Health and Medical Administration Commons^™

Factors That Determine The Place Of Childbirth In Lagos State, Nigeria, Ohiemi Emmanuel Adegbe

Walden Dissertations and Doctoral Studies

AbstractNigeria is among the 10 countries in the world with the worst maternal mortality. Though most of these deaths can be prevented using antenatal care (ANC) and having institutional deliveries, in Nigeria, ANC attendance and institutional delivery are suboptimal. Research is lacking on the reasons for the disparity between the use of antenatal services compared to deliveries at health centers. The aim of this study was to determine the associations between sociodemographic, obstetric, and health service factors and the place of delivery used by pregnant women in predominantly urban, cosmopolitan Lagos, Nigeria. Because both service delivery and demand factor categories …

Job-Related Stress And Burnout On Turnover Intention Of Nurses In Dallas, Texas, During Covid-19, George Ochieng

Walden Dissertations and Doctoral Studies

AbstractIn a country with a large aging population such as the United States, nursing is a crucial profession that is also a high-stress and high-turnover occupation, leading to a shortage of nurses and increased healthcare costs. The year 2017 saw a 10-year high in nurse turnover. The general management problem is that current efforts to decrease the turnover of nurses remain ineffective. The specific problem studied was the high turnover of nurses in Dallas, Texas, linked to work-related stress and burnout. This quantitative nonexperimental regression and moderation research study aimed to study factors that predict or reduce turnover intention. This …

Service-Level Factors Affecting Completion Of Antenatal Care Attendance In Uganda, Lorna Barungi Muhirwe

Walden Dissertations and Doctoral Studies

Lack of universal coverage of proven, low-cost, high-impact interventions—particularly for underserved and rural populations—remains a key reason for the high rates of maternal deaths in Uganda. Antenatal care (ANC) ensures early detection and treatment of pregnancy-related complications. Completion of recommended ANC visits remains suboptimal, particularly for rural women in Uganda. The purpose of this quantitative, cross-sectional study was to assess facility-level factors affecting completion of ANC attendance among women of reproductive age in a rural district in Uganda. The Dutton theory for initial and continued health services utilization was used to analyze the relationship between facility level factors and ANC …

The Relationship Between Organizational Culture And Hospital Performance In The Veterans Health Administration, Darline Jasmin Nabbie

Walden Dissertations and Doctoral Studies

High quality care consists of a culture that involves staff who are engaged and keepthemselves accountable when providing care. In 2014, employees described their organizational culture at the Veteran Affairs (VA) as entrenched and intimidating. An audit also revealed that in 2014, patients were receiving substandard care. The present study was an analysis of the relationship between organizational culture and hospital performance in the Veterans Health Administration (VHA). This study provided key stakeholders such as the VA administration an understanding of work climate as an indicator of organizational culture and how it affected hospital performance with the VHA. The VHA …

Perceptions Of Nurse's Personal Smartphone Use At Work, Esperanza Criscuolo

Walden Dissertations and Doctoral Studies

Distracted nurses who use their personal smartphone at work has resulted in the diversion of attention from patient care. The specific problem is the personal smartphone use by nurses in the hospital settings has resulted in distracted patient care, leading to wrongful release of patient’s information, medical errors, injury or preventable patient death. The purpose of this qualitative study was to describe the perceptions of nurses regarding distracted patient care in their clinical workplace due to personal smartphone use by nurses. The study was grounded in the distraction-conflict theory conceptual framework. The key research question examined the perceptions of nurses …

Associations Between Provider Type And Medicaid Overpayments, Kezia Hercules

Walden Dissertations and Doctoral Studies

Healthcare costs have been rapidly increasing in the United States and consume a significant percentage of the Gross Domestic Product (GDP). A percentage of these costs are attributed to increased incidences of healthcare overpayments to providers. This study examined the impact of these overpayments by provider type, and the underlying reasons which resulted in overpayments from the Medicaid perspective. The theoretical framework used in this study was Ostrom’s institutional analysis and development (IAD) framework. The study used all available data (N = 682) from New York State Medicaid Inspector General final audits of providers for Medicaid overpayments. A chi-square test …

Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi

Walden Dissertations and Doctoral Studies

AbstractObesity has become a global wellness concern for young adults. In the past, there were very few studies conducted on predictors of obesity among young adults, even though there have been several studies on the potential predictors of obesity on the general population. The social ecological model was used to guide this quantitative cross-sectional study to identify the possible predictors of obesity among young adults. The Behavioral Risk Factor Surveillance System was used to analyze the potential predictors of obesity among young adults between the ages 18 – 34 years old in Montgomery County, Frederick County, and Princess Georges County, …

A Lebanese Health Care Organization’S Strategies To Secure Sustainable Funding, Dania Mahmoud Al Assadi

Walden Dissertations and Doctoral Studies

Fundraising and donations are the main sources of revenue for behavioral health care nonprofit organizations (NPOs) worldwide. Economic, political, social, or health crises impact fundraising and donation sources for behavioral health care NPOs. This qualitative case study addressed strategies that senior leaders of a Lebanese behavioral health care NPO could use in times of crisis. The study also addressed the behavioral health leaders’ experience managing a funding crisis. The Baldrige conceptual framework was used to assess the organization’s effectiveness in seven key areas. Interviews with the senior leaders and analysis of the organization’s archival data were used to inform the …

Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux

Walden Dissertations and Doctoral Studies

The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff …

Using Health Navigators To Reduce Readmission Rates Among Medicaid Or Uninsured Female Patients In The Emergency Department, Susan Renee Ibanez

Walden Dissertations and Doctoral Studies

AbstractThere has not been a significant decrease in hospital readmission rates since the 1980s, which has impacted staffing, operational, and financial resources. Unnecessary 30-day readmissions result in penalties in reimbursement, additional costs, and adverse reactions resulting from the admission for the patient. This quantitative study explored the impact of using health navigators for an emergency department (ED) patient population. The theoretical framework was based on the Donabedian model. The study focused on female patients,some of whom were covered by Medicaid, and some were uninsured. This study posed research questions targeting reducing readmission for female ED patients with no insurance or …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

Managers’ Challenges Complying With Environmental Regulations In Ghana’S Mining Sector, Augustin Tandoh

Walden Dissertations and Doctoral Studies

Even though Ghana’s mining industry has been and continues to be of remarkable benefit to the national economy, environmental pollution continues to plague the industry. The purpose of the qualitative case study was to obtain the perceptions of 9 nongovernmental organization (NGO) stakeholders of the challenges faced by managers in the Ghanaian mining industry tasked with complying with Ghana Environmental Protection Agency (GEPA) regulations. Freeman’s stakeholder theory was the theoretical framework of the study. Data were collected from semistructured interviews with a purposive sample of Ghanaian and international NGO representatives who sought to work with, or even shame and pressure, …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Interprofessional Reflective Journals: Content Themes And Self-Regulated Learning, Joan M. Tunningley

Journal of Occupational Therapy Education

Self-reflection has been linked with clinical reasoning, academic, and clinical outcomes. The purpose of this study was to examine self-reflective journal entries from thirty students for interprofessional core competencies and for self-regulated learning components. The text data was analyzed using an in-depth three cycle coding process, thoroughly described in the methods. The findings were structured into two themes confirming interprofessional content learning: collaboration, team, and communication; and respect and roles. One additional theme emerged, transformation and relatedness, which indicated self-regulated learning components as well as supporting transformative learning. This qualitative case-study contributed to the research of occupational therapy students’ self-reflection …

Patient Blood Management Programs And Their Association With Patient And Organizational Outcomes, Sandra L. Lamm

Theses and Dissertations

Blood transfusions are the most common hospital procedure. However, many transfusions may be unnecessary. These unnecessary transfusion may expose patients to the potential risks of transfusion without improving patient outcomes Patient blood management (PBM) programs emphasize conserving a patient’s own blood resources and only transfusing the minimum amount needed. This study examined the organizational and environmental factors associated with a hospital having a PBM program, or having processes based on PBM, and their impact on organizational and patient outcomes potentially affected by blood transfusions.

A PBM survey was created for this study and used to gather information on hospitals having …

Another Step In Diagnostics Consultation Model© Actualization: Examining The Impact Of Consultation Workflow Processes On Providers' Clinical Decision Making, Elizabeth K. Leibach

Theses and Dissertations

Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions …

Innovations In Diabetes Care For A Better "New Normal" Beyond Covid-19., Shivani Agarwal, Michelle L Griffith, Elizabeth J Murphy, Carol Greenlee, Jeffrey Boord, Robert A Gabbay

Hospital Medicine

The coronavirus disease pandemic has created opportunities for innovation in diabetes care that were not possible before. From the lens of this "new normal" state, we have an opportunity to rapidly implement, test, and iterate models of diabetes care to achieve the quadruple aim of improving medical outcomes, patient experience, provider satisfaction, and reducing costs. In this perspective, we discuss several innovative diabetes models of care which promote collaborative care models and improve access to high-quality specialty diabetes care. We discuss ongoing threats to diabetes care innovation, and offer practical solutions to foster evolution and sustain current strides made during …

Perception Of Stakeholders On Current Perfusion Education In Malaysia, Rafiq Sumardi Omar

Student Works (2020-2029)

Perfusionist is known as a certified medical technician liable for extracorporeal oxygenation of the blood during open-heart surgery. Current curriculum is believed to be at par and is aligned with the National Occupational Skills Standard, however, the scope of perfusion practice keeps changing with the advancement of technology and procedures, and there is a demand for specialty area such as extracorporeal membrane oxygenation (ECMO). Therefore, current curriculum should be re-evaluated by taking consideration from multiple stakeholders’ perception on current needs, content, educational strategies, teaching methods, assessment methods, and curriculum management. Hence, this study aimed to explore perception of stakeholders in …

Perception Of Undergraduate Medical Students On Integration Of Radiological Anatomy For Pre-Clinical Teaching, Reshma Mohamed Ansari

Student Works (2020-2029)

Integration is the way forward to enable accommodation of the ever-expanding content in medical education. While revising the curriculum, stakeholders’ perception aids to tailor a curriculum matching their needs. Radiological anatomy (RA) is an integrated discipline of topographical, cross-sectional anatomy with radiological representation of structural anatomy. Though RA has been widely incorporated in most of the medical curricula, there is a dearth of standardization in terms of student learning time (SLT), content and teachers. This study was planned to record the perception of MBBS students on RA teaching in pre-clinical years in University of Cyberjaya, Malaysia. A modified, piloted and …