Health and Medical Administration Commons^™

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …

The Impact Of Electronic Health Records On Healthcare Service Delivery, Patient Safety, And Quality, Kate Elizabeth Trout

Theses & Dissertations

The HITECH Act has provided over $30 billion of support through the Meaningful Use program to implement Electronic Health Records (EHRs) with aims to improve healthcare service delivery, efficiency, quality, and patient safety. New healthcare models, such as pay-for-performance and value-based purchasing, were envisioned to aligning quality with reimbursement mediated with the use of EHRs. It is unclear of how EHRs and Meaningful Use have impacted health service delivery, patient safety, and quality of care. Thus, making it difficult to determine if the specific set of objectives for Meaningful Use have had a positive impact on outcomes, which ultimately is …

Improving Employee Engagement Through The Development Of An Enterprise Performance Management System, Carlton D. Abner

Doctor of Nursing Practice (DNP) Projects

There is ample evidence of our health care delivery system relying heavily on value-based outcomes. The increased focus on outcomes has required health care organizations to adjust how they approach data and how they successfully implement performance management systems. These performance management systems help the organization identify, measure, and report the organization’s performance at an enterprise level using key performance indicators clearly linked to the organization’s overall strategy. As one organization began implementing an enterprise performance management system, the goal of this project was to show how participating in projects with that level of strategic impact can lead to improved …

Interventions To Increase Vaccination Rates In Homeless Adults Aged 50 Years And Older In A Shelter-Based Clinic, Rubeena Smith

Doctor of Nursing Practice

Pronounced disparities in adult immunizations exist across the country. In homeless adults over 50 years of age with chronic diseases, coverage rates for influenza and pneumococcal vaccinations falls at 30% as compared to the 60% coverage rate found in the general public. Hepatitis B immunization rates are also significantly lower in the elderly homeless population. Increased prevalence of chronic diseases in the elderly homeless shelter residents’ increase their risk for severe complications following influenza, hepatitis B and meningococcal infections. To prevent disease epidemics and further disability in the homeless population, the need for appropriate and timely vaccinations is critical. Attitudes …

An Initiative To Improve Primary Prevention Of Heart Disease In Adults With Type Ii Diabetes Based On The Acc/Aha (2013) And Ada (2016) Guidelines, Litzie Garza

Doctor of Nursing Practice

Heart disease is the leading cause of death in the United States and in Texas. Hyperlipidemia is a precursor to cardiovascular disease and is a highly manageable and treatable acute and chronic disease in the outpatient primary care setting. This project is designed to increase clinicians’ adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (2016) clinical practice guidelines for the prevention of heart disease in 40 to 75 year old adults with type II diabetes through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a …

Implementation Of Quality Improvement Interventions To Increase Provider Adherence To Standards Of Medical Care In Diabetes, Elizabeth A. Betz

Doctor of Nursing Practice

Purpose: To improve a South Texas primary care clinic’s diabetes management system by implementation of a quality improvement intervention to help staff and medical providers increase adherence to the American Diabetes Association standards of care related to screening referrals and orders for urine microalbumin, in order to improve self-care and health outcomes for adult patients with diabetes. Background and Problem: Diabetes is the 7th leading cause of death in the United States and the cause of vision loss, amputations, and end-stage renal disease. The patients at the Wellness Center do not consistently receive routine screenings for neuropathy, retinopathy, nephropathy, microalbumin, …

Quality Improvement Programs’ Contribution To Successful Clinical Practice Changes, Erika O. Bowen

Theses & Dissertations

There is a great deal of healthcare literature on the importance of QI programs and the significant contributions they make toward patient safety and patient satisfaction; however, documentation of outcome measures and predictors of success remains challenging. This study examined the experiences of physician participants who attended a state supported South Texas medical school’s CSE course to gain an understanding of QI education, demonstrate the need for formal QI education, and determine if a change in clinical practice occurred as a result of attending a structured QI course. Kirkpatrick’s (1967) four-level evaluation model was used as a framework to guide …

