Health and Medical Administration Commons^™

Why A Women’S Domestic Violence Long-Term Shelter Is Needed, Markquatt Ford

Walden Dissertations and Doctoral Studies

This qualitative project provided a content analysis of primary and secondary data to do a need assessment of how a short-term shelter, a home for victims of domestic violence in Kansas City, Mo, can turn into a long-term shelter for victims of domestic violence. This organization was a short-term shelter, a not-for-profit organization that works for the positive social change and rehabilitation of female victims of domestic violence in Kansas City, Mo. The organization followed a traditional organizational model with a short-term scope of action. A long-term shelter is supposed to provide the residents with sufficient programs for recovery to …

Implementation Of A Nonverbal Scrub Cap Identification System To Improve Communication And Perception Of Patient Safety Among Unfamiliar, De-Identified Staff Members In The Operating Room., Keri Ann Roskowinski

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Operating room (OR), professionals deliver patient care with brief introductions, and roles were not always identified, and although team members wear identification (ID) badges, they were usually covered by sterile gowns and other routine personal protective equipment (PPE). Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to determine if a simple intervention to apply the individual’s name and role to a scrub cap could improve identification, OR team communication, and consequently, patient safety. The participants in this project consisted of nurses, physicians, anesthesia providers, scrub technicians, students, medical sales representatives, and those that identified as …

Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw

Walden Dissertations and Doctoral Studies

In the United States, the total cost for vaccine preventable diseases was $8.95 billion in 2015. The unvaccinated accounted for 80% of the total costs. This quantitative study was conducted to investigate the success and/or gaps in the implementation of the measles, mumps, and rubella (MMR) vaccine through the Vaccine for Children (VFC) Program by the Ohio Department of Health. General systems theory was chosen as a theoretical framework due to the complicated nature of the healthcare system. Healthcare is a complex system composed of multidisciplinary units that have their own structure and purpose that interact to accomplish the mission …

Nurse Staffing And Leadership Support On In-Patient Hospital Safety, Kearia Deresa Watson-Orr

Walden Dissertations and Doctoral Studies

In-patient hospital safety relates to healthcare facilities protecting patients from medical errors. The “problem of many hands” exists, where there is a gap in understanding who is responsible for in-patient hospital safety, nurse staffing, or leadership support. The purpose of this quantitative study was to determine the association between nurse staffing (nurse-to-patient ratios and hours worked) and in-patient safety (perception of in-patient safety by nurses) as well as the association between leadership support (work climate promotes patient safety and actions of hospital management to show that patient safety is a top priority) and in-patient safety (perception of in-patient safety) based …

Implementation Of Lean Principles During Operating Room Turnovers, Makenzie Marshall

Doctor of Nursing Practice Projects

Background

Many operating rooms across the country face the daunting task of making their turnovers between surgical patients quicker and more efficient. Turnover time is defined as the time it takes to clean an operating room and set up the next sterile field between surgical patients. The time begins when the patient leaves the operating room suite and stops when the next patient enters the same suite. Running an operating room is a complex and costly endeavor, and even small shortfalls can have a snowball effect, leading to delays, wasteful spending, and substandard patient outcomes; therefore, it is imperative to …

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 …

Generational Differences In Nursing Turnover, Adam Bennett

Walden Dissertations and Doctoral Studies

Nursing is currently the largest job category in U.S. health care requiring proper recruitment and retention of nurses. As the current generation of nurses ages out of the workforce due to retirement, new nurses will need to cover the gaps in the workforce. The purpose of this quantitative correlational study was to examine the relationship between voluntary turnover, involuntary turnover, and career change among nurses who were born between 1980 and 1995 (Millennials) and those born between 1965 and 1979 (Generation X). The theoretical framework was Mannheim’s theory of generations. Secondary data were collected from exit interviews with 811 respondents …

Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter

Walden Dissertations and Doctoral Studies

AbstractHistorically, the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community has reported low patient satisfaction for health care. The purpose of this quantitative study was to examine the statistical relationship between patient satisfaction among LGBTQ patients (independent variable) and patient volume and hospital revenue (dependent variables) in the U.S. state of Georgia. The study was grounded on Andersen's model of healthcare utilization. Two research questions guided this study related to the statistical relationship between hospital revenue and patient satisfaction within health systems and the statistical relationship between patient satisfaction and patient volume. The study included 567 members of the LGBTQ …

Promoting Wellness And Preventing Burnout: Our Success Story, Judith Schultz Cstr, Caiss, Carol Fox Ma, Rn, Ccrn

Administration & Leadership

No abstract provided.

The Importance Of Violence Prevention Coordinators To Your Trauma Program, Carol Fox Rn, Ma, Ccrn, Melissa Mee

Administration & Leadership

No abstract provided.

Scoping Review: Konsep Layanan Kedokteran Olahraga Di Rumah Sakit, Bunga Listia Paramita, Dumilah Ayuningtyas

Jurnal Keolahragaan

Kedokteran olahraga berperan penting dalam pelaksanaan "exercise is medicine". Sayangnya, Indonesia belum memiliki dasar kebijakan yang kuat tentang layanan kedokteran olahraga di rumah sakit sebagai salah satu dukungan kesehatan bagi atlet dan siapa saja yang ingin aktif berolahraga. Penelitian ini bertujuan untuk memetakan konsep layanan kedokteran olahraga di rumah sakit mulai dari jenis layanan, personel, bangunan dan infrastruktur, dan peralatan dengan menggunakan metode scoping review berdasarkan Preferred Reporting Items for Systematic Reviews and Meta-Analyze Extensions for Scoping Reviews melalui Pubmed, Google Cendekia, Springeropen, Direktori Open Access Journal, dan Portal Garuda. Hasilnya dikelompokkan dengan pendekatan klasifikasi rumah sakit umum …

Caring For Older Adults In The Hallway Of A Crowded Emergency Department, Rebecca Weeks, Kathy Sawasky, Michael Malone

Journal of Geriatric Emergency Medicine

This paper describes strategies for emergency department providers to address the needs of older adults when facilities are overcrowded and care extends into the hallway.

Pharmacy-Led Medication Reconciliation Program Reduces Adverse Drug Events And Improves Satisfaction In A Community Hospital, L. Hayley Burgess, Joan Kramer, Carley Castelein, Joseph M. Parra, Victoria Timmons, Samantha Pickens, Sarah Fraker, Christopher Cameron Skinner

HCA Healthcare Journal of Medicine

Background

Pharmacy-led medication reconciliation identifies and corrects medication errors that can potentially cause moderate to severe harm. This research sought to identify the impact of pharmacy-led medication reconciliation on patient outcomes and describe the changes in healthcare workers’ perceptions of the program.

Methods

A pharmacy-led admission medication reconciliation program pilot started in July 2019, and a discharge medication reconciliation proof of concept was tested in September 2020 at a 432-bed hospital. The following periods were compared: August 2018 to February 2019 (pre-program implementation) and August 2019 to February 2020 (post-program implementation). Endpoints included patient outcomes, workforce productivity and interdisciplinary healthcare …

Feeling Not Wanted/Loved And Depression: Does Gender Matter?, Manik Ahuja, Joy Okoro, Esther Frimpong, Riddhi P. Doshi, Rajvi J. Wani

ETSU Faculty Works

Depression affects over 17 million American adults yearly and has been identified as the leading cause of disability in people between the ages of 15 and 44 years. There is evidence that feeling neglect or a lack of parental attachment during childhood is associated with depression. One construct that has been overlooked is love from a parent. The purpose of this study was to analyze the association between individuals who felt not wanted/loved during adolescence and lifetime depression and to examine this association by gender. We examined 5114 participants aged 24–32 years at Wave IV of the National Longitudinal Study …

Evolution Or Revolution In Telehealth Regulation, George Horvath

Texas A&M Law Review

A frequently repeated adage, attributed to a wide range of authors and orators, holds that a serious crisis should never be allowed to go to waste. The moment in which we find ourselves renders this adage particularly timely. Responses to one of the defining crises of our age—the COVID–19 pandemic—have mostly been reactive. This includes the responses of multiple actors involved with telehealth. Congress, federal regulators, state legislatures, state regulators, private insurers, and health care providers, confronting the challenges of the pandemic, have responded by making ad hoc adjustments to the regulation and use of telehealth. Moving the conversation beyond …

The “Ebb And Flow” Of Documentation: Does The Transition Between Two Electronic Medical Records Systems Affect Emergency Department Efficiency?, Michelle Angeline Md, Erica B. Shaver Md, Christopher Kiefer Md, Kimberly D. Quedado Phd, Melinda Sharon, Stephen Davis Phd, Kyle Hurst Md, Christopher S. Goode Md, Thomas C. Marshall Md

Faculty & Staff Scholarship

Background: Electronic Medical Record (EMR) systems are electronic databases for compiling patient records. As healthcare networks expand, it is critical for providers to have access to patient data more broadly. As a result individual healthcare facilities must adjust to enterprise wide EMRs.

Objective: This study examined the operational effects of transitioning from an Emergency Department (ED) specific EMR to an enterprise wide EMR by evaluating throughput metrics in a community ED.

Methods: During a 6-month transition period (July-December 2017) in a community-based, academic ED located in North Central West Virginia, length of stay (LOS) and the following operational metrics were …

Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction

Postgraduate programs for PAs provide formal postgraduate training for clinical specialty areas. These programs are intended to provide intense specialty training in various fields, as well as to standardize education beyond the entry level. The purpose of this descriptive study was to determine if there are consistent trends or clear differences in program length, approach to training, validation of learning, and accreditation through the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for postgraduate programs with a surgical focus in the United States.

Methods

This study is a non-experimental and descriptive research design. Program directors were mailed …

Health Care Capacity Surge Strategies, Jennifer L. Wenhold

Florida Public Health Review

While streamlining emergency powers might offer some advantages, recent events demonstrate how Florida’s Department of Health worked collaboratively to address the Novel Coronavirus Disease 2019 (COVID-19) pandemic. As Florida began experiencing a need for increased health care capacity, Division of Medical Quality Assurance (MQA) officials reviewed health care practitioners’ licensing and regulatory framework to identify mitigation strategies to boost staffing of front-line responders where needed. Florida officials responded quickly to the spread of COVID-19 and adopted health care workforce strategies that were grouped into three categories: (1) those involving licensed practitioners, (2) those involving soon-to-be licensed practitioners, and (3) those …

Discharge Process Optimization, Erin M. O’Neal

Doctor of Nursing Practice Projects

As the demands of the nurse become increased with higher acuity and documentation requirements, the delivery of discharge instructions is often one of the most, and at times, only, formal education opportunities between the nurse and the patient. It is imperative to modify the discharge process to ensure patients have the ability to confidently care for themselves after they leave the hospital. The aim of this project was to create a nursing discharge workflow that meets the educational needs of the patients. This project was a quality improvement project designed to change the nursing workflow to provide a better discharge …

Hormone Therapy For Treatment Of Depression, Johna Beard

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads to …

Enhanced Recovery After Surgery: Necessity Of Real Time Tracking In Quality Measures And Outcomes, Emily Owens

Master's Projects and Capstones

Abstract

A High Reliability Organization (HRO), such as this Northern California Medical Center, holds itself to high standards of performance in the areas of recognition, ranking, and accreditation. The commonality between these high-scored and valuable acknowledgements is the pillars of Quality Outcomes. As benchmarking and reporting allow this facility to measure outcomes against self and other plans, it greatly strengthens the internal focus for continual improvement and goal setting in direct patient care and outcomes. A deeper layer of the Quality Department includes the bundle “ERAS – Enhanced Recovery After Surgery”, which is compiled of principles aiming to minimize opioid …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the …

Careless, Brenna Holland

Capstones

About This Project

I began working on this project six months ago, but my interest in the home care industry can be traced much further back. In the mid-aughts, my grandfather was diagnosed with Alzheimer’s. Hoping to live independently for as long as possible, he sought out the help of an in-home health aide. It was then that he learned he fell into a coverage gap; one that, even today, prevents many Americans from accessing home care services.

Faced with two options—father-son cohabitation or an institution—my grandfather moved in with my family, where he slipped into a catatonic depression prompted …

Patient Placement Matters: The Impact Of Unnecessary Lateral Movement On Patients, Jacqueline Strinden

Doctor of Nursing Practice (DNP) Projects

Patient Placement Matters: The Impact of Unnecessary Lateral Movement on Patients

Abstract

Background: National trends to decrease the number of licensed beds have created inpatient capacity constraints which have resulted in increased unnecessary lateral patient movement events, which contribute to decreased patient safety and quality of care. The incidence of adverse events increases significantly when multiple unnecessary lateral relocations result from secondary efforts to relieve hospital capacity constraints and improve efficiency.

Problem: At a 352 acute care hospital, 12,906 patient movement events were evaluated over a baseline period of three months resulting in an average of 1.48 unnecessary lateral patient …

Chosen Family: One Woman’S Fight To Become Her Best Friend’S Next Of Kin, Yessenia M. Moreno

Capstones

Nearly 70,000 people have died of COVID-19 in the state of New York. For the queer community, this time of death and mourning has highlighted how complicated things can get at the end of someone’s life.

This audio documentary, “Chosen Family, ”is the story of one woman’s fight to overcome the legal system and become her best friend’s health care proxy in the final battle of his life .

Link to capstone project: https://medium.com/@yessimoreno/7b3d96691b9f

Improving Medication Administration Safety In A Correctional Facility With An Electronic Medication Administration System, Rosalinda Salazar

Master's Projects and Capstones

Problem: According to the World Health Organization (2020), medication errors are one of the leading causes of injury and avoidable harm in health care globally.

Context: The county jail houses approximately 700 inmates/patients on a daily basis, and the potential for error when administering medications is high as medications are prepared manually using a paper medication administration record.

Interventions: The jail began using an electronic health record/barcode administration system on October 19, 2020.

Measures: Unusual occurrence reports related to medication errors were reviewed. The time frame included 6 months before electronic implementation, and 6 months after implementation.

Results: Unusual occurrence …

Development And Implementation Of An Evidence-Based Practice Mentor Fellowship, Stacy L. Alves

Doctor of Nursing Practice (DNP) Projects

Background: The Institute of Medicine (2008) set a goal that 90% of healthcare decisions would be based on the best evidence possible by 2020, yet many challenges remain. Common barriers include clinicians’ beliefs about the value of evidence-based practices, their competency to implement it, and systems issues such as time, resources, and organizational value and preparedness (Melnyk et al., 2017).

Local Problem: A hospital within an integrated health care system sought to increase the use of EBP for clinical decision making. A gap analysis revealed a lack of sufficient EBP mentors to lead efforts to promote system-wide EBP implementation.

Context: …

Feasibility Of A “Network Of Champions” In Implementing A Program To Address Physician Well-Being, Kerri Palamara, Sara Poplau, Cheryl Rusten, Maria L. Walter, Cynthia D. Smith, Clare Sipler, Susan Hingle, Mark Linzer

Journal of Wellness

Introduction: Healthcare leaders have been challenged to mitigate burnout and foster well-being among physicians. Professional societies are beginning to address this in a systematic manner.

Methods: In 2014, the American College of Physicians (ACP) endeavored to improve well-being for its 160,000 members of internists and trainees through a Well-being Champion (WBC) program based in the majority of its 85 national and international chapters. The program was supported by an evidence-based curriculum, chapter volunteers who served as champions, and in-person and virtual trainings. Training included a 1-2 day program in 2018 and 2019, focused on educating champions on causes …