Health Services Administration Commons^™

Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment Recommendations: A Scoping Review, Charles W. Stewart Cpnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: Pediatric health is significantly affected by social determinants of health. Screening for and addressing social determinants of health helps to decrease negative effect on health outcomes. The purpose of this project is to determine if there is an association between addressing or not addressing social determinants of health by the healthcare provider and parents’ adherence to treatment recommendations in children with urinary tract infections.

Methods: Between October 2020 and November 2021, a literature review was performed to obtain data from studies regarding urinary tract infections, social determinants of health and adherence to treatment recommendations. The University of Tennessee Health …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

Impact Of Ante- And Postnatal Depression Screening In Women With Hiv: A Scoping Review, Kimberly M. Grider Bsn, Rn, Pmh-Bc, Bao Chau Le Bsn, Rn, Blessing Okon Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Maternal depression has been identified as a strong predictor of poor prenatal care. Among pregnant women living with Human Immunodeficiency Virus (HIV), mental health-related factors such as depression could potentially undermine effective antiretroviral therapy (ART) adherence, increase mortality, and cause poor HIV viral suppression consequently impacting vertical transmission of HIV. This scoping review aims to identify existing knowledge regarding the impact of ante- and postnatal depression screening in women with HIV and to adduce the necessity for effective screening.

Methods A literature search was performed for studies with primary outcomes of depression screening within the context of ante- or …

Using Digital Storytelling To Assess Patient Experience With Management Of Diabetes In Everyday Life (Model) Study Intervention, Arati Joshi

Longitudinal Scholar's Project

African Americans are disproportionately affected by obesity-associated diabetes compared to their White counterparts. While social determinants of health may contribute to their poor health outcomes, studies have shown that pragmatic primary care-based interventions can be effective in improving the management of obesity-associated diabetes. The Management of Diabetes in Everyday Life (MODEL) is a pragmatic randomized comparative effectiveness trial of three approaches (health coaching, text-messaging, and enhanced usual care) to supporting medically underserved African American patients with uncontrolled diabetes in improving their self-care decisions. The purpose of this study is to assess the effect of the MODEL program participation on the …

Responding To The Pandemic: A Multicountry Study On Social-Political Factors And Health Outcomes Of Covid-19, Lan Yao

Theses and Dissertations (ETD)

Introduction. Coronavirus Disease 2019 (COVID-19) poses a major global threat to human beings, which has caused devastating consequences of population health, political, and economic crises in many countries. This dissertation was composed of three research activities to study the following aims: (1) review the existing literature focusing on political factors and health outcomes of COVID-19; (2) assess the relationship between democracy and case fatality rate of COVID-19 by controlling for the effect of age, comorbidity, health expenditure, healthcare workforce, and population density; and (3) identify the trajectory pattern cases peak days, deaths peak days, and peak periods.

Methods. We accessed …

Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo

Theses and Dissertations (ETD)

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. …

Black Women Survive Breast Cancer With Community-Based Care, Shelley I. White-Means, Jill Dapremont, Barbara D. Davis, Tronlyn Thompson

Faculty Presentations

PURPOSE Community-based breast cancer support agencies who address non-medical, social determinants of health needs that serve as barriers to maximizing breast health outcomes may play a vital role in mitigating breast cancer mortality. They share a common emphasis on addressing social, economic, and psychological needs of breast cancer survivors and those at risk of breast cancer. This paper is third in a series of papers exploring why the rate of breast cancer mortality is two times higher for African American women than white women in Memphis. We sought insights from community-based breast cancer support agencies because they have a close-up …

Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry

Faculty Presentations

This presentation described the opening of a student-run pro bono pediatric therapy clinic that provides services to children/families who are economically disadvantaged. The benefits of participation for students and clients were reviewed, and fund-raising and the development of a mission statement were discussed.

