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Articles 1 - 30 of 76
Full-Text Articles in Medicine and Health Sciences
Effectiveness Of 7-Day And 30-Day Interval Aftercare To Reduce Psychiatric Readmissions, Aldrick Dwight Barr
Effectiveness Of 7-Day And 30-Day Interval Aftercare To Reduce Psychiatric Readmissions, Aldrick Dwight Barr
Walden Dissertations and Doctoral Studies
The results for psychiatric readmissions and 7- and 30-day follow-up care post psychiatric discharge are mixed. Psychiatric readmissions of psychiatric patients are costly. The purpose of this quantitative study was to evaluate the association between 7- and 30-day follow-up care percentages and 30-day readmission rates for an inpatient psychiatric facility (IPF). The transtheoretical model was used to assess patient readiness for behavior change and a patient-centered guide that provides strategies for patient progression during hospital readmission and post psychiatric hospital discharge. In this study, a quantitative, correlational research design utilizing public secondary data retrieved from the Centers of Medicaid and …
Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna
Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna
Walden Dissertations and Doctoral Studies
More than half of the population of the Commonwealth of the Northern Mariana Islands had not visited their primary care provider for a year in 2016. The Chamorro people are less willing to seek or access care than other ethnic groups. This qualitative study aimed to understand the Chamorro people's access and utilization of Saipan's health care services to improve their access and, ultimately, their health. The theoretical frameworks included Penchansky and Thomas's theory of access to explore the Chamorro people of Saipan's lived experiences with availability, accessibility, accommodation, affordability, and acceptability of health care services, as well as Spector's …
Nurse Turnover A Crisis In Healthcare, Billie Robinson
Nurse Turnover A Crisis In Healthcare, Billie Robinson
Walden Dissertations and Doctoral Studies
AbstractNurse turnover is a global, national, and local problem that impacts the ability of healthcare leaders to deliver high quality healthcare to the populations in need of healthcare services. The purpose of this study is to identify reasons nurses leave organizations. The Leader-Member Exchange Theory undergirds the quantitative research which was conducted using the Supervisor Leader Communication Inventory. Nurse leaders communicate with acute care nurses using principles of the Leader- Member Exchange Theory. The survey was distributed to members of the Georgia Nurse Association. Positive correlations were revealed between the independent and dependent variables. SPSS was used to establish the …
Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan
Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan
Walden Dissertations and Doctoral Studies
Balanced diversity in health care promotes patient satisfaction and enhances innovation. Obtaining a culturally balanced workplace requires recruitment strategies that encourage inclusiveness among team members from various backgrounds. The purpose of this doctoral study was to explore the issue of lack of diversity in a behavioral health organization’s (BHO’s) student intern program and identify strategies for creating greater diversity in the workplace. The Baldrige excellence framework, the conceptual framework that guided the research, was designed to help BHOs to improve their overall business performance to accomplish goals and increase organizational sustainability. Three themes emerged from the data analysis: diversity training, …
Service-Level Factors Affecting Completion Of Antenatal Care Attendance In Uganda, Lorna Barungi Muhirwe
Service-Level Factors Affecting Completion Of Antenatal Care Attendance In Uganda, Lorna Barungi Muhirwe
Walden Dissertations and Doctoral Studies
Lack of universal coverage of proven, low-cost, high-impact interventions—particularly for underserved and rural populations—remains a key reason for the high rates of maternal deaths in Uganda. Antenatal care (ANC) ensures early detection and treatment of pregnancy-related complications. Completion of recommended ANC visits remains suboptimal, particularly for rural women in Uganda. The purpose of this quantitative, cross-sectional study was to assess facility-level factors affecting completion of ANC attendance among women of reproductive age in a rural district in Uganda. The Dutton theory for initial and continued health services utilization was used to analyze the relationship between facility level factors and ANC …
Perceptions Of Nurse's Personal Smartphone Use At Work, Esperanza Criscuolo
Perceptions Of Nurse's Personal Smartphone Use At Work, Esperanza Criscuolo
Walden Dissertations and Doctoral Studies
Distracted nurses who use their personal smartphone at work has resulted in the diversion of attention from patient care. The specific problem is the personal smartphone use by nurses in the hospital settings has resulted in distracted patient care, leading to wrongful release of patient’s information, medical errors, injury or preventable patient death. The purpose of this qualitative study was to describe the perceptions of nurses regarding distracted patient care in their clinical workplace due to personal smartphone use by nurses. The study was grounded in the distraction-conflict theory conceptual framework. The key research question examined the perceptions of nurses …
Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi
Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi
Walden Dissertations and Doctoral Studies
AbstractObesity has become a global wellness concern for young adults. In the past, there were very few studies conducted on predictors of obesity among young adults, even though there have been several studies on the potential predictors of obesity on the general population. The social ecological model was used to guide this quantitative cross-sectional study to identify the possible predictors of obesity among young adults. The Behavioral Risk Factor Surveillance System was used to analyze the potential predictors of obesity among young adults between the ages 18 – 34 years old in Montgomery County, Frederick County, and Princess Georges County, …
Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi
Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi
Walden Dissertations and Doctoral Studies
AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …
State Consent Policies And The Meaningful Use Of Electronic Health Records Among Nonfederal Acute Care Hospitals In The United States, Adetoro Kafilat Longe
State Consent Policies And The Meaningful Use Of Electronic Health Records Among Nonfederal Acute Care Hospitals In The United States, Adetoro Kafilat Longe
Walden Dissertations and Doctoral Studies
The less-than-nationwide use of electronic health record (EHR) systems to send, receive, and integrate (SRI) patient summary of care (PSC) records limits the ability of hospital administrators to maximize efficiency and improve quality in the continuum of care. Despite obvious differences in state health information exchange (HIE) consent policies, there is no known research that has determined if and what aspects of state-level HIE legislation affect the use of EHR systems to SRI PSC records. Guided by the unified theory of acceptance and use of technology (UTAUT), the purpose of this quantitative cross-sectional research study was to examine the relationship …
Health Care Manager Electronic Medical Record Systems Implementation Strategies To Improve Patient Outcomes, Mcarthur Bruno Damis
Health Care Manager Electronic Medical Record Systems Implementation Strategies To Improve Patient Outcomes, Mcarthur Bruno Damis
Walden Dissertations and Doctoral Studies
Ineffective implementation of electronic medical record systems (EMRS) among health care outpatient clinics results in substantial financial loss. Health care managers (HCMs) in outpatient clinics who fail to implement EMRS adversely affect employee usage and performance. Grounded in fayolism theory, the purpose of this qualitative multiple case study was to explore the strategies health care managers used to implement EMRS in their organizations. The participants were six HCMs in a U.S East Coast city. Thematic analysis was used to analyze the data from semistructured interviews and internal company documents. Five themes emerged: internal communication, overcoming barriers, time management, compensation improving …
Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe
Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe
Walden Dissertations and Doctoral Studies
Hospital readmissions are a reflection of poor quality of care. The readmission rate in an acute care for the elderly (ACE) unit was above the national benchmark in 2017. The specific problem includes lack of communication, collaboration, and coordination among the interdisciplinary team. Further, in older adults, the problem is accentuated by health illiteracy, comorbidities, cognitive impairment, polypharmacy, and unclear discharge and follow-up care instructions. Poor care transition costs Medicare 17.4 billion dollars a year. Multidisciplinary rounds (MDRs) have been adopted by many hospitals as evidence-based interventions to reduce readmissions within 30 days. This Doctor of Nursing Practice (DNP) project …
Strategies For Managing Work-Related Stress In The Petroleum Industry, Esang Lazarus Esitikot
Strategies For Managing Work-Related Stress In The Petroleum Industry, Esang Lazarus Esitikot
Walden Dissertations and Doctoral Studies
High work-related stress negatively impacts workers’ health and productivity in the Nigerian petroleum industry. Supervisors in the Nigerian petroleum industry who lack strategies to reduce work-related stress significantly lose worker health and organizational productivity. Grounded in person-environment fit theory, the purpose of this qualitative multiple case study was to explore strategies Nigerian petroleum industry supervisors use to manage work-related stress. Participants were six supervisors who have successfully used strategies to reduce work-related stress in the Nigerian petroleum industry. Data were collected from semistructured interviews and internal company documents relevant to reducing work-related stress and analyzed using thematic analysis. Three major …
30-Day Hospital Readmission Rates In Illinois Hospitals For Patients With Heart Failure And Pneumonia, Kristine Rucker-Morrow
30-Day Hospital Readmission Rates In Illinois Hospitals For Patients With Heart Failure And Pneumonia, Kristine Rucker-Morrow
Walden Dissertations and Doctoral Studies
Despite efforts from hospitals across the United States, 30-day hospital readmission rates for patients with chronic conditions are on the rise. The purpose of this quantitative study was to examine the relationships in Illinois hospitals between patients with heart failure (HF) and pneumonia (PN) and 30-day hospital readmission rates by using the Pearson’s product-moment correlation test, focusing on how often these patients were readmitted and whether the hospital-wide rate of readmission after discharge changed. Andersen-Newman’s behavioral model with health services utilization was the theoretical framework, and a pre-collected Centers for Medicaid Services dataset was used for analysis. Results found a …
Effect Of Clinical Trial Participation On Patient Experience And Overall Hospital Scores, Bridget Tyrka
Effect Of Clinical Trial Participation On Patient Experience And Overall Hospital Scores, Bridget Tyrka
Walden Dissertations and Doctoral Studies
AbstractDespite groundbreaking advances in technology and medicine in the United States and intensive examination of health services quality initiatives, issues of quality and patient-reported experience measures in the hospital sector remain unimproved. Although evidence-based medicine has improved through innovation in clinical research, healthcare systems have reportedly struggled to implement advances in medicine and lack the skill sets to become learning health systems. As clinical practice and clinical trials (CTs) have rarely intersected in the past, a significant lack of quantitative research has been dedicated to correlate improved patient outcomes with participation in CTs. The analysis sought a correlation, if any, …
Exploring Quality Management Strategies To Mitigate Culture Shock Among Cochlear Implant Users, Victor Mulume' Ambila
Exploring Quality Management Strategies To Mitigate Culture Shock Among Cochlear Implant Users, Victor Mulume' Ambila
Walden Dissertations and Doctoral Studies
AbstractAfter the cochlear implant (CI) activation period and therapy, adult CI users who travel overseas encounter culture shock factors that paralyze their coping capability, which need normalization through management strategies during the post-cochlear-implantation process (PCIP). In the structure of the conceptual framework, a plan is presented for addressing the management strategy. An integrated system of product-process-service-care portrays the product as an active implant within an individual bearer fostering a CI user’s physical, physiological, and psychological traits. The problematic aspects alter the end users’ coping capability in an unfamiliar host environment abroad. The qualitative research approach used was a single case …
The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager
The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager
Walden Dissertations and Doctoral Studies
Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …
Healthcare Leader Strategies For Leveraging Electronic Heath Records, Danessa Thomas
Healthcare Leader Strategies For Leveraging Electronic Heath Records, Danessa Thomas
Walden Dissertations and Doctoral Studies
AbstractHealthcare organizations may incur significant losses of productivity and profit because of the absence or incomplete implementation of Electronic Health Records (EHRs). EHRs are important to healthcare leaders because they enhance communication between providers and patients, reduce unnecessary costs, and increase adherence to clinical guidelines. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies that some successful healthcare leaders used to leverage EHRs in their organization to increase profit and productivity. The participants were nurse managers from four healthcare organizations that successfully implemented an EHR system in Georgia. Thematic analysis was …
Creating A Pain Management Clinical Practice Guideline For Hospice Patients, Tiffany Ann Bowland
Creating A Pain Management Clinical Practice Guideline For Hospice Patients, Tiffany Ann Bowland
Walden Dissertations and Doctoral Studies
Current evidence-based research shows that pain in hospice patients is a growing problem. A gap in practice was identified as the current clinical practice guideline (CPG) in a hospice center in South Carolina was outdated and not being employed. A literature review revealed that updated CPGs provide better outcomes in pain management for end-of-life care. The project answered the practice-focused question: In the context of hospice, what are current evidence-based strategies for managing pain. The Stettler model and Kolcaba’s comfort theory guided the development of the CPG. Three nurse case managers and two physicians participated in the creation of CPG. …
Strategies Healthcare Leaders Use To Improve Patient Satisfaction, Kajon Franklin
Strategies Healthcare Leaders Use To Improve Patient Satisfaction, Kajon Franklin
Walden Dissertations and Doctoral Studies
For all healthcare leaders, patient satisfaction plays a key role in healthcare; poor patient satisfaction within healthcare organizations can lead to poor patient health outcomes, decreased revenue, and poor employee engagement. Grounded in Mayeroff’s theory of caring, the purpose of this qualitative single case study was to explore strategies healthcare leaders use to improve patient satisfaction. The participants consisted of five healthcare leaders in metropolitan Detroit, Michigan, who implemented strategies that improved patient satisfaction. Data was collected using semistructured interviews, archival document review, and data from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database. Yin’s five-step process …
Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller
Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller
Walden Dissertations and Doctoral Studies
AbstractConflation of moral and compassionate healthcare within the business model that is focused on customer service, disempowers, dehumanizes, and destabilizes nursing as well as the financial stability of healthcare. The purpose of this research was to determine nurses’ perceptions of how their work environment supported or contradicted a potential expansion of the quadruple aim. The quadruple aim was the primary conceptual framework for this research. The overarching research question was about how the environment of care supports professional nurses’ provision of high-quality person- centered care and bolsters meaningful and purposeful careers. The synthesized grounded theory methodology was used to collect …
The Impact Of Inpatient Boarding In North Carolina Emergency Departments, Miracle Howard
The Impact Of Inpatient Boarding In North Carolina Emergency Departments, Miracle Howard
Walden Dissertations and Doctoral Studies
Currently, emergency department overcrowding has negatively impacted hospitals' financial, operational, and organizational performance globally. A contributing factor to emergency department overcrowding includes the delay of the throughput process for patients who have a time-sensitive diagnosis and are admitted to the emergency department. This causes adverse hospital outcomes such as longer length of stays and increase hospitalization cost. This study utilized secondary data to address a relationship between admitted patients who have time-sensitive diagnoses such as chest pain and chronic obstructive pulmonary disease within North Carolina emergency departments and length of stay, utilization of services, and overall hospital cost. The conceptual …
The Impact Of Telehealth Services Offered By Home Care Agencies On Patient Safety, Moyna Temple
The Impact Of Telehealth Services Offered By Home Care Agencies On Patient Safety, Moyna Temple
Walden Dissertations and Doctoral Studies
There is little available research about how home care agencies attempt to address patient safety during the nurse virtual healthcare visit. The purpose of this quantitative correlational study was to determine, during the delivery of telehealth care by a home care agency, to what extent the level of education of the registered nurse, the level of education of the director of the home care agency, and the clinical decision support system (CDSS) impact patient safety. The framework for the study was the complex sociotechnological systems model. Data from the 2007 National Home and Hospice Care Survey were analyzed using logistic …
Managers’ Challenges Complying With Environmental Regulations In Ghana’S Mining Sector, Augustin Tandoh
Managers’ Challenges Complying With Environmental Regulations In Ghana’S Mining Sector, Augustin Tandoh
Walden Dissertations and Doctoral Studies
Even though Ghana’s mining industry has been and continues to be of remarkable benefit to the national economy, environmental pollution continues to plague the industry. The purpose of the qualitative case study was to obtain the perceptions of 9 nongovernmental organization (NGO) stakeholders of the challenges faced by managers in the Ghanaian mining industry tasked with complying with Ghana Environmental Protection Agency (GEPA) regulations. Freeman’s stakeholder theory was the theoretical framework of the study. Data were collected from semistructured interviews with a purposive sample of Ghanaian and international NGO representatives who sought to work with, or even shame and pressure, …
Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag
Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag
Walden Dissertations and Doctoral Studies
Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …
The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu
The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu
Walden Dissertations and Doctoral Studies
Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …
Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat
Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat
Walden Dissertations and Doctoral Studies
Research has shown that educational programs have led to developing the professional skills and behaviors of front-line health care providers who care for overweight or at-risk obese patients. The purpose of this project was to provide an educational program on best practices for weight management to health care providers at a large military clinic. The project question was developed to assess whether the educational program increased the knowledge and confidence of health care providers in the management of obesity. Utilizing Pender's health promotion model, a quasi-experimental study was conducted in which 15 health care providers, including licensed and unlicensed personnel …
Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy
Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy
Walden Dissertations and Doctoral Studies
AbstractLow quality of care is a problem for many United States (U.S.) emergency departments (E.D.). The use of electronic medical records (EMR) with quick embedded tools, treatment plans, and protocols decrease E.D. overcrowding, reduce boarding time, to approximate the 4- hour recommendation by the Joint Commission on Accreditation of Healthcare Organizations, and improve quality of care. The project question asked whether a systematic review of EMRs with quick embedded tools, treatment plans, and protocols decreased overcrowding and boarding time, and improved E.D. quality care. This systematic review used the Johns Hopkins Model to answer the project question by guiding selection, …
Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris
Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris
Walden Dissertations and Doctoral Studies
Individuals serving in the nurse manager role are critical stakeholders supporting frontline nurses delivering quality care within acute care settings. Despite evidence supporting nurse managers’ contributions to improved quality outcomes for patients by proxy, there is scant evidence supporting direct relationships between the role and outcomes. This study intended to provide quantitative evidence of relationships between nurse managers’ engagement, nurse managers’ tenure, and patient outcomes. The leadership complexity theory classified the nurse manager as a meso-level leader, requiring support from the macro- and microlevels of the organization. Acting as a liaison, meso-level leaders’ function in the space between executive leadership …
Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher
Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher
Walden Dissertations and Doctoral Studies
In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …
Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken
Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken
Walden Dissertations and Doctoral Studies
This study was conducted to test how social exclusion, experienced through a culture of healthcare hierarchy, influenced the feelings/attitudes of respiratory therapists (RTs) who are excluded from discussions of end-of-life (EOL) care. Data analysis was conducted using a multivariate analysis of variance to address the research questions. A quantitative nonexperimental survey research design incorporating four evidence-based surveys was used. There was no significance found between professional exclusion from EOL care discussions and the abilities of RTs to collaborate with intensive care unit (ICU) team members within the shared decision-making model as it relates to providing care in the ICU. There …