Medication Nonadherence, Health Care Utilization, And Safemed Care Transitions Model Impact In Super-Utilizers, Satya Surbhi

Theses and Dissertations (ETD)

BACKGROUND: Super-utilizers are individuals with disproportionately high inpatient and emergency department (ED) use, and mostly have multiple chronic conditions and use multiple concurrent medications. They place a substantial burden on the U.S. healthcare system and have become the focus of policy initiatives aimed at reducing their disproportionate inpatient and ED use. Medication management is critical for these patients since nonadherence to essential chronic medications is associated with poor health outcomes, and higher health care utilization and costs. OBJECTIVES: This dissertation employed a three empirical research papers approach to study the following aims: (1) the prevalence and patterns of medication nonadherence …

Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles

Doctor of Nursing Practice

The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical guidelines. Provider …

Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao

Doctoral Projects

Background: Smartphones have a great potential for students to learn more efficiently. Students now have the ability to download applications with pertinent information in the palm of their hand for both educational and clinical duties. This descriptive correlational quantitative research examines whether student registered nurse anesthetists own and use smartphones as supplementary learning tools.

Methods: An online survey was sent through AANA to Masters and DNP student registered nurse anesthetists (SRNAs) in the United States. Respondents were asked if they owned smartphones and how often they used smartphones for educational and clinical duties. Data Analysis was conducted using a Chi-square …

Reproducibility And Reliability Of Chromatin Immunoprecipitation In Clinical Research, Kelli Mcdonough

Master's Theses and Doctoral Dissertations

Association between histones and DNA is crucial for many cellular functions such as gene transcription and epigenetic silencing. Changes to chromatin structure influence gene expression via histone modifications. Chromatin immunoprecipitation (ChIP) is an experimental technique used to investigate the interactions between histones and DNA. ChIP determines the specific location in the genome that histone modifications are associated with, indicating the target of the histone modifiers. Despite the appeal of ChIP as an in vitro technique, there are limitations to its use. There is variability from one preparation to the next, given the many steps and reagents used throughout the technique. …

A Test Of The Behavioral Model Of Health Services Use On Non-Emergent Emergency Department Use, Moira Crosby Mcmanus

Health Services Research Dissertations

Even though emergency departments (EDs) were created to treat trauma and emergent cases, there has been an increase in emergency department (ED) utilization for non-emergent reasons over the past half of a century. As non-emergent utilization grows as a result of the ED becoming a prevalent substitute for primary care, overcrowding of the ED and increased wait times will continue. Additionally, unnecessary cost to both the ED and the patient will be incurred. Previous research has examined and determined various reasons and risk factors driving non-emergent ED use, among them the influence of living location and the number of non-emergent …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Data Mining Twitter For Cancer, Diabetes, And Asthma Insights, Kimberly Chulis

Open Access Dissertations

Twitter may be a data resource to support healthcare research. Literature is still limited related to the potential of Twitter data as it relates to healthcare. The purpose of this study was to contrast the processes by which a large collection of unstructured disease-related tweets could be converted into structured data to be further analyzed. This was done with the objective of gaining insights into the content and behavioral patterns associated with disease-specific communications on Twitter. Twelve months of Twitter data related to cancer, diabetes, and asthma were collected to form a baseline dataset containing over 34 million tweets. As …

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

Psychometric Testing Of The Presence Of Nursing Scale: Measurability Of Patient Perceptions Of Nursing Presence Capability Of Nurses In An Academic Medical Center, Rebecca L. Turpin

Electronic Theses and Dissertations

Introduction: Nursing presence occurs when nurses expend themselves on the behalf of a unique patient. This phenomenon requires further research to develop instruments. The Presence of Nursing Scale (PONS) measures the patient’s perspective (Kostovich, 2012). Psychometric testing of PONS-Revised using exploratory factor analysis is warranted to further develop a reliable and valid measure of nursing presence. Contextual workplace variables need exploration in inpatient settings for correlation with nursing presence.

Method(s): A convenience sample of 122 adult inpatients from ten acute-care nursing units in a Southeastern Magnet hospital were surveyed to conduct the first psychometric testing of this revised instrument using …

Association Between Alcohol Screening And Brief Intervention During Routine Check-Ups And Alcohol Consumption Among Adults Living In California, Gene Kilian Wells

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Alcohol consumption accounts for 1 in 10 deaths among U.S. adults, and has cost upwards of $200 billion in a single year due to lost productivity. Alcohol Screening and Brief Intervention (ASBI) was developed as a treatment approach for use in primary care to identify and reduce hazardous and harmful substance use behaviors among the general population. Although ASBI has proven to be successful, implementation rates remain low. Few studies have been conducted in Nevada to encourage or improve ASBI implementation in primary care. In order to better support Nevada policy decisions, this study investigates the proportion of ASBI …

Three Essays On Informal Payments In The Health Care Sector In Russia, Alexandra Polovinka

Dissertations

Health care is one of the most corrupt sectors in Russia. In 2015 twenty percent of patients paid a bribe for the health care services once or twice, and thirteen percent more than twice (Russian Public Opinion Research Center, 2015). Using data on adults from over 5,000 households in Russia, this three-essay study analyzes out-of-pocket formal (official) and informal (unofficial, bribes) payments for the health care.

In the first essay, I study whether there is a difference in the amount of unofficial pay-ments across five types of health care services (ambulance, inpatient, outpatient, dental, and medical checkups) and two types …

The Preferences Of Exercise And Physical Activity In Individuals With An Intellectual Disability, Zachary J. Burt

MSU Graduate Theses

The purpose of this study was to explore the preferences of exercise and physical activity in individuals with an intellectual disability. It took place during Bear Play, a physical activity program geared towards working with individuals with a disability at Missouri State University. This project was facilitated through the partnership of Missouri State University's Kinesiology department and the Arc of The Ozarks. A convenience sample was drawn from individuals participating in the program during the 2015-2016 academic year. Each participant was asked to complete a survey. Data were collected by using a survey administered on an IPAD and covered many …

Determining The Impact Of Anthropometric Factors On Rock Climbing Performance, Ryan T. Mitchell

MSU Graduate Theses

The purpose of this study was to determine whether anthropometric factors have an effect on overall performance in rock climbing between three different difficulties of rock walls. Fourteen, recreational rock climbers participated in this study (Age- 21.93+/-2.62y, Height- 176.8+/-11.1cm, Weight- 73.4+/-18.7kgs, % Fat- 21.02 +/- 6.41, BMI- 23.36+/-4.59). The anthropometric tests included: push-ups, sit-ups, pull-ups, vertical jump, and sit and reach. Immediately following these tests, the participants climbed the three different rock walls for approximately 10 minutes. The data collected is represented through the average number of climbs, distance traveled, and an RPE scale, to determine overall performance. A stepwise …

Understanding Conceptualizations And Structural Environment For Improving Pre-Pregnancy Planning For Adolescent Girls And Young Women In Harare, Zimbabwe, Chiwoneso Beverley Tinago

Theses and Dissertations

Zimbabwe has a high maternal mortality with adolescent girls and young women facing disproportionately high risk of maternal morbidity and mortality. Current approaches to reducing maternal mortality in Zimbabwe focus on the pregnancy period with antenatal care, obstetric care, and micronutrient supplementation during pregnancy. Although important, these approaches are not reaching a large number of women and may benefit from integration with pre-pregnancy approaches. The importance of pre-pregnancy interventions to promote young women’s health has been emphasized, yet many young women in developing countries like Zimbabwe do not have access to pre-pregnancy care because little is understood about the concept …

Practice Characteristics That Matter In The Provision Of Health Education Services By Primary Care Physicians, George Paul Newby Jr.

Theses and Dissertations

The onset of chronic disease is occurring earlier and more often in the lives of adult citizens of the United States. The literature has effectively demonstrated the efficacy that physician provision of health education services offers their patients and the positive effects it has for lowering risk factors for chronic disease. The literature has described the complexities physicians encounter in providing these services. The literature is not as plentiful in defining and describing the characteristics of physician practice that are associated with increased health education provision.

This study is an analysis of the factors that are associated with provision of …

Private Vs. Public Healthcare In South Africa, Montgomery Young

Honors Theses

This paper explores the South African healthcare system in regards to the gap between the private and public healthcare sectors. Public healthcare is government funded and offered to all citizens of South Africa, but there are many disadvantages such as long wait times, rushed appointments, old facilities, and poor disease control and prevention practices. Citizens can opt to purchase private insurance in order to be treated at private hospitals and health clinics. The private healthcare sector has many perks that set it apart from public healthcare, such as short wait times, appointments are not rushed, better facilities, and proper disease …

Transforming A Primary Care Practice Into A Patient Centered Medical Home, Heloise Lim

Doctor of Nursing Practice (DNP) Projects

Patient-Centered Medical Home (PCMH) recognition is a process and a road map to improving quality of and access to care. Extant studies have shown that adoption of the PCMH model of care has lowered healthcare expenditure by 15-20% (Nielsen, Langner, Zema, Hacker, & Grundy, 2012). In an effort to reduce healthcare cost in the United States, private and public sectors have embraced the philosophy of PCMH by developing national programs and initiatives for primary care practices to obtain PCMH recognition. A number of payers and health plans have used PCMH recognition as a means to validate high-performing practices and reward …

Increasing Compliance Of Bar Code Medication Administration In The Emergency Room, Clare Wisor

Seton Hall University DNP Final Projects

Purpose: To ensure quality healthcare, it is necessary to provide safe medication administration. The specific goal is the reduction of medication errors in the hospital setting with concentration in the emergency room (ER). Bar-code medication administration (BCMA) has proven to be effective on the in-patient units in the hospitals researched and visited as part of this project, but the issue still remains that the emergency rooms exhibit a decreased compliance rate. The purpose of this Doctor of Nursing Practice (DNP) project, is to reverse the situation in a local community hospital that has a 50 bed emergency room, promoting increased …

Prescription Strength Ibuprofen Interferes With Prophylactic Adaptations To Heavy Exercise, Jessica Ehrbar

Masters Theses, 2010-2019

Purpose: This proof of concept study was designed to assess the influence of prescription-strength Ibuprofen (IBU) on the repeated bout effect (RBE) of heavy exercise. METHODS: Eight males (23 ± 4 yrs) with no recent history of lower-body resistance training completed two separate testing phases separated by a seven-day washout period. Each phase consisted of two sessions of single-legged resistance exercise (RE), performed on the same leg, separated by ten days. One RE trial included 10 sets of 10 repetitions of maximal unilateral eccentric leg extensions at 120% 1RM. Each phase was characterized by a distinct treatment of either 800mg …

Impact Of Emergency Department Sepsis Policy, Lynette Rayman

Evidence-Based Practice Project Reports

Sepsis is a serious concern of key healthcare stakeholders due to high incidence, mortality, and cost. The objectives of this evidence-based project were to 1) identify potential sepsis patients early during the emergency department (ED) triage process and 2) implement Sepsis Order Sets. Kotter’s change model and the Stetler model of evidence-based practice guided this project. An extensive literature search was undertaken to find best practice evidence regarding care of sepsis patients. Recommended care includes a protocolized format utilizing a screening tool and point of care lactate levels for early identification of sepsis, and early treatment with antibiotics and fluid …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Assessing The Role Of Faith-Based Organizations In Health Promotion, Troylyn Braud Francis

Theses and Dissertations (ETD)

Objective: The objective of this analysis was to evaluate the relationship between organizational readiness (OR) and weight loss and physical activity outcomes among faith-based organizations (FBOs).

Methods: Data for this study were collected in two phases. Phase I data were based on a feasibility study and targeted African-American individuals (N = 55) who participated in an obesity prevention program. The intervention was accomplished in two stages, which included a 10-week core period followed by a 6-month maintenance period. Phase II data were based on key informant interviews that were conducted with community health leaders (CHLs) (N=6) from participating …