Health and Medical Administration Commons^™

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 …

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, …

Evaluation Of The Effectiveness Of An On-Site Referral System To Increase Mammography Screening Compliance: Scoping Review, Piper Black, Elizabeth R. Upchurch, Ravina Patel, Vicki Chandler Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Early detection of breast cancer through routine mammography screenings has increased the 5-year survival rate to 99% for women with cancer in the localized stage (American Cancer Society, 2021). However, this survival rate is lessened amongst women in the rural population (Leung et al., 2014). This scoping review investigates health disparities to identify interventions that improve mammography rates for women residing in rural areas.

Methods A scoping review was performed using an exclusive search for peer-reviewed mammography and rural health sources. Search phrases included were, ('Mammogram screening in rural areas'), ('Health care disparities in rural areas'), ('Secondary prevention in …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

Responding To Sexual Abuse In Health Care: Development Of A Guide For Patients, Tristan Mcintosh, Heidi Walsh, Meredith Parsons, Erin D. Solomon, Jessica Mozersky, James M. Dubois

Journal of Patient-Centered Research and Reviews

This report details the development of a stakeholder- and evidence-informed online resource guide for patients that provides information to raise awareness about sexual abuse in health care, the value of chaperones, and options for responding to sexual abuse. The guide was developed to reflect lessons learned from 10 years of researching physician wrongdoing (ie, sexual violations, improper prescribing, and unnecessary invasive procedures), a 5-year National Institutes of Health-funded mixed-methods study of 280 cases of egregious wrongdoing in medicine, and an expert working group. Focus groups were conducted with 22 patients from diverse backgrounds to obtain feedback on the acceptability of …

Using Digital Storytelling To Assess Patient Experience With Management Of Diabetes In Everyday Life (Model) Study Intervention, Arati Joshi

Longitudinal Scholar's Project

African Americans are disproportionately affected by obesity-associated diabetes compared to their White counterparts. While social determinants of health may contribute to their poor health outcomes, studies have shown that pragmatic primary care-based interventions can be effective in improving the management of obesity-associated diabetes. The Management of Diabetes in Everyday Life (MODEL) is a pragmatic randomized comparative effectiveness trial of three approaches (health coaching, text-messaging, and enhanced usual care) to supporting medically underserved African American patients with uncontrolled diabetes in improving their self-care decisions. The purpose of this study is to assess the effect of the MODEL program participation on the …

The Relationship Of Child Health And Parenting Stress To Child Neurocognitive Development, Nancy Alise Farrell

Theses and Dissertations (ETD)

Problem. Although the United States rates high in economic resources, the neurocognitive development (NCD) of children falls behind many other developed nations. Levels of parenting stress may be linked to sociodemographic factors such as the high incidence of poverty in children or health disparities in children, which in turn may affect NCD in children. Using the data from an observational, longitudinal cohort study of a diverse population could provide information related to parenting stress, child health, and related factors to guide and support interventions with families and policies to improve child NCD. Aims. The overall aim of this study was …

Please Don’T Shoot The Messenger, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

This editorial emphasizes the importance of discerning reliable information amid the influx of COVID-19-related studies and guidelines. Drawing parallels with the ancient Greek sentiment from Sophocles' play Antigone, JMDA Editor Dr. Chris Smiley advocates for an open-minded approach to trustworthy sources, citing the World Health Organization's seven steps for evaluation. The Michigan Dental Association is highlighted as a reliable resource for synthesizing evolving information for clinicians. Despite pandemic-induced frustrations, the editorial urges practitioners to navigate changes resiliently, recognizing the dynamic nature of public health guidance.

Bridging The Patient Engagement Gap In Research And Quality Improvement Utilizing The Henry Ford Flexible Engagement Model, Heather A. Olden, Sara Santarossa, Dana Murphy, Christine C. Johnson, Karen E. Kippen

Journal of Patient-Centered Research and Reviews

Purpose: This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings.

Methods: Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants …

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

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, …

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 …

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 …

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 …

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 …

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 …

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 …

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. …

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 …

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 …

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 …

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 …

Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw

Walden Dissertations and Doctoral Studies

In the United States, the total cost for vaccine preventable diseases was $8.95 billion in 2015. The unvaccinated accounted for 80% of the total costs. This quantitative study was conducted to investigate the success and/or gaps in the implementation of the measles, mumps, and rubella (MMR) vaccine through the Vaccine for Children (VFC) Program by the Ohio Department of Health. General systems theory was chosen as a theoretical framework due to the complicated nature of the healthcare system. Healthcare is a complex system composed of multidisciplinary units that have their own structure and purpose that interact to accomplish the mission …

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 …

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 …

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 …

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 …