Health and Medical Administration Commons^™

Assessing Clinical Software User Needs For Improved Clinical Decision Support Tools, Kimberly B. Denney

Walden Dissertations and Doctoral Studies

Consolidating patient and clinical data to support better-informed clinical decisions remains a primary function of electronic health records (EHRs). In the United States, nearly 6 million patients receive care from an accountable care organization (ACO). Knowledge of clinical decision support (CDS) tool design for use by physicians participating in ACOs remains limited. The purpose of this quantitative study was to examine whether a significant correlation exists between characteristics of alert content and alert timing (the independent variables) and physician perceptions of improved ACO quality measure adherence during electronic ordering (the dependent variable). Sociotechnical theory supported the theoretical framework for this …

The Influence Of On-Site Surgical Pathology Services In Rural Hospitals On Physician Satisfaction, Belinda D. Presley

Walden Dissertations and Doctoral Studies

Abstract

There is limited information regarding physician satisfaction as it relates to the presence of a surgical pathology department in rural hospitals. Physician satisfaction directly influences the quality of patient care. The theoretical frameworks that informed this study included institutional theory and population ecology. The research questions addressed differences in levels of physician satisfaction between physicians who have access to an on-site surgical pathology department and physicians who do not have such access. The research also examined differences in satisfaction between physician specialties that have or do not have access to an on-site surgical pathology department services. A quantitative, cross-sectional …

Diffusion Of Technology In Small To Medium Medical Providers In Saudi Arabia, Ziad Hisham Arnaout

Walden Dissertations and Doctoral Studies

The Saudi ministry of health reported that government health care spending doubled from 2008 to 2011. To address increased demand, the government encouraged small to medium enterprise (SME) growth. However, SME leaders could not leverage technology as a growth enabler because they lacked strategies to address operating inefficiencies associated with technology. Only 50% of hospitals fully implemented information technology. The purpose of this phenomenological study was to explore lived experiences of SME leaders on strategies needed to accelerate technology implementation. This exploration drew on a conceptual framework developed from Wainwright and Waring's framework addressing issues of technology adoption. Data were …

Differentiating Demographic Factors In Latino Patients With Type 2 Diabetes, Carol Lynne Manning

Walden Dissertations and Doctoral Studies

The American Diabetes Association (ADA) data suggest that Latinos share a greater burden of disease than do non-Latino Whites with type 2 diabetes. As a result of poor glycemic control, Latinos also suffer consequences such as blindness, kidney disease, and limb amputation more often than do other ethnic groups. The purpose of this study was to compare demographic factors of Latinos with well-controlled type 2 diabetes, as measured by a HgbA1c of 7 or less (n = 118) to Latinos not well controlled (n = 105). This cross sectional study used a secondary data set with a sample selected from …

Increasing Knowledge About Alpha-1 Antitrypsin Deficiency In The Chronic Obstructive Pulmonary Disease Population, Maureen Ann Wentink Barta

Walden Dissertations and Doctoral Studies

The purpose of the project was to increase awareness about alpha-1 antitrypsin deficiency (AATD) in chronic obstructive pulmonary disease (COPD), particularly among those with a familial history of genetic factor AATD; an additional goal was to understand its relationship to COPD. COPD is the third leading cause of death in the United States, with more than half of COPD patients experiencing significant disabilities. Major causes for COPD include smoking, air pollution, secondary smoke, upper respiratory infections, hereditary factors, occupational factors, environmental factors, and socioeconomic factors. Genetic factors, however, also play a significant role in early onset COPD and in those …

Interdisciplinary Bedside Rounding: Patient Satisfaction With Nursing Communication And Decreased Hospital Readmissions, Luanne Parks

Walden Dissertations and Doctoral Studies

There is a lack of quality communication among health care professionals and patients in the hospital setting, which can negatively impact patient satisfaction and increase hospital readmission rates. Interdisciplinary bedside rounding (IBR) is a method of rounding that uses direct communication and discussion of the patient at the bedside, and the use of IRB may improve the quality communication among health care professionals and patients. The purpose of this program outcomes evaluation project was to evaluate whether IBR increased patient satisfaction with nursing communication and if IBR decreased hospital readmission rates. The Iowa model of evidence-based practice provided a framework …

Health Literacy And Health Decision Making Attitudes In People With Human Immunodeficiency Virus, Christine Miranda

Walden Dissertations and Doctoral Studies

Health literacy has been recognized as a vital issue in the self-care management of persons living with HIV/AIDS (PLWHA). The purpose of this study was to determine the impact of functional, communicative, and critical health literacy dimensions on positive and negative attitudes toward health decision making. The transtheoretical model of health behavior change (TTM) provided the theoretical framework to explain this association. A culturally-adapted survey was used in this cross-sectional study to measure health literacy dimensions, positive and negatives attitudes toward health decision making, and other factors in 100 Puerto Ricans living with HIV/AIDS. Demographic factors and clinical and immunological …

Third-Degree Family Health History And Perception Of Disease Risk, Liana Carrasco Romero

Walden Dissertations and Doctoral Studies

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the …

Examining The Impact Of Accreditation On A Primary Healthcare Organization In Qatar, Alia Ghareeb

Walden Dissertations and Doctoral Studies

Although a modest body of literature exists on accreditation, little research was conducted on the impact of accreditation on primary healthcare organizations in the Middle East. This study assessed the changes resulting from the integration of Accreditation Canada International's accreditation program in a primary healthcare organization in the State of Qatar. The study also investigated how accreditation helped introduce organizational changes through promoting organizational learning as well as quality improvement initiatives. Pomey's Dimension of Change framework and questionnaire was used to measure the effect of Accreditation Canada International standards on the perceived quality performance and the progress towards organizational learning. …

The Effects Of Financial Literacy On Patient Engagement, Melanie Meyer

Walden Dissertations and Doctoral Studies

Health care reform has caused consumers to learn more about what it means to have health insurance and its costs. Patient engagement, a critical component of health care reform, reflects provider and consumer attention to shared decision making between patient and physician. The problem addressed in this study is that although researchers have studied patient engagement, there has been insufficient exploration of the relationship between financial literacy and patient engagement, which could negatively impact health outcomes not only for patients or consumers but for society as a whole. The purpose of this quantitative research was to determine if a relationship …

Correlates Of Developmental Disabilities Direct Service Professionals' High Turnover Rate, Doreen Marie Colangelo

Walden Dissertations and Doctoral Studies

Workplace turnover is destructive to organizations both financially and operationally. The cost of selecting and replacing the wrong candidate for a position ranges from a few thousand to several million dollars. The goal for this correlational study was to assess the efficacy of an applicant test instrument for identifying key personality traits of direct service professionals (DSP) in the developmental disabilities arena which correlate with successful job tenure and decrease turnover cost. The theoretical framework that grounded this study was the poor job fit theory. The population studied consisted of DSP's hired by an organization in Glynn County, GA. Anonymous …

Exploring Strategies For Implementing Barcode Medication Administration Systems, Julie A. Frederick

Walden Dissertations and Doctoral Studies

The number of medication errors associated with preventable deaths in healthcare facilities remains at a high rate for healthcare leaders. Practices of medication delivery remain similar to those 10 years ago. Hospitals that have implemented barcoding medication administration systems have reported a decrease in medication errors ranging from 60% to as high as 93%. Despite this utility of barcoding, only 50% of U.S. hospitals have implemented barcode medication administration. This comparative case study explored the strategies hospital leaders used to implement barcode medication administration systems, utilizing the sociotechnical theory for a conceptual framework. Face-to-face, semistructured interviews were used to identify …

Nonattendance Rates And Barriers To Health Care In Outpatient Clinic Settings, Susan Louise Geiger

Walden Dissertations and Doctoral Studies

Lower socioeconomic status, ethnicity, and race are associated with reduced health care use in the United States. Patients who continually miss their appointments suffer significant negative results, including a disruption in continuity of care, complications with their chronic illnesses, and an increase in hospital readmissions. The health belief model was used as the theoretical support for this project that investigated the underlying causes of no-shows at an urban hospital-based outpatient clinic in the United States. It used a quantitative, descriptive design and examined a minority, underserved, and underinsured population that was receiving care at the research site and had a …

Climate Change Implications For Health-Care Waste Incineration Trends During Emergency Situations, Emilia Mmbando Raila

Walden Dissertations and Doctoral Studies

Healthcare waste (HCW) incineration practices in the global South countries are among the major sources of black carbon (BC) emissions or smoke. This study analyzes HCW incineration trends during emergency situations and smoke from HCW incineration processes in Haiti. The study was prompted by the current arguments about the climate change and the growing health effects associated with BC emissions. The conceptual framework was based on both adverse health effects from BC emissions exposure and climate change potential of BC emissions. Therefore, the goal was to determine whether cardboard HCW sharps containers emit lower BC emissions to the atmosphere during …

The Relationship Between Stressors And Intent To Leave Nursing Homes Among Directors Of Nursing, Crystal R. Williamson

