Health and Medical Administration Commons^™

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 …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Macro-Level Factors Impacting Colorectal Cancer Screening Behavior Among Church-Going Chinese Immigrants In The U.S.: A Convergent Mixed-Method Study, Xian Cao

Electronic Theses and Dissertations, 2020-2023

Chinese immigrants (CIs) had low colorectal cancer (CRC) screening rates. Macro-level health determinants may affect CIs' CRC screening; however, this is not well established. Thus, this research looked at the macro-level social factors of CRC screening among CIs. The POET theoretical framework guided this study, which includes four components: population (P), organization (O), environment (E), and technology (T). A convergent mixed method was used to investigate whether sociodemographic, acculturation, religious social capital, and mobile media-based cancer information seeking may predict CIs' endoscopic screening, and how these variables impact it. A validated survey and an interview covering the same factors were …

Health Workers On The Political Frontlines, Gideon Lasco

Development Studies Faculty Publications

No abstract provided.

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 …

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.

The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown

Walden Dissertations and Doctoral Studies

AbstractThe widespread adoption of electronic health records (EHRs) is encouraged because of their potential to improve the quality of care provided. It was unknown to what extent the meaningful use of EHRs would impact patient safety and satisfaction in general and specialty hospitals. The researcher’s purpose for this quantitative correlational research was to examine the impact of meaningful EHR use of EHRs on patient safety and satisfaction outcomes in general and specialty hospitals in Philadelphia (PA). The constructs of the institutional theory guided the study. The hypotheses that guided the study included (a) Meaningful EHR use positively influences patient satisfaction …

Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell

Theses and Dissertations

Study 1

OBJECTIVES: The research aim of this study was to identify predictors associated with the receipt of PFCC among U.S. children/families

METHODS: Caregivers of 38,803 non-institutionalized children, aged 0 to 17 years, were surveyed by the National Survey of Children’s Health (NSCH) 2018–20019. Patient/family-centered care (PFCC) was measured using five components of health care delivery that were answered on a 4-point Likert scale. Logistic regression models were analyzed for the overall receipt of PFCC and each component of PFCC, with survey weighting added to adjust for complex sampling design.

RESULTS: Many predictors were associated with the receipt of PFCC. …

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 …

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 …

Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield

Walden Dissertations and Doctoral Studies

AbstractOpioid use accounts for many deaths each day in the United States. Although research has shown that retention in medication assisted treatment (MAT) programs increases quality of life for those individuals with opioid use disorder (OUD) and decreases premature death, there has been limited research on the perspectives of individuals with OUD in MAT programs and why they remained in or left the programs. The purpose of this qualitative phenomenological study, guided by Merleau-Ponty’s theory of perception, was to explore the lived experiences of those with OUD treated in a MAT program. An algorithm type interview was conducted to ask …

The Relationship Between Team Engagement And Physician Engagement, Lynne Miles

Walden Dissertations and Doctoral Studies

AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis

Walden Dissertations and Doctoral Studies

AbstractThe Zika virus does not have a known treatment, despite ongoing efforts since 2016 to develop a vaccine. The Zika virus has been labeled by World Health Organization and the Department of Defense as a threat to the readiness, resiliency, and preparedness of military service members and dependents that currently travel or serve in areas where high concentrations of the virus are present. As such, it is important to understand how the military community understanding of the Zika virus is impacted by military health services and education. A phenomenological qualitative approach was utilized to conduct this study. Twenty active-duty military …

Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant

Walden Dissertations and Doctoral Studies

The United States lacks postdischarge services, which can negatively impact hospital readmissions within 30 days. It is important for case managers to effectively leverage outpatient services to enhance patient care and reduce readmission rates. Grounded in the practice change model framework, this qualitative single case study explores the perspectives of case managers involved with postdischarge services for patients diagnosed with coronary artery disease (CAD). Participants included 13 case managers from two metropolitan hospitals in Atlanta, Georgia. To address the research problem and study purpose, data collection techniques included semi-structured interviews, case management discharge summaries, and reflective journal notes. The thematic …

Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick

Walden Dissertations and Doctoral Studies

The specific research problem that was addressed through this study is the low rate of postpartum visits among Medicaid-enrolled women, leading to increased postpartum complications and readmissions. The purpose of this quantitative study was to evaluate if hospital readmissions can be reduced by integrated care home visiting services relating to postpartum visit compliance. The research questions evaluated the relationships between postpartum visit compliance, hospital readmissions among Medicaid-enrolled women in Indiana, and an integrated care home visiting program. The Donabedian model for quality-of-care grounds this study and is based on structure, process, and outcome. Through this model, healthcare leaders can evaluate …

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …

Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe

Walden Dissertations and Doctoral Studies

Emergency departments (EDs) are experiencing an influx of patients with opioid-related which result in increased opioid misuse, abuse, and overdoses. The purpose of this study was to examine the relationship between opioid-related ED visits and financial liability of hospitals by evaluating if an increase in opioid-related ED visits leads to an increase in average ED visit costs. The framework used for this study was Reason’s theory of failures, which involves improving healthcare maturity in terms of risk management, achieved through enhanced efficiency. The analyzed research questions included analysis between the number of opioid-related ED visits and financial liability of hospitals …

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 …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter

Walden Dissertations and Doctoral Studies

Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …

Improving Egypt’S Access To Vaccines And Medicines: Communication During Covid-19 / تحسين إتاحة الوصول إلى اللقاحات والأدوية في مصر: سياسة توعية الجمهور خلال أزمة فيروس كورونا, Alaa Abdel-Rahman, Sarah Attef, Helen Gabrah, Reem El-Sayed, Sarah El-Lithy

Papers, Posters, and Presentations

Since the start of the COVID-19 pandemic, the Egyptian government has been following protocol as best as possible when it comes to responding to the needs of the health and economic sectors amid difficult times. From lockdown measures to the WHO’s recommended practices in terms of isolation of cases and treatments, Egypt has been lauded as one of the fastest and most effective countries in terms of COVID-19 emergency response. Authorities have implemented several awareness campaigns directed at citizens to inform them about the pandemic, how to prevent infection, what to do if infected and how to act accordingly. Authorities …

Assessment Of The Impact Of The Lockdown On The Use Of Medications For Chronic Diseases In The State Of Goa, Sayed Sf, Dias A, Viegas M

Manipal Journal of Medical Sciences

Background: The COVID-19 pandemic came as a shock to citizens globally and those dependent on medications for chronic conditions were hit the hardest during the long lockdowns. This study aims to assess how the medications for chronic conditions in the state of Goa were impacted and the change in practices and attitude towards purchase and compliance.

Methods: It was a cross sectional study conducted on 264 participants from various parts of Goa, a state on the western coast of India. Data was collected using an online questionnaire using Google forms which involved closed and open ended questions assessing attitude, compliance …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga

Walden Dissertations and Doctoral Studies

A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied; however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The …

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 …

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …