Health and Medical Administration Commons^™

Impact Of Advanced Access Scheduling On Missed Appointment Rates In Primary Care, Helen Yvonne Krippel

Walden Dissertations and Doctoral Studies

A major problem encountered within outpatient physician offices are missed appointments. Missed appointment research revealed how no-show rates remain a focus for healthcare administrators as decreasing no-show rates may reverse harmful health consequences. The purpose of this study, which also addressed the research gap, was to determine if there was an association between advanced access scheduling and no-show rates for patients scheduled with preferred primary care physicians versus nonpreferred primary care physicians. The health belief model was the conceptual framework as missing a prescheduled appointment is a health behavior. The 1st and 2nd research questions examined whether there was a …

Advanced Practice Registered Nurses And Their Knowledge Regarding The Hindrance Of Obesity, Crystal Rainey

Walden Dissertations and Doctoral Studies

Advanced Practice Registered Nurses and Their Knowledge

Regarding the Hindrance of Obesity

by

Crystal N. Rainey

MSN, Walden University, 2014

BSN, University of Arkansas in Little Rock, 2011

AASN, Southeast Arkansas College, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2020

Human Resource Strategies Used To Retain Millennials In Hospitals, Thomas F. Turner

Walden Dissertations and Doctoral Studies

Lead hospital human resource managers (HRMs) experience new recruitment, retention, and training costs for Millennial employees to close the skill gaps and address challenges from Baby Boomer employees retiring. The median turnover rate of 3 years for Millennial workers in hospitals is more than 3 times higher than older workers at hospitals. The purpose of this qualitative multiple case study was to identify retention strategies hospital HRMs use to address the retention of millennial generational employees beyond 3 years. Transformational leadership theory was the conceptual framework for the study. The data collection process included semistructured interviews and a review of …

The Impact Of Digital Self-Scheduling On No-Show Event Rates In Outpatient Clinics, Karen M. Marhefka

Walden Dissertations and Doctoral Studies

The failure of patients to keep scheduled appointments results in significant loss of revenue due to decreased administrative efficiency, expensive clinical resource time, disruptive continuity of care between the patient and the provider, and reduced quality of care. The purpose of this quantitative study was to explore the use of digital self-scheduling as an emerging alternative to traditional office-assisted scheduling methods and determine if its use has an impact on reducing the occurrence of no-show events. The theoretical framework used for the study was the Consumer Behavior Theory. Three years of de-identified secondary data were collected from a large, adult …

Racial Differences In Hospital Readmission And Reimbursement Rates For Patients With Congestive Heart Failure, Catherine Talongwa

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a …

Newly Licensed Registered Nurse Generation Cohorts And Retention In First Registered Nurse Positions, Elizabeth S. Gizenski

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to evaluate the association between newly licensed registered nurses (NLRN) generational cohorts and NLRN who plan to leave or have left their first nursing position. The research problem focused on the generational cohorts of NLRN and retention. The research questions addressed different generations of NLRN, their intent to stay in their first job, and whether poor orientation was a factor for those who already left their first nursing position. The theoretical foundation was Strauss–Howe’s generational theory explaining how each generation views the world based on what they experienced in their lifetime. Data retrieved …

Inpatient Stays Involving Mental Illness And Substance Use Disorders, Latonya Smith

Walden Dissertations and Doctoral Studies

Nearly one-third of Americans suffer from a mental illness. Twenty-three million people are affected by substance use or a dependency issue and the length of stay for patients enrolled in treatment services is rising. Mental health issues and substance use are rising within the United States and are associated with increased healthcare costs and the need for healthcare services. The purpose of this quantitative study was to determine the association between inpatient services, residential, outpatient, age, and payer source on substance use and mental health services using the 2017 Substance Abuse and National Mental Health Services Administration survey. The Donadebian …

Successful Retention Strategies By Perfusion Managers To Reduce Perfusionist Attrition, Krysta Lynne Gleeson