Journal of Sustainable Social Impact

According to the Centers for Medicare and Medicaid Services, some nursing homes have been ranked worst in the nation when rating the quality of resident care. The purpose of this study was to determine the relative strength of workplace stress, job satisfaction, organizational support, and personal data (number of years employed, age, highest education level) in predicting director of nursing (DON) intentions to leave the position. This information contributes to social change because it is important to know that DONs need to experience general satisfaction in order to maintain stable leadership that positively contributes to the quality of care in …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Testing The Waters: Are Health Education Specialists Willing To Conduct Rapid Hiv Testing?, Angela W. Prehn, Jacquie Fraser, Anthony J. Santella

2010-2016 Archived Posters

Approximately 1 in 5 people with HIV are not aware of their infection; access to testing is an important part of public health. In a national study, Health Education Specialists with high HIV knowledge and favorable attitudes towards persons with HIV/AIDS were more willing to be trained to conduct rapid HIV testing (RHT)

Healthy Work Environment Orientation Training And Psychiatric Nurse Retention, Lawanda Rollins

Walden Dissertations and Doctoral Studies

According to recent research, more than 75% of newly employed nurses leave employment within 6 months. Changes in organizational training programs are needed in order to improve psychiatric nurse retention, nationally and globally. A healthy work environment (HWE) has been described as an environment that includes mentoring for good communication skills; it is also one that explores collaborative strategies for safe practice; professional advancement; and empowerment through research, education, and skill development. Examination of the impact of this HWE psychiatric nurse orientation training program on nurse retention was done using Rogers' theory of diffusion. Study variables included the length of …

Direct-To-Consumer Advertising Of Drugs And Patients' Health Care Seeking Behaviors, Patricia Elaine Kennedy-Tucker

Walden Dissertations and Doctoral Studies

Known as direct-to-consumer advertising (DTCA), pharmaceutical companies in the United States are permitted to advertise prescription drugs directly to consumers. The purpose of this quantitative study was to determine if an association exists between DTCA and health care-seeking behaviors. The theoretical framework for this study involved social learning theory, information integration theory, and prospect theory. The research questions identified if exposure to DTCA (a) is associated with physician office visits, (b) influences a patient/physician conversation regarding a prescription, (c) influences requesting a prescription, and (d) has an impact on patients' ratings of the overall interaction with the physician. Data were …

Enhancing Nurses' Perceptions Of Patient Safety Culture Through The Just Culture Model, Aida Solomon

Walden Dissertations and Doctoral Studies

An organizational culture of safety affects employees' attitudes, beliefs, perceptions, and values related to safe practice as well as their behaviors and level of engagement. The purpose of this project was to determine the influence of introducing the just culture model through staff engagement in an interactive workshop. A convenience sample of acute care staff were recruited for this 1-sample pretest and posttest project design. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture instrument was used to measure safety culture perceptions on 7 dimensions pre and post intervention. For the theoretical framework, Ajzen's theory of …

Factors Influencing Diabetes Self-Management Of Filipino Americans With Type 2 Diabetes Mellitus: A Holistic Approach, Jocelyn B. Sonsona

Walden Dissertations and Doctoral Studies

There is an increasing prevalence of Type 2 diabetes mellitus among Filipino Americans. However, how well Filipino Americans with diabetes self-manage their disease and what factors influence their diabetes self-management behaviors remain unknown. Based on a holistic approach, this quantitative study was designed to investigate the diabetes self-management behaviors of this population and the factors influencing their self-management behaviors. The combined roles of diabetes knowledge, diabetes self-efficacy, spirituality, and social support were examined in predicting diabetes self-care behaviors. A convenience sample of 113 Filipino Americans with Type 2 diabetes mellitus completed the Diabetes Knowledge Test, Self-Efficacy for Diabetes Test, Daily …

Diffusion Of Social Network Technology And Overuse Among Health Industry Knowledge Workers, Abdel Rahman Toure

Walden Dissertations and Doctoral Studies

Many organizations now realize the important role of social network technology (SNT) in building social capital and hence broadening their customer base. However, observations have indicated that, while working, many knowledge workers use SNT to engage in non-job related activities, potentially leading to a decrease in productivity. The purpose of this study was to examine the relationship between the usage of SNT and productivity in the health sector. The theoretical foundation of this study emanated from Rogers's theory of diffusion of innovations and Campbell, Rodney, Scott, and Christopher's theory of performance. Collection of data involved a self-administered survey designed with …

A Correlational Analysis Of Empowerment And Experience With Resistance To Change, Rita Elizabeth Burgess

