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A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill Jan 2016

A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill

Walden Dissertations and Doctoral Studies

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio …


A Meta-Analysis Of Association Between One-Carbon Metabolism Gene Polymorphisms And Risk Of Prostate Cancer, Mahmood Tazari Jan 2015

A Meta-Analysis Of Association Between One-Carbon Metabolism Gene Polymorphisms And Risk Of Prostate Cancer, Mahmood Tazari

Walden Dissertations and Doctoral Studies

Prostate cancer is the most common cancer among men. The purpose of this quantitative, meta-analysis study was to examine one-carbon metabolism gene polymorphisms in a group of genes to determine their association with prostate cancer risk. The genetic epidemiology theory provided the framework for the study. The data collected were from published articles. From over 2,800 individual studies, 20 articles were retained for results and data abstraction, following the title, abstract screen, and full text screening in the second phase. The data were analyzed by a meta-analysis statistical method, combining the results from selected studies to estimate the overall association. …


The Relationship Between Information Technology And Organizational Effectiveness As Perceived By Health Care Providers, Christian Chikwem Ukaga Jan 2015

The Relationship Between Information Technology And Organizational Effectiveness As Perceived By Health Care Providers, Christian Chikwem Ukaga

Walden Dissertations and Doctoral Studies

The U.S. Congress has made health information technology a central component of the national quest to improve health care delivery. The problem addressed in this study was the uncertainty among healthcare providers regarding the benefits of health care information technology adoption relative to healthcare delivery processes and outcomes. The purpose of the study was to understand the effectiveness of information technology as perceived by healthcare providers. The research questions were designed to investigate the relationship between health information technology and organizational effectiveness, exchange of information, organizational process, organizational productivity, and direct personal care. Sociotechnical systems theory and Donabedian's framework for …


Assessing Clinical Software User Needs For Improved Clinical Decision Support Tools, Kimberly B. Denney Jan 2015

Assessing Clinical Software User Needs For Improved Clinical Decision Support Tools, Kimberly B. Denney

Walden Dissertations and Doctoral Studies

Consolidating patient and clinical data to support better-informed clinical decisions remains a primary function of electronic health records (EHRs). In the United States, nearly 6 million patients receive care from an accountable care organization (ACO). Knowledge of clinical decision support (CDS) tool design for use by physicians participating in ACOs remains limited. The purpose of this quantitative study was to examine whether a significant correlation exists between characteristics of alert content and alert timing (the independent variables) and physician perceptions of improved ACO quality measure adherence during electronic ordering (the dependent variable). Sociotechnical theory supported the theoretical framework for this …


A Qualitative Analysis Of Migrant Women Farmworkers' A Qualit Ative Analysis Of Migrant Women Farmworkers’ Perceptions Of Maternal Care Management, Stacey A. Pilling Jan 2015

A Qualitative Analysis Of Migrant Women Farmworkers' A Qualit Ative Analysis Of Migrant Women Farmworkers’ Perceptions Of Maternal Care Management, Stacey A. Pilling

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to examine migrant women farmworkers' views of perinatal care management while working in the fields. Like men, women migrant farmworkers are exposed to many physical, chemical, and biological hazards that pose human health risks. However, women of childbearing age are at an increased risk of having reproductive health difficulties and adverse pregnancy outcomes, and the infant mortality rate among migrant farmworkers is estimated to be twice the national average. Perinatal care is a critical factor in reducing adverse outcomes for perinatal and newborn mortality. Face-to-face interviews were conducted with 15 migrant women farmworkers …


Nurses Knowledge, Skills, And Attitude Toward Electronic Health Records (Ehr), Sharon L. Adams Jan 2015

Nurses Knowledge, Skills, And Attitude Toward Electronic Health Records (Ehr), Sharon L. Adams

Walden Dissertations and Doctoral Studies

Information technology (IT) has been rapidly integrated into the healthcare industry, including nursing, and has the ability to reduce errors, cut cost, and enhance patient care. However, approximately 45% of the current nurse workforce lacks adequate training in computer skills, which may hinder the adoption of health-related IT in the workplace. Characteristics of Rogers's diffusion of innovation (relative advantage, compatibility, complexity, trialability, and observability) guided this project. This project was conducted to address the problem of IT adoption on a local level and was designed to assess whether simulation training on a generic electronic health record (EHR) system would improve …


Regression Analysis Of Cloud Computing Adoption For U.S. Hospitals, Terence H. Lee Jan 2015

Regression Analysis Of Cloud Computing Adoption For U.S. Hospitals, Terence H. Lee

Walden Dissertations and Doctoral Studies

Industrial experts agree that cloud computing can significantly improve business and public access to low cost computing power and storage. Despite the benefits of cloud computing, recent research surveys indicated that its adoption in U.S. hospitals is slower than expected. The purpose of this study was to understand what factors influence cloud adoption in U.S. hospitals. The theoretical foundation of the research was the diffusion of innovations and technology-organization-environment framework. The research question was to examine the predictability of cloud computing adoption for U.S. hospitals as a function of 6 influential factors: relative advantage, compatibility, complexity, organizational size, structure, and …


Diffusion Of Technology In Small To Medium Medical Providers In Saudi Arabia, Ziad Hisham Arnaout Jan 2015

Diffusion Of Technology In Small To Medium Medical Providers In Saudi Arabia, Ziad Hisham Arnaout

Walden Dissertations and Doctoral Studies

The Saudi ministry of health reported that government health care spending doubled from 2008 to 2011. To address increased demand, the government encouraged small to medium enterprise (SME) growth. However, SME leaders could not leverage technology as a growth enabler because they lacked strategies to address operating inefficiencies associated with technology. Only 50% of hospitals fully implemented information technology. The purpose of this phenomenological study was to explore lived experiences of SME leaders on strategies needed to accelerate technology implementation. This exploration drew on a conceptual framework developed from Wainwright and Waring's framework addressing issues of technology adoption. Data were …


Correlation Analysis Of Climatic Variables, Migration And Dengue Cases In Southeast Florida, Brunilda Lugo Jan 2015

Correlation Analysis Of Climatic Variables, Migration And Dengue Cases In Southeast Florida, Brunilda Lugo

Walden Dissertations and Doctoral Studies

Dengue fever is a debilitating, viral, mosquito-borne disease occurring in tropical and subtropical areas in the world. The majority of dengue cases in the United States were acquired in endemic areas by travelers or immigrants. However, in recent years, autochthonous (locally acquired) dengue cases have been diagnosed in Florida. The purpose of this study was to find an association between potential risk factors and the expansion of dengue fever in the United States. Guided by the eco-bio-social framework, which offers a broad assessment of risk factors for the illness, a retrospective design was used with archival data to correlate changes …


Diffusion Of Electronic Health Records In Rural Primary Care Clinics, Patricia Lynn Mason Jan 2015

Diffusion Of Electronic Health Records In Rural Primary Care Clinics, Patricia Lynn Mason

Walden Dissertations and Doctoral Studies

By the end of 2015, Medicare-eligible physicians at primary care practices (PCP) who do not use an electronic health record (EHR) system will incur stiff penalties if they fail to meet the deadline for using EHRs. Yet, less than 30% of rural primary clinics have fully functional EHR systems. The purpose of this phenomenology study was to explore rural primary care physicians and physician assistants' experiences regarding overcoming barriers to implementing EHRs. Complex adaptive systems formed the conceptual framework for this study. Data were collected through face-to-face interviews with a purposeful sample of 21 physicians and physician assistants across 2 …


The Distribution Of Type 1 Diabetes Onset In The United States By Demographic Factors, Margaret Beckstrand Jan 2015

The Distribution Of Type 1 Diabetes Onset In The United States By Demographic Factors, Margaret Beckstrand

Walden Dissertations and Doctoral Studies

Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene …


Nitrate In Private Wells:Knowledge, Oppinions,And Perceptions Of Stakeholders, Augustus D. Jaja Jan 2015

Nitrate In Private Wells:Knowledge, Oppinions,And Perceptions Of Stakeholders, Augustus D. Jaja

