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Full-Text Articles in Health and Medical Administration

Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor Jan 2023

Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor

Walden Dissertations and Doctoral Studies

Diabetes education is a principal component of optimal diabetes care that is often underutilized despite the known benefits that include reductions in complications as well as improved glycemic control and self-management knowledge. The purpose of this quantitative study was to examine the association between the completion of diabetes education, referral source, and visit modality. Because the completion of diabetes education is multifaceted, Levesque’s theoretical framework of health access, which incorporates dimensions of the accessibility of services and the abilities of potential users in the utilization of health services, was used to ground the study. A retrospective chart review was conducted …

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Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

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Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn Jan 2023

Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn

Walden Dissertations and Doctoral Studies

In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …

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Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti Jan 2023

Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs), specifically clostridioides difficile (CDI) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia, increase mortality and length of stay and cost the United States billions of dollars each year. Though preventable, continued incidence demonstrates that infection prevention interventions remain challenging for health system administrators. The purpose of this quantitative study was to identify whether there was a significant difference between Magnet accreditation and non-Magnet accreditation and the frequency of HAIs, specifically, CDI and MRSA bacteremia. The independent variable was Magnet accreditation status; the dependent variables were CDI and MRSA bacteremia. The foundation of the study focused on Donabedian’s framework of …

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Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White Jan 2023

Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White

Walden Dissertations and Doctoral Studies

This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …

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Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr Jan 2023

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

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The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson Jan 2023

The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson

Walden Dissertations and Doctoral Studies

The U.S. population aged 65 years old and older is steadily increasing. Some of thispopulation resides in nursing homes; thus, the necessity for quality care provided in nursing homes has increased. Consistent, quality care remains a constant challenge for the government, nursing home administrators, health care consumers, and researchers. Nurse staffing has been identified as a critical structural measure that affects the quality of care and outcomes in nursing homes. The purpose of this quantitative study was to examine the relationship between nurse staffing and quality of care outcomes in Mississippi’s nursing homes. Donabedian’s structure, process, and outcome (SPO) model …

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African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks Jan 2023

African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks

Walden Dissertations and Doctoral Studies

Few studies have studied how community-based services (CBS) work to mitigate the strong Black woman image (SBWI) coping mechanism for Black women to improve their mental health. The purpose of this generic, qualitative study was to understand the experiences of 10 African American women, ages 18 and older, who identified with the SBWI and had received CBS to address their stress-related coping strategies. Transactional theory of coping with stress and the SBWI approach was used as the framework to help explain how stress in terms of the SBWI impacted the response of the African American women within their environment. Data …

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Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg Jan 2023

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood Jan 2023

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

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Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins Jan 2023

Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins

Walden Dissertations and Doctoral Studies

Limited resources exist for managing the increasing cases of hypertension and type 2 diabetes, which underlines the need to continuously review reimbursement plans to ensure care affordability for chronic illness. The purpose of this quantitative study was to determine whether a correlation existed between the number of patients with type 2 diabetes, hypertension, and demographic characteristics (independent variables) seen at Federally Qualified Health Centers (FQHCs) and the allocation of grant funds from Health Resources and Service Administration (HRSA) (dependent variable) from 2016 – 2020 among adults 18 years old and older in the United States. Guided by the Transaction Cost …

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Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

Many individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …

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Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff Jan 2023

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

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Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb Jan 2022

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

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The Relationship Between Length Of Stay, Hospital Characteristics, And Cost Of Care In Acute Care Hospitals In The U.S., Maria Mikhataykina Jan 2022

The Relationship Between Length Of Stay, Hospital Characteristics, And Cost Of Care In Acute Care Hospitals In The U.S., Maria Mikhataykina

Walden Dissertations and Doctoral Studies

Rising healthcare costs make access to healthcare less accessible for many individuals. Hospital administrators, payer stakeholders, and patients are concerned with rising healthcare costs, as many patients may be hindered from receiving quality health care. Grounded in complex adaptive systems theory, the purpose of this quantitative correlation study was to examine the relationship between inpatient hospital (a) LOS, (b) bed size, (c) location, (d) region, (e) control/ownership, and cost of care. The participants were community hospitals participating in the Nationwide Inpatient Sample (NIS) data collection tool of the Healthcare Cost and Utilization Project. The results of the multiple linear regression …

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The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson Jan 2022

The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson

Walden Dissertations and Doctoral Studies

Home dialysis is a cost-effective and efficient means of treating end-stage renal disease. Under-utilization of home dialysis results in higher than necessary Medicare spending and loss of quality of life for patients. The purpose of this study was to understand the relationship between a nephrologist's length of time in practice, a nephrologist's belonging to a Joint Venture (JV) financial arrangement with a home modality program, and the use of home dialysis and home modality education using a quantitative, correlational design. Roger's diffusion of innovation theory explains the varying willingness of individuals to accept innovation. Secondary data were collected from Medicare …

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Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia Jan 2022

Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia

Walden Dissertations and Doctoral Studies

Healthcare costs have continued to increase in the United States. The Centers for Medicare and Medicaid Services (CMS) have proposed policy changes to reduce inequities between hospital outpatient centers and independent freestanding facilities when reimbursing for the same service. The purpose of this quantitative study was to explore if there was a difference in the payments to the Outpatient Prospective Payment System between the years 2017 and 2018 to assist hospital administrators in preparing for Medicare reimbursement cuts. The study was grounded in the agency theory and aimed to determine the relationship among the provider, payer, and patient. The research …

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The Impact Of Telemedicine Availability On Fatal Opioid Overdose Rates In Texas, 2020, Cara W. Hall Jan 2022

The Impact Of Telemedicine Availability On Fatal Opioid Overdose Rates In Texas, 2020, Cara W. Hall

Walden Dissertations and Doctoral Studies

AbstractSubstance use disorders (SUDs) and fatal overdoses are a significant problem in the United States. A viable and effective method for treating SUDs is through telemedicine (tele-SUD) visits. Tele-SUD visits are an effective means of meeting with patients virtually, especially in the post-COVID-19 environment; however, a problem in health care exists concerning the availability of tele-SUD services in middle America. The purpose of this study was to investigate the impact of tele-SUD availability on rates of opioid overdose deaths in the state of Texas. Donabedian’s model of health care quality evaluation was used as the theoretical framework. A quantitative, independent …

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Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin Jan 2022

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …

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Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli Jan 2022

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 …

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Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies Jan 2022

Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies

Walden Dissertations and Doctoral Studies

Performance related to patient satisfaction is becoming a significant factor in determining reimbursement for hospital-based services. Furthermore, consumers are increasingly accessing publicly available quality and patient experience information to make decisions about where to receive care. Understanding which hospital characteristics influence patient satisfaction is critical to the healthcare administrator to ensure the financial viability of the organization and to meet the needs and expectations of the community. Many studies have examined the relationship between a single performance characteristic and patient satisfaction. This secondary data quantitative study used regression analysis to analyze the relationship between three hospital performance characteristics (i.e., the …

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Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro Jan 2022

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …

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Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore Jan 2022

Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore

Walden Dissertations and Doctoral Studies

Fraudulent business activities have the potential for adverse business outcomes. Speech pathology business owners who lack a robust fraud prevention strategy may subject their practices to severe civil and criminal penalties. Grounded in Wilhelm’s eight-stage fraud management lifecycle theory, the purpose of this qualitative multiple case study was to explore strategies speech pathologist business owners used to prevent Medicare claims fraud. The participants were five speech pathologist business owners from three practices in a western U.S. state who successfully implemented fraud prevention strategies. Data were collected using semistructured interviews and reviewing organization policies and procedures manuals. Three themes emerged using …

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Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater Jan 2022

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 …

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The Relationship Between Allied Health Therapy Leaders In Hospitals And Patient Satisfaction, Dickson Rodriguez Jan 2022

The Relationship Between Allied Health Therapy Leaders In Hospitals And Patient Satisfaction, Dickson Rodriguez

Walden Dissertations and Doctoral Studies

AbstractAlthough allied health professions account for 60% of the health care workforce, funding to support training and leadership in the allied health fields remains nominal. The purpose of this quantitative study was to investigate whether there is a relationship between allied health therapy leaders in hospitals and patient satisfaction. The Donabedian model was used as the theoretical framework, as it made it possible to conceptualize the underlying parts and processes that may contribute to poor quality of care for patients receiving healthcare. A quantitative methodology with a cross-sectional design was used to provide quantifiable information to ascertain whether the results …

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Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig Jan 2022

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

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Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen Jan 2022

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …

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Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi Jan 2022

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

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Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe Jan 2022

Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe

Walden Dissertations and Doctoral Studies

AbstractFood insecurity is not having enough food or resources or not being able to procure nutritious foods. An observation that nurses in one oncology clinic rarely assessed their patients for food insecurity as part of their regular assessment led to the development and testing of an educational intervention for nurses which was to create awareness on the importance of assessing food insecurity among oncology patients and to learn to use the Household Food Insecurity Assess Scale (HFIAS) in assessing patients. Summative evaluation was done using a pre/and posttest. The Maslow’s hierarchy of needs and the Virginia Henderson nursing need theories …

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Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun Jan 2022

Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun

Walden Dissertations and Doctoral Studies

AbstractLike other individuals from diverse backgrounds, nurses who work in nursing homes are susceptible to becoming overweight. The way that others see and respond to the overweight person also may vary and even result in some level of discrimination. The purpose of this study was to explore the perspective of nurse managers about obese staff in the workplace. A qualitative phenomenological descriptive study design was used, guided by the theory of interpersonal relations and the relational leadership framework, to examine the lived experiences of managers working with obese nurses in nursing home settings in a large metropolitan region in the …

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