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

Theses and Dissertations (ETD)

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

Does The Electronic Health Record Improve The Timeliness Review And Notification Of Medical Laboratory And X-Ray Test Results?, Ruby Estes

Applied Research Projects

The medical community struggles with timeliness issues throughout the different healthcare environments in many areas of patient care. The demands of meeting patient care needs is great everywhere. One area that can lead to extreme adverse outcomes and affects patient safety is failure to review and follow-up on medical test results timely. In addition the lack of timely follow-up and treatment can lead to medico-legal implications for all healthcare professionals involved in the patients care. Some timeliness issues have been attributed to understaffed healthcare institutions, lack of trained staff, and in many instances inefficient and insufficient processes. This is an …

How Barriers To Using The Electronic Health Record Effects Behavioral Healthcare, Jennifer Woodard

Applied Research Projects

The healthcare scene is rapidly changing due to the introduction of the electronic health record (EHR) and advances in technology. This means more patient data is readily available for use and gives physicians and patients’ faster access to that data. With the passing of recent legislature such as the Health Information Technology for Economic and Clinical Health Act and the American Recovery and Reinvestment Act of 2009, resulting in the rapid adoption of electronic health records due to incentive payment programs. With this comes the push for use of the electronic health record to prepare for Meaningful Use and improved …

Is Cloud Computing In Healthcare Providing A Safe Environment For Storing Protected Health Information? A Systematic Review And Meta-Analysis, Ashley N. Hayes

Applied Research Projects

Over the past several years, cloud computing has become increasingly more popular for the use of storing, accessing, and maintaining electronic health records (EHRs). In comparison to conventional EHR management tools, such as installed software, cloud computing offers more capabilities for medical facilities and their patients. Experts claim that in addition to changing the face of health information technology, it will also advance healthcare services, and benefit medical research. As the use of cloud computing has increased, so has the amount of healthcare data breaches. This study is proposing that there is a correlation between the increase in cloud computing …

Adoption Rate Of A Certified Ehr At Medical Practices With Five Or Fewer Physicians, Nelda Onwualiaobu

Applied Research Projects

The adoption rate of a certified electronic health record (EHR) for small medical practices have been the subject of discussion because prior research shows that larger medical practices have a higher rate of adoption than small medical practices. The major reason for this disparity has been the cost of adoption and implementation as many small practices are not financially equipped to shoulder this burden. The purpose of this research was to determine the adoption rate of a certified EHR for medical practices with five or fewer physicians. Through a google search and filtering the results of the search, the office …

Are Bay County Florida Healthcare Facilities Ready For Pama Imaging Cds Mandate?, Kelly Johnson

Applied Research Projects

The Electronic Health Record (EHR) has been a major player on the healthcare scene in recent years. Its use has ushered in a new phase of focus on quality healthcare combined with and aided by technological integration. Within this technological integration have come adjutant tools including Clinical Decision Support (CDS) tools. Among these applications are those focused on appropriate imaging by use of CDS designed according to Appropriate Use Criteria (AUC). The imaging CDS tools are available to aid the provider in selecting the appropriate imaging study for the clinical indications present. The Protecting Access to Medicare Act (PAMA) passed …

Ehr Quality Documentation Research Thesis, Ashley Danielle Holmes

Applied Research Projects

This research proposal contains and introduction to my proposed research, background of the issue at hand, purpose of the research, significance of the research, research questions that I will be asking, definition of terms, limitations that I may be facing, literature review, SWOT Analysis, and Work Flow diagram on literature review. Also discussed are my proposed research methodology, research design, population sample, data collection procedures, as well as a table of survey variables that I propose to include. This proposal will go over why documentation quality and quantity is so important and the history behind why we are facing a …

Nutrition Informatics: Information Technology Transition For Registered Dieticians, Arlanda Bell

Applied Research Projects

The passing of the Health Information Technology for Economic and Clinical Health Act (HITECH) has created a growing push for healthcare organizations to no longer use paper based records and convert to an Electronic Health Record (EHR). Along with the adoption of an EHR comes a necessary change for ancillary services like nutrition and dietetic services because it affects patient care as well. In order to maintain a professional standard in patient healthcare as other health disciplines have done, the development of nutrition informatics model has become necessary. Nutrition informatics will prove to be a necessary addition to the developing …

Icd-10 Implementation: What Impact Did It Have On Medical Facilities Across The Country?, Tammy Collins

Applied Research Projects

The Department of Health and Human Services mandated that all Health InsurancePortability and Accountability Act (HIPAA) covered entities implement The International Classification of Diseases tenth edition (ICD-10) on October 1, 2015. The United States was the last industrialized country to move to the new coding system. A survey of HIM professionals was conducted across the United States to determine what efforts they experienced during the implementation of ICD-10; outline a timeline of implementation efforts for the transition of ICD-9 to ICD-10; uncover the major expenses organizations incurred through the implantation process; define training initiatives; and disclose the financial impact the …

Super-Utilization: The New Perfect Storm Of Health Reform, Jill Diane Nault

Theses and Dissertations (ETD)

This three-essay dissertation was focused on geographic variation of super-utilization, or the disproportionately high healthcare utilization and costs attributed to a small sub-set of the inpatient population. For purposes of this research, super-utilization was operationalized as high repeat utilization (HRU) and referred to inpatient utilization and inpatient readmission expenditures attributed to beneficiaries with four or more 30-day readmissions per year. The overall purpose of the research was to identify geographic areas at increased risk for HRU. These areas corresponded to where beneficiaries live and were aligned with the geographically-bound healthcare delivery systems. Each essay employed an observational study design using …

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

Theses and Dissertations (ETD)

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

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

User Acceptance Of Neurology Telemedicine Technology In The Emergency Department, Teresa W. Mcneil

Applied Research Projects

There is currently a significant shortage of trained neurologists in the country. In addition to the shortfall of neurologists, there is an increasing need for this specialty due to an aging population, increase in the incident of neurologic diseases and an increasing demand for healthcare (Freeman, 2013). The development of tele neurology technology has been shown to help address these problems. As with any new technology there are multiple barriers to overcome, one of those being user acceptance of the technology. A survey of users of the telemedicine product VGo was conducted at Hunt Regional Medical Center to access the …

Information Governance: An Investigation Of Interface Errors Between Source And Receiving Systems, Michelle R. Mitcheff

Applied Research Projects

The monitoring of interoperability of information in healthcare organizations is of increasing interest due to patient safety, operational and financial considerations. This monitoring is referred to as information governance (IG) and is a complex topic based on several underlying concepts. Interfacing information at the foundational, structural and semantic level is necessary for meaningful use of health information. Issues that arise range from incongruent transfer of information from source systems to receiving systems, discrepancies in the source system and receiving system and failures in interfacing information. This research project examines information governance from the perspective of failures in interfacing information from …

Will Meaningful Use (Mu) Improve Cancer Data Reporting?, Curtisha Manire

Applied Research Projects

The American Recover and Reinvestment Act directives supply the healthcare community with the improvement of technology across the nation through the Health Information Technology Economic and Clinical Health (HITECH) Act passed in 2009 by promoting healthcare technology. In order to reach the goal of an interoperability that supports reliable communication systems, certain individual technological objectives need to be addressed in particular, Meaningful Use (MU). Meaningful Use objectives contribute to interoperability, with potential outcomes that may increase accuracy and reduce time for reporting. This study will describe how cancer data reporting methods impacts data accuracy and turnaround time evolving around transitions …

Medicaid Discontinuity Among Adults With Cardiovascular Disease Or High Risk Conditions: Associations With Medication Adherence And Health Care Utilization, Kiraat Divyang Munshi

Theses and Dissertations (ETD)

BACKGROUND: Medicaid coverage among adults is often characterized by discontinuity – loss of Medicaid coverage, and churning, or entering and exiting Medicaid – over short durations. Little is known about the impact of having discontinuous Medicaid coverage on access to care, preventive care, pharmacotherapy, primary care, and hospitalizations, among non-elderly adults with cardiovascular disease (CVD) or high-risk conditions.

OBJECTIVES: This dissertation employed a three empirical research papers approach to pursue the following aims: (1) characterize the adult subpopulations with CVD or conditions placing them at high risk for CVD who lack continuous Medicaid coverage, and examine the characteristics associated with …

The Impact Of Ciwa-Ar Tool On Healthcare Professionals, Laronda Tinsley

Applied Research Projects

Alcohol is one of the most abused substances worldwide. The regular consumption of alcohol can lead to dependency which depresses the central nervous system. Consequently, when a heavy drinker is no longer consuming alcohol, the central nervous system is no longer suppressed and may go into a hyperexcitable state known as alcohol withdrawal syndrome (AWS). Symptoms can vary from mild to life threatening. Patients who experience alcohol withdrawal symptoms often have a more complicated hospitalization, an extended length of stay, and increased utilization of intensive care and medical services. The Clinical Institute Withdrawal Assessment of Alcohol Scale-revised (CIWA-Ar) is a …

Measuring Quality Of Health Care In Type Ii Diabetes Mellitus Patients Using Certified Electronic Health Records, Tracey A. Hines

Applied Research Projects

Great strides have been made in health care over the past six years after the implementation of the policy known as meaningful use by the Center of Medicare and Medicaid Services. Health care subsidies and monetary incentive programs were created for eligible professionals and critical area hospitals to encourage the use of certified electronic health records in an effort to improve quality care of all acute and chronically ill patients, as well as provide routine examinations for healthy individuals.

Patients diagnosed with type II diabetes mellitus were studied using a certified electronic health record system for compliance in physician ordered …

Necessity Of Analytics In Today’S Healthcare Revenue Cycle, Kristen N. Thomas

Applied Research Projects

Because of the recently growing pressures to improve quality and reduce costs, healthcare organizations are rapidly adopting IT in order to improve their operations and clinical care. As a result, an accumulation of vast amounts of data are becoming available for use. It is important for healthcare to use this data. Strome (2010) states that healthcare analytics is the application of statistical tools and techniques to healthcare-related data in order to study past situations (i.e., operational performance or clinical outcomes) to improve the quality and efficiency of clinical and business processes and performance. With the introduction of healthcare analytical tools, …

Hipaa Violations On Social Media, Tamesha Helen Parris

Applied Research Projects

With the rise of social media networks such as Facebook and Twitter, healthcare professionals and students pursing healthcare careers communicate, collaborate, and network on an array of websites and apps. With the use of social media, the users can reach a large audience in a matter of seconds, with this ease; users can transmit information and has presented challenges in the form of unauthorized disclosure of patient’s health information on social media sites. The purpose of this study is to see if the number of HIPAA violations increased due to the use of social media and what steps are healthcare …

Video Visits: A Closer Look At Patient Satisfaction And Quality Of Virtual Medical Care, Saddia Cheema

Applied Research Projects

Electronic medical services via video visits has revolutionized the delivery of medical care by Physicians and medical staff alike. Its steady evolution and progression towards the future of healthcare has provided insight on how to better serve patients and community members seeking care. This study will explore patient satisfaction and the quality of virtual medical care services provided by Physicians thru video visits as well as the impact of minimizing the spread of communicable diseases. Statistical data was gathered from a major U.S. healthcare company evaluating survey responses as well as feedback provided by member experience who visited with their …

Health Literacy Improves Health Care Quality, Rebecca Cook

Applied Research Projects

A lack of knowledge about health literacy is a cause for quality healthcare concern as the world advances in health information technology. Many patients struggle to understand and navigate their health and well-being as a result of lack of understanding of the treatment plan due to low literacy skills. Several federal policy initiatives promote health literacy as the responsibility of the healthcare organization. Improving health outcomes through health literacy should be a commitment of healthcare organization through providing clear communication, simplified forms, assistance, and even follow-up calls. Three major initiatives will combat health literacy to include the Affordable Care Act; …

Maintaining The Master Patient Index: The Impact Of Patient Registration Processes On Data Integrity, Matthew Biddle

Applied Research Projects

The master patient index is one of the most important components within a healthcare system. It ensures that an individual patient is given a unique identifier that is used across the various separate clinical, financial and administrative systems and ensures that all information about that patient is organized and complete. Ensuring the MPI is accurate is critical since errors can have significant costs- both financially and in terms of patient outcomes. Patient registrars are the first line of defense when it comes to correctly identifying incoming patients and is where many errors in the MPI occur. Errors can be simple …