Health and Medical Administration Commons^™

Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris

Walden Dissertations and Doctoral Studies

Individuals serving in the nurse manager role are critical stakeholders supporting frontline nurses delivering quality care within acute care settings. Despite evidence supporting nurse managers’ contributions to improved quality outcomes for patients by proxy, there is scant evidence supporting direct relationships between the role and outcomes. This study intended to provide quantitative evidence of relationships between nurse managers’ engagement, nurse managers’ tenure, and patient outcomes. The leadership complexity theory classified the nurse manager as a meso-level leader, requiring support from the macro- and microlevels of the organization. Acting as a liaison, meso-level leaders’ function in the space between executive leadership …

Perceptions Of Healthcare Workers About Jamaica’S Health Disaster Management Plan, Terence Raphael Walters

Walden Dissertations and Doctoral Studies

Disasters cause several barriers to the provision of healthcare services in Jamaica. These include damaged infrastructure, reduced access to medical care and supplies, increased demand for healthcare services, and physical and psychosocial impacts on healthcare workers. It is not known how effective the Ministry of Health Procedures Manual No. 7, Disaster Management is and how healthcare workers in Jamaica perceive the effectiveness of the plan. The purpose of this study was to explore how healthcare workers in Jamaica perceived the effectiveness of the plan. The procedures manual requires collective actions by healthcare workers to be implemented successfully, and therefore collective …

Strategies To Recruit Age-Diverse Volunteers For A Nonprofit Behavioral Health Organization, Karen A. Peters

Walden Dissertations and Doctoral Studies

Volunteers are a crucial resource for behavioral health organizations, especially those that rely predominantly on a volunteer workforce for delivery of services. In such instances, the inability to maintain an adequate and age-diverse volunteer workforce threatens organizational sustainability and interrupts valued services to the community. A case study was completed to identify volunteer recruitment and retention challenges for a behavioral health nonprofit organization in the southwestern United States. The Baldrige Excellence Framework was used to guide the study, with emphasis placed on the assessment of the organization’s leadership, strategy, and workforce. Data sources included interviews with organizational leaders, organizational records, …

Strategies To Address Substance-Abusing And Substance-Impaired Healthcare Professionals, Anna Marie Smith, Douglas G. Campbell

International Journal of Applied Management and Technology

This research explored strategies used by some healthcare leaders to address substance abusing and impaired healthcare professionals. The conceptual framework for this qualitative case study was the concept of due diligence. Data were collected from 40 managers and supervisors, 3 executives, and company documents, and analyzed to reveal elements of a comprehensive strategy. A effective comprehensive strategy consists of policies that address the causes, the short term and long term aspects, and both the ethical and legal aspects. Policies and procedures are equally applied, are easily accessible, are well communicated, are supported by training, provides positive encouragement. provides a path …

Relationship Between Nurse Job Satisfaction Variables And Voluntary Turnover Intention, Mmayen Monday Nnah

Walden Dissertations and Doctoral Studies

Increased turnover among hospital nurses has adverse business outcomes. Hospital nurse managers are concerned with minimizing turnover to reduce hospital costs, lower risk to patients, and positively impact hospital performance. Grounded in motivation-hygiene theory, the purpose of this quantitative correlational study was to examine the relationship among nurses' views of the quality of work environments, level of management support, opportunities for promotion, and nurses' voluntary turnover intentions. Data were collected from nurses with registered nurse status or a bachelor of science in nursing degrees working in hospital settings in the United States (N = 82), who completed the Job Satisfaction …

Strategies To Retain Mental Health Workers In Community Mental Health Clinics, Debbie L. Young

Walden Dissertations and Doctoral Studies

In 2017, the United States employee turnover rate for mental health workers with 2 or more years of experience was more than 50%. High turnover rates among these mental health workers are associated with inadequate quality of care for patients with mental health issues in community mental health clinics. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple case study was to explore retention strategies used by health care administrators to retain their mental health workers with more than 2 years of experience. The participants consisted of 6 health care administrators who successfully implemented strategies to minimize high …

Congestive Heart Failure And Strategies To Improve Quality Of Life, Esther Akunna Okorie

Walden Dissertations and Doctoral Studies

Congestive heart failure is a global, chronic, progressive, and debilitating disease affecting mostly older adults. The multiple complications associated with the health issue led to readmissions and markedly reduced ability of heart failure (HF) patients to perform the self-care management of the problem. Nurses are responsible for providing a standardized quality education for patients; however, nurses at the project site lacked adequate skills and knowledge to bridge the gap in HF self-care management education. The project was guided by health belief model and self-care deficit with the goal of boosting the staff knowledge and confidence with providing patient HF self-care …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

Strategies Used In Ehealth Systems Adoption, Joshua Adams

Walden Dissertations and Doctoral Studies

Failure to adopt an interoperable eHealth system limits the accurate communication exchange of pertinent health-care-related data for diagnosis and treatment. Patient data are located in disparate health information systems, and the adoption of an interoperable eHealth system is complex and requires strategic planning by senior health care IT leaders. Grounded in DeLone and McLean’s information system success model, the purpose of this qualitative case study was to explore strategies used by some senior information technology (IT) health care leaders in the successful adoption of an eHealth system. The participants were 8 senior health care IT leaders in the eastern United …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson

Walden Dissertations and Doctoral Studies

Patient perception of care has become a main priority in the delivery of high-quality health care. The creation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a nationally standardized method of evaluating patient perception to be incorporated in the reimbursement process defined by the Centers for Medicare and Medicaid Services (CMS). The purpose of this study was to examine the relationship between HCAHPS scores and readmission rates in 2 states in the South Atlantic region of the United States. Using social construction theory, this quantitative study utilized multiple regression analysis to analyze HCAHPS scores (independent …

Predictive Factors Of Determinants Of Health And Services Provided At Adult Day Service Centers, Nardia Anthonalla Aldridge

Walden Dissertations and Doctoral Studies

The National Association of Adult Day Service Centers has suggested that adult day service centers can provide services to meet the complex needs of the older adult and delay nursing home placement. Researchers have yet been able to establish the predictive nature of determinants of health in Adult Day Care Centers (ADSCs). The purpose of this correlational study was to examine the relationship between the determinants of health and the presence of therapeutic services and nursing services at ADSCs. The open system theory guided this study. Data sets from the Centers for Disease Control and Prevention, 2016 Adult Day Services …

Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada

Walden Dissertations and Doctoral Studies

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health …

Understanding Health Behavior In Caribbean Americans, Keva Alleyne

Walden Dissertations and Doctoral Studies

There has been a significant increase in the number of Caribbean immigrants to the United States with the population being over 4 million in 2014 and over 1 million of the immigrants residing in New York State. Among this population, there has been an increase in chronic diseases that has been linked to unhealthy eating behavior. Caribbean immigrants’ approach to their health behavior was examined in this qualitative, phenomenological study. With a focus on the different aspects of the acculturation theory as the theoretical foundation, 9 participants from across the United States were interviewed about their approach to health, cultural …

Evaluating The Impact Of An Early Alert Team Implementation On Sepsis Mortality Rates, Shelley Ann Hyndman

Walden Dissertations and Doctoral Studies

Sepsis is ranked as one of the leading causes of death among hospitalized patients in the United States. Early identification and treatment of sepsis according to time-sensitive evidence-based protocols is essential to improve outcomes. Existing sepsis research focused on fostering consensus on sepsis definitions and evidence-based treatment protocols; yet, the literature lacks prescriptive evidence regarding organizational structures that reduce patient mortality. The purpose of this quantitative study was to understand how a change in organizational infrastructure could influence the delivery of sepsis-focused care. Using Donabedian’s theoretical framework, the research questions for this study focused on an implementation of an Early …

Impact Of Advanced Access Scheduling On Missed Appointment Rates In Primary Care, Helen Yvonne Krippel

Walden Dissertations and Doctoral Studies

A major problem encountered within outpatient physician offices are missed appointments. Missed appointment research revealed how no-show rates remain a focus for healthcare administrators as decreasing no-show rates may reverse harmful health consequences. The purpose of this study, which also addressed the research gap, was to determine if there was an association between advanced access scheduling and no-show rates for patients scheduled with preferred primary care physicians versus nonpreferred primary care physicians. The health belief model was the conceptual framework as missing a prescheduled appointment is a health behavior. The 1st and 2nd research questions examined whether there was a …

Advanced Practice Registered Nurses And Their Knowledge Regarding The Hindrance Of Obesity, Crystal Rainey

Walden Dissertations and Doctoral Studies

Advanced Practice Registered Nurses and Their Knowledge

Regarding the Hindrance of Obesity

by

Crystal N. Rainey

MSN, Walden University, 2014

BSN, University of Arkansas in Little Rock, 2011

AASN, Southeast Arkansas College, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2020

The Impact Of Digital Self-Scheduling On No-Show Event Rates In Outpatient Clinics, Karen M. Marhefka

Walden Dissertations and Doctoral Studies

The failure of patients to keep scheduled appointments results in significant loss of revenue due to decreased administrative efficiency, expensive clinical resource time, disruptive continuity of care between the patient and the provider, and reduced quality of care. The purpose of this quantitative study was to explore the use of digital self-scheduling as an emerging alternative to traditional office-assisted scheduling methods and determine if its use has an impact on reducing the occurrence of no-show events. The theoretical framework used for the study was the Consumer Behavior Theory. Three years of de-identified secondary data were collected from a large, adult …

Newly Licensed Registered Nurse Generation Cohorts And Retention In First Registered Nurse Positions, Elizabeth S. Gizenski

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to evaluate the association between newly licensed registered nurses (NLRN) generational cohorts and NLRN who plan to leave or have left their first nursing position. The research problem focused on the generational cohorts of NLRN and retention. The research questions addressed different generations of NLRN, their intent to stay in their first job, and whether poor orientation was a factor for those who already left their first nursing position. The theoretical foundation was Strauss–Howe’s generational theory explaining how each generation views the world based on what they experienced in their lifetime. Data retrieved …

Inpatient Stays Involving Mental Illness And Substance Use Disorders, Latonya Smith

Walden Dissertations and Doctoral Studies

Nearly one-third of Americans suffer from a mental illness. Twenty-three million people are affected by substance use or a dependency issue and the length of stay for patients enrolled in treatment services is rising. Mental health issues and substance use are rising within the United States and are associated with increased healthcare costs and the need for healthcare services. The purpose of this quantitative study was to determine the association between inpatient services, residential, outpatient, age, and payer source on substance use and mental health services using the 2017 Substance Abuse and National Mental Health Services Administration survey. The Donadebian …

Successful Retention Strategies By Perfusion Managers To Reduce Perfusionist Attrition, Krysta Lynne Gleeson

Walden Dissertations and Doctoral Studies

Perfusion managers who lack strategies to mitigate perfusionist attrition place a strain on their remaining employees and incur replacement costs for their organization. Grounded in Vroom’s expectancy model, the purpose of this multiple case study was to explore strategies perfusion managers use to mitigate perfusionists attrition within open-heart centers in a northeast U.S. city. Data were collected through digital semistructured interviews with 5 licensed perfusionists who demonstrated successful staff retention. Perfusionist job listings were used as a secondary data source. Data were analyzed using Yin’s 5 step process. Four significant themes emerged: job satisfaction, work-life balance, surveys, and compensation. Perfusion …

Treatment Plans For Diabetes Management During Hurricane Maria In Puerto Rico, Joel De La Cruz Oller

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate the health outcomes of diabetic patients in Puerto Rico, before, during, and after Hurricane Maria, in 2017. The Department of Health in Puerto Rico provided the secondary data for the variables low-density lipoproteins (LDL) cholesterol, hemoglobin A1C (HbA1c), mortality, and consumer price index (CPI). The inclusion criteria were participants for whom electronic data were available before, during, and after Hurricane Maria; the sample size was 450. The theoretical framework for this investigation was the health outcomes and impact assessment. The data were analyzed by univariate and analysis of variance (ANOVA) to compare …

Care Management And Readmission Among Elderly African American Patients With Chronic Illnesses, Vivien Lyn Salmon

Walden Dissertations and Doctoral Studies

More than 70 million Americans aged 50 years and older suffer from at least 1 or more chronic condition and use the emergency department frequently. By 2025, chronic illness will affect an estimated 164 million Americans or nearly 49% of the population. The rapid rise in chronic illness is due to a combination of an aging population, longer life expectancies, and poor lifestyle choices. This quantitative study provided a statistical analysis on the impact of care management on readmissions among African Americans between the ages of 65 and 80, with diabetes, hypertension, asthma, or multiple chronic conditions. Logistic regression was …

Guidelines For Chronic Back Pain: An Education Module For Health Providers, Ron Pascual

Walden Dissertations and Doctoral Studies

Effective chronic back pain management and patient self-care guidelines are necessary for healthcare providers treating patients with complaints of low back pain (LBP). The purpose of this doctoral project was to provide an evidence-based educational program aimed at improving the knowledge and skills of healthcare professionals regarding the Center for Disease Control (CDC) and American Chronic Pain Association (ACPA) guidelines, emphasizing alternative pain management treatments. The staff education project was supported by the biomedical pain model and chronic care model. A panel of 3 experts including the clinic’s board-certified anesthesiologist and pain management specialist, clinical manager, and leading medical director …

Measuring Knowledge Of Chronic Kidney Disease (Ckd) Among Community College Students, Jacquelyn Caldwell Moore

Walden Dissertations and Doctoral Studies

Chronic Kidney Disease (CKD) once detected is easily treated; however, it has become a major health problem associated with increased morbidity and mortality rates, creating an economic burden worldwide. While approximately 24 million Americans over the age of 20 suffer from CKD, there is a lack of awareness among the general population. Using a pre/post assessment, this quantitative study measured the impact of a 75-minute workshop on 126 community college students' knowledge of kidney disease, perception of its severity, and perceived susceptibility. The theoretical framework for the study was the health belief model, which suggests that individuals will make positive …

Quality Of Life For Persons With Chronic Disease Utilizing Mobile Integrated Healthcare, Dr John Robert Ash

Walden Dissertations and Doctoral Studies

The use of mobile integrated healthcare-community paramedicine (MIH-CP) has the potential to be integrated into existing chronic disease management initiatives as a means of reducing unnecessary hospitalizations and costs as well as improving quality of life (QOL). The purpose of this study was to analyze the relationships between demographics, noncommunicable disease type (NCD), and changes in self-perceived, self-reported QOL for those who have participated in an MIH-CP program. The research design for this study was a pretest/posttest design using secondary data that were obtained from a research partner using the MIH-CP intervention and collecting QOL data using the Euroqol QOL …

Sustainable Building Certification In Healthcare And Patient Satisfaction, Brian Jay Goehner

Walden Dissertations and Doctoral Studies

Eco-friendly healthcare delivery concepts are becoming more accepted as hospital leaders seek to control energy costs, mitigate contributions to climate change, and preserve scarce resources. Leadership in Energy and Environmental Design (LEED) offers healthcare leaders a framework for designing and constructing sustainable facilities that meet efficiency goals. The purpose of this quantitative cross-sectional study was to build an understanding of whether LEED certification influences Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. Using complex systems theory as the framework, the research questions were focused on exploring if higher levels of LEED certification led to greater HCAHPS overall hospital …

Leadership Strategies To Maintain Hospital Business Office Productivity During A Merger, Scott Alan Hughes

Walden Dissertations and Doctoral Studies

In 2017, healthcare system mergers in the United States set a record with 115 deals made and 11 involved sellers with net revenue of at least $1 billion; however, it is common for hospital business office productivity to suffer during a merger. Grounded in the theory of business process re-engineering, the purpose of this qualitative single case study was to explore strategies hospital leaders in the southeastern United States used to maintain business office productivity as they completed a merger. A review of documentation from archival records supplemented in-depth interviews with 7 purposively selected hospital leaders. Yin’s 5-step analysis guided …

Impact Of Integrated Laboratory Data Transfer Portals On Patient Results And Reports, Charmane Latrece Richie

Walden Dissertations and Doctoral Studies

An operational problem exists in which some healthcare organizations cannot maintain a suitable supporting data transfer system, which impacts the integrated laboratory data transfer portals designed to receive and send secure patient laboratory results and reports. This quantitative study examined whether an association exists between patient reporting turnaround times and specific test code nomenclatures used when comparing an older referral laboratory interface (RLI) laboratory information system (LIS) to the newer electronic orders and resulting (EOR) system using the Covance expanded laboratory management services (ELMS) NexGEN database from 2016-2020. The Donabedian model served as the framework for this study. The sampling …

Strategies Health Care Leaders Use To Implement Strategic Change Initiatives Successfully, Sophia F. Brown

Walden Dissertations and Doctoral Studies

Health care organizations lose a significant competitive edge when leaders fail to align strategic change initiatives with necessary operational activities. Health care leaders who struggle to maintain a competitive edge are at high risk for failure. Pettigrew and Whipp's content, process, and context strategic change management and Hoshin Kanri (HK) program deployment models constituted the composite conceptual framework for this study. The purpose of this qualitative multiple case study was to explore strategies health care leaders use to implement strategic change initiatives successfully. The participants comprised of 4 strategic change leaders from 2 health care organizations in Manhattan, New York, …

Pharmacy Manager Strategies For Reducing Financial Losses From Adverse Drug Events By Polypharmacy Patients, Francis Rudden

Walden Dissertations and Doctoral Studies

Every year over 100,000 deaths occur in the U.S. from adverse drug events derived from medication errors. Medication errors account for an annual cost of $100 to $200 billion. Healthcare pharmacists lack strategies to reduce adverse drug events and medication errors from taking place. Grounded in complex adaptive system theory, the purpose of this qualitative multiple case study was to explore strategies to reduce advere drug events and medication errors. The participants were 5 pharmacist managers in a county in central Florida. These pharmacists were from different community pharmacies, and each had a minimum of 5 years’ experience in the …