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine data describing nitrate concentration and cases of congenital cardiac defects. Residents with private wells and other stakeholders need data to make informed environmental decisions about the adverse health implications of nitrate contamination of private well water. Researchers have examined the exposure of nitrate in contaminated groundwater, but they have not examined nitrate levels in unregulated water systems. This gap in the literature highlighted the need to provide nitrate data for future research and private well users. Guided by the social ecological model, a quantitative, cross-sectional, nonexperimental design was used to survey …


Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye Jan 2015

Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye

Walden Dissertations and Doctoral Studies

The application of geographic information systems was used to map obesogenic conditions by zip code tabulation areas in Durham County, North Carolina and evaluated associations between those conditions and the understudied area of early childhood obesity. Of the thirty one percent of the children in Durham County, North Carolina who were considered obese in 2010, four hundred and thirty three (1:5) 2 - 4 year old children who received supplemental nutrition services for women, infants and children were obese with BMI levels greater or equal to the 95th percentile and were used as the criterion variable in the study (N=433). …


Climate Change Implications For Health-Care Waste Incineration Trends During Emergency Situations, Emilia Mmbando Raila Jan 2015

Climate Change Implications For Health-Care Waste Incineration Trends During Emergency Situations, Emilia Mmbando Raila

Walden Dissertations and Doctoral Studies

Healthcare waste (HCW) incineration practices in the global South countries are among the major sources of black carbon (BC) emissions or smoke. This study analyzes HCW incineration trends during emergency situations and smoke from HCW incineration processes in Haiti. The study was prompted by the current arguments about the climate change and the growing health effects associated with BC emissions. The conceptual framework was based on both adverse health effects from BC emissions exposure and climate change potential of BC emissions. Therefore, the goal was to determine whether cardboard HCW sharps containers emit lower BC emissions to the atmosphere during …


Automated Medication Dispensing Cabinet And Medication Errors, Marie Helen Walsh Jan 2015

Automated Medication Dispensing Cabinet And Medication Errors, Marie Helen Walsh

Walden Dissertations and Doctoral Studies

The number of deaths due to medical errors in hospitals ranges from 44,000 to 98,000 yearly. More than 7,000 of these deaths have taken place due to medication errors. This project evaluated the implementation of an automated medication dispensing cabinet or PYXIS machine in a 25-bed upper Midwestern critical access hospital. Lewin's stage theory of organizational change and Roger's diffusion of innovations theory supported the project. Nursing staff members were asked to complete an anonymous, qualitative survey approximately 1 month after the implementation of the PYXIS and again 1 year later. Questions were focused on the device and its use …


Refining Computerized Physician Order Entry Initiatives In An Adult Intensive Care Unit, Chevita Fuller Jan 2014

Refining Computerized Physician Order Entry Initiatives In An Adult Intensive Care Unit, Chevita Fuller

Walden Dissertations and Doctoral Studies

Computerized physician order entry (CPOE) is used in healthcare organizations to improve workflow processes and transcription, as well as to prevent prescribing errors. Previous research has indicated challenges associated with CPOE for end-users that predispose patients to unsafe practices. Unsafe CPOE practices can be detrimental within the intensive care unit (ICU) setting due to the complexity of nursing care. Consequently, end-user satisfaction and understanding of CPOE and electronic health record (EHR) functionality are vital to avoid error omissions. CPOE initiatives should be refined post system implementation to improve clinical workflow, medication processes, and end-user satisfaction. The purpose of this quality …


Food Safety Knowledge And Self-Reported Practices Of Food Handlers In Jamaica, Marcia Annmarie Thelwell-Reid Jan 2014

Food Safety Knowledge And Self-Reported Practices Of Food Handlers In Jamaica, Marcia Annmarie Thelwell-Reid

Walden Dissertations and Doctoral Studies

Food-borne illnesses are responsible for disease globally. One of the most important strategies for combating food-borne diseases is the training of food handlers. Using social cognition theory as a framework, the purpose of this study was to assess the effectiveness of the mandatory training program for food handlers in a rural parish in Jamaica. A cross-sectional survey, using self-administered questionnaires, was used to assess and compare food safety knowledge and self-reported practices of food handlers trained in 2 government training programs, while using untrained food handlers as controls. Descriptive and inferential statistics such as t test, chi-square test, and ANOVA …


