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Articles 121 - 150 of 744
Full-Text Articles in Health and Medical Administration
Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike
Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike
Walden Dissertations and Doctoral Studies
Nurses play a significant role in mobility management, an essential element of care for critically ill adults. However, the current practice of mobility management comes from patient orders without the adoption of an evidence-based physiologic assessment guide to support safe patient mobility resulting in unreliable outcomes. Physiologic stability may change during mobility and unsafe patient mobilization can result in negative patient outcomes that increase patient recovery time. The purpose of this systematic review was to look at the current practice of physiologic assessment measures and then use the findings to influence safe patient mobility practices in intensive care units. The …
Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan
Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan
Walden Dissertations and Doctoral Studies
Ineffective strategies to contain the costs of medical supply inventory can result in financial loss and are a significant challenge for hospital leaders. Grounded in complex adaptive systems theory, the purpose of this qualitative single case study was to explore the cost-containment strategies that private hospital business leaders use to reduce the expense of pharmaceutical inventory. The participants comprised six private hospital business leaders in one healthcare organization in Myanmar. Data were collected from semistructured interviews, internal company documents, and publicly available annual reports. Four themes emerged from Yin’s five-step data analysis method: (a) management controls, (b) specialist engagement and …
Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli
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 …
Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt
Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt
Walden Dissertations and Doctoral Studies
Physicians in residency training (PIRTs) in the United States are facing extreme burnout. The prevalence of burnout among physicians in residency training may cause adverse consequences such as medical malfeasance, alcoholism, or suicide due to physical and mental exhaustion. The purpose of this study was to analyze the servant leadership style of physician trainers and burnout among PIRTs in academic medical centers in the United States to ultimately increase wellness and thereby mitigate burnout. Servant leadership was the theoretical foundation for this study. This research investigated whether servant leadership characteristics of physician trainers played a statistically significant role in burnout …
Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates, Shavonda L. Greene
Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates, Shavonda L. Greene
Walden Dissertations and Doctoral Studies
AbstractAdult homeless patient 30-day readmission is a concern for nursing healthcare leaders who still have problems in providing effective strategies for revisit reduction in various acute care settings across the United States. The purpose of this quantitative comparative study was to examine the association between nursing healthcare leadership strategies, 30-day homeless patient readmission rates, and hospital discharge rates at hospitals in California. The theoretical foundation for the research study was Pender’s health promotion model theory, which identifies preventative health measures and describes the critical function of nurses in helping patients to prevent illness by self-care and bold alternatives. Research questions …
Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky
Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky
Walden Dissertations and Doctoral Studies
Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …
Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru
Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru
Walden Dissertations and Doctoral Studies
The high prevalence of obesity continues to pose significant health challenges globally. According to the U.S. Preventive Service Task Force, obesity affects more than 35% of men and 40% of women in the United States. The national annual cost of medical care related to obesity is estimated at $147 to $210 billion. Intensive behavioral interventions in adults with obesity can lead to clinically sufficient improvements. The project aimed to determine if the current evidence-based clinical guideline of behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults would improve primary care providers’ knowledge of adult obesity management. The …
Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González
Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González
Walden Dissertations and Doctoral Studies
Business executives risk higher healthcare costs and absenteeism rates without implementing cost-effective strategies to support wellness within the organization. To offset rising healthcare costs and absenteeism, executives should implement wellness programs as a component of the benefits package provided to their employees and families. Grounded in the theory of planned behavior, the purpose of this qualitative multiple case study was to explore the cost-effective strategies that executives in the private and not-for-profit sectors implemented to encourage employees to adopt healthy habits for increasing productivity and decreasing organizations’ healthcare costs. Six executives from the healthcare sector within the southern region of …
Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler
Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler
Walden Dissertations and Doctoral Studies
AbstractThe Centers for Medicare and Medicaid Services implemented the Hospital Readmission Reduction Program in 2012. Ten years later, hospitals across the United States have had negligible improvement in reducing preventable 30-day hospital readmissions for COPD patients. Healthcare, specifically the hospital setting, consists of complex processes and procedures. Not one process or procedure is the sole cause of correcting excessive preventable 30-day readmissions of patients with COPD. The essential elements of provider communication were studied using the Complex Adaptive Systems theory in this quantitative study. Each fundamental element of provider communication was the independent variable, and the preventable 30-day COPD excessive …
Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall
Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall
Walden Dissertations and Doctoral Studies
Managed care leaders of independent physician associations (IPAs) lack strategies for allocating existing funds to avoid business closure. Medical providers are concerned with the quality of care for patients if the allocation of funding is not executed correctly. Grounded in the competing values framework (CVF), the purpose of this qualitative single case study was to explore strategies managed care leaders of IPAs use to allocate funds to avoid business closure. Participants were six executive leaders of an IPA in Los Angeles, the United States, who successfully managed the allocation of funds in a managed healthcare system. Data were collected from …
Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka
Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka
Walden Dissertations and Doctoral Studies
Low health literacy can adversely affect individuals and groups without access to health information. Health insurance leaders who lack strategies to decrease low health literacy may lose their ability to provide quality health services and control care costs. Grounded in the health belief model and the Andersen health service model, the purpose of this qualitative multiple case study was to identify the strategies private health insurance leaders use to increase medical utilization to reduce healthcare costs. The three participants were from two private insurance companies in Las Vegas, Nevada. Data were gathered through semistructured, open-ended interviews via videoconferencing, a review …
Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell
Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell
Walden Dissertations and Doctoral Studies
Readmissions for chronic obstructive pulmonary disease (COPD) are a major contributor to healthcare costs and patient outcomes. The Hospital Readmissions Reduction Program (HRRP) by the Centers of Medicare and Medicaid was implemented to decrease high rates of readmissions for serious medical problems, including COPD. The purpose of this study was to determine whether HRRP resulted in reductions in readmissions and costs for COPD patients. The Donabedian model was used as the theoretical framework to investigate three research questions concerning whether there are statistically significant differences in terms of readmission rates, total charges, and primary type of insurance payment before and …
Generational Differences In Nursing Turnover, Adam Bennett
Generational Differences In Nursing Turnover, Adam Bennett
Walden Dissertations and Doctoral Studies
Nursing is currently the largest job category in U.S. health care requiring proper recruitment and retention of nurses. As the current generation of nurses ages out of the workforce due to retirement, new nurses will need to cover the gaps in the workforce. The purpose of this quantitative correlational study was to examine the relationship between voluntary turnover, involuntary turnover, and career change among nurses who were born between 1980 and 1995 (Millennials) and those born between 1965 and 1979 (Generation X). The theoretical framework was Mannheim’s theory of generations. Secondary data were collected from exit interviews with 811 respondents …
The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown
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
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 …
The Role Of Self-Efficacy Against Workplace Stress, The Intent To Leave, And Burnout In Nursing, Alexis Collier
The Role Of Self-Efficacy Against Workplace Stress, The Intent To Leave, And Burnout In Nursing, Alexis Collier
Walden Dissertations and Doctoral Studies
Healthcare administrators must sustain the nursing workforce by minimizing workplace stress, the intent to leave, and burnout while maintaining a safe, accessible, high-quality, patient-centered care environment. This quantitative study examined the relationship between the independent variable of self-efficacy and the dependent variables of nurse burnout, workplace stress, and the intent to leave. The theory that grounded this study was the theory of self-efficacy. The research questions were formatted to determine the correlation between the self-efficacy levels of nurses and burnout, workplace stress, and the intent to leave. A quantitative, nonexperimental, cross-sectional (analytical) design addressed the research questions. The secondary data …
Relationship Between Incentive Program Costs, Incentive Payments, And Profitability, Claire Claire Turner
Relationship Between Incentive Program Costs, Incentive Payments, And Profitability, Claire Claire Turner
Walden Dissertations and Doctoral Studies
The lack of profitability among primary care businesses can have harmful impacts on business operations. Primary care businesses owners must remain profitable to remain in business and provide quality health care to patients. Grounded in Freeman’s stakeholder theory, the purpose of this quantitative correlational study was to examine the relationship between incentive program costs, incentive payments, and profitability. Data were collected from 73 primary care physician business owners in the Inland Empire region of southern California. The multiple linear regression analysis results indicated the model was able to significantly predict profitability, F(2,70) = 1343.6, p <.001, R2 = .975. Incentive payments (t = 51.837, p < .001, = .928) was the only statistically significant predictor. Key recommendations include educating primary care physicians on the potential financial benefits of full participation in the commercial line of business pay-for-performance incentive programs and creating a campaign to bring in patients for wellness visits. The implications for positive social change include the potential for an additional revenue stream for primary care physician business owners, which could support more clinics, increasing patient access. Patients having better access to healthcare could positively affect the health and wellness of individuals in local communities.
Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater
Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater
Walden Dissertations and Doctoral Studies
Rural healthcare leader deficiency in implementing successful strategies to retain nurses can deleteriously impact the quality of patient care and impede the organization's financial performance. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore successful nurse retention strategies used by rural healthcare leaders. Data were collected from semistructured interviews with eight pastoral healthcare leaders in the eastern region of the United States who improved nurse retention and a review of relevant supporting documentation from company websites. Coding was used for data analysis and theme determination. Three themes emerged: effective nurse retention incentives, meaningful relationships …
Providers’ Perceptions Of Chiropractic Care In Treatment Of Opioid Addiction, Rebekah Jan Khan
Providers’ Perceptions Of Chiropractic Care In Treatment Of Opioid Addiction, Rebekah Jan Khan
Walden Dissertations and Doctoral Studies
Fifteen hundred people in the United States die each week from opioid-related overdoses. In addition, the U.S. court system has been inundated with individuals facing legal proceedings, with opioid addiction, impacted competency, and recidivism. There has been a call for alternatives to address the crisis. The purpose of this qualitative study was to explore the perceptions of (addiction) providers regarding chiropractic treatment in the management of opioid addiction. The health belief theory was used to guide the study. Interview data were collected from six participants via Zoom or phone. Thematic analysis resulted in four emergent themes: lack of knowledge of …
Racial Differences Of Patient Satisfaction And Quality Of Care In Nursing Homes, Marie Chantal Lamothe
Racial Differences Of Patient Satisfaction And Quality Of Care In Nursing Homes, Marie Chantal Lamothe
Walden Dissertations and Doctoral Studies
AbstractLong Term Care (LTC) facilities are a vital contributor to the elderly community regarding their dependent care. However, less is known about how racial disparity impacts patient satisfaction and quality of care in LTC facilities. This non-experimental retrospective quantitative study compared the racial differences of patient satisfaction levels quality of care in LTC facilities (nursing homes that include predominately non-White patients versus predominately White patients). The theoretical framework used for this study the consumer multidimensional model of nursing home care quality to analyze quality of nursing home in the view of providers and consumers. Long Term Care: Fact on Care …
Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson
Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson
Walden Dissertations and Doctoral Studies
This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …
Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts
Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts
Walden Dissertations and Doctoral Studies
A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …
Relationship Between Telemedicine Use And Hpsa Scores In Rural California Areas, Ziad Gerges
Relationship Between Telemedicine Use And Hpsa Scores In Rural California Areas, Ziad Gerges
Walden Dissertations and Doctoral Studies
It is the purpose of this quantitative study to determine whether telemedicine has improved healthcare coverage in rural California as measured by HPSA scores, and especially for intensive care units (ICUs). This study examined the relationship between ICU length of stay, telemedicine use among ICU providers, and HPSA scores in rural California areas. This study explored whether there is a significant relationship between HPSA score of hospitals in rural California areas and ICU length of stay and if there is a significant relationship between HPSA score of hospitals in rural California areas and ICU telemedicine use. This study was guided …
Effects Of Covid-19 On Maternal And Child Health In Haiti, Abbi M. Lee
Effects Of Covid-19 On Maternal And Child Health In Haiti, Abbi M. Lee
Walden Dissertations and Doctoral Studies
Haiti has a history of natural disasters that have played a part in the country’s weak infrastructure, poor quality health care, and short life expectancy. The purpose of this qualitative case study was to understand the experiences of health care professionals providing prenatal, perinatal, and postpartum health care services before and during the COVID-19 pandemic in Haiti to gain an understanding of the gaps in disaster response in reproductive health care. The theoretical bases for this study were community resilience theory and reproductive justice theory. Data were collected from interviews with 10 health care professionals working in Haiti providing reproductive …
Relationship Between Rurality, Home Telehealth, And Bed Days Of Care For Military Veterans Readmitted For Heart Failure, Storm Li Morgan
Relationship Between Rurality, Home Telehealth, And Bed Days Of Care For Military Veterans Readmitted For Heart Failure, Storm Li Morgan
Walden Dissertations and Doctoral Studies
Heart failure (HF), the leading hospital admission diagnosis for military veteran patients discharged from a Department of Veterans Affairs (VA) hospital, is more common in patients residing in rural than urban areas. Primary care managers prioritize reducing readmissions for HF as up to 80% of health care costs for HF, projected to increase to $69.7 billion annually by 2030, incur during hospitalizations. Underpinned in Andersen’s behavioral model of health services use, the purpose of this quantitative ex post facto correlational study was to examine the relationship between residence rurality, home telehealth enrollment, and bed days of care for military veteran …
Nurse Management Education To Improve Job Satisfaction And Nurse Retention, Motunrayo Omoloye Adegorusi
Nurse Management Education To Improve Job Satisfaction And Nurse Retention, Motunrayo Omoloye Adegorusi
Walden Dissertations and Doctoral Studies
Abstract Nurses play a critical role as primary care providers in correctional facilities, as well as custodians of security. However, there is a significant disparity in the supply of nurses in correctional settings relative to other practice settings, which is a major gap in practice. The current problem arises from the inability to retain nurses in the correctional settings. Prisons have a harsh work environment characterized by a difficult patient population and stringent policies that govern operations. Additionally, a high level of bureaucracy impedes system reforms and transformations. The purpose of the DNP project was to find out if the …
American Urologists’ Concerns With Nonclinical Activities Moderating Burnout, Nichele Lynn Greer
American Urologists’ Concerns With Nonclinical Activities Moderating Burnout, Nichele Lynn Greer
Walden Dissertations and Doctoral Studies
As burnout continues to increase in the healthcare field and specifically in the specialty of urology, gaining knowledge of certain risk factors associated with burnout can potentially help prevent further increases. Intervention programs may also be developed as a result of understanding these relationships. The purpose of this quantitative correlational analysis was to determine whether hours worked on nonclinical activities moderated the relationship between age and burnout as well as gender and burnout in American urologists. The theoretical foundations utilized in this research were the jobs demands resources model, which suggested that burnout occurs as a result of job demands …
Website Accessibility Strategies, Gary W. Hrezo
Website Accessibility Strategies, Gary W. Hrezo
Walden Dissertations and Doctoral Studies
Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …
The Correlation Between Staffing Hours And Nursing Home Resident Fall Rate, Nduka Ikpo Eke
The Correlation Between Staffing Hours And Nursing Home Resident Fall Rate, Nduka Ikpo Eke
Walden Dissertations and Doctoral Studies
AbstractHealthcare administrators and researchers have had the burden of determining best practice protocols that minimize falls among older adults living in nursing homes for several years. Several studies have investigated, and identified intrinsic and extrinsic factors that lead to falls among other adults and made recommendations along the lines of their findings. However, researchers are yet to establish the impact of staffing hours on nursing home resident fall rate. The purpose of this study was to determine the correlation if any, between nursing home residents fall rate and the staffing hours they receive daily from certified nursing assistants (CNAs), licensed …
Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer
Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer
Walden Dissertations and Doctoral Studies
The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …