Health and Medical Administration Commons^™

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

Improving Access To Cardiac Catheterization, Sunitha Dharman

Student Scholarly Projects

The American Heart Association lists cardiovascular disease as the underlying cause of death for 874,613 people who lost their lives in 2019 (Tsao et al., 2022). On average, someone in the United States has a myocardial infarction every 40 seconds, and someone dies of a stroke every 3 minutes and 30 seconds. Studies support coronary artery disease as a significant contributor to cardiac arrest in a non-hospital setting (Yannopoulos et al., 2019). The authors provide evidence supporting the importance of early cardiac catheterization. There is a 10-15% survival rate with a higher level of functioning compared to delayed or no …

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …

Lesbian, Gay, Bisexual, Transgender, Queer (Lgbtqia+) Health Disparities In Sexual Health And Sexual Education, Cole T. Mcbride

Curriculum and Instruction Undergraduate Honors Theses

Background: Comprehensive sex education instills knowledge and promotes the health of all youth, however, most sex education remains heteronormative. School-based programs in the United States (US) emphasize monogamous, heterosexual relationships. In 2021, only 7.4% of students received sex education that included positive representations of both LGB and transgender people and nonbinary topics, while 72% of programs across the US omit LGBTQ+ topics. Most new HIV diagnoses occur in gay and bisexual men aged 13-34, but the sex education environment for this group is increasingly hostile as more states prohibit addressing these topics in public schools.

Purpose: The purpose …

Covid-19 Vaccine Hesitancy And Vaccination Rate Among The Latino Population In South Carolina, Brynn E. Lynagh

Senior Theses

It is common knowledge that COVID-19 disproportionately impacts racial and ethnic minorities in the United States. Furthermore, these sects of the population exhibit increased vaccine hesitancy and lower vaccination rates as compared to the aggregated population of the United States, furthering the risk posed by COVID-19 to these communities. In particular, this study focuses on the Latino population in South Carolina, the vaccination rate among this community, and the perspectives which contributed to their vaccination decision. Two hundred Spanish and Portuguese speaking residents of South Carolina were interviewed using a paper survey conducted by pre-trained interviewers. The survey gathered data …

Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry

Walden Dissertations and Doctoral Studies

Over the last 10 years, institutes of higher learning (IHLs) in the southeastern United States have endured natural disasters that have caused flooding, water, and wind damage and resulted in student evacuations, class disruptions, and building damage. IHLs are further challenged with resuming campus operations despite the emotional impact resulting after a natural disaster occurs. There is limited research relative to the experiences of campus leadership who share the responsibility of keeping students, visitors, and university artifacts safe during and after a hurricane-related event. This research study served as a qualitative phenomenological assessment of campus leadership experiences during a post-hurricane-related …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …

Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell

Walden Dissertations and Doctoral Studies

AbstractThis project sought to enhance the care offered in a local clinic to individuals with an intellectual and developmental disability (IDD) during the COVID-19 pandemic. Individuals with IDD are faced with the challenges of coping with some social conditions. Mainly waiting for extended periods in a doctor’s office can be challenging. To reduce this population’s waiting time, a staff education program was developed to address this concern. Currently, this local clinic did not have a prescreening exercise that would meet the needs of this population. This DNP project aimed to develop a staff education program for staff in a primary …

Electronic Cigarettes And Young Adults: Use Of Screening Tools And Provider Knowledge, Kayla Erin Chelf

DNP Projects

Background: Electronic Cigarette (e-cigarette) use is now more common than traditional cigarette use in adolescents and young adults (Dinardo & Rome, 2019). There is concern that the lack of screening for use and knowledge about the health consequences of e-cigarette use is driving this growth.

Objective: The purposes of this project were to (1) assess baseline e-cigarette knowledge and screening practices from healthcare professionals, and (2) evaluate changes in knowledge after delivery of an educational intervention about e-cigarettes.

Methods: In this quasi-experimental study a seven-question survey on screening practice and knowledge concerning e-cigarettes in young adults was posted on the …

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

Examining The Relationship Between Time Spent On Tasks, Job Responsibilities, And Job Satisfaction Among Nurse Practitioners, Iasia E. Owens

Walden Dissertations and Doctoral Studies

Managing patient care with the help of nurse practitioners is an expanding trend in healthcare and achieving job satisfaction is a priority for these professionals. The purpose of this quantitative study was to examine two research questions and the associated variables concerning the relationship between time spent on tasks, job responsibilities, and job satisfaction among nurse practitioners. Conway’s role theory, which is used to explore and predict behaviors of workers in certain roles, informed this study. Data were derived from the 2017 National Survey of Nurse Practitioners and 972 participants were included. Correlation and linear regression analyses were used to …

Using Multi-Theory Model (Mtm) To Predict Intention To Promote Physical Activity By Primary Care Providers, Shirley Mcclendon

Walden Dissertations and Doctoral Studies

Physical inactivity persists as a public health concern worldwide and results in more than a million deaths per year. This modifiable behavior can result in improved health when primary care providers (PCPs) communicate recommendations to patients and behavior change is supported. In this study, a quantitative cross-sectional design was used to investigate the intentions of PCPs in providing physical activity counseling, using the constructs of the multi-theory model (MTM) of health behavior change as the theoretical framework. An anonymous 37-item electronic survey was administered to participants practicing primary care and family medicine from rural areas in the Southeastern region of …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

Integrating Culturally Tailored Interventions To Increase Cervical Cancer Screening: A Quality Improvement Initiative In A Primary Care Clinic, Marife Centeno Solomon

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: While the incidence of cervical cancer in the US has significantly decreased due to the utilization of vaccination and screening tests, Asian, Native Hawaiian, and other Pacific Islander women consistently have the lowest rate of cervical cancer screening, making them at risk for undetected cervical cancer disease.

Problem: The low cervical cancer screening uptake can be attributed to a knowledge deficit about cervical cancer and its screening and the importance of early detection. Being an immigrant and with limited English proficiency can hinder women of Asian, Native Hawaiian, and other Pacific Islander from getting screened for cervical …

Evaluating The Effectiveness Of Healthcare Competency Training Delivery Methods, Vanessa Jennings

Capstone Projects and Master's Theses

Decades of research express the need to strengthen the trust between minority groups and the healthcare system through addressing and reducing cross-cultural miscommunication. Though Central Coast VNA and Hospice is a well-established organization, the rate at which underrepresented individuals (i.e., LatinX, Asian, African American, Pacific Islander) access their services is low. Issues contributing to the low number of underrepresented individuals include language barriers, a poorly structured system, and a lack of cultural competency training among the staff. The result is an underserved population, a failure to meet the agency’s mission, and a perpetuation of systemic racism. To address this problem, …

Is Health Literacy A Defined Risk Factor? A Literature Review Of Health Literacy As It Relates To Immigrant Populations In The U.S., Kelly Zdanuczyk

International Development, Community and Environment (IDCE)

Throughout its lifespan the definition of health literacy in the United States has been ambiguous and disagreeable. This discrepancy has created disparity among health outcomes for vulnerable populations who are classified with lower degrees of health literacy and thus have a harder time interacting with the healthcare system. This paper will review published peer-reviewed literature on the topic of health literacy as it relates to immigrant populations in the United States and explore the ways in which low health literacy results in negative health outcomes. The literature review finds the discrepancies among health literacy, as it pertains to immigrant communities …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

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 …

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …