Health and Medical Administration Commons^™

Hospital Nurse Burnout: A Continuing Problem, David P. Paul Iii, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse

Management Faculty Research

RNs are a critically important component of the U.S. healthcare system. RN burnout – the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. We examine the background, causes and consequences of burnout among RNs in U.S. hospitals, in order to identify solutions to this problem. Findings indicate that Burnout Syndrome in RNs can be analyzed in terms of four clusters of characteristics: individual, management, organizational, and work. The consequences of burnout include increased RN turnover rates, poor job performance, and threats to patient safety. RN burnout in hospitals …

Macra And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Alberto Coustasse

Management Faculty Research

The purpose of this research was to study MACRA (Medicare Access & CHIP Reauthorization Act) and to determine how its implementation would financially impact rural hospitals. Although the long-term effects of MACRA have not been able to be studied, MACRA has the prospective to negatively impact rural hospitals financially. MACRA has potential risks and benefits for physicians associated with its two reimbursement payment methods. The estimated negative reimbursements and set reductions to hospital reimbursement have supported the idea that physicians and all healthcare organizations need to be aware and prepared for MACRA.

The Opioid Epidemic In West Virginia, Nicholas Bowden, Rachel Merino, Sruthi Katamneni, Alberto Coustasse

Management Faculty Research

The rate of overdose-related to the use of licit and illicit opioids has drastically increased over the last decade in the U.S. The epicenter being West Virginia the highest rates of overdoses accounting for 41.5 deaths for 100,000 people among the 33,091 deaths in 2015. The number of people injecting drugs has increased from 36% in 2005 to 54% in 2015. The total U.S cost of prescription opioid abuse in 2011 has been estimated at $25 billion, and criminal-justice-system costs to $5.1 billion. The reasons for this opioid epidemic incidence in WV have been a combination of sociocultural factors, a …

Primary Care Practices’ Progress Of Using Electronic Health Information Exchange (Hie), Susan M. Heyde

Applied Research Projects

Now that EHRs are purportedly fully implemented in the healthcare industry, it is important to evaluate the electronic Health Information Exchange (HIE) between primary care facilities, laboratories, hospitals, specialists, regional coops, and public health authorities.

Meaningful Use Stage 3 implementation is to begin this year, 2018. Complementing this implementation, the Medicare Access and CHIP Reauthorization Act, MACRA, was signed into law on April 16, 2015. MACRA removes eligible clinicians from EHR Incentive Programs that were previously established by the HITECH Act. MACRA also creates the Quality Payment Program that the CMS will use for Medicare and Medicaid reimbursement to primary …

What's Happening: April 17, 2018, Maine Medical Center

What's Happening

No abstract provided.

The Importance Of Clinical Documentation Improvement, Amanda Shanty Baksh

Applied Research Projects

The world of technology in the twenty first century is forever expanding. In the healthcare field, patient data has transformed from paper charts into electronic health records. Electronic health records allow for organized patient information however, an enormous amount of information becomes available. Sometimes the massive amount of information is not always needed but important detail the medical chart is looked for by insurance companies for reimbursement. There is a special department in hospitals called the Clinical Documentation Improvement specialists who are made up of experienced medical coders, registered nurses, mid-level practitioners such as nurse practitioner’s s or physician’s assistants …

03-06-2018 Approved Hsc Committee Meeting Minutes, Patrice Martin

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

No abstract provided.

What's Happening: April 9, 2018, Maine Medical Center

What's Happening

No abstract provided.

04-10-2018 Revised Hsc Committee Meeting Agenda, Patrice Martin

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

No abstract provided.

04-10-2018 Hsc Committee Agenda, Patrice Martin

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

No abstract provided.

What's Happening: April 2, 2018, Maine Medical Center

What's Happening

No abstract provided.

Abstracts From The 24th Annual Health Care Systems Research Network Conference, April 11–13, 2018, Minneapolis, Minnesota

Journal of Patient-Centered Research and Reviews

Founded in 1994, the Health Care Systems Research Network (HCSRN) is a consortium of 18 research centers that are housed in community-based health systems. The organization's annual conference serves as a venue for research teams to disseminate scientific findings, stimulate new collaborations, and share insights about conducting research in real-world care-delivery settings. Abstracts accepted for presentation at HCSRN 2018 are published within this supplement of the Journal of Patient-Centered Research and Reviews.

Dental Practice Success Vol. 5 No. 1, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

Violencia Obstétrica: Los Derechos De Autonomía Reproductiva, Tratamiento Justo Y Accesibilidad En El Ámbito De La Salud Maternal En San Carlos, Salta / Obstetric Violence: The Rights To Reproductive Autonomy, Fair Treatment, And Accessibility Of Maternal Health Services In San Carlos, Salta, Emily Gleason

Independent Study Project (ISP) Collection

In Argentina, there exists a national legislature (Ley N° 25.929 and 26.485) that is intended to ensure women’s rights to maternal and reproductive healthcare services free from obstetric violence; that is, the right to autonomy, fair treatment, and accessibility of maternal healthcare services. Women have the inherent right to receive fair and equitable maternal healthcare and receive humanized births, or partos humanizados. Despite the existence of these laws, however, there is still a rampant amount of obstetric violence that women in Argentina experience. Their rights to autonomous, accessible, and just maternal health services are often ignored or outright denied. …

Contextual Intelligence Behaviors Of Female Hospital Managers In The United States, Matthew R. Kutz, Debra A. Ball, Gretchen K. Carroll

School of Human Movement, Sport, and Leisure Studies Faculty Publications

Healthcare is a dynamic and challenging work environment with high levels of ambiguity and volatility. Leadership behaviors and models are needed that present a new framework for leadership behaviors in this type of environment. Contextual intelligence (CI) has been suggested as a useful and viable solution to leading in turbulent environments. This investigation explored the frequency of CI behaviors of female healthcare managers from 13 different hospitals. 474 females healthcare managers’ demographic data, including Myers–Briggs Type Indicator confirmed personality preference, were administered the Contextual Intelligence Profile (CIP), which rates the frequency 12 CI behaviors are demonstrated (0 = never to …

Healthcare Facilities: Another Target For Ransomware Attacks, David P. Paul Iii, Nikki Spence, Niharika Bhardwa, Alberto Coustasse Dr.Ph, Md, Mba, Mph

Management Faculty Research

Ransomware is a type of malware used by cyber criminals who encrypt files and then extort money in return for unlocking those files. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. We examine recent ransomware infections in healthcare settings, the liabilities and cost associated with such infections, and discuss possible risk mitigation tactics. Risks associated with ransomware attacks on healthcare facilities include financial, future business loss and damage to reputation. Healthcare facilities should have a disaster plan with adequate data backups and educate employees who are the usual sources of ransomware attacks.

The 340b Program: Benefits And Limitations, Craig Kimble Pharmd, Mba, Ms, Bcacp, Alberto Coustasse Dr.Ph. Md, Mba, Mph

Management Faculty Research

This in progress study reviews challenges and successes associated with implementing a 340B program at Marshall Health and Cabell Huntington Hospital (CHH) in Huntington, West Virginia. CHH qualified as a participant in the 340B program because it has met qualification as a disproportionate share hospital (DSH). The site has also been able to open two outpatient pharmacies to serve the targeted patient population. The pharmacies have also been able to use savings from the program to embed clinical pharmacists into the physician care areas to provide medication therapy management services including discharge counselling, disease state management services, patient financial assistance …

Burnout Syndrome And Nurse-To-Patient Ratio In The Workplace, Ekaterina Gutsan, Jami Patton, William K. Willis, Alberto Coustasse Dr.Ph. Md, Mba, Mph

Management Faculty Research

Introduction: Burnout among Registered Nurses has been a great concern within the U.S. healthcare system and has been reported in many hospitals. Nurse Burnout has been defined as a chronic response to work-related stress comprising three components or dimensions: emotional exhaustion, depersonalization, and personal accomplishment. The purpose of this research was to analyze the nurse-to-patient ratio to determine how it affects the psychological, mental, emotional health and the nurse overall productivity in the workplace.

Methodology: The methodology was a review of literatures and a semi-structured interview. There were four primary databases and one website used in this research, and 31 …

Improving Admission Medication Reconciliation Completion At Gw Hospital, Amanda Nizam, Andrew Shelton, Dembi Iyekegbe, Matthew Cichocki, Puya Jafari, Paul Pickmans, Jessica Logan, Cherinne Arundel

GW Research Days 2016 - 2020

Background: Medication errors represent a major cause of adverse events in hospitalized inpatients. 27-83% of hospitalized patients will have at least one discrepancy in their medication history at admission, with 11%–59% of errors having clinical importance. Current processes for completing admission medication reconciliations are ill-defined, further increasing the risk of errors. Implementation of a standardized medication reconciliation process has led to a reduction in medication errors. Aim Statement: To increase the number of admission medication reconciliations completed within 48 hours of admission to GW Hospital by 25% over three months. Methods: From September 2017 until December 2017, an educational intervention …

The Changing Composition And Capacity Of Medicare Providers, 2012-2015, Xinxin Han, Clese Elaine Erikson, Qian Luo

GW Research Days 2016 - 2020

Objective: Over the past decade, U.S. medical school enrollment has increased nearly 30 percent, and the growth in mid-level new graduates was even faster. Many of these new graduates are currently serving the large and growing Medicare population. Yet, little evidence so far has documented the workforce that are serving Medicare population. In the anticipation of physician supply shortages, it is important to understand who are taking care of Medicare population recently, and whether there are changes in the overall capacity and patient risk profiles of Medicare providers.

Methods: Data were from 2012-2015 Medicare Physician and Other Supplier Aggregate Tables …

How The European Union Is Embracing Cross-Border Telemedicine And What The U.S. State Medical Boards Can Learn From It, Sohyun Laura Chang, Jesse M. Pines, Jane H. Thorpe

GW Research Days 2016 - 2020

Despite the fact that there have been many advances in the field of telemedicine, the United States (U.S.) state and federal laws have not kept pace with these technological advancements and may operate as a barrier to growth in the field of telemedicine. On the other hand, the European Union (EU) has developed a robust legal framework for the practice of telemedicine. The aim of this research project is to evaluate what elements of the EU legal experience could be used to support efforts to better align telemedicine law with the practice of telemedicine in the U.S.

Based on the …

Inpatient Satisfaction At Different Public Sector Hospitals Of A Metropolitan City In Pakistan: A Comparative Cross-Sectional Study, Mehwish Hussain, Rehana Rehman, Zia Ikramuddin, Nava Asad, Ayesha Farooq

Department of Biological & Biomedical Sciences

Objective: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan.
Methods: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance.
Result: Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four …

The Emerging Issue Of Hepatitis C Virus In The United States And In West Virginia, Alberto Coustasse Dr.Ph. Md,Mba, Mph, Maggie Phillips Rn, Bsn, Mha, Jumana Abboud Mha, Neha Botre Mha, David P. Paul Iii

Management Faculty Research

Introduction:

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S., Especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, although somewhat expensive. West Virginia, a predominantly rural state, is beginning to face a mounting financial crisis due to HCV.

Purpose of the Study:

The purpose of this study was to examine the effects of early identification and treatment for patients …

Incorporating Just Culture Principles Into Clinical Learning Experiences, Paula Gendreau, Dnp, Msn, Rn, Cne

Doctor of Nursing Practice Projects

Background: Although nursing student’s confidence regarding patient safety is influenced by both clinical faculty and environments in which they learn, faculty seemed to have the most influence in shaping student’s attitudes surrounding a culture of safety. Objectives: To explore and support faculty culture of safety practices that promote meaningful learning experiences for students surrounding patient safety in clinical learning environments.

Methods: An embedded mixed method design was utilized for this pilot study. Quantitative data was collected both pre- and post-semester utilizing an adapted Health Professional Education in Patient Safety Survey, and post-semester qualitative data further expanded on faculty perceptions and …

Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Continuing education (CE) is an essential component of building and maintaining the competence and performance of health professionals. Evidence of its impact on practice is lacking. Organizations need evidence of CE transfer to the practice setting to demonstrate its value and inform CE practice.

Objectives: The purpose of this study was to provide evidence of CE’s impact on practice by analyzing nurses’ reports of intent to change practice, actual practice change, and examples of practice change. Research assessing the effects of CE on nursing practice across multiple courses involving different topics, levels of nursing practice and location supports generalizability. …

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

Nurse Managers And Hospital Nurse Educators’ Views Related To The Knowledge, Skill And Attitude Requirements Of Newly Licensed Nurses In The Las Vegas And Salt Lake Valleys, Delos Jones, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: In 2017, approximately 230,569 new Registered Nurses (RNs) were licensed in the United States. Of these, over a quarter will leave their first position in less than a year. While 90% of academic leaders feel nursing graduates are ready for practice, only 10% of clinical leaders agree. Recent changes in health care, and an intensifying theory-practice gap hint that newly licensed nurses (NLNs) may not be equipped for today’s workplace.

Objective: This qualitative project asked, “What do nurse managers and hospital educators perceive as required knowledge, skills and attitudes (KSAs) for NLNs to ensure successful and safe orientation or …

Missed Nursing Care Reported By Medical-Surgical Rns In A Community Hospital, Anne Schmidt, Dnp, Msn, Rn, Aprn-Bc, Cenp

Doctor of Nursing Practice Projects

Background: Missed nursing care is defined as any lapse in essential patient care. It is a previously studied, persistent phenomenon. If unrecognized, it can compromise patients’ recoveries, trigger adverse events, and increase healthcare costs.

Objectives: To examine the prevalence of missed nursing care reported by medical-surgical registered nurses (RNs) and contributing factors for its occurrence.

Methods: The project used a cross-sectional, correlational design. A convenience sample of 96 RNs, recruited from three medical-surgical units, completed the MISSCARE Survey between September and October 2017. An analysis of survey responses quantified the frequency, nature, and common contributing factors for care omissions. The …

Evaluation Of The Associations Between Unplanned Readmissions And The Lace Index And Other Variables, Cathy Stankiewicz, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: Unplanned readmissions, within 30 days following an inpatient hospital admission, are common and costly. Research has identified factors that predict readmissions, and predictive algorithms, such as the LACE index, have been studied and widely adopted by hospitals despite demonstrated variability in predictive ability.

Objectives: To examine the associations between unplanned readmissions and the LACE index, and other variables that reflect patient- and encounter-level factors not currently incorporated in the LACE index.

Methods: A retrospective analysis was conducted utilizing data from electronic health records of inpatients discharged from a large quaternary hospital located in the southeastern United States between January …

Evaluating Patient Outcomes When Adding Licensed Practical Nurses To The Staffing Mix, Isabel C.M. Shephard, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: An incorporation of licensed practical nurses (LPNs) in the RN staffing mix was made in a small community hospital. Research shows that RNs at the bedside equates to less adverse patient outcomes such as falls, pressure ulcers and an increase on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Objectives: To evaluate the effects of incorporating LPNs in the staffing mix on the number of patient falls, pressure ulcers and HCAHPS survey results.

Methods: A Pre and Post study design was used to compare baseline data obtained four months prior to implementing and four months during …