Health and Medical Administration Commons^™

Understanding Willingness Towards Deprescribing Among Older Adults With Osteoporosis, Queenie Paltanwale

Electronic Theses and Dissertations

Objectives: To describe and identify the socio-behavioral factors predicting willingness towards deprescribing among older adults with osteoporosis.Design, Setting, and Participants: For this population-based survey study of US Medicare beneficiaries, data was obtained from the Medication Attitudes Module distributed to the participants in Round 6 (2015) of the National Health and Aging Trends Study. Our study population consisted to respondents who were diagnosed with osteoporosis in round 6 or earlier and who responded to the Medication Attitude Module. Main outcome and Measures: Response to the statement “I would like to reduce the number of medicines I am taking” was the main …

The Medicalisation Of Gender Nonconformity Through Language: A Keywords Analysis, Angelo Cosma Galluzzo

sprinkle: an undergraduate journal of feminist and queer studies

Language is an important part of the way gender nonconformity is legislated and medicalised. In 2012, the American Psychiatric Association (APA) changed the nomenclature of the ‘gender identity disorder’ (GID) to ‘gender dysphoria in the ‘Diagnostic and Statistical Manual of Mental Disorders (DSM) to reduce the social stigma attached to transgender identities. While the recognition of gender nonconformity by the medical authorities has led to some beneficial consequences, scholars have shown that the language of pathology has narrowed the definitions of gender nonconformity and has created social stigma. I use the web pages of five major health providers of English-speaking …

Exploring The Influence Of Self-Efficacy And Autonomy On Outdoor Recreation Behaviors During The Covid-19 Pandemic, Katheryn E. Carpenter

Graduate Theses/Dissertations

Outdoor Recreation (OR) provides the benefits of physical activity and traditional leisure along with the addition of the benefits associated with an outdoor environment. Self Determination Theory (SDT) and Social Cognitive Theory (SCT) state that self-efficacy (SE) and autonomy can increase depending on the physical and social environment. The purpose of this study was to explore the relationship between self-efficacy and autonomy on OR behaviors during the COVID-19 pandemic. It was hypothesized there would be a correlation between individuals who participate in OR activities and self-efficacy as well as autonomy. The research also explored barriers and facilitators to OR via …

Go Talk To Your Employee: A Sequential Mediation Analysis Of Leader Communication Frequency And Employee Turnover Intent, Max Weaver

Electronic Theses and Dissertations

Employee turnover has significant negative costs to healthcare organizations. While leadership communication styles and quality have been empirically supported to reduce turnover intentions, our understanding of specific modalities of leader intervention is not well understood. This paper sought to understand how the specific act of communication frequency reduces turnover. Through the lens of Leader-Member Exchange (LMX) and role dynamic theories, mediating effects of LMX quality and job satisfaction were investigated to further understand this proposed relationship in a sample of healthcare workers in the Midwest/US. Results indicate that communication frequency was negatively related to turnover intent. Furthermore, while LMX and …

J Mich Dent Assoc January 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “The Dentist’s Role in Recognizing Sleep-Disordered Breathing in Children”.
• A feature article, “Dental Sleep Medicine Education: Do You Want a Nap or a Full Night’s Sleep?”.
• The feature article, “In-office Plans: Where Are We Now? What Have We Learned?”
• News you need, Editorial and regular department articles on MDA Foundation activities, …

10-12-2021 Hsc Committee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Blue Light And Adult Sleep Outcomes, Andrew Caddas

Undergraduate Distinction Papers

This study investigated the effects blue light from self-luminous devices has on adult sleeping patterns. We investigated sleep quality and duration qualitatively with a randomized, double-blind, cross-over, placebo-controlled design with a wash-out period. Participants wore blue light blocking lenses or placebo lenses whenever they were using a self-luminous device throughout each day for one week. Each morning, participants filled out a survey to report their number of hours slept, time to fall asleep, and amount of time spent on self-luminous devices. Participants took the Pittsburgh Insomnia Rating Scale (PIRS) at the end of the one week trial (See Appendix A). …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

Improving Employee Engagement On An Inpatient Unit: A Quality Improvement Project, Holly Mccormack

DNP Scholarly Projects

BACKGROUND: Engaged employees are paramount to the success of an organization. They are more invested in their organization and the unit on which they work. This investment in the organization results in higher patient satisfaction and safety, less staff turnover, and improved quality. According to the literature, generational differences may be necessary to consider when improving employee engagement. To successfully lead a multigenerational workforce, nurse leaders should consider these differences and incorporate them into their strategic plan for employee engagement.

METHODS: A pilot survey was conducted on a medical-surgical unit to assess a perceived lack of engagement. Subsequently, work engagement …

Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger

Walden Dissertations and Doctoral Studies

People who have not overcome childhood trauma and who have developed mental illnesses have difficulties dealing with life challenges. The purpose of this quantitative study used a correlational design to test any relationship between childhood trauma experience levels and resilience against life challenges in adulthood. The theoretical framework used for this study was Barnes’ social support theory. Data were collected from 104 participants over a 7-week period. Participants voluntarily answered the ACE questionnaire, 2-way support scale, and resilience scale. Key results indicate that people with mental illness who receive social support are positive impacted by that support. Receiving adequate levels …

Understanding Perspectives Of Clinical And Non-Clinical Healthcare Administrators On Culture And Diversity In The Healthcare Workplace, Katherine Counts

Theses and Dissertations--Community & Leadership Development

The racial and ethnic composition of the U.S. population is becoming increasingly more diverse. The 2010 U.S. Census reported a 29% increase in minority groups other than non-Hispanic Whites. In response to these changing demographics, healthcare organizations have struggled to keep pace with these trends in their hiring of a diverse staff. Healthcare leaders appear to be lagging in their efforts to make adequate changes to increase diversity in their organizations. What factors may be contributing to this inequity? One possible explanation is a limited knowledge of healthcare leaders regarding culture and diversity within the workplace. To this end, this …

Large Scale Organizational Intervention To Improve Emergency Department Throughput In A Community Hospital, Karen Elliott

DNP Scholarly Projects

Abstract

BACKGROUND: Emergency Department boarding is a well-documented systemic problem across the country. ED-2b, the time from decision to admit a patient to Emergency Department departure, is specified by the Joint Commission as a quality measure for Emergency Department boarding. ED-2b metrics have been a longstanding challenge at this community hospital outside the nation’s capital. The aim of this study was to reduce median ED-2b times by 10% compared to fiscal year 2020 (FY20). To accomplish the reduction in time, a multidisciplinary throughput committee was developed with subsequent action plans designed to improve Emergency Department throughput.

METHODS: The Plan Do …

Mortality Outcomes In Therapeutic Versus Prophylactic Anticoagulation In Obese Patients In Predominantly Hispanic Population, Dave Patel, Moktar Ahmed Sheikh-Salah, Raul Garcia, Jewel Udenwagu, Jose Campo Maldonado, Christopher Romero

MEDI 9331 Scholarly Activities Clinical Years

Introduction: As of January 26, 2021, there have been 1,988,063 confirmed cases with 34,701 fatalities from COVID-19 in the state of Texas. As the fatalities increased in Rio Grande Valley, there was overwhelming evidence that showed that obesity, an already hypercoagulable state, was a risk factor that contributed to the severity of COVID-19 infection (Sanchis-Gomar, et. Al. 2020). The prevalence of obesity amongst the population in in the RGV presents an opportunity to correlate trends in outcomes with the obese population that are admitted for inpatient management of COVID-19.

Materials and Methods: This retrospective cohort study looks at patient’s electronic …

Potential Perioperative Complications Due To Difference In Timing Of Systemic Heparinization During Ruptured Aneurysm Coiling, Rouzbeh Kotaki, Ameer E. Hassan, Wondwossen G. Tekle

MEDI 9331 Scholarly Activities Clinical Years

Potential Perioperative Complications Due To Differences in Timing Of Systemic Heparin Distribution During Ruptured Aneurysm Coiling

Introduction:

In general, systematic heparin anticoagulation is standard in regards to neurovascular intervention. When coiling ruptured aneurysms, many neurointerventionalists have their own protocol as to timing of systemic heparinization. There is ample research and literature reviewing the frequency of perioperative events, predictors and outcomes, as well as the efficacy in the use of anticoagulants and/or antiplatelets before, during, and after neurovascular procedures to prevent adverse outcomes. However, there currently exists a dearth of research in regards to timing of distribution of heparin intraoperatively and …

The Impact Of The Hospital Value-Based Purchasing Program On Healthy Days, Health Inequity, And Hospital Community Benefit Spending, Samhita Kadiyala

Scripps Senior Theses

The Hospital Value-Based Purchasing Program (HVBP) is a Centers for Medicare and Medicaid Services (CMS) program implemented in 2012 to reward acute-care hospitals with incentive payments for the quality of care provided to Medicare patients in inpatient settings. Under this policy, payment adjustments are made based on a variety of factors including clinical quality, patient experience, and cost reductions. This paper uses state-level variation in the implementation of HVBP to ascertain whether the policy led to improvements in Healthy Days (a CDC-designed composite measure of individuals’ self-reported number of physically and mentally “healthy” days per month), health disparities, and community …

Dental Practice Success Special Issue: Financial Foundations For The New Dentist (January 2021), American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

The Attitudes And Perceived Barriers Regarding The Practice Of Evidence-Based Management Among Healthcare Managers In Saudi Arabia, Njoud Alsubaie, Bussma Bugis

Internet Journal of Allied Health Sciences and Practice

Purpose: The study purpose was to explore attitudes and identify perceived barriers regarding the practice of evidence-based management (EBMgt) by healthcare managers. Method: A cross-sectional descriptive study was conducted using a simple random sample. The study population included middle- and lower-level healthcare managers at a specialized hospital in Saudi Arabia. A total of 165 healthcare managers were invited to complete a hard copy-survey. Results: The surveys were completed by 120 respondents, yielding a response rate of 72%. The study results showed that most of the participants had a favourable attitude towards the practice of EBMgt. However, a lack of …

Developing And Evaluating Strategies To Implement An Insulin Patient Decision Aid In An Academic Primary Care Clinic In Malaysia, Tong Wen Ting

Student Works (2020-2029)

Patient decision aids (PDAs) are decision-making tools to facilitate shared decision-making; however, their routine use in clinical consultations is still lacking. This study aims to develop and evaluate strategies to effectively implement a locally developed insulin PDA in an academic primary care clinic in Malaysia. This implementation study began with a qualitative exploration to identify PDA implementation barriers in Malaysian public healthcare settings (Phase 1). In Phase 2, an implementation intervention was systematically developed for the insulin PDA in an academic primary care clinic. This involved stakeholders using a multi-voting technique to prioritise Phase 1 barriers. Next, strategies were identified …

The Precaution Adoption Process Model In Describing Emergency Action Plan Adoption, Samantha E. Scarneo-Miller, Douglas J. Casa, Shuang Yin, Timothy E. Moore, Yuki Murata, Johna Kay Register-Mihalik, Lindsay J. Distefano

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to identify the ability of the Precaution Adoption Process Model (PAPM) to classify athletic trainers (ATs) and athletic directors (ADs) readiness to act with regards to adopting an emergency action plan (EAP), and describe factors influencing PAPM stages. Method: We used a cross-sectional questionnaire design to evaluate readiness to act for developing an EAP among ATs and ADs working in United States high schools. The PAPM is a participant-driven model to identify someone’s readiness to act or change and has seven stages: Unaware, Unengaged, Undecided, Decided not to Act, Decided to Act, Acting …

From The Legal Literature: Covid And The Criminal Law, Francesca Laguardia

Department of Justice Studies Faculty Scholarship and Creative Works

No abstract provided.

Developing An End-Of-Life Discussion Protocols, James Hawley

Rural Health Professions Projects

End of life (EOL) issues are far too often addressed reactively in Emergency Departments when patients can no longer express their wishes. This scenario can result in unwanted futile care, increased healthcare costs, and emotional hardships for family and healthcare workers. The purpose of this quality improvement project was to implement a provider-patient communication protocol that would shift advanced directive conversations proactively back into the local rural primary care setting.

11-30-2021 Hsc Committee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

The Strategic Orientation Of Skilled Nursing Facilities, Jennifer R. Palazzolo

Theses and Dissertations

Since the early 2000s, skilled nursing facilities (SNFs) have operated in an environment made uncertain by changes in health care policy, growth in substitutes for nursing care, and increasing demand for services. To better understand how SNFs are strategically positioning themselves to survive and thrive, this study develops a taxonomy of strategic groups of SNFs.

A conceptual framework is based in Strategic Management Theory and classification of SNFs is based on scope of business decisions including length of stay, complexity of patients, and referral networks with hospitals. Two-step, hierarchical cluster analysis finds six strategy groups of SNFs: Post-Acute Care Focus …

Changing The Culture Of Nurse Practitioners: Incorporating Medical Billing And Coding To Prevent Fraud, Waste And Abuse, Tralissa Morrow

DNP Research Projects

Medical coding and billing errors are avoidable problems that have afflicted practitioners for decades. Correct coding and billing are required for reimbursement of healthcare services. Fraud, waste and abuse increase healthcare costs, reduce the quality of care provided and directly impact costs to patients. This pilot study was intended to evaluate the impact of an educational webinar on medical billing and coding, fraud, waste and abuse on nurse practitioner (NP) knowledge using a pretest posttest design. Mean scores increased from 58.4% to 76.4%. Test reliability was low at 0.477 (pretest) and 0.142 (posttest) with two questions that were unable to …

Evaluating Integration In Collaborative Cross-Disciplinary Fda New Drug Reviews Using An Input-Process-Output Model., Kevin Bugin, Gaetano R. Lotrecchiano, Michael O'Rourke, Joan Butler

Clinical Research and Leadership Faculty Publications

Background/Objectives: The US Food and Drug Administration (FDA) is responsible for assessing safety (risks) and effectiveness (benefits) of new drug products using the data provided in a Sponsor's new drug product marketing application before they can be marketed. The FDA forms cross-disciplinary review teams to conduct these assessments. Recently, the FDA began implementing more interdisciplinary approaches to its assessments, reducing redundancy in review processes and documentation by increasing team integration around review issues.

Methods: Through a phenomenological descriptive comparative case study, the impact of FDA's new interdisciplinary approach on review team integration was compared with its traditional multidisciplinary review approach. …

Job-Related Stress And Burnout On Turnover Intention Of Nurses In Dallas, Texas, During Covid-19, George Ochieng

Walden Dissertations and Doctoral Studies

AbstractIn a country with a large aging population such as the United States, nursing is a crucial profession that is also a high-stress and high-turnover occupation, leading to a shortage of nurses and increased healthcare costs. The year 2017 saw a 10-year high in nurse turnover. The general management problem is that current efforts to decrease the turnover of nurses remain ineffective. The specific problem studied was the high turnover of nurses in Dallas, Texas, linked to work-related stress and burnout. This quantitative nonexperimental regression and moderation research study aimed to study factors that predict or reduce turnover intention. This …

Physician Retention Strategies In Small Military Treatment Facilities, Stacey Sherrice Amos

Walden Dissertations and Doctoral Studies

During a time of increasing physician shortages, health care leaders must identify successful physician retention strategies. Health care leaders are concerned with physician retention, as a lack of physicians minimizes patient access to care. Grounded in the stakeholder theory, the purpose of this qualitative multiple case study was to explore strategies health care leaders in small military treatment facilities in rural areas use to improve physician retention. The participants were five health care leaders from different Army military treatment facilities located in rural areas throughout the continental United States who had more than four months of experience in physician shortages …

Nurse Turnover A Crisis In Healthcare, Billie Robinson

Walden Dissertations and Doctoral Studies

Nurse turnover is a global, national, and local problem that impacts the ability of healthcare leaders to deliver high quality healthcare to the populations in need of healthcare services. The purpose of this study is to identify reasons nurses leave organizations. The Leader-Member Exchange Theory undergirds the quantitative research which was conducted using the Supervisor Leader Communication Inventory. Nurse leaders communicate with acute care nurses using principles of the Leader- Member Exchange Theory. The survey was distributed to members of the Georgia Nurse Association. Positive correlations were revealed between the independent and dependent variables. SPSS was used to establish the …