Walden Dissertations and Doctoral Studies

Perfusion managers who lack strategies to mitigate perfusionist attrition place a strain on their remaining employees and incur replacement costs for their organization. Grounded in Vroom’s expectancy model, the purpose of this multiple case study was to explore strategies perfusion managers use to mitigate perfusionists attrition within open-heart centers in a northeast U.S. city. Data were collected through digital semistructured interviews with 5 licensed perfusionists who demonstrated successful staff retention. Perfusionist job listings were used as a secondary data source. Data were analyzed using Yin’s 5 step process. Four significant themes emerged: job satisfaction, work-life balance, surveys, and compensation. Perfusion …

An Examination Of Virginia Wic Staff’S Attitudes And Knowledge Towards The Brush, Book, Bed Oral Health Program, Tia Jackson, Tegwyn H. Brickhouse, Lizbeth Snead, Natalie Pennywell

Graduate Research Posters

Introduction: Families who are low income and have low oral health literacy tend to have poor oral health. The Brush, Book, Bed (BBB) program helps caregivers establish a consistent night routine for their children that includes brushing teeth, reading, and an age-appropriate bedtime. BBB has been shown to increase oral hygiene behaviors and therefore oral health outcomes. Studies have shown that children who participate in Women, Infants, and Children, (WIC) programs are more likely to access dental services. This study examined local Richmond, Virginia (VA) WIC staff on their current oral health knowledge and views on implementing BBB.

Methods: A …

A Systematic Review Of Culturally Sensitive Strategies To Address Obesity Among Hispanic-American Pediatric Patients In The Primary Care Setting, Rachel Vurbeff

Walden Dissertations and Doctoral Studies

Obesity significantly increases morbidity and mortality, and its incidence amongHispanic-American children and adolescents exceeds that of any other ethnic group in the United States. Without proper intervention, these children and adolescents will experience the burden of costly comorbidities across the lifespan. Guided by Leininger’s theory of culture care diversity and universality, the purpose of this project was to identify evidence-based, culturally sensitive strategies to prevent and treat obesity among Hispanic-American pediatric patients in the primary care setting through a systematic review of the literature utilizing the Joanna Briggs Institute method. The practice-focused question that guided this review focused on finding …

Attitude Towards Patient Undergraduate Medical Students In The University Of Malaya, Jeevitha Rajasingam

Student Works (2020-2029)

In the last two decades, patient safety awareness has become one of the emerging themes. To prevent from doing harm to patients, safe medical practices should be implemented and followed strictly. Therefore, a basic understanding of human factor principles need to be instilled into all health care workers. Medical universities play a vital role in fostering patient safety attitudes of their students towards the importance of patient safety during their practise. However, the medical curricula still face challenges regarding the correct timing and appropriate methods of instruction in their understanding of their principles. Experiments have shown that patient safety classes …

Evaluation Of The Tuberculosis Management Program In Ghana, Boampong Akese

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major health issue estimated to be affecting about 1/3 of the world’s population. TB is a major health problem in Ghana primarily because of weak health infrastructure and poor TB case detection and management practices. Measuring and evaluating the performance of health programs is an important aspect of health care services in any country. The purpose of this quantitative study was to evaluate the TB management program in Ghana. A cross-sectional research design was used to answer the research questions. Secondary data were obtained from the Ghana District Health Information Management System database. The theoretical foundation …

Antibiotic Stewardship And The Quality Of Life For Residents Over 65 Years, Reshma Beharry-Guest

Walden Dissertations and Doctoral Studies

Antibiotics were often over-prescribed in long term care facilities (LTCFs) and antibiotic stewardship guidelines, established by the CDC were not followed. The nursing home administrator was responsible for the quality of care for the residents and ensured that the facility met and/or exceeded the CMS antibiotic stewardship standard of care. The purpose of this quantitative study was to analyze operational secondary data collected from a Texas LTCF regarding antibiotic utilization for male and female residents over 65 years. The theoretical framework of the social cognitive theory was applicable for quality improvement in the LTCF setting. The data analysis showed that …

