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Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem Jan 2019

Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem

Walden Dissertations and Doctoral Studies

Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the …


Acuity-Based Nurse Staffing And The Impact On Patient Outcomes, Sara Kollman Jan 2019

Acuity-Based Nurse Staffing And The Impact On Patient Outcomes, Sara Kollman

Walden Dissertations and Doctoral Studies

The costs of healthcare in the United States are of national concern. The systematic review of the literature (SRL) explored the practice-focused nursing question regarding the relationship between the use of acuity-based staffing (ABS) models and positive patient outcomes. Analyzing the impact of ABS models on patient quality outcomes and the potential economic value could provide evidence essential for the healthcare executives responsible for fiscally prudent labor management and for creating an evidence-based business case for adequate, patient-centric nurse staffing. The synergy model for patient care and Covell's nursing intellectual capital theory guided the doctoral project. The Preferred Reporting Items …


Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George Jan 2019

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …


Wellness Paradigms In Predicting Stress And Burnout Among Beginning Expatriate Teachers, Kimala Proctor Jan 2019

Wellness Paradigms In Predicting Stress And Burnout Among Beginning Expatriate Teachers, Kimala Proctor

Walden Dissertations and Doctoral Studies

Research indicates that the current teacher shortage is in part due to stress and burnout. A topic that has not been examined is beginning expatriate English medium teachers (EMTs) with 5 years or less of teaching experience in the United Arab Emirates and the relationship between using individualized, self-initiated wellness paradigms and stress, job burnout, and intent to leave the teaching profession. The transactional model of stress and coping, Maslach's multidimensional theory of burnout, and the health promotion model were used to evaluate the moderating effects of the EMTs' burnout and stress levels on their wellness and intent to leave. …


Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson Jan 2019

Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson

Walden Dissertations and Doctoral Studies

Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …


Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins Jan 2019

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …


Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins Jan 2019

Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins

Walden Dissertations and Doctoral Studies

Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …


Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku Jan 2019

Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku

Walden Dissertations and Doctoral Studies

Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …


Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey Jan 2019

Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey

Walden Dissertations and Doctoral Studies

A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of …


Employee Commitment Among Direct Care Professionals In An Intermediate Health Care Facility, Sharron Theresa Nicholson-Mccall Jan 2019

Employee Commitment Among Direct Care Professionals In An Intermediate Health Care Facility, Sharron Theresa Nicholson-Mccall

Walden Dissertations and Doctoral Studies

Lack of employee commitment affects the overall practice in healthcare organizations and can cause a disruption in the lives of people with intellectual disabilities who are receiving care. Researchers have demonstrated that increasing employee commitment and decreasing employee turnover are related to employee commitment in healthcare organizations. The purpose of this single case study was to explore strategies that leaders of an intermediate care facility for individuals with intellectual disabilities in the northwestern United States used to enhance employee commitment. Meyer and Herchovitch's model of employee commitment was the conceptual framework for this study. Data were collecting from semistructured interviews …


Predictors Of Admission For Stroke Or Transient Ischemic Attack Patients, Jessica Janice Tucker Jan 2019

Predictors Of Admission For Stroke Or Transient Ischemic Attack Patients, Jessica Janice Tucker

Walden Dissertations and Doctoral Studies

Approximately 11% of patients diagnosed with a stroke or a transient ischemic attack are readmitted to the hospital, creating a cost burden of nearly $2 billion per year for Medicare beneficiaries. Because researchers and policy makers consider hospital readmission for patients with strokes or transient ischemic attack to be an indicator for the delivery of quality care, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital's Medicare reimbursement in 1 year for excessive readmissions, potentially impacting the financial sustainability of various healthcare organizations. The ecological systems theory allows for the understanding …


Health Care Leaders' Strategies To Reduce Nursing Turnover, John Clayton Phelps Jan 2019

Health Care Leaders' Strategies To Reduce Nursing Turnover, John Clayton Phelps

Walden Dissertations and Doctoral Studies

Health care leaders who lack effective nurse turnover strategies can negatively affect patient quality of care, productivity, and profitability. The purpose of this single case study was to explore strategies health care leaders used to reduce nursing turnover in a health care organization. The conceptual framework for this study was Herzberg's 2-factor theory. Data were collected from semistructured interviews with 4 health care leaders in the West Texas region who had a history of reducing nurse turnover for a minimum of 5 years from the date of hire, and from review of organizational documents related to the strategies to reduce …


Strategies For Achieving Patient-Centered Healthcare And Cost Containment, Quincy Von Handy Jan 2019

Strategies For Achieving Patient-Centered Healthcare And Cost Containment, Quincy Von Handy

Walden Dissertations and Doctoral Studies

Implementing successful value-centered care strategies that support patient-centeredness while reducing cost is a significant challenge for healthcare leaders. In 2001, the Committee on Quality of Healthcare in America and the Institute of Medicine identified patient-centeredness as 1 of 6 improvement goals to improve quality of care for the 21st century. The purpose of this multiple case study was to explore patient-centered strategies that healthcare managers used to reduce the cost of healthcare for elderly patients without reducing the quality of patient care. The conceptual framework that grounded this study was patient-centered care, and the opposing theory was the primary care …


Nurses' Lived Experiences Of Oppression And Power Dynamics In The Hospital Setting, Khadijatu A. Leary Jan 2019

Nurses' Lived Experiences Of Oppression And Power Dynamics In The Hospital Setting, Khadijatu A. Leary

Walden Dissertations and Doctoral Studies

The persistent and chronic nursing shortage presents an urgency to understand the root causes of nurses' increasing mobility and movement within and outside of the nursing workforce. A key to understanding nurses' dissatisfaction is to explore the work environment in which they practice. The purpose of this heuristic, phenomenological study was to understand nurses' experiences of oppression and the power dynamics in the hospital setting, which may provide insight to nursing turnover. The conceptual framework was Harvey's civilized oppression theory. Data were collected from semistructured interviews of 9 registered nurses by phone that met inclusion criteria of having more than …


Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide Jan 2019

Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide

Walden Dissertations and Doctoral Studies

This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing …


Cameroonian Immigrants ' Behaviors, Beliefs And Knowledge Of Type 2 Diabetes: In Minnesota, Brendabell Ebanga Njee Jan 2019

Cameroonian Immigrants ' Behaviors, Beliefs And Knowledge Of Type 2 Diabetes: In Minnesota, Brendabell Ebanga Njee

Walden Dissertations and Doctoral Studies

Nondiabetic immigrants from Cameroon who migrate to Minnesota lack knowledge of risk factors associated with type 2 diabetes and face challenges accessing health care services. Nondiabetic immigrants from Cameroon lack culturally appropriate health care services and therefore find it difficult to follow providers' recommendations. This phenomenological study explored the perceptions and experiences of nondiabetic immigrants from Cameroon regarding access to affordable, quality health care services as well as their behaviors, beliefs, and knowledge of type 2 diabetes self-management. Bronfenbrenner's social ecological model provided the theoretical framework. Research questions addressed access to affordable health care services, knowledge, and perception of type …


Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George Jan 2019

Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George

Walden Dissertations and Doctoral Studies

Pediatric bipolar disorder (PBD) is a growing public health problem in the United States, especially among adolescent children. Despite awareness of the diagnosis and the effects that it has on the child, little attention has been given to the effects that PBD has on the guardian. The purpose of this qualitative phenomenological study was to explore the factors influencing guardians' experiences related to PBD. Penchansky and Thomas' Theory of Access and Family Systems Theory were used in this study to explore guardians lived experiences of PBD, its effects on the entire family system, and mental health service treatment. This approach …


Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua Jan 2019

Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua

Walden Dissertations and Doctoral Studies

Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …


Understanding The Lived Experiences Of Counselors Who Have Been Assaulted By Clients, Cynthia S. Ellison Jan 2019

Understanding The Lived Experiences Of Counselors Who Have Been Assaulted By Clients, Cynthia S. Ellison

Walden Dissertations and Doctoral Studies

Assault of community-based mental health professionals is a worldwide phenomenon, and current extant literature examines the prevalence of client assault on counselors, social workers, and psychiatric personnel. While there is significant quantitative scholarship on the incidence of this phenomenon on social workers and psychiatric personnel, there are limited statistical data on client-perpetrated violence against community-based counselors and no qualitative studies found that examined how these professionals experience this occupation risk. Therefore, the purpose of this study was to explore how counselors who work in community-based settings make sense of these experiences. Through semi structured interviews, 6 community-based counselors living in …


Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse Jan 2019

Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse

Walden Dissertations and Doctoral Studies

High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …


Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera Jan 2019

Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera

Walden Dissertations and Doctoral Studies

The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …


Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush Jan 2019

Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush

Walden Dissertations and Doctoral Studies

Hospital systems in the United States are facing a dilemma regarding capacity management in the emergency department (ED) and the inpatient care setting. The average wait time in EDs across the United States exceeds 98 minutes, which is also the point at which patients begin to abandon healthcare treatment. The purpose of this quantitative study was to examine the use of queueing theory in capacity management on length-of-stay (LOS) rates, left-without-being-seen (LWBS) rates, and boarding rates in the ED and inpatient setting. The boarding rates represent the rate in which patients were roomed in the ED but required inpatient care. …


The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong Jan 2019

The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong

Walden Dissertations and Doctoral Studies

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …


Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee Jan 2019

Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee

Walden Dissertations and Doctoral Studies

High no-show rates in the ambulatory setting lead to underutilized resources, decreased clinic revenue, and lower productivity. The purpose of this single case study was to explore strategies that administrators used to maintain acceptable no-show rates and maintain the sustainability of the healthcare practice. The target population for this study included local chapter members of a professional healthcare organization that provided access to practice managers and administrators in the Las Vegas, Nevada regional area where there are a large number of practices that are not part of a health system; the sustainability of these practices is dependent on allocation of …


Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack Jan 2019

Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack

Walden Dissertations and Doctoral Studies

Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2 factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel …


Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell Jan 2019

Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell

Walden Dissertations and Doctoral Studies

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …


Mobile Technology Deployment Strategies For Improving The Quality Of Healthcare, Won K. Song Jan 2019

Mobile Technology Deployment Strategies For Improving The Quality Of Healthcare, Won K. Song

Walden Dissertations and Doctoral Studies

Ineffective deployment of mobile technology jeopardizes healthcare quality, cost control, and access, resulting in healthcare organizations losing customers and revenue. A multiple case study was conducted to explore the strategies that chief information officers (CIOs) used for the effective deployment of mobile technology in healthcare organizations. The study population consisted of 3 healthcare CIOs and 2 healthcare information technology consultants who have experience in deploying mobile technology in a healthcare organization in the United States. The conceptual framework that grounded the study was Wallace and Iyer's health information technology value hierarchy. Data were collected using semistructured interviews and document reviews, …


A Delphi Study Analysis Of Best Practices For Data Quality And Management In Healthcare Information Systems, Olivia L. Pollard Jan 2019

A Delphi Study Analysis Of Best Practices For Data Quality And Management In Healthcare Information Systems, Olivia L. Pollard

Walden Dissertations and Doctoral Studies

Healthcare in the US continues to suffer from the poor data quality practices processes that would ensure accuracy of patient health care records and information. A lack of current scholarly research on best practices in data quality and records management has failed to identify potential flaws within the relatively new electronic health records environment that affect not only patient safety but also cost, reimbursements, services, and most importantly, patient safety. The focus of this study was to current best practices using a panel of 25 health care industry data quality experts. The conceptual lens was developed from the International Monetary …


Effective Nurse Recruitment Methods For Long-Term Care Facilities, Keith Laprade Jan 2019

Effective Nurse Recruitment Methods For Long-Term Care Facilities, Keith Laprade

Walden Dissertations and Doctoral Studies

Nurse recruitment is a challenge for long-term care (LTC) leaders. Some owners of LTC businesses lack knowledge of how to attract, market, and hire qualified nurses to help ensure success. The purpose of this multiple case study was to explore the methods and strategies LTC leaders used to recruit nurses. The target population consisted of leaders of 3 LTC facilities who were responsible for recruiting nurses. This selection was based on findings that organization leaders experienced a downsizing of more than 20% of their personnel. The conceptual framework was the motivation-hygiene theory. Working conditions were influenced by Herzberg's 2-factor principles …


Successful Demand Forecasting Modeling Strategies For Increasing Small Retail Medical Supply Profitability, Arica Watkins Jan 2019

Successful Demand Forecasting Modeling Strategies For Increasing Small Retail Medical Supply Profitability, Arica Watkins

Walden Dissertations and Doctoral Studies

The lack of effective demand forecasting strategies can result in imprecise inventory replenishment, inventory overstock, and unused inventory. The purpose of this single case study was to explore successful demand forecasting strategies that leaders of a small, retail, medical supply business used to increase profitability. The conceptual framework for this study was Winters's forecasting demand approach. Data were collected from semistructured, face-to-face interviews with 8 business leaders of a private, small, retail, medical supply business in the southeastern United States and the review of company artifacts. Yin's 5-step qualitative data analysis process of compiling, disassembling, reassembling, interpreting, and concluding was …