Louisiana. No …
Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White
Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White
Walden Dissertations and Doctoral Studies
This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Walden Dissertations and Doctoral Studies
Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …
Strategies For Clinical Managers To Reduce Nosocomial Infections, Samisha Lynn Davis
Strategies For Clinical Managers To Reduce Nosocomial Infections, Samisha Lynn Davis
Walden Dissertations and Doctoral Studies
Increasing nosocomial infection rates threaten patient safety when approximately 100 million patients annually acquire at least one nosocomial infection during their hospital stay. Some clinical managers lack strategies to reduce the incidence and costs of nosocomial infections. Clinical managers need training in proactive infection control guidelines that may reduce infection rates and increase profitability. Grounded in adaptive leadership theory, the purpose of this qualitative multiple case study was to explore successful strategies that clinical managers used to reduce incidence and costs associated with nosocomial infections. The participants were four clinical managers employed by health care organizations in the Southeast Texas …
Influence Of Nurse Residency Programs On Turnover Intent For New Nurse Graduates, Ashley Raye Peters
Influence Of Nurse Residency Programs On Turnover Intent For New Nurse Graduates, Ashley Raye Peters
Walden Dissertations and Doctoral Studies
Nursing turnover and nursing intent to leave is increasing due to burnout, retirement, and a competitive labor market. The purpose of this quantitative study was to determine whether there were statistical differences in turnover intent for nurses with new associate degrees and nurses with new bachelor’s degrees after participation in a nurse residency program. The theory of cognitive dissonance formed the foundation for the two research questions concerning whether there was a difference in turnover intent for nurses with associate degrees and nurses with bachelor's degrees after initial completion of a new nurse residency program and after a year of …
Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry
Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry
Walden Dissertations and Doctoral Studies
Over the last 10 years, institutes of higher learning (IHLs) in the southeastern United States have endured natural disasters that have caused flooding, water, and wind damage and resulted in student evacuations, class disruptions, and building damage. IHLs are further challenged with resuming campus operations despite the emotional impact resulting after a natural disaster occurs. There is limited research relative to the experiences of campus leadership who share the responsibility of keeping students, visitors, and university artifacts safe during and after a hurricane-related event. This research study served as a qualitative phenomenological assessment of campus leadership experiences during a post-hurricane-related …
Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones
Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones
Walden Dissertations and Doctoral Studies
Underrepresentation is a significant issue for Black female nurses to secure nurse leadership positions in healthcare facilities. Leadership by Black female nurses is needed to provide culturally appropriate quality of care, to have a more diverse workplace, and to ensure that the needs of diverse patient populations are met. The purpose of this quantitative study was to explore the barriers and challenges faced by Black female nurses who failed to achieve their advancement goals into leadership roles.Using the National Sample Survey of Registered Nurses (NSSRN) database, the independent variables used were interpersonal differences with colleagues or supervisors, lack of good …
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Walden Dissertations and Doctoral Studies
Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …
Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris
Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris
Walden Dissertations and Doctoral Studies
Inaccurate patient information resulting from duplicate record data entry errors can compromise patient safety. Emergency room (ER) visits in the United States have increased by 15% over the last decade, and the increase has prompted hospitals to implement fast-track admissions in the ER to mitigate overcrowding and expedite the admission process for patients with low-acuity symptoms. Although duplicate record data entry errors occur frequently in ER admissions, there is a lack of information about fast-track ER admissions and the predictors of different types of confirmed duplicate record data entry errors. This correlational quantitative study examined the associations between work shift …
Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo
Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo
Walden Dissertations and Doctoral Studies
AbstractSome South African healthcare managers and physicians find sustaining quality, cost-effective healthcare services challenging. Healthcare leaders are concerned about the high cost of healthcare as it can negatively impact sustainability and patient outcomes. Grounded in the cost-effectiveness theory and complex adaptive system theory, the purpose of this qualitative multiple-case study was to explore strategies some South African healthcare leaders use to sustain healthcare delivery in lower- and middle-income countries. The participants were five healthcare practitioners in rural areas of South Africa. Data were collected through semistructured interviews and secondary data sources. Thematic analysis of the data yielded four themes: patients’ …
Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy
Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy
Walden Dissertations and Doctoral Studies
Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …
Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande
Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande
Walden Dissertations and Doctoral Studies
AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …
Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande
Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande
Walden Dissertations and Doctoral Studies
Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …
Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby
Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby
Walden Dissertations and Doctoral Studies
AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …
Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow
Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow
Walden Dissertations and Doctoral Studies
For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …
The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes
The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes
Walden Dissertations and Doctoral Studies
AbstractPhysical activity (PA) is recognized as a treatment protocol for lung cancer patients that improves physical impairments and reduces symptoms of psychological stress. This qualitative interpretive phenomenological analysis (IPA) study was conducted to explore the lived experience of lung cancer patients and how PA is influenced by anxiety, depression, and fatigue. This study was guided by Bandura’s self-efficacy theory and Engel’s biopsychosocial model. In-depth semi structured interviews were conducted with seven lung cancer participants over Zoom and in person. The data were analyzed using manual hand coding. The analysis revealed themes in patients’ experiences about how PA participation is influenced …
The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins
The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins
Walden Dissertations and Doctoral Studies
Patient satisfaction has been utilized to measure healthcare quality and outcomes, which affects reimbursement. Some claim such measures could be biased as they do not consider the patient’s socioeconomic status. Measuring the quality of care, Area Deprivation Index (ADI), and patient experience has been captured and publicly reported; and the measuring indicator Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS), however, hospitals serving patients in low ADI areas generally score poorly. Grounded in the theory of Donabedian, the purpose of this quantitative correlational study was to examine the relationship between patient experience associated with socioeconomic disparities and how patients …
Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike
Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike
Walden Dissertations and Doctoral Studies
AbstractThe purpose of this study was to explore respiratory therapists’ (RTs') perceived roles and responsibilities in a COPD multidisciplinary care team, and how those roles and responsibilities were affected when RTs were monitored and evaluated by a team member. Accountability theory was used to guide the development of this study. The study’s goal was to provide needed information on the specific roles and responsibilities of RTs in a COPD multidisciplinary care team because RTs knowing their roles and responsibilities could improve the quality of care and enhance the delivery of healthcare services for patients with COPD. The study’s research method …
Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor
Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor
Walden Dissertations and Doctoral Studies
Diabetes education is a principal component of optimal diabetes care that is often underutilized despite the known benefits that include reductions in complications as well as improved glycemic control and self-management knowledge. The purpose of this quantitative study was to examine the association between the completion of diabetes education, referral source, and visit modality. Because the completion of diabetes education is multifaceted, Levesque’s theoretical framework of health access, which incorporates dimensions of the accessibility of services and the abilities of potential users in the utilization of health services, was used to ground the study. A retrospective chart review was conducted …
Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn
Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn
Walden Dissertations and Doctoral Studies
In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …