Medicine and Health Sciences Commons^™

How Increased Ransomware Attacks Have Impacted Hospitals In The United States, Mackenzie Dotson

Theses, Dissertations and Capstones

Introduction: The healthcare industry, particularly hospitals, have fallen prey to the alarming rise of ransomware attacks. In recent years, highly sophisticated cybergroups, armed with substantial funds and advanced technology, have intensified their focus on hospitals. Despite the advice against it, most hospitals have paid the ransom in order to regain access to their electronic systems and patient data, underlining the severity of these attacks.

Purpose of the Study: The purpose of this research was to evaluate the effects of ransomware attacks on hospitals in the US to determine if the patients were at risk due to hackers withholding patient information …

Reducing Readmission Rates Among Patients Who Have A Dual Diagnosis Of Both Mental And Physical Illnesses, Hannah M. Shahan

Electronic Theses and Dissertations

Readmission rates are a primary indicator used by acute care hospitals to determine the effectiveness of healthcare treatments and interventions. High readmission rates indicate the existence of a gap in the continuum of care. Acute care hospitals focus on the treatment of the immediately urgent physical health condition. Once the immediate presenting illness is treated or stabilized, the patient is discharged. This focus largely leaves mental illness undiagnosed and untreated. However, chronic, untreated mental illnesses are often comorbid with physical illnesses. In studies comparing patients with comorbid physical and mental illness to patients with only a physical illness, comorbidity was …

Emergency Preparedness And Response: Examining Rural Hospitals (Rhs) Communication Systems Before, During, And After A Natural Disaster, Geremy D. Lloyd

Electronic Theses and Dissertations

Introduction: Rural Hospitals (RHs) have distinctive characteristics that constitute unparalleled challenges. One of those challenges is the ability to communicate effectively in a disaster, impacting the various effects on the affected society. Research has shown that effective emergency preparedness and response (EPR) communication is paramount when communicating informed details about emergent events. Despite the evolving complexities of communication and the technology associated with disaster communication, very few studies have successfully investigated RHs communication systems before, during, and after a natural disaster. The purpose of this study was to examine and assess RHs communication systems and to highlight the strengths, identify …

U.S. Army Medical Command’S Medical Treatment Facilities’ Response To Sars-Cov-2 (Covid-19), Seyedmohammad Ahmadshahi

All Theses

Starting in December 2019 to the current time in May 2022, COVID-19 was a devastating pandemic with approximately 440 million cases and 6 million deaths worldwide (Centers for Disease Control and Prevention [CDC], 2021). The United States (US) with roughly 90 million cases and 1 million deaths (CDC, 2021) was one of the epicenters of the outbreak since the beginning. The pandemic has significantly impacted the health systems across the US with unpredictable surges of highly infectious patients with uncertain symptomology and acuity levels, requiring isolation and critical level of care (Brambilla et al., 2021).

Based on the findings from …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …

Hospital-Based Professional Spiritual Care: Evaluating The Utilization, Availability, And Impact Of Chaplains., Kelsey B. White

Electronic Theses and Dissertations

BACKGROUND: The Affordable Care Act, enacted in 2010, transformed healthcare policy and forced hospitals to reevaluate traditional methods for care delivery. Researcher advocated for patient-centered models of care to reduce costs, address inequitable access to services, and improve service quality. These models prioritize patient values, preferences, and beliefs inclusive of patients’ religious and spiritual needs. Professional chaplains provide religious and spiritual care within many hospital settings. This dissertation explored the characteristics of hospitalized persons using chaplains, the factors associated with a hospital reporting a chaplaincy department, and how those services impacted patient satisfaction. METHODS: The first analysis used a two-part …

Implementing Geriatric Frailty Screening In Acute Care, Christine Longley

Student Scholarly Projects

Practice Problem: Frailty is a syndrome of age-related physiologic decline characterized by an increased burden of symptoms and higher susceptibility to adverse health, including higher functional decline rates, pressure ulcers, falls, and delirium. In the general medicine unit of this project, geriatric patients were not screened for frailty.

PICOT: The PICOT question that guided this project was: In hospitalized patients 65-years-of-age and older (P), how does implementing a geriatric frailty screening tool (I), compared to standard assessments (C), influence frailty identification and personalized plans of care (O) over eight weeks (T)?

Evidence: Literature supports screening for frailty in the hospitalized …

Antecedents And Consequences Of Hospitals’ Responses To Institutions: Three Contemporary Essays Concerning Ontario Reforms, Gabriel J. A. Huppé

Electronic Thesis and Dissertation Repository

This dissertation contributes new insights on the antecedents and consequences of hospitals’ responses to institutions. It consists in three essays that collectively explore why and how hospitals balance their technical requirement of providing high-quality and affordable healthcare with an evolving constellation of institutional demands. The collective findings provide a contemporary perspective on the reconditioning of decoupling as a multi-form process, and a nuanced conception of factors affecting the institutionalization and deinstitutionalization of practices within hospitals.

Extending research on institutional leadership, Essay 1 examines hospitals’ approaches to an external mandate for energy conservation and climate mitigation. Through a qualitative investigation, it …

Association Between Health Literacy Levels And Behavioral Health Hospitalizations And Emergency Department Utilization In The United States, Rebecca Lynn Hoen

Legacy Theses & Dissertations (2009 - 2024)

Behavioral health disorders are common in the United States (US) and are associated with potentially preventable high-cost health care utilization, such as inpatient hospitalization and emergency department utilization. Health literacy (HL) may be an important modifiable contributing factor to this preventable utilization, as limited health literacy is common in the US and has been linked to increased risk of hospitalization and emergency department utilization. However, few published studies have examined the association between health literacy and behavioral health disorders, and no studies have examined either the association between health literacy and utilization or the potential effects HL interventions might have …

Optimizing Operating Room Throughput, Amanda Brendel

Student Scholarly Projects

Practice Problem: Throughput is an instrumental aspect for hospitals to maximize patient capacity; therefore, methods to improve patient flow should be consistently implemented. Surgical areas are a major contributor to inpatient admissions and the subsequent revenue; however, without the appropriate oversight, patient throughput can be negatively impacted.

PICOT: The PICOT question that guided this project was: In operating room patients who require inpatient admission (P), how does the implementation of a standardized bed flow process (I), compared to the current methods for care transitions (C), reduce perioperative delays and improve hospital financial metrics (O), over a three-month period (T)?

Evidence: …

Underrepresentation Of African American Male Nurses In Leadership Development, Moses Tucker

Walden Dissertations and Doctoral Studies

AbstractUnderrepresentation in nursing is a major concern for the African American community. Presently, racial, and ethnic minorities are underrepresented in the nursing workforce and other healthcare occupations. Having a more diverse workforce may help meet both current and future healthcare needs of the population being served. This quantitative study explored how African American male nurses are underrepresented in leadership in the Delaware Valley in Pennsylvania. Secondary data from the National Nursing Workforce Survey was used to obtain relevant data. The study highlighted how the movement into leadership for African American nurses is impeded by (a) a lack of mentors, (b) …

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …

Human Resource Strategies Used To Retain Millennials In Hospitals, Thomas F. Turner

Walden Dissertations and Doctoral Studies

Lead hospital human resource managers (HRMs) experience new recruitment, retention, and training costs for Millennial employees to close the skill gaps and address challenges from Baby Boomer employees retiring. The median turnover rate of 3 years for Millennial workers in hospitals is more than 3 times higher than older workers at hospitals. The purpose of this qualitative multiple case study was to identify retention strategies hospital HRMs use to address the retention of millennial generational employees beyond 3 years. Transformational leadership theory was the conceptual framework for the study. The data collection process included semistructured interviews and a review of …

Financial Consequences Of Covid-19 For U.S. Hospitals, Laura Petty, Trevor Mullins

Theses, Dissertations and Capstones

Introduction: The coronavirus pandemic has caused many financial issues for many businesses including putting a substantial strain on hospitals in the U.S. The impact of COVID-19 on the financial well-being of hospitals has been evaluated and the severity is still being measured as the pandemic is ongoing. The purpose of this research was to assess the financial consequences of the COVID-19 pandemic for hospitals in the United States.

Methodology: A literature review with a semi-structured interview with an expert from a local hospital was used for the methodology of this qualitative study. Five government websites and five databases …

Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood

Walden Dissertations and Doctoral Studies

High absenteeism in female employees costs Canadian hospitals millions of dollars annually. Leaders of Canadian hospitals who lack strategies to reduce absenteeism in female employees witness significant financial losses in their organizations. Grounded in Herzberg's two-factor theory, the purpose of this multiple case study was to explore strategies Canadian hospital leaders used to reduce absenteeism in female employees. Data were collected from semistructured interviews, annual reports, and publicly available datasets relating to hospital retention strategies and were analyzed using a thematic analysis. Four themes on strategies to reduce absenteeism emerged: creating a supportive stance towards absenteeism, investing in mental health …

Evaluating The Hospitals General Service Readiness Index In Guinea For Enhancing Their Performances, Mohamed Elmahady Camara

Walden Dissertations and Doctoral Studies

The healthcare system of Guinea has reported low scores on service availability and readiness assessment (SARA); the scores indicated the low availability of quality drugs, vaccines, medical equipment, and other technologies and involves a continuous history of poor quality-performance metrics. Thus the operational health problems in Guinea could be summarized as health problems (high rate of maternal, neonatal, and infant mortality, high prevalence of communicable and non-communicable diseases) and health system problems (lack of appropriate governance). Therefore, amelioration of the quality of health care and patient safety is needed. The objective of this study was to consider Guinea hospital performance …

Value-Based Reimbursements In The Us Health Care Market : Direct And Spillover Effects Of Medicare Readmissions Program, Soumyadeb Chatterjee

Legacy Theses & Dissertations (2009 - 2024)

In this thesis, I take up the question of how the Medicare penalties introduced by the Hospital Readmissions Reduction program (HRRP) impacted the US health care system. The demand side of US health care system is highly fragmented where hospitals and other providers have to serve very different kinds of patients from different payers. Since the majority of a hospital's income is drawn from Medicare, a sharp reduction in its reimbursements is bound to have an effect on its health care delivery to all patients.

The Extent To Which A Professional Development Program Can Support Caring Nursing Practice In Western Australian Hospitals, Tonia Naylor

Theses

Continuous professional development (CPD) has been purported to be able to enhance and support caring nursing practice; however, the relationship has never been studied in Western Australia. CPD is used in Australia as an overarching term. It includes three types of study leave; accredited courses, training with defence force reserves, and professional development (PD). The aim of this study was to determine the extent to which a professional development program can support caring nursing practice in Western Australian (WA) hospitals.

A PD program consisting of a one-day Master Class (MC) on caring nursing practice with additional and optional on-line reflective …

Policy Analysis Of California Senate Bill 1138: Mandating Plant-Based Meal Options In Hospitals And Prisons, David Morton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity, chronic disease, and poor nutrition are prevalent in the United States while healthcare costs rise. Nutritional research advancements have suggested the healthfulness of plant-based diets. In 2018, the California state senate passed Senate Bill 1138, requiring plant-based meal options in hospitals and prisons. This paper sought to examine the context surrounding the bill, determine the appropriateness of the bill, and recommend next steps for nutritional policies in the United States. In a review of the literature, malnutrition in hospitals and prisons is highly prevalent, and state governments have already made efforts to improve their citizens’ nutrition. In this analysis, …

Hospital Charge And Ricing Transparency, Kunal N. Patel

All ETDs from UAB

Hospital pricing is not uniformly disclosed to patients up-front before the delivery of healthcare. Moreover, pricing is not commonly understood by consumers and researchers, because the information was largely unavailable due to the lack of a federal policy mandate to make the information publicly available up until recently. The federal government instituted a series of regulations that initially began to take effect in 2019 in order to increase hospital pricing transparency with the aim of bending the healthcare cost curve. In this dissertation, hospital response, hospital standard charge variation, and healthcare management and policy expert opinion surrounding the implementation of …

Examining Women’S Perceptions Of Maternity Care In Public And Private Sectors Of National Guard Hospitals In Saudi Arabia: A Qualitative Study, Hanin M. Almahmoud

Theses and Dissertations

Every second, a baby is born. The process of birth is a complex one – biologically, medically, and emotionally. In particular, women in labor need both physical and emotional care. They need to be heard, to be comforted, and to be safe.

Women’s satisfaction can be used as a legitimate way to measure the quality of maternity care. Moreover, when health systems practice patient-centered care and listen to women’s concerns and what they want out of their care, it can lead to improvements in their satisfaction. Hospitals in Saudi Arabia are considered to be among the best and most technologically …

Examining The Need For Psychosocial Services In Pediatric Non-Accidental Trauma, Samantha Nicole O'Bannon

Loma Linda University Electronic Theses, Dissertations & Projects

Child abuse is a significant issue within our society. In 2014, there were a reported 702,208 cases of child abuse and neglect across the country, with nearly 120,000 suffering from physical abuse. Research has shown the adverse physical and psychological consequences of child maltreatment. Despite what we know about the benefits of early intervention for this population, the degree of implementation of psychosocial interventions, specifically in a hospital setting, remains unclear. In an initial study that utilized archival data from the Loma Linda University Children’s Hospital (LLUCH) Trauma Registry Database, researchers found that the majority of children admitted to the …

Rn To Apn Role Transition, Bethney Hernandez

Honors Theses

Role Transition can be difficult whether the transition is planned or unplanned. The transition from student to practitioner for nurses who follow the traditional path to licensure is challenging. Practitioners who change specialties, roles or scope of practice experience some of these same challenges, as well as unique challenges. The consequences of an unsuccessful role transition include unresolved stress, reduced job satisfaction, increased risk of errors, and changing roles again, without settling into the current role. This literature review will explore these challenges from the perspective of Meleis’s Transition Theory. Successful transitions occur when the practitioner finds employment, feels pride …

Adventist Healthcare: A Qualitative Study Of 19th Century Founding Governing Principles In 21st Century Adventist Hospitals, Cesiah Yareth Pimentel Melendez

Dissertations

Problem and Purpose

Founding values and principles can help organizations stay focused on fulfilling their mission. This is especially true in faith-based organizations that seek to continue their founding principles as a governing commitment to their core identity. This study identified Adventist healthcare founding principles in Ellen G. White's early health visions and explored how Adventist healthcare leaders perceived these principles as governing principles applied to current Adventist healthcare practices.

Conceptual Framework and Research Design

Two metaphors and three areas of literature review guided my approach of this qualitative study of Adventist healthcare founding principles. My first metaphor of DNA …

Endogenous Policy Design In Healthcare : A Case Study Of Emergency Department Crowding, Katrina Alexandra Hull

Legacy Theses & Dissertations (2009 - 2024)

The United States’ health care system has faced growing per capita use, and subsequent crowding, of the emergency department since the 1990’s, evidenced by longer wait times and the institution of ambulance diversions. Emergency departments are but one element of a complex system, with difficulties which persist despite policy efforts.

The Steering Towards Readiness Framework : The Lived Experience Of Clinical Facilitators In Identifying, Assessing And Managing Students At Risk Of Not Being Ready To Practice As Beginning Practitioners Within Western Australian Health Settings, Rosealie Southwell

Theses

Clinical facilitators (CFs) are a fundamental resource for student registered nurses (RNs) as they facilitate the consolidation of theory and practice in preparation for registration with the Nursing and Midwifery Board of Australia (NMBA). Health service providers (HSPs) and higher education providers (HEPs) require CFs to identify, assess and manage (I, A & M) the risks of final placement nursing students and, in doing so, protect risk to patient safety. This research aimed to explore the lived experience of CFs in Western Australia in identifying, assessing and managing risk of a student progressing to be a RN. The study used …

Early Data From The Maine Ombudsman’S Hospital Advocacy Program: A Deeper Look At Difficult To Place Patients, Joseph Zamboni

Muskie School Capstones and Dissertations

There is little data available on the complex cause and effect of delayed hospital discharge; however, some evidence suggests that long-stay patients tend to be complex, older, and sicker. In Maine, a 2014 Maine Health Association report found complex hospital patients were waiting weeks, months and sometimes over a year in Maine Hospitals before accessing long-term services and supports. In response to these concerns around delayed discharge from hospitals, the First Regular Session of the 127th Maine Legislature created the Commission to study Difficult to Place Patients. The Commission ultimately passed Legislation that gave the Maine Long- Term Care Ombudsman …

Medical Art Therapy, Hope Kinney, Elizabeth Mueller

LMU/LLS Theses and Dissertations

This research explores the experiences and practices of Medical Art Therapists; specifically, how working with clients in a medical setting, often as a part of a multidisciplinary team, impacts the work of an Art Therapist. Researchers reviewed the general literature regarding children and adults’ experiences of hospitalization and utilization of psychosocial services. Medical Art Therapy literature is reviewed next, emphasizing work with children, families, and adults. Informed by the literature, researchers invited Medical Art Therapists to participate in a focus group and/or follow-up survey. Researchers conducted a focus group in which participants discussed their experiences and created response art. A …

Determining The Effects Of Hospital Consolidation: An Examination Of The Impact Of Hospital M&A On Financial And Quality Metrics, Hailey Perry

Honors Theses

The modern explosion of M&A activity in the United States has generated significant controversy and advocates both for and against hospital consolidation have been quite vocal in presenting their cases. Using mergers and acquisitions reports from Irving Levin Associates as well as financial and quality metrics from the Centers for Medicare and Medicaid Services and the American Hospital Directory, this study examines the differences between consolidated and unconsolidated hospitals in terms of overall revenue and quality, in addition to prices and costs for specified diagnoses.

Consolidated hospitals undergo significant changes during their transition and oftentimes operate in a manner different …

Minimum Nurse To Patient Ratios, Kate Bolinksy

Honors Projects

No abstract provided.