Diffusion Of Social Network Technology And Overuse Among Health Industry Knowledge Workers, Abdel Rahman Toure Jan 2014

Diffusion Of Social Network Technology And Overuse Among Health Industry Knowledge Workers, Abdel Rahman Toure

Walden Dissertations and Doctoral Studies

Many organizations now realize the important role of social network technology (SNT) in building social capital and hence broadening their customer base. However, observations have indicated that, while working, many knowledge workers use SNT to engage in non-job related activities, potentially leading to a decrease in productivity. The purpose of this study was to examine the relationship between the usage of SNT and productivity in the health sector. The theoretical foundation of this study emanated from Rogers's theory of diffusion of innovations and Campbell, Rodney, Scott, and Christopher's theory of performance. Collection of data involved a self-administered survey designed with …


Acceptance And Usage Of Electronic Health Record Systems In Small Medical Practices, Ritu Tannan Jan 2011

Acceptance And Usage Of Electronic Health Record Systems In Small Medical Practices, Ritu Tannan

Walden Dissertations and Doctoral Studies

One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based practices. The purpose of this study was to explore opinions and beliefs on the barriers to the diffusion of an ERH system using Q-methodology. Specifically, the research questions examined the subjectivity in the patterns of perspectives at the preadoption stage of the nonusers and at the postadoption …


The Role Of Leadership In Safety Performance And Results, Halina E. Caravello Jan 2011

The Role Of Leadership In Safety Performance And Results, Halina E. Caravello

Walden Dissertations and Doctoral Studies

Employee injury rates in U.S. land-based operations in the energy industry are 2 to 3 times higher relative to other regions in the world. Although a rich literature exists on drivers of safety performance, no previous studies investigated factors influencing this elevated rate. Leadership has been identified as a key contributor to safety outcomes and this grounded theory study drew upon the full range leadership model, situational leadership, and leader-member exchange theories for the conceptual framework. Leadership aspects influencing safety performance were investigated through guided interviews of 27 study participants; data analyses included open and axial coding, and constant comparisons …


Academic Predictors Of National Council Licensure Examination For Registered Nurses Pass Rates, Maybeth J. Elliott Jan 2011

Academic Predictors Of National Council Licensure Examination For Registered Nurses Pass Rates, Maybeth J. Elliott

Walden Dissertations and Doctoral Studies

The United States continues to be affected by a severe, long-standing nursing shortage that is not projected to resolve within the next 10 or more years. Unsuccessful passage of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) among graduate nurses remains one of several key contributors to the nursing shortage. The goal of this study was to identify if either cumulative fall semester GPA; the overall prenursing science, mathematics, and English GPA; type of high school background; TOEFL score; clinical pass or fail; and on-time program completion best predicted passage of NCLEX-RN. Archived records from the academic years of …


A Correlational Study Of Telework Frequency, Information Communication Technology, And Job Satisfaction Of Home-Based Teleworkers, Shana P. Webster-Trotman Jan 2010

A Correlational Study Of Telework Frequency, Information Communication Technology, And Job Satisfaction Of Home-Based Teleworkers, Shana P. Webster-Trotman

Walden Dissertations and Doctoral Studies

In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction has been found to have a significant impact on voluntary turnover. The purpose of the study was to assess the relationship among telework frequency, information communication technology (ICT), and job satisfaction. The research questions were designed to answer whether correlational relationships exist among telework frequency, ICT, and job satisfaction and …


The Use Of Human Patient Simulators To Enhance The Clinical Decision Making Of Nursing Students, Sharon Kay Powell-Laney Jan 2010

The Use Of Human Patient Simulators To Enhance The Clinical Decision Making Of Nursing Students, Sharon Kay Powell-Laney

Walden Dissertations and Doctoral Studies

One of the newest teaching modalities in nursing education is the use of human patient simulators (HPS). An HPS simulation scenario creates a software program vignette in which students interact with a manikin to practice caring for critical patients in a risk-free environment. Although used extensively in schools of nursing, there is little research that examines if these expensive simulators improve the clinical decision-making ability of nursing students. The purpose of this experimental differentiated treatment study was to assess if HPS technology leads to increased clinical decision-making ability and clinical performance more than the teaching modality of a paper and …