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Articles 511 - 540 of 744
Full-Text Articles in Health and Medical Administration
Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist
Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist
Walden Dissertations and Doctoral Studies
Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …
The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails
The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails
Walden Dissertations and Doctoral Studies
Within the 21st century, Type II diabetes has emerged as a public health crisis. African Americans and Hispanic Americans have the highest rates of Type II diabetes and obesity compared to European Americans. The purpose of this DNP project was to teach medical assistants (MA) to provide self-management of diabetes and obesity for the African American population in the local clinical setting. An educational tool kit for health providers was developed to guide the educational project. The chronic care model was used to guide the development of the educational toolkit. A pretest posttest design was incorporated into the educational program. …
Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione
Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione
Walden Dissertations and Doctoral Studies
The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected …
Pain Management, Gender, And Quality Of Life In Cancer Patients, John Robert Buhmeyer
Pain Management, Gender, And Quality Of Life In Cancer Patients, John Robert Buhmeyer
Walden Dissertations and Doctoral Studies
The type of cancer pain management used may have an effect on the quality of life (QOL) of cancer patients. Researchers have determined that cancer patients are inadequately treated for pain and pain management is an essential determinant of patient survivability and QOL. Numerous clinical studies have been accomplished concerning opioid administration and noncancer and cancer pain management exist. Previous studies have examined the relationship between cannabinoid products, noncancer pain, cancer pain, and related QOL for patients but have not focused on the QOL of cancer patients while also moderating for gender. These relationships were investigated using the health belief …
Nigerian Hospital-Based Interprofessional Collaborative Patterns And Organizational Implications, Osaeloka Christiandolus Ekwueme
Nigerian Hospital-Based Interprofessional Collaborative Patterns And Organizational Implications, Osaeloka Christiandolus Ekwueme
Walden Dissertations and Doctoral Studies
Interprofessional collaboration is recognized as the innovative, evidence-based strategy that strengthens health systems and improves performance and health outcomes. While resource-rich countries have benefited much from the implementation of this initiative, literature is scarce regarding sub-Sahara Africa. This quantitative cross-sectional descriptive study described the extent of interprofessional collaborative practice at the tertiary care level in Nigeria and its implications on patient health outcomes, professionals' performance, satisfaction, and healthy practice environment. The relational coordination theory (RCT) provided the conceptual framework for the study. Key research questions were on the association between the extents of interprofessional practice and each of the outcome …
County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga
County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga
Walden Dissertations and Doctoral Studies
Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability …
Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson
Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson
Walden Dissertations and Doctoral Studies
Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …
Financial Strategies And Initiatives For Preventing Rural Hospital Closure, Chinue Uecker
Financial Strategies And Initiatives For Preventing Rural Hospital Closure, Chinue Uecker
Walden Dissertations and Doctoral Studies
In the United States, rural hospital closures increased 34% since 2015 due to financial reasons, affecting access to healthcare services in rural communities. For rural hospital leaders, improving the hospital's financial performance is a valuable strategic goal. This multiple case study was designed to explore strategies that rural hospital leaders implement to improve their hospital's financial performance in Arizona, Georgia, Illinois, Oklahoma, Pennsylvania, and the United States Virgin Islands. The strategic decision-making framework supported the study because top leaders make decisions that affect the organization's health and survival. Fifteen rural hospital leaders who maintain their hospital's financial stability provided hospital …
The Relationship Between Technology Threat Avoidance And Innovation In Health Care Organizations, Melvin R. Fenner Jr
The Relationship Between Technology Threat Avoidance And Innovation In Health Care Organizations, Melvin R. Fenner Jr
Walden Dissertations and Doctoral Studies
Most leaders of healthcare delivery organizations have increased their rate of technological innovation, but some still struggle to keep pace with other industries. The problem addressed in this study was that senior leaders in some rural ambulatory healthcare facilities failed to innovate, even with recent healthcare technological innovations, which could lead to increased medical errors and a loss of efficiency. The purpose of the study was to examine if a relationship exists between the avoidance of technology threats by senior leaders in ambulatory healthcare organizations and the innovation propensity of the organization. Technology threat avoidance theory served as the theoretical …
Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor
Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor
Walden Dissertations and Doctoral Studies
The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by …
Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson
Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson
Walden Dissertations and Doctoral Studies
Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …
Implementation Of An Early Progressive Mobility Program In The Intensive Care Units, Rene Merced Rodriguez
Implementation Of An Early Progressive Mobility Program In The Intensive Care Units, Rene Merced Rodriguez
Walden Dissertations and Doctoral Studies
In the United States, adult ICU patient care consumes $90 billion annually, or 1% of the gross national product. In the ICU, about 40% of the patients are mechanically ventilated resulting in an 11% greater length of stay (LOS) that requires 35% more resources. And, an estimated 60% of these patients are adversely impacted for as long as five years following discharge. Patient immobility while ventilated contributes to poor quality and financial outcomes. The Institute of Healthcare Improvement (IHI) reports on average early patient mobility (EPM) reduces a 4.5-day LOS by as much as 1.3 days; and reduces the risk …
The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow
The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow
Walden Dissertations and Doctoral Studies
Pressure ulcers are a serious health condition that have negative consequences for patients and organizations. The primary cause of pressure ulcers is intense and/or prolonged pressure or pressure in combination with shear that results in damage to the skin and underlying soft tissue. Early identification of patients at risk for pressure ulcers and 2-hour repositioning to off-load pressure are key components in reducing pressure ulcer development. Despite ongoing efforts to prevent pressure ulcers, the incidence and prevalence of hospital-acquired pressure ulcers (HAPUs) at the practicum site exceeded the benchmark for Magnet hospitals and the health system's goal of 1%. Patient …
Relationship Between Health Care Costs And Type Of Insurance, Macey Buker
Relationship Between Health Care Costs And Type Of Insurance, Macey Buker
Walden Dissertations and Doctoral Studies
Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way …
Healthcare Executive Leadership Development And Succession Planning, Robin Ford Dillard
Healthcare Executive Leadership Development And Succession Planning, Robin Ford Dillard
Walden Dissertations and Doctoral Studies
Business leaders face leadership crises as executives from the baby boomer generation retire, creating a shortage of experienced and knowledgeable leaders. Some business leaders are unprepared for the replacement of retiring senior-level executives and lack strategies for succession planning. The findings of this study indicate succession planning and leadership development play a significant role in preparing future healthcare leaders in their ability to improve the quality of patient care and improve the strategic and financial health of the organization. Guided by the human capital theory the purpose of this multiple case study was to explore the strategies used by healthcare …
The Barriers And Quality Of Care Issues For Individuals Diagnosed With 22q11.2 Deletion Syndrome, Barbara Bavette Miller
The Barriers And Quality Of Care Issues For Individuals Diagnosed With 22q11.2 Deletion Syndrome, Barbara Bavette Miller
Walden Dissertations and Doctoral Studies
Individuals diagnosed with 22q11.2 deletion syndrome (22q) have many barriers and quality of life issues associated with the condition. Without an obvious anomaly, affected individuals may live years without a proper diagnosis. The purpose of this qualitative case study research was to explore perceptions of caregivers of individuals with 22q. Uncertainty in illness theory was used as it describes the inability to find answers with unpredictable medical issues. The central research question focused on at how challenges associated with a 22q diagnosis are addressed. Interviews were conducted with 10 caregivers. Guided by the uncertainty in illness theory, data analysis was …
Nursing Leadership Influence On Evidence-Based Practice Culture And Integration, Natalie Kay Lenhart
Nursing Leadership Influence On Evidence-Based Practice Culture And Integration, Natalie Kay Lenhart
Walden Dissertations and Doctoral Studies
Translating research to practice takes 10-20 years or more and evidence-based practice (EBP) integration remains at 10%-20%, despite recommendations requiring EBP-guided decisions. EBP integration has been associated with up to 30% decreases in healthcare system spending, improved quality outcomes, and increased staff satisfaction. Nurse leaders are accountable for EBP enculturation, yet rate quality and safety as the highest priority and EBP as the lowest. This knowledge gap perpetuates low EBP integration rates and hinders EBP enculturation. Asking whether EBP facilitative interventions for nurse leaders increase scores on organizational culture and readiness, beliefs, and EBP use scales addressed the knowledge gap …
Relationship Between Medicare Alternative Payment Methodology And Hospital Program Service Revenue, Sandra J. Gubbine
Relationship Between Medicare Alternative Payment Methodology And Hospital Program Service Revenue, Sandra J. Gubbine
Walden Dissertations and Doctoral Studies
Medicare paid $388.7 billion to acute care hospitals in 2014 representing the largest portion of the health care sector in the United States. Medicare implemented an innovative reimbursement model called Value Based Purchasing (VBP) to ensure hospitals provide quality care for the dollars spent. This correlation study used the VBP theoretical framework developed by Dudley as the foundation for the reimbursement model implemented by Medicare in 2013. The data used for this study came from the Centers of Medicare and Medicaid, as well as from Guidestar. The data focused on acute care, nonprofit hospitals located in New Jersey, New York, …
Comparing The Effectiveness Of Masters-Prepared And Non-Masters-Prepared Nurse Leaders, Subha Narasimha Chari
Comparing The Effectiveness Of Masters-Prepared And Non-Masters-Prepared Nurse Leaders, Subha Narasimha Chari
Walden Dissertations and Doctoral Studies
The complex nature of healthcare requires nurse leaders to be skilled in professional practice, communication, teamwork, and problem solving to improve staff satisfaction and patient outcomes. The American Association of Colleges of Nursing and Institute of Medicine promotes graduate education for nurse leaders to enhance the delivery of quality care to the nation's diverse patient populations. Guided by the diffusion of innovation theory, this project explored the differences in nursing care hours, staff turnover, nurse quality indicators, as well as leadership characteristics on units lead by masters-prepared and non-masters-prepared nurses. Forty-eight nurse leaders completed the impact of graduate education among …
Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch
Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch
Walden Dissertations and Doctoral Studies
While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …
Organizational Complexity And Hospitals' Adoption Of Electronic Medical Records For Closed-Loop Medication Therapy Management, Ebenezer Siaw Adu
Organizational Complexity And Hospitals' Adoption Of Electronic Medical Records For Closed-Loop Medication Therapy Management, Ebenezer Siaw Adu
Walden Dissertations and Doctoral Studies
Over 700,000 adverse drug events (ADEs) result in emergency hospital visits annually, and many of these ADEs are preventable through the use of health information technology in hospitals. However, only 12.6% of U.S. hospitals have developed the capacity to adopt closed-loop electronic medical records (EMR). Organizational complexity may be a major factor influencing hospitals' adoption of closed-loop EMR. This quantitative study explored how organizational complexity influenced hospitals' adoption of closed-loop EMR. Diffusion of innovation theory was the foundation for this study. Logistic regression was used to establish possible relationships between organizational complexity and hospitals' adoption of EMR for closed-loop medication …
Strategies To Reduce Effects Of Organizational Stress In Health Care Workplaces, Kate Chinyere Mbidoaka
Strategies To Reduce Effects Of Organizational Stress In Health Care Workplaces, Kate Chinyere Mbidoaka
Walden Dissertations and Doctoral Studies
Workplace stress has become a frequent occurrence in the race for competitive business advantage. This stress leads to negative physiological consequences in the workplace, causing productivity and profitability to suffer. The purpose of this single case study was to explore the stress management strategies that some health care business leaders used to reduce the effects of work-related stress on their employees to improve productivity. The interview process included 3 managers employed at a health care institution in Houston, Texas, with records of implementing successful strategies for mitigating the effects of workplace stress. The conceptual framework was job demands-resources model, pertinent …
Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd
Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd
Walden Dissertations and Doctoral Studies
Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …
Effects Of Lifestyle Changes On The Health Of African Americans With Type 2 Diabetes, Charles Duro
Effects Of Lifestyle Changes On The Health Of African Americans With Type 2 Diabetes, Charles Duro
Walden Dissertations and Doctoral Studies
African Americans are adversely affected by Type 2 diabetes at a greater rate than their European American counterparts; however, research on the effects of Type 2 diabetes on African Americans is limited. Lifestyle modifications that include the incorporation of physical activity and dietary changes can help patients with Type 2 diabetes better manage their disease and improve their overall quality of health. The purpose of this phenomenological study was to explore the experiences of African Americans with Type 2 diabetes who incorporated these self-management behaviors, discerning if they had improved health and quality of life. The self-efficacy framework was applied …
Frequent Fall Risk Assessment Reduces Fall Rates In Elderly Patients In Long-Term Care, Omokhele Rosemary Aliu
Frequent Fall Risk Assessment Reduces Fall Rates In Elderly Patients In Long-Term Care, Omokhele Rosemary Aliu
Walden Dissertations and Doctoral Studies
Falls are a serious issue for the elderly living in long-term care facilities, as falls contribute to signiï¬?cant health problems such as increased dependence, loss of autonomy, confusion, immobilization, depression, restriction in daily activities, and, in some cases, death. An estimated 424,000 fatal falls in elderly patients residing in long-term facilities occur annually in the United States costing $34 billion in direct medical costs. One way to reduce falls among elderly patients in long-term care is to assess for fall risk frequently and implement evidence-based strategies to prevent falls. Patients in this project site facility had been assessed for fall …
Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire
Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire
Walden Dissertations and Doctoral Studies
Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital's outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer …
Leadership Development For The Formal Nurse Leader, Lori Neu
Leadership Development For The Formal Nurse Leader, Lori Neu
Walden Dissertations and Doctoral Studies
Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …
Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki
Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki
Walden Dissertations and Doctoral Studies
Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …
Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari
Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari
Walden Dissertations and Doctoral Studies
Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …
Restaurant Management Strategies To Comply With Food Safety Regulations, Dr. Carlos Juan Calcador
Restaurant Management Strategies To Comply With Food Safety Regulations, Dr. Carlos Juan Calcador
Walden Dissertations and Doctoral Studies
The recent economic crisis in Puerto Rico has created decreased health department fiscal capabilities, adding more responsibilities to health department officials in charge of restaurant inspections without adding more operational funds, which in turn led to less regulatory capacity. This situation instigated increased food safety regulation violations, and food safety legislation changes, imposing more economic pressure to restaurant owners, which leads to a lack of restaurant sustainability. The purpose of this case study was to explore strategies six business visionaries, smart entrepreneurs, who have positioned themselves as successful restaurateurs, in the restaurant industry in Puerto Rico. They were key factors …