Understanding Medical Students' Perceived Readiness To Serve As Culturally Competent Practitioners, Michel'le Janae Bryant

Seton Hall University Dissertations and Theses (ETDs)

Background: The US population is more culturally diverse than ever. Although advancements have been made in improving the nation’s overall health, health disparities continue among different racial and ethnic groups. To promote person-centered care practices, medical students must be ready to serve diverse patient populations and provide equitable care. Despite their training, some medical students report feeling unprepared to treat diverse patient populations, potentially impacting their clinical practice and patient care outcomes.

Purpose: This study’s purpose was to explore the perceived readiness of final-year medical students in the US to provide culturally competent care utilizing the Readiness Theory and The …

Emergency Department Patient Navigator Post Chest Pain Diagnosis Discharge, Nancy Simoes

Seton Hall University Dissertations and Theses (ETDs)

Abstract The most common complaint seen in the Emergency Department, along with abdominal pain, is nonspecific chest pain. Often, these complaints cause prolonged lengths of stay in the ED, followed by hospital admissions and subsequent readmissions for various reasons. When thinking about these various reasons, the question for prevention of readmission comes to mind. What could we do as a department to keep patients from continuously using the Emergency Department as a primary point of care instead of outpatient facilities when necessary? Project Aim: The purpose of this quality improvement project was to initiate the need for a patient navigator …

Exploring And Identifying Healthcare Leaders Competencies Required For Effective Decision Making In A High Velocity Environment To Achieve Sustainability Under The Regulatory Compliance Tenets Of The Patient Protection Affordable Care Act, Sylvester Foote

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Healthcare organizations face challenges in efficiently accommodating increased participant demands with limited resources and capacity. The modern reimbursement environment prioritized the maximization of operational efficiency and the reduction of unnecessary cost (i.e., waste) while maintaining or improving quality. As healthcare organizations adapt, significant pressures are placed on leaders to make difficult operational and budgetary decisions (Hamrock, Eric, et al., 2013).

As healthcare goes through this transformation within its high velocity environment defined as environments in which there is rapid and discontinuous change in demand, competitors, technology and /or regulations, such that information is often …

Exploring Community College Health Science Adjunct Faculty's Perception Of Culturally Responsive Teaching Practices And Implementation Readiness, Catherine Sirangelo

Seton Hall University Dissertations and Theses (ETDs)

Introduction. Millions of students enroll in public community colleges in the United States. They are often first-generation or first in their family to go to college. They are often culturally and linguistically diverse, with English not being their first language. They often choose a community college because of its high-quality, lower cost, and successful implementation of programs to assist and acclimate them to post-secondary education. Students look to community college as a first step into a professional healthcare career. Health Science faculty teaching at community colleges are either full-time or part-time (adjunct) contingency faculty. Adjunct faculty are often content experts …

Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne

Seton Hall University Dissertations and Theses (ETDs)

Burnout is a problem among workers in Nigeria, especially among nurses (Ozumba, & Alabere, 2019). This study examined whether there was a significant relationship between the employee perception of the servant leadership behaviors of the nurse supervisor and the employee’s self-rating of burnout: exhaustion and disengagement, and servant leadership behaviors of the nurse supervisor, and engagement: vigor, dedication, and absorption. Exhaustion refers to an intensive physical, affective, and cognitive strain while disengagement refers to the distancing of oneself from one’s work, and experiencing negative attitudes toward the work object, work content, or one’s work in general (Demerouti et al., 2001). …

Exploring Ghanaian Immigrants' Healthcare Access And Utilization Of The U.S. Health System, Kweku J. Agyeman

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

EXPLORING THE GHANAIAN IMMIGRANTS’ HEALTHCARE ACCESS AND

HEALTHCARE UTILIZATION OF U.S. HEALTHCARE SYSTEM

BY

Kweku J. Agyeman

Background and Purpose of the Study: Healthcare access and utilization in the U.S. continue to pose serious challenges to immigrants. Although the U.S. spends the most on healthcare ($3.8 trillion) among developed countries, accessing and utilizing the U.S. healthcare has become an illusion to most immigrants living in the U.S. including Ghanaians. To date, little is known specifically about Ghanaian immigrants’ access and utilization of the U.S. Healthcare system. For Ghanaians and other immigrants to fully understand the complex U.S. Healthcare …

Understanding Intelligent Non-Adherence By Measuring The Differences In Knowledge, Attitudes, Beliefs, And Behaviors Of Self-Care In Heart Failure Patients, Marco Mimbela

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Research shows that six in ten U.S. adults have a chronic disease and four in ten have two or more (CDC, 2018). Of all chronic diseases, heart failure is the leading cause of hospitalization and mortality in the U.S. (Kilgore, Patel, Kielhorn, Maya, & Sharma, 2017). Luckily, this condition can be managed through various self-care practices. Although healthcare providers are educating their patients on these self-care practices, patients are making a conscious decision to non-adhere. This phenomenon is known as intelligent non-adherence and is mostly affected by an individual’s level of knowledge, attitudes, beliefs, …

Incorporating Emergency Management Training Within School-Based Health Centers, Alicia Christian

Seton Hall University Dissertations and Theses (ETDs)

Background: Emergencies are situations that present without warning but require skilled individuals to provide aid to someone needing assistance. The pediatric primary care setting rarely experiences emergency-based care, which could lead to a lack of training in this area of expertise. As pediatric primary care extends to schools, there is also a need to ensure staff and providers have an annual emergency management training program. Project Aim: The current program aimed to determine the need to incorporate emergency management training in the school-based health center (SBHC) setting. Methods: This quality improvement project method was a pre-intervention with post-intervention design. The …

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Debriefing With Pearls & Watson’S Caritas, Heather A. Uccello

Seton Hall University Dissertations and Theses (ETDs)

Debriefing, an important aspect of students’ clinical experience, is a reflective, critical thinking analysis and communication strategy that provides rapid feedback after either a simulated or genuine clinical event. To teach this higher-level critical thinking skill throughout the learning process, nursing programs require specific methodology and faculty expertise. The National League for Nursing supports nurse educators having a theory-based strategy, formal training, and ongoing competency evaluation. Informed by Jean Watson’s Theory and the Promoting Excellence and Reflective Learning in Simulation standardized debriefing tool methodology, this project outlines a framework that nursing schools can use to potentially improve the debriefing process …

Exploring The Relationship Between Burnout And Supervisory Support Among Respiratory Therapists, Ahmad Eissa Alhaykan

Seton Hall University Dissertations and Theses (ETDs)

Background: Respiratory therapists (RTs) provide patient-centered care in diverse clinical settings for various patients. RTs most frequently work with acutely injured and critically ill patients. Working with these populations often takes an emotional toll on the practitioner, resulting in high rates of burnout. A high prevalence of burnout has been detected among health professionals. Even though RTs face unique stresses in the workplace, there is a lack of research addressing burnout among these professionals. Because workplace stressors are not expected to decrease in the near future in healthcare organizations, the search for protecting factors against burnout, such as supervisory …

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …

Exploring Communication Processes During Transitions From Acute Care To Skilled Nursing Facilities And Perceived Barriers To Communication, Marrizzia Oxford

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: The need for skilled care and long-term care services often becomes necessary as the older adult transitions into the golden years. In the United States, more than 1.5 million adults live in long-term care facilities, with this number expected to double by 2050 (Johnson, Pope joy & Radina, 2010). Effective communication between the healthcare professionals who refer individuals from an acute care setting to a skilled nursing facility can be challenging and ultimately impact their transfer status and Plan of Care (POC) or plan of action implementation for meeting healthcare goals of the patient …

Exploring The Relationship Between Work Engagement And Psychological Contract Fulfillment In Health Care Organization-Employed Physicians, Oyebanjo Olowe

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

While physician employment by healthcare organizations (HCO) in the United States continues to rise and private practice ownership continues to decline, many physicians are disengaged and leaving their organization as their job expectations are not fulfilled. Concurrently, some are changing practice patterns that may lead to decreased access to care despite the forecasted shortage of 84,900 fewer physicians and the aging US population's project growth by 2033. Prior work on physician work engagement has been practitioner-based, never using the widely accepted validated Utrecht work engagement scale. Also, there has been little work on psychological contract fulfillment (PCF ) in …

Exploring Quality Of Life Perceptions Among Pre-Clinical And Clinical Phases Saudi Medical Students, Olfat Gushgari

Seton Hall University Dissertations and Theses (ETDs)

Background: Medical students are widely recognized as a high-risk population for poor quality of life (QOL). Various studies have highlighted that medical students have a lower QOL than, compared to other students from different specialties tend to exhibit; specifically, the QOL of Saudi medical students is of growing concern, and it is imperative that Saudi medical schools recognize and address the QOL of these students.

Purpose: The purpose of this study was to explore the QOL of Saudi medical students during the pre-clinical and clinical phases of their studies. In addition, this study explored the QOL perceptions according …

What Are The Nurse’S Perception Of The Effectiveness Of The Electronic Go-Jo Monitoring System On Hand Hygiene Compliance And Hospital Acquired Infection’S?, Patricia James

Seton Hall University DNP Final Projects

Background: The importance of hand hygiene compliance in preventing hospital acquired infections is well known. Yet national averages for compliance rates with hand hygiene among healthcare workers remains unsatisfactory. Noncompliance with hand hygiene practices can contribute to increased patient mortality, prolonged length of hospitalization, increase healthcare costs and decreased reimbursement for hospitals from the Centers for Medicare and Medicaid. Project Aim: The purpose of this quality improvement project was to explore the nurses’ perceptions of the effectiveness of the electronic Go-Jo monitoring system on hand hygiene compliance and hospital acquired infections. Methods: This was a performance …

Medical Providers’ Knowledge, Beliefs And Attitudes In The Effectiveness Of The Centers Of Disease Control And Prevention 2016 Guideline For Prescribing Opioids For Chronic Pain, Maria Adamian

Seton Hall University Dissertations and Theses (ETDs)

Statement of Problem: Opioid epidemic in United States has been, in part, linked to prescribing practices of practitioners who treat chronic pain. The increase in morbidity and mortality associated with widespread prescription of opioid pain relievers (OPRs) has been the driving force in the reassessment of clinical prescribing guidelines. Given the enormity and urgency of the problem, in 2016, the Centers for Disease Control and Prevention (CDC) introduced guidelines for prescribing opioids to chronic noncancer pain to primary care practitioners. The introduction of the clinical guidelines sparked much concerns from providers and activist groups. There is little known in the …

Relationships Between Social Determinants Of Health And Patient Readmissions To An Acute Care Hospital Within 30 Days Of Discharge, Wren Mosee Lester

Seton Hall University Dissertations and Theses (ETDs)

Background: The Hospital Readmission Reduction Program (HRRP) is a part of the Affordable Care Act (ACA), which addresses the cost and quality of health care. The HRRP and policy penalizes hospitals for excessive readmission rates. The overall purpose of the program is to improve the quality of care, reduce costs and improve operational efficiency in hospitals. (Zhang, 2014).

Purpose: The purpose of this study was to identify and examine what social determinants of health, at an individual level and community level, were associated with the likelihood of being readmitted into the hospital, within 30 days of discharge, for patients …

Exploring Direct And Indirect Effects Of English Proficiency On Access, Utilization, And Health Status Among Californian Adults With Limited English Proficiency (Lep), Renee E. Pierre-Louis

Seton Hall University Dissertations and Theses (ETDs)

Background and Study Purpose: Findings from previous studies suggest that, in a health care delivery context, individuals with limited English proficiency (LEP) are adversely impacted by lack of patient-provider language concordance. Yet, the concept of LEP has been mostly studied in the context of cultural competence and language has been generally considered a demographic or cultural characteristic. There is a growing body of research concerning LEP and health status; however, it is limited. This study sought to evaluate the effects of LEP on access, utilization, and self-rated health status (SRHS) among LEP respondents to a large health interview survey …

Increasing Compliance Of Bar Code Medication Administration In The Emergency Room, Clare Wisor

Seton Hall University DNP Final Projects

Purpose: To ensure quality healthcare, it is necessary to provide safe medication administration. The specific goal is the reduction of medication errors in the hospital setting with concentration in the emergency room (ER). Bar-code medication administration (BCMA) has proven to be effective on the in-patient units in the hospitals researched and visited as part of this project, but the issue still remains that the emergency rooms exhibit a decreased compliance rate. The purpose of this Doctor of Nursing Practice (DNP) project, is to reverse the situation in a local community hospital that has a 50 bed emergency room, promoting increased …

Understanding How Patients Perceive Their Medical Providers’ Communication In A Hospital Based Emergency Department Setting, Balpreet K. Grewal-Virk

Seton Hall University Dissertations and Theses (ETDs)

Background: In recent years, a chief patient complaint has been that there is a breakdown in communication with their healthcare provider. This is concerning because poor provider-patient communication can lead to reduced medication adherence, misdiagnosis, increased healthcare costs, and even death. Furthermore, the implementation of the Affordable Care Act has availed healthcare insurance to more individuals, which will increase the insured patient population. This will lead to a rise in patient visits, but also means that there are not enough physicians to support this new volume of patients. Other healthcare providers, like nurse practitioners and physicians assistants are more …

Assessing Cultural Competence In Health Professional Student's, Sophia Jones

Seton Hall University Dissertations and Theses (ETDs)

Background-The United States has become a more diverse society and healthcare professionals must be ready to meet the needs of this more culturally diverse society. Students studying in the many areas of healthcare must learn to be culturally competent. To ensure that students are culturally competent and can provide culturally competent care routed in a global perspective their abilities must be developed and assessed. With the absence of any such assessment tool in the literature reviewed the objective set forth in a preliminary study was to develop a tool to assess cultural competence from a global perspective. With this …

Comparing Generational Differences In Job Satisfaction And Retention (Anticipated Turnover) Among Nurses Working In Magnet Versus Non-Magnet Designated Hospitals, Laura E. Cima

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Experts in the nursing profession predict a catastrophic nursing shortage by 2025. Nursing shortages have devastating effects on hospitals from a quality of care, patient and family satisfaction and financial perspectives. Given these issues, the most logical approach to this shortage is retention of nurses rather than recruitment. The Magnet designation is one mechanism to retain nursing staff.

Another phenomenon exists within the work environment that makes this shortage different from others. Currently, there are four generations of nurses working in the healthcare environment. Each of these generational cohorts has different values and …

The Advanced Practice Nurse And Patient-Centered Medical Home: Maintaining Patient Focus, Meeting The Institute For Healthcare Improvement Triple Aim Through The Electronic Health Record, Aileen Teresa Twomey

Seton Hall University DNP Final Projects

The Federal Government enacted the Heath Information Technology for Economic and Clinical Health Act (HITECH) in 2009, which incentivized providers to use electronic health records (EHR) for meaningful use (MU); the Patient-Centered Medical Home (PCMH) stems from the Act. Research by the National Council on Quality Assurance (NCQA) shows that primary care practices have a positive influence on the health of patients, families and communities. These positive influences are related to their ability to deliver first-contact access, and to develop long-term therapeutic relationships that focus on the person rather than the disease, improving patient health outcomes and reducing health care …

Mandated Healthcare Will It Work?, Anna Vira

Seton Hall University Dissertations and Theses (ETDs)

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Justification For The Continuance Of A Pediatric Physician's Office Laboratory, Veronica C. Santilli

Seton Hall University Dissertations and Theses (ETDs)

The continued viability of the Physician's Office Laboratory (POL) has been questioned because of barriers imposed by managed care organizations, oversight by regulatory agencies and competition for professionally trained laboratory staff. Pediatricians view the POL as an important adjunct to quality healthcare services for children and do not consider the POL as a "profit center", whose priority is generation of revenues for the The practice. parents of pediatric patients consider an on-site laboratory a convenience and valuable service. Through an analysis of patients' satisfaction, physicians' perceptions of enhancement to quality care, managed care reimbursement data and costs associated with maintenance …