Medicine and Health Sciences Commons^™

Nurse Management Education To Improve Job Satisfaction And Nurse Retention, Motunrayo Omoloye Adegorusi

Walden Dissertations and Doctoral Studies

Abstract Nurses play a critical role as primary care providers in correctional facilities, as well as custodians of security. However, there is a significant disparity in the supply of nurses in correctional settings relative to other practice settings, which is a major gap in practice. The current problem arises from the inability to retain nurses in the correctional settings. Prisons have a harsh work environment characterized by a difficult patient population and stringent policies that govern operations. Additionally, a high level of bureaucracy impedes system reforms and transformations. The purpose of the DNP project was to find out if the …

American Urologists’ Concerns With Nonclinical Activities Moderating Burnout, Nichele Lynn Greer

Walden Dissertations and Doctoral Studies

As burnout continues to increase in the healthcare field and specifically in the specialty of urology, gaining knowledge of certain risk factors associated with burnout can potentially help prevent further increases. Intervention programs may also be developed as a result of understanding these relationships. The purpose of this quantitative correlational analysis was to determine whether hours worked on nonclinical activities moderated the relationship between age and burnout as well as gender and burnout in American urologists. The theoretical foundations utilized in this research were the jobs demands resources model, which suggested that burnout occurs as a result of job demands …

Website Accessibility Strategies, Gary W. Hrezo

Walden Dissertations and Doctoral Studies

Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …

Qualitative Comparison Of The United States And United Kingdom Healthcare Systems, Rachel Cazzaniga

Graduate Theses/Dissertations

The United States and United Kingdom healthcare systems vary based on their public access, financial dependence, health outcomes, gross domestic product, and much more. The systems have continued to grow with different focuses of importance in the quality of care that is being distributed to their populations. The U.K. universal healthcare system represents their value of accessibility and affordability, while the U.S. privatized system(s) represents their value of economic growth. The study provided a qualitative analysis of the systems' differences by integrating real world experiences and perceptions of the systems from individuals that have encountered and interacted as a patient …

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington

Journal of the Georgia Public Health Association

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.

Methods: This study examined the perception of health …

Dentistry And The Law: Network Leasing Arrangements And Their Effect On Fees, Dan Schulte Jd

The Journal of the Michigan Dental Association

Dentists entering network leasing arrangements often face uncertainty about fees due to the lack of transparent fee schedules. While leasing companies aim to connect dentists with insurers and plans, the absence of clear payment information poses challenges. Dentists may receive varying amounts for the same services, impacting financial predictability. The article emphasizes the importance of understanding contract terms, obtaining fee schedules, and monitoring patient volume to assess the arrangement's overall benefit.

Medication Usage In Independent Living: A Continuing Care Retirement Community Aging In Place Initiative, Aarti Deshpande, Carrie B Rubenstein, Ruth Benfield, Lee Burnside

All Poster Presentations

Purpose: The purpose of the study was to identify medication use concerns in this community.

Background: In this study, Swedish Geriatric Medicine Fellow partnered with this community to identify medication use concerns in this population.

Continuing Care Retirement Communities (CCRCs) are intended to support residents as they age in place. These communities tend to be well resourced but less studied. This survey attempts to identify medication use concerns in this population. Mirabella CCRC has 324 Independent living (IL) residents, 82 of which are couples. The average age is 85 years. The current cost of an IL unit is from $4673- …

Implementation Of New Policy Software To Enable Quick Access To Best Practice Resources, Mary Alice Duthie, Debbie Shuster

All Poster Presentations

Purpose: Transition to a new policy software that would enable staff to quickly as easily locate Swedish policies and provide policy authors with a practical tool to work more efficiently on policy revisions.

Background/Significance: Existing policy software for Swedish had limited search functionality that caused issues with staff not being able to locate policies quickly or easily. This outdated software had been in place from 2007 – 2021 and contained only basic operations that remained unchanged during this time. If staff had difficulty finding policies in the software then there was the potential for either relying on others on the …

Blood Administration Documentation Audit Automation, Tonya Lawson, Harriette Lober, Andrea Nordmark

All Poster Presentations

Background: Blood administration is a high risk, low volume, complex procedure. It has strict regulatory requirements for documentation of at least 15 elements over the course of the procedure. There are frequently findings for deficient documentation during survey. Manual audits are time consuming and inaccurate. Every facility in the Providence system faces the same challenges to audit for compliance.

Problem: Detecting the rate of compliance for documentation of blood administration manually is difficult. Nursing documentation for blood administration is often incomplete. Manual audits are labor-intensive and have proven to have limited impact to increase documentation compliance.

Methods: We created an …

The Correlation Between Staffing Hours And Nursing Home Resident Fall Rate, Nduka Ikpo Eke

Walden Dissertations and Doctoral Studies

AbstractHealthcare administrators and researchers have had the burden of determining best practice protocols that minimize falls among older adults living in nursing homes for several years. Several studies have investigated, and identified intrinsic and extrinsic factors that lead to falls among other adults and made recommendations along the lines of their findings. However, researchers are yet to establish the impact of staffing hours on nursing home resident fall rate. The purpose of this study was to determine the correlation if any, between nursing home residents fall rate and the staffing hours they receive daily from certified nursing assistants (CNAs), licensed …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Environmental Racism In Baltimore: A Geographical Study Into The Connections Between Environmental Toxins And Public Health, Genevieve Block

Honors Theses

An investigation into the relationship between environmental toxins and environmental racism in Baltimore City, Maryland.

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …

Strategies To Implement Effective Succession Planning, Michelle Chapple

Walden Dissertations and Doctoral Studies

Most U.S. hospitals do not engage in succession planning at the executive level to account for retirees aging out of the workforce. The potential loss of institutional knowledge transfer threatens leadership development and organization stability. Guided by the leadership model succession theory, the purpose of this qualitative program evaluation was to offer a formative assessment to understand better strategies needed for effective succession planning by healthcare leaders. Five healthcare leaders from a single healthcare facility in Oklahoma City, Oklahoma, in the United States participated in semistructured, face-to-face interviews and provided company documents for review. Data were analyzed using descriptive and …

Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon

Walden Dissertations and Doctoral Studies

AbstractSome organizational leaders of home healthcare agencies (HHA) experience financial pressures to sustain within the changing regulatory landscape. Organization healthcare leaders who develop sustainability strategies remain competitive and employ the community. Grounded in the balanced scorecard framework, the purpose of this descriptive, qualitative multiple case study was to identify strategies home healthcare agency (HHA) leaders used to maintain sustainability. The participants were five organizational leaders of three HHA and two home health industry consultants in the Northeast United States who implemented sustainability. Data collected came from semistructured interviews, archival records, and organizational documentation. Three themes emerged from the thematic analysis: …

Challenges For Hospital Leadership In Obtaining Urology And Otolaryngology Community Preceptors, Donna Orsatti

Walden Dissertations and Doctoral Studies

Healthcare organizations are becoming more complex and medical education is constantly evolving in response to healthcare needs. These changes have an impact on community preceptors that supervise and train medical residents. Physicians willing to engage in community-based precepting are decreasing, thereby making it difficult for students to complete medical specializations. The purpose of this qualitative study was to understand the challenges healthcare leaders face when attempting to secure practicums or residencies in urology and otolaryngology. This case study used the Baldrige Excellence Framework as a lens to understand the organization’s functioning within the educational healthcare sector. In-depth, semi-structured interviews were …

Employee Engagement In A Clinical Ambulatory Setting, Paulette Zolicoffer

Walden Dissertations and Doctoral Studies

Low employee engagement can result in adverse business outcomes. Healthcare managers who lack strategies to increase employee engagement risk lower employee productivity and overall profitability. Grounded in organizational support theory, the purpose of this qualitative single case study was to explore strategies healthcare ambulatory managers use to increase employee engagement successfully. The participants were four mobile clinic managers from one organization in the northwest suburban region of Illinois who successfully implemented strategies to increase employee engagement. Data were collected using semistructured interviews and reviewing company documents and reports related to employee engagement. Through thematic analysis, three themes were identified: perceived …

Improving Disinfectant Cap Use On Central Lines In The Icu To Reduce Patient Risk For Clabsi: A Quality Improvement Project, Tali Cherim

Master's Theses and Capstones

BACKGROUND: Central line-associated bloodstream infections (CLABSI) are the most common type of preventable healthcare-associated bloodstream infection, and may increase length of stay (LOS), facility treatment costs, and patient mortality rates. Intensive Care Unit (ICU) patients are especially vulnerable to CLABSI due to their critical health conditions and other comorbid factors. A literature review provided evidence supporting the use of alcohol-impregnated disinfectant caps, such as SwabCap®, on central line (CL) ports to significantly reduce patients’ risk for CLABSI. This quality improvement project took place within an adult ICU of a Level II trauma facility in New England, where the Infection Prevention …

Queer Patients: An Underserved And At Risk Population, Joshua Schmidt

Capstone Showcase

Queer patients in America have faced a history of discrimination as both a community and as individuals. As such, this marginalization acts as a barrier to resources, including healthcare. Clinicians must be aware of said barrier and actively work towards dismantling it within their interactions with queer patients. This article makes a case for increasing sexual health conversations in order to assess queer patients and encourage a stronger patient-provider relationship for a community that is reluctant to seek medical attention, and also more likely to participate in higher risk behaviors.

Policy Analysis Of Foreign Trials Needed For Fda-Approved Inds For Devices And Drugs From 2016 To 2020, Rebekah Tilley

Master's Theses and Doctoral Dissertations

Any new drug or medical device requires testing before it can be commercialized. Although there are many paths a product can follow during preclinical testing to bringing it to the market, the need for multinational data is more necessary for drugs in comparison to medical devices. Since drugs do not always need additional data, there is a need to investigate why medical devices are more easily approved than drugs. The use of foreign data is fairly recent, and even though there are advantages to executing clinical trials in foreign countries, some companies do not want to run their studies outside …

Health Workers On The Political Frontlines, Gideon Lasco

Development Studies Faculty Publications

No abstract provided.