Walden Dissertations and Doctoral Studies

Despite more than 60 years of research about the nature of change, resistance to change remains a problem across industries. Health care leaders have limited knowledge of how health care managers' perceptions of empowerment, years of experience, and resistance to change (RTC) relate. The purpose for this nonexperimental correlational study was to examine the relationship between empowerment, years of experience, and RTC among managers via an online survey. The theoretical framework incorporated Kanter's structural empowerment theory and Kotter's change theory. The sample included 245 out of 1,181 health care managers from Veterans Administration (VA) hospitals in the New York metropolitan …

Emerging Diabetes Pandemic In India: A Case Study For An Integrative Approach, Chhaya Sanjeev Chaudhry

Walden Dissertations and Doctoral Studies

Every day, India sees the addition of 5,000 new cases of diabetes to its current diabetic population of 65 million people. This number is projected to cross the 100 million mark in 15 years. The emerging pandemic scale of diabetes growth is straining India's already-overburdened public healthcare resources. India is home to several well-established native and adapted foreign traditions of medicine that are widely practiced. These traditions include Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy. The modern and traditional medicine approaches are extensively used as independent systems. The purpose of this qualitative research case study was to evaluate the …

Church-Based Health Care Initiatives In East Baltimore, Maryland, Valerie Warner-Collins

2010-2016 Archived Posters

A qualitative case study that investigated the perceptions of clergy regarding their roles, and those of the church, in health care advocacy. Questions emanating from the research literature were piloted to 4 expert jurors before distribution to 17 main participants. The results indicated that barriers to health care access was predicated on clerical perceptions of the role of the church, severed relationships between collaborators, and several faulty and systemic factors of prior partnerships.

Leadership Strategies And Initiatives For Combating Medicaid Fraud And Abuse, Krista K. Laursen

2010-2016 Archived Posters

This study explored how health-care leaders in Arizona characterized limitations to the mitigation of Medicaid fraud and abuse. Emergent themes included the need for the application of modern technologies to combat Medicaid fraud and abuse and the concentration of Medicaid fraud and abuse mitigation efforts at the state level.

Weight Loss Surgery Maintenance And Psychosocial Development: A Narrative Perspective, Carrie J. L. Hickman

Walden Dissertations and Doctoral Studies

Bariatric surgery is not the panacea it was once thought to be for weight loss. Due to patient noncompliance issues, many weight loss surgery patients are relapsing and regaining the significant amounts of weight that bariatric surgery had initially helped them to lose. This failure is costly monetarily, psychologically, and medically to both the patient and to society. Using the narratives of 32 post-weight loss surgery patients, this narrative study explored: (a) whether Erikson's psychosocial stages of development occur after weight loss surgery, (b) whether successful patients (defined as those who are able to maintain their weight loss long term) …

Hardiness And Attitude On Hypertension Treatment Adherence Among Nigerian Health Care Workers, Chinwe N. Egwuagu-Ndubisi

Walden Dissertations and Doctoral Studies

Racial and ethnic minorities in the United States have higher rates of hypertension than European Americans. In this ethnographic study, 30 Nigerian immigrant health care workers with hypertension described their self-efficacy management of the disease to ascertain the relationship between health-related hardiness, individual attitudes on compliance, and medication adherence self-efficacy. Using a mixed methods designs comprised of survey tools and focus-group questionnaires, the research questions were focused on understanding attitudes and health practices within Nigerian culture that support self-efficacy management. The theoretical framework for this study is the social learning theory and the social cognitive theory postulated by Bandura. Content …

A Synthesized Model Of Compliance Based On Physician And Patient Reported Barriers To Hypertension Guidelines, Pamela Ballou-Nelson

Walden Dissertations and Doctoral Studies

Hypertension affects as many as 50-70 million Americans; early and consistent compliance to hypertension guidelines is important to prevent heart attack and stroke, both leading causes of death in the United States. Despite the advances in medicine and health-care technology, the effectiveness with which hypertension is managed at the individual and community level is less than optimal. The research questions in this study addressed the lack of physician compliance to hypertension guidelines and why patients fail to follow guidelines. Improving hypertension management depends on bridging the gap between physician awareness of evidence-based guidelines and patient compliance. Grounded theory was used …

Acceptance And Usage Of Electronic Health Record Systems In Small Medical Practices, Ritu Tannan

Walden Dissertations and Doctoral Studies

One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based practices. The purpose of this study was to explore opinions and beliefs on the barriers to the diffusion of an ERH system using Q-methodology. Specifically, the research questions examined the subjectivity in the patterns of perspectives at the preadoption stage of the nonusers and at the postadoption …