Health and Medical Administration Commons^™

Generational Differences In Nursing Turnover, Adam Bennett

Walden Dissertations and Doctoral Studies

Nursing is currently the largest job category in U.S. health care requiring proper recruitment and retention of nurses. As the current generation of nurses ages out of the workforce due to retirement, new nurses will need to cover the gaps in the workforce. The purpose of this quantitative correlational study was to examine the relationship between voluntary turnover, involuntary turnover, and career change among nurses who were born between 1980 and 1995 (Millennials) and those born between 1965 and 1979 (Generation X). The theoretical framework was Mannheim’s theory of generations. Secondary data were collected from exit interviews with 811 respondents …

The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown

Walden Dissertations and Doctoral Studies

AbstractThe widespread adoption of electronic health records (EHRs) is encouraged because of their potential to improve the quality of care provided. It was unknown to what extent the meaningful use of EHRs would impact patient safety and satisfaction in general and specialty hospitals. The researcher’s purpose for this quantitative correlational research was to examine the impact of meaningful EHR use of EHRs on patient safety and satisfaction outcomes in general and specialty hospitals in Philadelphia (PA). The constructs of the institutional theory guided the study. The hypotheses that guided the study included (a) Meaningful EHR use positively influences patient satisfaction …

Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter

Walden Dissertations and Doctoral Studies

Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …

The Role Of Self-Efficacy Against Workplace Stress, The Intent To Leave, And Burnout In Nursing, Alexis Collier

Walden Dissertations and Doctoral Studies

Healthcare administrators must sustain the nursing workforce by minimizing workplace stress, the intent to leave, and burnout while maintaining a safe, accessible, high-quality, patient-centered care environment. This quantitative study examined the relationship between the independent variable of self-efficacy and the dependent variables of nurse burnout, workplace stress, and the intent to leave. The theory that grounded this study was the theory of self-efficacy. The research questions were formatted to determine the correlation between the self-efficacy levels of nurses and burnout, workplace stress, and the intent to leave. A quantitative, nonexperimental, cross-sectional (analytical) design addressed the research questions. The secondary data …

Relationship Between Incentive Program Costs, Incentive Payments, And Profitability, Claire Claire Turner

Walden Dissertations and Doctoral Studies

The lack of profitability among primary care businesses can have harmful impacts on business operations. Primary care businesses owners must remain profitable to remain in business and provide quality health care to patients. Grounded in Freeman’s stakeholder theory, the purpose of this quantitative correlational study was to examine the relationship between incentive program costs, incentive payments, and profitability. Data were collected from 73 primary care physician business owners in the Inland Empire region of southern California. The multiple linear regression analysis results indicated the model was able to significantly predict profitability, F(2,70) = 1343.6, p <.001, R2 = .975. Incentive payments (t = 51.837, p < .001,  = .928) was the only statistically significant predictor. Key recommendations include educating primary care physicians on the potential financial benefits of full participation in the commercial line of business pay-for-performance incentive programs and creating a campaign to bring in patients for wellness visits. The implications for positive social change include the potential for an additional revenue stream for primary care physician business owners, which could support more clinics, increasing patient access. Patients having better access to healthcare could positively affect the health and wellness of individuals in local communities.

Nurse Managers' Patient Safety Communication, Christine Deatrick

Electronic Theses and Dissertations, 2020-2023

Medical errors are a continuing issue for healthcare organizations and can lead to patient harm or death. To bring about organizational learning and therefore reduce medical errors, information must successfully flow through an organization. Nurse managers play an essential role as the conduit of information between frontline staff and the organization. The primary purpose of this study is to describe the decision-making process of how nurse managers actively select and transmit information on patient safety concerns. A qualitative constructivist grounded theory approach was used. Nineteen unit-level nurse managers, working full-time in an acute care hospital with a minimum of one-year …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Implementation Of A Nonverbal Scrub Cap Identification System To Improve Communication And Perception Of Patient Safety Among Unfamiliar, De-Identified Staff Members In The Operating Room., Keri Ann Roskowinski

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Operating room (OR), professionals deliver patient care with brief introductions, and roles were not always identified, and although team members wear identification (ID) badges, they were usually covered by sterile gowns and other routine personal protective equipment (PPE). Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to determine if a simple intervention to apply the individual’s name and role to a scrub cap could improve identification, OR team communication, and consequently, patient safety. The participants in this project consisted of nurses, physicians, anesthesia providers, scrub technicians, students, medical sales representatives, and those that identified as …

A Qualitative Investigation Of Organizational Challenges And Facilitators To Screening Individuals Experiencing Homelessness For Hepatitis C Virus (Hcv) In Houston, Texas, Alane Celeste-Villalvir, J Michael Wilkerson, Christine Markham, Lourdes Rodriguez, Vanessa Schick

Faculty, Staff and Student Publications

BACKGROUND: Individuals experiencing homelessness may be at a disproportionately high risk for hepatitis C (HCV) because they may be more likely to engage in HCV risk behaviors. Community organizations that provide services to these vulnerable individuals can effectively screen, diagnose, and navigate them into HCV care. However, screening people experiencing homelessness for HCV at such organizations is limited by various challenges that remain understudied, including budgetary considerations and strategies to improve teamwork and communication. Accordingly, this study investigated the organizational challenges and facilitators to HCV screening of individuals experiencing homelessness as reported by homeless services providers.

METHODS: Staff (N = …

Characterizing Cancer And Covid-19 Outcomes Using Electronic Health Records, Youngran Kim, Liang Zhu, Huili Zhu, Xiaojin Li, Yan Huang, Chunhui Gu, Heather Bush, Caroline Chung, Guo-Qiang Zhang

Faculty, Staff and Student Publications

PURPOSE: Patients with cancer often have compromised immune system which can lead to worse COVID-19 outcomes. The purpose of this study is to assess the association between COVID-19 outcomes and existing cancer-specific characteristics.

PATIENTS AND METHODS: Patients aged 18 or older with laboratory-confirmed COVID-19 between June 1, 2020, and December 31, 2020, were identified (n = 314 004) from the Optum® de-identified COVID-19 Electronic Health Record (EHR) derived from more than 700 hospitals and 7000 clinics in the United States. To allow sufficient observational time, patients with less than one year of medical history in the EHR dataset before their …

The Associations Between Poor Antibiotic And Antimicrobial Resistance Knowledge And Inappropriate Antibiotic Use In The General Population Are Modified By Age, Huiling Guo, Zoe Jane-Lara Hildon, David Chien Boon Lye, Paulin Tay Straughan, Angela Chow

Research Collection School of Social Sciences

Objectives: Understanding factors influencing inappropriate antibiotic use can guide the design of interventions to improve antibiotic practices and reduce antimicrobial resistance (AMR). Methods: A nationally representative cross-sectional survey (N = 2004) was conducted between November 2020 and January 2021. Knowledge of antibiotic use and AMR using the World Health Organization’s Multi-Country AMR Survey questionnaire, and antibiotic practices were examined. Multivariable logistic regression was performed to identify factors associated with inappropriate antibiotic use and examine effect measure modifications. Results: After adjusting for potential confounding, poor knowledge of antibiotic use was associated with a 3x increased odds of inappropriate antibiotic use in …

Patient Perceptions Of Shared Decision-Making In The Acute Care Hospital And Their Association With Patient Experience And Readmission, Jill Haladay

Electronic Theses and Dissertations, 2020-2023

Avoidable hospital readmissions continue to be a concerning and costly healthcare issue. While the emphasis on reducing avoidable hospital readmissions persists, incentivization strategies are evolving. Initial strategies prioritized medical care delivery, but recent regulation highlights the value of effective transitional (discharge) care planning, and particularly, patient involvement in that process. This latter aspect of care has a clear indication for the application of shared decision-making. Shared decision-making (SDM) practice in the acute care setting largely represents a gap in the literature; yet understanding patient perceptions of SDM during hospitalization is an important and timely first step in exploring the effectiveness …

January 2022, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Welcome back!

January is Thyroid Disease Awareness Month!

