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Articles 1 - 22 of 22
Full-Text Articles in Health and Medical Administration
Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione
Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione
Walden Dissertations and Doctoral Studies
The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected …
Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston
Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston
Walden Dissertations and Doctoral Studies
Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …
Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett
Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett
Walden Dissertations and Doctoral Studies
Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …
Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor
Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor
Walden Dissertations and Doctoral Studies
Diabetes mellitus is a chronic disease that affects millions of people in the United States. The purpose of this project was to develop a guideline to help clinical staff provide clear and concise diabetes self-management instructions to patients in a community setting. Orem's self-care deficit theory (SCD) and health belief model (HBM) provided a platform to assess how patients' self-care deficit contributes to illness and the effect of patients' perception of illness. SCD theory and the HBM provided the framework for the development of the guideline to decrease diabetes acute complications through self-management education. The practice-focused question was whether the …
Analysis Of Latent Tuberculosis Infection Treatment Adherence In An Inner-City Clinic, Yvonne Washington-Turay
Analysis Of Latent Tuberculosis Infection Treatment Adherence In An Inner-City Clinic, Yvonne Washington-Turay
Walden Dissertations and Doctoral Studies
More than 10 million people in the United States are known to have latent tuberculosis infection (LTBI), and more than 300,000 begin treatment for LTBI annually. However, many fail to adhere to therapy for numerous reasons. The purpose of this project was to evaluate the impact of a new guideline, Targeted Tuberculin Testing and the Treatment of Latent Tuberculosis, at inner-city tuberculosis (TB) control clinic in the United States. The practice-focused question for the project asked if the implementation of the clinical guideline using a shorter regimen improved LTBI treatment adherence. The health beliefs model was the framework used to …
Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun
Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun
Walden Dissertations and Doctoral Studies
In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …
Streamlining Hospital Administrative Procedures To Reduce Costs, Dr. Claret Onukogu
Streamlining Hospital Administrative Procedures To Reduce Costs, Dr. Claret Onukogu
Walden Dissertations and Doctoral Studies
Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. …
Hypertension Awareness And Health Care Access/Use In Black Women With Hypertension, Marlène Trusiak
Hypertension Awareness And Health Care Access/Use In Black Women With Hypertension, Marlène Trusiak
Walden Dissertations and Doctoral Studies
Black women in the United States have a high prevalence of hypertension and suffer the most complications of cardiovascular disease. Black women, though aware of the dangers associated with hypertension, have limited opportunity to access health care and or change their lifestyles. The purpose of this quantitative cross-sectional study was to test if there was a significant difference in hypertension awareness, health care access/use, and lifestyle modifications in Black women prior to and post implementation of The Patient Protection and Affordable Care Act, as compared to women of other races. The behavior modification theory guided this study. Secondary data from …
Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth
Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth
Walden Dissertations and Doctoral Studies
Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …
Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda
Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda
Walden Dissertations and Doctoral Studies
Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …
Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip
Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip
Walden Dissertations and Doctoral Studies
Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …
County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga
County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga
Walden Dissertations and Doctoral Studies
Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability …
Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson
Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson
Walden Dissertations and Doctoral Studies
Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …
Financial Strategies And Initiatives For Preventing Rural Hospital Closure, Chinue Uecker
Financial Strategies And Initiatives For Preventing Rural Hospital Closure, Chinue Uecker
Walden Dissertations and Doctoral Studies
In the United States, rural hospital closures increased 34% since 2015 due to financial reasons, affecting access to healthcare services in rural communities. For rural hospital leaders, improving the hospital's financial performance is a valuable strategic goal. This multiple case study was designed to explore strategies that rural hospital leaders implement to improve their hospital's financial performance in Arizona, Georgia, Illinois, Oklahoma, Pennsylvania, and the United States Virgin Islands. The strategic decision-making framework supported the study because top leaders make decisions that affect the organization's health and survival. Fifteen rural hospital leaders who maintain their hospital's financial stability provided hospital …
Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright
Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright
Walden Dissertations and Doctoral Studies
Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …
Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper
Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper
Walden Dissertations and Doctoral Studies
The introduction of federal initiatives and incentives regarding health information technology fostered a movement towards the adoption of electronic health records (EHR). Implementation of EHRs sparked discussions among healthcare providers, patients, and others about the benefits or challenges of the move from the traditional paper method to the electronic version in healthcare settings. A knowledge gap in research involving the usefulness of EHRs and their impact to the delivery of care in other settings exists. The purpose of this qualitative study was to explore public health providers' perceptions of the meaningful use of EHRs in a disaster setting. Study participants …
Perceived Usefulness And Perceived Ease Of Use Impact On Patient Portal Use, Dasantila Sherifi
Perceived Usefulness And Perceived Ease Of Use Impact On Patient Portal Use, Dasantila Sherifi
Walden Dissertations and Doctoral Studies
Patient portals are web-based tools that provide patients with access to their health records and enhance communication with providers. Despite the efforts in expanding their use and patients interest in using them, patient portal usage remains low. Higher use of portals is associated with greater patient engagement and better healthcare quality and outcomes. This study investigated the impact of perceived usefulness (PU) and perceived ease of use (PEU) on patient portal usage. The conceptual framework was based on the Technology Acceptance Model, which suggests that PU and PEU of a system affect attitude and behavioral intention toward using the system, …
Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua
Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua
Walden Dissertations and Doctoral Studies
In comparison to the European healthcare system, the U.S. healthcare system has lower quality care, higher costs, and covers a smaller percentage of the population. Despite the high costs, the U.S. healthcare system remains dysfunctional. The purpose of this exploratory single case study was to identify the strategies that some healthcare managers in a hospital setting in the midwestern region of the United States use to improve efficiency while decreasing healthcare costs. Complex adaptive systems theory was used to frame this study that included face-to-face interviews with 6 highly experienced healthcare managers. Data were collected from audio recorded interviews and …
Low-Income Uninsured Perceptions, Beliefs, And Level Of Knowledge Concerning Primary Care Services, Pamela Ann Brown
Low-Income Uninsured Perceptions, Beliefs, And Level Of Knowledge Concerning Primary Care Services, Pamela Ann Brown
Walden Dissertations and Doctoral Studies
In the United States, there is an issue with low-income uninsured patients using emergency services for nonurgent conditions instead of using primary care services. Primary care services are more beneficial than emergency services for such patients, in that they can receive continual or follow-up care through primary care and thus achieve better health outcomes over the long term. Though information is available concerning factors in (or the rationale for) low-income uninsured patients choosing the emergency department (ED) instead of primary services for nonurgent conditions, research focusing on low-income uninsured patients' perspectives, beliefs, and level of knowledge about this matter is …
The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails
The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails
Walden Dissertations and Doctoral Studies
Within the 21st century, Type II diabetes has emerged as a public health crisis. African Americans and Hispanic Americans have the highest rates of Type II diabetes and obesity compared to European Americans. The purpose of this DNP project was to teach medical assistants (MA) to provide self-management of diabetes and obesity for the African American population in the local clinical setting. An educational tool kit for health providers was developed to guide the educational project. The chronic care model was used to guide the development of the educational toolkit. A pretest posttest design was incorporated into the educational program. …
Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline
Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline
Walden Dissertations and Doctoral Studies
Researchers have predicted that by 2020 the United States will experience a severe shortage of registered nurses. The purpose of this correlation study, using the National Sample Survey of Registered Nurses 2008, was to investigate the relationship between nurse job satisfaction and its effect on nurse retention nationwide. Secondary data sets from the 2008 National Sample Survey of Registered Nurses and examining relationships between the variable of nurse retention and job satisfaction. Bivariate (correlation coefficient, chi squares, and simple linear regression) and multivariate (logistic regression) analyses identified and connected associations and examined measurement levels between the dependent and independent variables, …
A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak
A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak
Walden Dissertations and Doctoral Studies
Assistive technology may delay cognitively impaired elders' need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah's 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer's or other dementia by 2037. Data were collected from a focus group of 10 seniors …