Health and Medical Administration Commons^™

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 …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

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

Walden Dissertations and Doctoral Studies

AbstractFor 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 …

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 …

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …

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 …

Marketing Efforts To Reengage Consumers In Cancer Screenings During The Covid-19 Pandemic, Angela M. Kasel

Walden Dissertations and Doctoral Studies

In 2020, U.S. hospitals became overwhelmed by patients with the viral illness COVID-19. Health systems were advised by the U.S. Surgeon General and Centers for Disease Control and Prevention to suspend elective procedures, including mammograms, colonoscopies, and lung computed tomography scans. The purpose of this quantitative study was to investigate whether there was a significant difference in completed appointments, cancer screenings, and cancer diagnoses in consumers receiving targeted direct mail and email communications during the COVID-19 pandemic, based on age, gender, and geographic location. The elaboration likelihood model of persuasion, which emphasized the use of marketing to change consumer behaviors …

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

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 …

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 …

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe 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 …

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 …

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Electronic Cigarettes And Young Adults: Use Of Screening Tools And Provider Knowledge, Kayla Erin Chelf

DNP Projects

Background: Electronic Cigarette (e-cigarette) use is now more common than traditional cigarette use in adolescents and young adults (Dinardo & Rome, 2019). There is concern that the lack of screening for use and knowledge about the health consequences of e-cigarette use is driving this growth.

Objective: The purposes of this project were to (1) assess baseline e-cigarette knowledge and screening practices from healthcare professionals, and (2) evaluate changes in knowledge after delivery of an educational intervention about e-cigarettes.

Methods: In this quasi-experimental study a seven-question survey on screening practice and knowledge concerning e-cigarettes in young adults was posted on the …

Evaluation Of A Discharge Clinic Implemented For Patients Without A Primary Care Provider Or Access To Their Primary Care Provider, Jessica Sass

DNP Projects

Background: Patients transitioning from an inpatient hospital stay to self-care responsibilities post-discharge are at risk for readmission resulting in increased cost and resource utilization. Care transition programs can result in cost avoidance and decreased resource utilization.

Purpose: The purposes of this project were to: (a) determine if implementation of a Discharge Clinic affected 30-day readmission rates in patients without a primary care provider, (b) ascertain if a visit by a paramedicine program paramedic impacted 30-day readmission rates in patients who missed their Discharge Clinic appointment, and (c) find out whether a second post-discharge phone call influenced 30-day readmission rates.

Method: …

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …