Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe,
2022
Walden University
Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo
Walden Dissertations and Doctoral Studies
Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …
Planning Patient Safety: Philosophical, Political, And Economic Changes Required For Preventable Death Abolition,
2022
Claremont Colleges
Planning Patient Safety: Philosophical, Political, And Economic Changes Required For Preventable Death Abolition, Catherine Kiani
CMC Senior Theses
Preventable medical errors are an epidemic. Between 250,000 and 400,000 people die from preventable errors each year in the USA. This investigation questions mechanisms for quality care improvement to eliminate preventable fatalities. I evaluated current patient safety protocols, analyzed their shortcomings, and with additional research recommended actions for better results. Such actions to improve patient safety are explored from three different perspectives: philosophical, economical, and political aspects. In chapter one, improvements within hospitals are reviewed – namely cultural changes needed from both physicians and hospital leadership. Abolishing hierarchical systems which preclude healthy collaboration among medical teams, diverting focus to patient …
Policies That Support Emergency Department Staff In Providing Behavioral Health Care,
2022
Walden University
Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig
Walden Dissertations and Doctoral Studies
A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …
Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting,
2022
Walden University
Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen
Walden Dissertations and Doctoral Studies
AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …
Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients,
2022
Walden University
Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi
Walden Dissertations and Doctoral Studies
AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …
Food Insecurity In Oncology Patients: An Educational Intervention For Nurses,
2022
Walden University
Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe
Walden Dissertations and Doctoral Studies
AbstractFood insecurity is not having enough food or resources or not being able to procure nutritious foods. An observation that nurses in one oncology clinic rarely assessed their patients for food insecurity as part of their regular assessment led to the development and testing of an educational intervention for nurses which was to create awareness on the importance of assessing food insecurity among oncology patients and to learn to use the Household Food Insecurity Assess Scale (HFIAS) in assessing patients. Summative evaluation was done using a pre/and posttest. The Maslow’s hierarchy of needs and the Virginia Henderson nursing need theories …
Understanding Obesity In The Workplace From The Nursing Manager’S Perspective,
2022
Walden University
Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun
Walden Dissertations and Doctoral Studies
AbstractLike other individuals from diverse backgrounds, nurses who work in nursing homes are susceptible to becoming overweight. The way that others see and respond to the overweight person also may vary and even result in some level of discrimination. The purpose of this study was to explore the perspective of nurse managers about obese staff in the workplace. A qualitative phenomenological descriptive study design was used, guided by the theory of interpersonal relations and the relational leadership framework, to examine the lived experiences of managers working with obese nurses in nursing home settings in a large metropolitan region in the …
Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care,
2022
Walden University
Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike
Walden Dissertations and Doctoral Studies
Nurses play a significant role in mobility management, an essential element of care for critically ill adults. However, the current practice of mobility management comes from patient orders without the adoption of an evidence-based physiologic assessment guide to support safe patient mobility resulting in unreliable outcomes. Physiologic stability may change during mobility and unsafe patient mobilization can result in negative patient outcomes that increase patient recovery time. The purpose of this systematic review was to look at the current practice of physiologic assessment measures and then use the findings to influence safe patient mobility practices in intensive care units. The …
Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory,
2022
Walden University
Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan
Walden Dissertations and Doctoral Studies
Ineffective strategies to contain the costs of medical supply inventory can result in financial loss and are a significant challenge for hospital leaders. Grounded in complex adaptive systems theory, the purpose of this qualitative single case study was to explore the cost-containment strategies that private hospital business leaders use to reduce the expense of pharmaceutical inventory. The participants comprised six private hospital business leaders in one healthcare organization in Myanmar. Data were collected from semistructured interviews, internal company documents, and publicly available annual reports. Four themes emerged from Yin’s five-step data analysis method: (a) management controls, (b) specialist engagement and …
Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress,
2022
Walden University
Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli
Walden Dissertations and Doctoral Studies
AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …
Servant Leadership On Burnout Among Physicians In Residency Training,
2022
Walden University
Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt
Walden Dissertations and Doctoral Studies
Physicians in residency training (PIRTs) in the United States are facing extreme burnout. The prevalence of burnout among physicians in residency training may cause adverse consequences such as medical malfeasance, alcoholism, or suicide due to physical and mental exhaustion. The purpose of this study was to analyze the servant leadership style of physician trainers and burnout among PIRTs in academic medical centers in the United States to ultimately increase wellness and thereby mitigate burnout. Servant leadership was the theoretical foundation for this study. This research investigated whether servant leadership characteristics of physician trainers played a statistically significant role in burnout …
Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates,
2022
Walden University
Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates, Shavonda L. Greene
Walden Dissertations and Doctoral Studies
AbstractAdult homeless patient 30-day readmission is a concern for nursing healthcare leaders who still have problems in providing effective strategies for revisit reduction in various acute care settings across the United States. The purpose of this quantitative comparative study was to examine the association between nursing healthcare leadership strategies, 30-day homeless patient readmission rates, and hospital discharge rates at hospitals in California. The theoretical foundation for the research study was Pender’s health promotion model theory, which identifies preventative health measures and describes the critical function of nurses in helping patients to prevent illness by self-care and bold alternatives. Research questions …
Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers,
2022
Walden University
Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky
Walden Dissertations and Doctoral Studies
Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …
Primary Care Provider Education On Behavioral Interventions For Management Of Adult,
2022
Walden University
Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru
Walden Dissertations and Doctoral Studies
The high prevalence of obesity continues to pose significant health challenges globally. According to the U.S. Preventive Service Task Force, obesity affects more than 35% of men and 40% of women in the United States. The national annual cost of medical care related to obesity is estimated at $147 to $210 billion. Intensive behavioral interventions in adults with obesity can lead to clinically sufficient improvements. The project aimed to determine if the current evidence-based clinical guideline of behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults would improve primary care providers’ knowledge of adult obesity management. The …
Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs,
2022
Walden University
Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González
Walden Dissertations and Doctoral Studies
Business executives risk higher healthcare costs and absenteeism rates without implementing cost-effective strategies to support wellness within the organization. To offset rising healthcare costs and absenteeism, executives should implement wellness programs as a component of the benefits package provided to their employees and families. Grounded in the theory of planned behavior, the purpose of this qualitative multiple case study was to explore the cost-effective strategies that executives in the private and not-for-profit sectors implemented to encourage employees to adopt healthy habits for increasing productivity and decreasing organizations’ healthcare costs. Six executives from the healthcare sector within the southern region of …
Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates,
2022
Walden University
Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler
Walden Dissertations and Doctoral Studies
AbstractThe Centers for Medicare and Medicaid Services implemented the Hospital Readmission Reduction Program in 2012. Ten years later, hospitals across the United States have had negligible improvement in reducing preventable 30-day hospital readmissions for COPD patients. Healthcare, specifically the hospital setting, consists of complex processes and procedures. Not one process or procedure is the sole cause of correcting excessive preventable 30-day readmissions of patients with COPD. The essential elements of provider communication were studied using the Complex Adaptive Systems theory in this quantitative study. Each fundamental element of provider communication was the independent variable, and the preventable 30-day COPD excessive …
Successful Allocation Of Funds In Managed Health Care Programs Revenue,
2022
Walden University
Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall
Walden Dissertations and Doctoral Studies
Managed care leaders of independent physician associations (IPAs) lack strategies for allocating existing funds to avoid business closure. Medical providers are concerned with the quality of care for patients if the allocation of funding is not executed correctly. Grounded in the competing values framework (CVF), the purpose of this qualitative single case study was to explore strategies managed care leaders of IPAs use to allocate funds to avoid business closure. Participants were six executive leaders of an IPA in Los Angeles, the United States, who successfully managed the allocation of funds in a managed healthcare system. Data were collected from …
Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs,
2022
Walden University
Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka
Walden Dissertations and Doctoral Studies
Low health literacy can adversely affect individuals and groups without access to health information. Health insurance leaders who lack strategies to decrease low health literacy may lose their ability to provide quality health services and control care costs. Grounded in the health belief model and the Andersen health service model, the purpose of this qualitative multiple case study was to identify the strategies private health insurance leaders use to increase medical utilization to reduce healthcare costs. The three participants were from two private insurance companies in Las Vegas, Nevada. Data were gathered through semistructured, open-ended interviews via videoconferencing, a review …
Hospital Ownership And Type As Predictors Of 30-Day Psychiatric Readmissions And Follow-Up,
2022
Walden University
Hospital Ownership And Type As Predictors Of 30-Day Psychiatric Readmissions And Follow-Up, Zacquia Mckinley
Walden Dissertations and Doctoral Studies
Studies have suggested that differences in hospital ownership structures impact the rates of 30-day hospital readmission and 30-day hospital follow-up in patients with psychiatric diagnoses. The purpose of this quantitative study was to examine the relationship between hospital ownership, hospital type, rates of 30-day psychiatric readmission, and rates of 30-day follow-up for psychiatric patients. This study drew on Donabedian's conceptual model of hospital quality assessment and used ANOVA testing for the four research questions concerning whether there is a significant relationship between 1) hospital ownership and inpatient psychiatric patient readmission within 30 days of discharge, 2) hospital type, and inpatient …
Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs.,
2022
Walden University
Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell
Walden Dissertations and Doctoral Studies
Readmissions for chronic obstructive pulmonary disease (COPD) are a major contributor to healthcare costs and patient outcomes. The Hospital Readmissions Reduction Program (HRRP) by the Centers of Medicare and Medicaid was implemented to decrease high rates of readmissions for serious medical problems, including COPD. The purpose of this study was to determine whether HRRP resulted in reductions in readmissions and costs for COPD patients. The Donabedian model was used as the theoretical framework to investigate three research questions concerning whether there are statistically significant differences in terms of readmission rates, total charges, and primary type of insurance payment before and …