Frequency In Copd And Cad Emergency Department Visits In South Carolina: Medicare Versus Self-Pay, Alexandria Brown

Walden Dissertations and Doctoral Studies

Coronary artery diseases (CAD) and chronic obstructive pulmonary diseases (COPD) represent the most common cause of emergency department (ED) visits and hospitalization for both Medicare and self-pay patients, which amount to nearly 2 to 4 million spent annually. The purpose of this quantitative stud ywas to identify the relationship between ED frequency among CAD and COPD Medicare and self-pay recipients 18 to 65 years within South Carolina between 2016 to 2018. The variables for this study were age and payer (independent) and ED frequency (dependent). Using a sample size of 7,689 an ANOVA Regression and t-test analyses were used to …

Strategies Nursing Managers Use To Prevent And Address Workplace Conflicts, Ifeanyi Emmanuel Ezeani

Walden Dissertations and Doctoral Studies

Workplace conflicts negatively impact organizational performance. Health care leaders are concerned that workplace conflicts lead to stress and low performance by nurses and negatively affect the delivery of care to patients. Grounded in the social exchange theory, the purpose of this qualitative multiple case study was to explore strategies health care nursing managers use to address workplace conflict. Data were collected through semistructured interviews with five nursing managers from multiple healthcare organizations in the Western region of the United States who have successful strategies to address workplace conflict. The data analysis using Yin’s five-step approach identified four main themes: perception …

Why A Women’S Domestic Violence Long-Term Shelter Is Needed, Markquatt Ford

Walden Dissertations and Doctoral Studies

This qualitative project provided a content analysis of primary and secondary data to do a need assessment of how a short-term shelter, a home for victims of domestic violence in Kansas City, Mo, can turn into a long-term shelter for victims of domestic violence. This organization was a short-term shelter, a not-for-profit organization that works for the positive social change and rehabilitation of female victims of domestic violence in Kansas City, Mo. The organization followed a traditional organizational model with a short-term scope of action. A long-term shelter is supposed to provide the residents with sufficient programs for recovery to …

Predictors Of Radio Frequency Identification Adoption For Medication Administration In Hospitals, Sherita Freeman

Walden Dissertations and Doctoral Studies

Medication administration challenges within the United States hospital system have led to adverse drug events from medication errors among patients, resulting in 1.3 million emergency room visits and 350,000 hospitalizations annually. Radio frequency identification (RFID) has been identified as a useful tool within hospital systems; however, this technology has been slow to be incorporated to manage medication administration processes, necessitating exploration of predicting factors of RFID adoption. This quantitative, cross-sectional study explored the contributing factors of United States hospital’s adoption of RFID for medication administration using the technology-organization-environment framework as a foundation and secondary data from the Health Information Management …

Successful Strategies To Sustain Practice Changes In Healthcare, Erin Gable

Walden Dissertations and Doctoral Studies

Healthcare managers implement evidence-based practice to meet the growing needs of aging populations. However, many healthcare leaders fail to sustain newly implemented practices. Grounded in the promoting action on research implementation in health services conceptual framework, the purpose of this qualitative interpretative descriptive study was to explore strategies healthcare leaders use to sustain practice changes to meet increasing demands for quality care of the aging population. The participants included eight healthcare managers from Canada and the United States who led strategies to sustain practice change. The four themes that emerged using semistructured interviews and thematic analysis were staff buy-in, staff …

Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove

Walden Dissertations and Doctoral Studies

Healthcare organizations’ leaders' lack of strategies to effectively deploy and monitor departments’ productivity goals affect overall organizations’ performance. Healthcare leaders who fail to deploy and monitor departmental productivity strategies effectively are limited to enhancing healthcare organizations’ performance outcomes. Grounded in transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies healthcare organizations’ leaders use to effectively identify, deploy, and monitor departments’ goals for improving their overall organization's performance. The participants were 20 healthcare leaders who successfully demonstrated success in improving their organizations’ departmental-specific productivity performance. Data were collected using semistructured interviews and a review of …

Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott

Walden Dissertations and Doctoral Studies

Despite the 2009 mandate from the U.S. Government that healthcare organizations adopt and implement electronic medical records (EMR) systems to avoid fines and take advantage of the benefits EMR systems provide, adoption of EMR systems in the United States has been low. Since 2011, medical facilities have received incentive payments if they demonstrated “meaningful use” of certified EMR systems; however, medical facilities unable to demonstrate meaningful use beginning in 2015 have faced up to 5% penalties. Grounded in the diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies that hospital project managers use …