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2023

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Full-Text Articles in Health and Medical Administration

Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones Jan 2023

Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones

Walden Dissertations and Doctoral Studies

Underrepresentation is a significant issue for Black female nurses to secure nurse leadership positions in healthcare facilities. Leadership by Black female nurses is needed to provide culturally appropriate quality of care, to have a more diverse workplace, and to ensure that the needs of diverse patient populations are met. The purpose of this quantitative study was to explore the barriers and challenges faced by Black female nurses who failed to achieve their advancement goals into leadership roles.Using the National Sample Survey of Registered Nurses (NSSRN) database, the independent variables used were interpersonal differences with colleagues or supervisors, lack of good …

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Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell Jan 2023

Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell

Walden Dissertations and Doctoral Studies

AbstractThis project sought to enhance the care offered in a local clinic to individuals with an intellectual and developmental disability (IDD) during the COVID-19 pandemic. Individuals with IDD are faced with the challenges of coping with some social conditions. Mainly waiting for extended periods in a doctor’s office can be challenging. To reduce this population’s waiting time, a staff education program was developed to address this concern. Currently, this local clinic did not have a prescreening exercise that would meet the needs of this population. This DNP project aimed to develop a staff education program for staff in a primary …

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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

AbstractMany 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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Impact Of A Workplace Wellness Program On Health Literacy And Type 2 Diabetes Management Among Blue-Collar Workers In South Carolina, Caitlin E. Townsend Jan 2023

Impact Of A Workplace Wellness Program On Health Literacy And Type 2 Diabetes Management Among Blue-Collar Workers In South Carolina, Caitlin E. Townsend

Walden Dissertations and Doctoral Studies

The prevalence of chronic diseases and their management is significantly different between blue- and white-collar employees. Social determinants of health are determining factors of health for blue-collar manufacturing employees in South Carolina. Type 2 Diabetes is a complex chronic condition that has been associated with serious co-morbidities, but it can be managed and/or treated. Workplace wellness programs provide an ideal setting for health education and promotion efforts targeted toward population health management. While workplace wellness programs have been proven successful, there is limited research on the relationship and impact on health literacy. This quantitative, descriptive study used secondary data to …

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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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Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu Jan 2023

Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu

Walden Dissertations and Doctoral Studies

Nurse turnover is a significant problem that hospital managers and administrators face in delivering high-quality patient care while ensuring organizational profitability. In the United States, the average cost of replacing a nurse ranges from $40,000 to $100,000. Hospital managers are significantly challenged to reduce nurse turnover and keep costs down. Grounded in the Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore the strategies hospital managers use to reduce nurse turnover. The participants included five hospital managers at five medical centers in Arizona with successful experience in reducing nurse turnover. Data were collected from semistructured interviews …

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Trauma-Informed Practices For Behavioral Health Leaders Serving Sex-Trafficking Survivors And Personnel, Evelyn Cordero Molina Jan 2023

Trauma-Informed Practices For Behavioral Health Leaders Serving Sex-Trafficking Survivors And Personnel, Evelyn Cordero Molina

Walden Dissertations and Doctoral Studies

Trauma-informed practices are essential to successful treatment outcomes and employee wellness in the context of sex trafficking clinical intervention. This single case study described the trauma-informed practices developed in a residential program for biologically-female sex trafficking survivors in the Southwest United States. The Baldrige excellence framework and the trauma-informed framework informed the study to comprehend organizational key factors and principles in the context of the residential program. Data were collected through semistructured interviews with four leaders at the senior and middle management levels, and internal documentation such as procedures, protocols, strategic plans, and yearly reports were included in the analysis. …

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Examining The Relationship Between Time Spent On Tasks, Job Responsibilities, And Job Satisfaction Among Nurse Practitioners, Iasia E. Owens Jan 2023

Examining The Relationship Between Time Spent On Tasks, Job Responsibilities, And Job Satisfaction Among Nurse Practitioners, Iasia E. Owens

Walden Dissertations and Doctoral Studies

Managing patient care with the help of nurse practitioners is an expanding trend in healthcare and achieving job satisfaction is a priority for these professionals. The purpose of this quantitative study was to examine two research questions and the associated variables concerning the relationship between time spent on tasks, job responsibilities, and job satisfaction among nurse practitioners. Conway’s role theory, which is used to explore and predict behaviors of workers in certain roles, informed this study. Data were derived from the 2017 National Survey of Nurse Practitioners and 972 participants were included. Correlation and linear regression analyses were used to …

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Influence Of Nurse Residency Programs On Turnover Intent For New Nurse Graduates, Ashley Raye Peters Jan 2023

Influence Of Nurse Residency Programs On Turnover Intent For New Nurse Graduates, Ashley Raye Peters

Walden Dissertations and Doctoral Studies

Nursing turnover and nursing intent to leave is increasing due to burnout, retirement, and a competitive labor market. The purpose of this quantitative study was to determine whether there were statistical differences in turnover intent for nurses with new associate degrees and nurses with new bachelor’s degrees after participation in a nurse residency program. The theory of cognitive dissonance formed the foundation for the two research questions concerning whether there was a difference in turnover intent for nurses with associate degrees and nurses with bachelor's degrees after initial completion of a new nurse residency program and after a year of …

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Impact Of Pulmonary Embolism Response Teams On Patient Quality Ratings, Sabrina Renee' Simpkins-Morris Jan 2023

Impact Of Pulmonary Embolism Response Teams On Patient Quality Ratings, Sabrina Renee' Simpkins-Morris

Walden Dissertations and Doctoral Studies

AbstractLeaders of health care organizations have limited evidence of the impact of pulmonary embolism response teams (PERTs) on quality outcomes for patients with an intermediate and high-risk pulmonary embolism (PE). The purpose of this quantitative study was to determine whether there was any significant difference in patient HCAHPS linear mean scores for instructions given about medication and overall care between acute care hospitals with and without PERT teams. Donabedian’s framework for assessing health care quality was used as the theoretical foundation for this research. Survey data collected by the Centers for Medicare and Medicaid, as part of its Hospital Consumer …

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Perioperative Nurses' Perceptions And Barriers To Implementing The Colorectal Surgery Care Bundle, Kaydian Kerry-Ann Grant Jan 2023

Perioperative Nurses' Perceptions And Barriers To Implementing The Colorectal Surgery Care Bundle, Kaydian Kerry-Ann Grant

Walden Dissertations and Doctoral Studies

AbstractDespite evidence that surgical care bundle usage prevents surgical site infections (SSIs) in colorectal surgeries, there is a consistent increase in SSIs. Perioperative nurses are in a unique position to provide insight into the process for colorectal surgical care bundle usage, yet little is known about how perioperative nurses view the process. The perioperative patient focused model was used in this qualitative interpretative phenomenological study to examine the perceptions of perioperative nurses regarding the use of colorectal surgery care bundle and its role in preventing SSIs in patients undergoing colon and rectal surgeries. Sixteen perioperative nurses who were members of …

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Organizational Characteristics As Predictors Of Hospital Accreditation, Rebecca B. Graystone Jan 2023

Organizational Characteristics As Predictors Of Hospital Accreditation, Rebecca B. Graystone

Walden Dissertations and Doctoral Studies

Abstract Hospital accreditation has had wide and longstanding acceptance as a key quality tool to drive efficient, effective healthcare. Researchers have more recently questioned factors commonly related with accreditation achievement given accreditation’s general association to better patient care, risk management, and cost reduction. Even less information was known about predictors of accreditation failure, which could be addressed by hospital administrators in advance of seeking application. Accordingly, the purpose of this cross-sectional study was to examine if hospital structures and processes were predictors of accreditation failure. The research questions explored hospital size, ownership status, geographic location, hospital leadership, empowerment, practice, and …

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Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry Jan 2023

Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry

Walden Dissertations and Doctoral Studies

Over the last 10 years, institutes of higher learning (IHLs) in the southeastern United States have endured natural disasters that have caused flooding, water, and wind damage and resulted in student evacuations, class disruptions, and building damage. IHLs are further challenged with resuming campus operations despite the emotional impact resulting after a natural disaster occurs. There is limited research relative to the experiences of campus leadership who share the responsibility of keeping students, visitors, and university artifacts safe during and after a hurricane-related event. This research study served as a qualitative phenomenological assessment of campus leadership experiences during a post-hurricane-related …

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The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik Jan 2023

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …

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Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed Jan 2023

Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed

Walden Dissertations and Doctoral Studies

Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care …

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Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande Jan 2023

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

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Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

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Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr Jan 2023

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

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The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins Jan 2023

The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins

Walden Dissertations and Doctoral Studies

Patient satisfaction has been utilized to measure healthcare quality and outcomes, which affects reimbursement. Some claim such measures could be biased as they do not consider the patient’s socioeconomic status. Measuring the quality of care, Area Deprivation Index (ADI), and patient experience has been captured and publicly reported; and the measuring indicator Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS), however, hospitals serving patients in low ADI areas generally score poorly. Grounded in the theory of Donabedian, the purpose of this quantitative correlational study was to examine the relationship between patient experience associated with socioeconomic disparities and how patients …

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Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike Jan 2023

Respiratory Therapists’ Perceptions Of Their Roles In A Copd Multidisciplinary Care Team, Iheako Charles Ike

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this study was to explore respiratory therapists’ (RTs') perceived roles and responsibilities in a COPD multidisciplinary care team, and how those roles and responsibilities were affected when RTs were monitored and evaluated by a team member. Accountability theory was used to guide the development of this study. The study’s goal was to provide needed information on the specific roles and responsibilities of RTs in a COPD multidisciplinary care team because RTs knowing their roles and responsibilities could improve the quality of care and enhance the delivery of healthcare services for patients with COPD. The study’s research method …

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Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder Jan 2023

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

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Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch Jan 2023

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

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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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