Understanding Challenges And Solutions With Systemigrams: Application To Electronic Medical Record Systems, Amit Malhan, Laquanda L. Johnson, Robert Pavur

Journal of International Technology and Information Management

The medical field is becoming bigger and more complex in the 21st century, diseases both emergent and re-emergent are on the rise and are costing lives around the world. Evolution of many diseases has made people find a reason to seek medical care in healthcare centers. This has led to increased development of health care facilities as peoples’ urge to get quality diagnosis and treatment rises. However, in the past patients ended up waiting a long time in their efforts to obtain these services. These wait times were due to the lack of proper documentation and recording of the personal …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Planning Patient Safety: Philosophical, Political, And Economic Changes Required For Preventable Death Abolition, Catherine Kiani

CMC Senior Theses

Preventable medical errors are an epidemic. Between 250,000 and 400,000 people die from preventable errors each year in the USA. This investigation questions mechanisms for quality care improvement to eliminate preventable fatalities. I evaluated current patient safety protocols, analyzed their shortcomings, and with additional research recommended actions for better results. Such actions to improve patient safety are explored from three different perspectives: philosophical, economical, and political aspects. In chapter one, improvements within hospitals are reviewed – namely cultural changes needed from both physicians and hospital leadership. Abolishing hierarchical systems which preclude healthy collaboration among medical teams, diverting focus to patient …

A Qualitative Investigation Of Organizational Challenges And Facilitators To Screening Individuals Experiencing Homelessness For Hepatitis C Virus (Hcv) In Houston, Texas, Alane Celeste-Villalvir, J Michael Wilkerson, Christine Markham, Lourdes Rodriguez, Vanessa Schick

Faculty, Staff and Student Publications

BACKGROUND: Individuals experiencing homelessness may be at a disproportionately high risk for hepatitis C (HCV) because they may be more likely to engage in HCV risk behaviors. Community organizations that provide services to these vulnerable individuals can effectively screen, diagnose, and navigate them into HCV care. However, screening people experiencing homelessness for HCV at such organizations is limited by various challenges that remain understudied, including budgetary considerations and strategies to improve teamwork and communication. Accordingly, this study investigated the organizational challenges and facilitators to HCV screening of individuals experiencing homelessness as reported by homeless services providers.

METHODS: Staff (N = …

Characterizing Cancer And Covid-19 Outcomes Using Electronic Health Records, Youngran Kim, Liang Zhu, Huili Zhu, Xiaojin Li, Yan Huang, Chunhui Gu, Heather Bush, Caroline Chung, Guo-Qiang Zhang

Faculty, Staff and Student Publications

PURPOSE: Patients with cancer often have compromised immune system which can lead to worse COVID-19 outcomes. The purpose of this study is to assess the association between COVID-19 outcomes and existing cancer-specific characteristics.

PATIENTS AND METHODS: Patients aged 18 or older with laboratory-confirmed COVID-19 between June 1, 2020, and December 31, 2020, were identified (n = 314 004) from the Optum® de-identified COVID-19 Electronic Health Record (EHR) derived from more than 700 hospitals and 7000 clinics in the United States. To allow sufficient observational time, patients with less than one year of medical history in the EHR dataset before their …

Patient Perceptions Of Shared Decision-Making In The Acute Care Hospital And Their Association With Patient Experience And Readmission, Jill Haladay

Electronic Theses and Dissertations, 2020-2023

Avoidable hospital readmissions continue to be a concerning and costly healthcare issue. While the emphasis on reducing avoidable hospital readmissions persists, incentivization strategies are evolving. Initial strategies prioritized medical care delivery, but recent regulation highlights the value of effective transitional (discharge) care planning, and particularly, patient involvement in that process. This latter aspect of care has a clear indication for the application of shared decision-making. Shared decision-making (SDM) practice in the acute care setting largely represents a gap in the literature; yet understanding patient perceptions of SDM during hospitalization is an important and timely first step in exploring the effectiveness …

Frequency In Copd And Cad Emergency Department Visits In South Carolina: Medicare Versus Self-Pay, Alexandria Brown

Walden Dissertations and Doctoral Studies

Coronary artery diseases (CAD) and chronic obstructive pulmonary diseases (COPD) represent the most common cause of emergency department (ED) visits and hospitalization for both Medicare and self-pay patients, which amount to nearly 2 to 4 million spent annually. The purpose of this quantitative stud ywas to identify the relationship between ED frequency among CAD and COPD Medicare and self-pay recipients 18 to 65 years within South Carolina between 2016 to 2018. The variables for this study were age and payer (independent) and ED frequency (dependent). Using a sample size of 7,689 an ANOVA Regression and t-test analyses were used to …