Comparison Of Diagnosis And Hospital Referral Rates Between Physician And Non-Physician Practitioners, Joshua Alan Fisher

Walden Dissertations and Doctoral Studies

Physician extenders as support in healthcare facilities has been increasing in the United States and has the potential to help in currently under served communities. This study evaluated the quality of care provided by physician extenders through the examination of average diagnosis and referral rates that may inform healthcare leaders and policymakers in future decisions. The literature review pointed to a gap in the research related to the quality of care based on patient diagnosis and referral rates by physicians and physician extenders. The conclusions were based on a quantitative analysis of secondary data from the National Ambulatory Medical Care …

Respiratory Therapists' Roles In Reducing 30-Day Readmission Rates For Patients With Copd, Soumaya M. Osen

Walden Dissertations and Doctoral Studies

Since 2014, hospital administrators initiated several measures to reduce the 30-day readmission rates for patients with chronic obstructive pulmonary disease (COPD). The research problem was that the respiratory therapists (RTs) were excluded from the discharge planning teams in many hospitals while 20% of patients with COPD continue to be readmitted within 30-day post discharge. The purpose of this qualitative study was to seek understanding of the care managers’ perceptions regarding the potential role of the respiratory therapists in the discharge planning for patients with COPD. The theoretical framework for this study was the systems theory in management. The research questions …

Healthcare Organizational Design Strategies To Improve Performance, Katherine Madonna Chubbs

Walden Dissertations and Doctoral Studies

Business leaders are exploring ways to improve organizational performance through organizational design, including reviewing the structures of their organization. Grounded in McKinsey’s 7S framework, the purpose of this qualitative single case study was to explore organizational design strategies healthcare leaders used to improve organization performance. Participants were 6 leaders within a healthcare organization in Alberta, Canada, who successfully developed and implemented organizational design strategies to improve organizational performance. The data collection techniques included a review of internal and external documents, a reflective journal, and semistructured interviews. I used methodological triangulation and thematic analysis to complete the data analysis. The data …

The Complete Care Model: Improving Diabetic Patient Outcomes In Correctional Facilities, Chad Williams

Walden Dissertations and Doctoral Studies

Diabetes is a growing problem, becoming an increasing concern within prisons. Research suggests that as many as 4.9% of the inmate population is diagnosed with diabetes. To provide constitutionally required healthcare to the inmate population, corrections officials must identify a validated diabetes treatment modality geared toward improving diabetes outcomes. The purpose of this quantitative study was to evaluate the impact of a patient centered medical home (PCMH) based model of healthcare within the California Correctional Health Care Services (CCHCS) on diabetic prisoners. Using the social construct theory as the framework, the research questions were focused on determining whether there was …

Mindfulness In Healthcare: Exploring The Gap Between Leadership Practice And Employee Burnout, Bryn Saunders

Walden Dissertations and Doctoral Studies

A healthcare employee’s ability to provide proficient, or quality, care to patients is impeded by burnout. Previous studies showed high levels of burnout is a common problem in healthcare, indicating there is a lack of support for employee health. The purpose of this quantitative study was to determine whether mindfulness training reduced burnout in healthcare professionals. The study focused on increasing knowledge between the leadership practices and programs used to improve healthcare proficiency by analyzing the relationship between mindfulness and three measures of burnout: sense of efficacy, depersonalization, and emotional exhaustion. The Western concept of mindfulness that emphasizes self-awareness and …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Recognition, Classification, And Help-Seeking Behavior Of Nigerian Immigrants In Minnesota, Frederick Nnabuchionye

Walden Dissertations and Doctoral Studies

Immigrants from non-Western cultures are known to underutilize mental health services in the United States. Part of the problem is in the way how cultures recognize and classify symptoms as a mental disorder. A report from the Minnesota Ombudsman's Office for Mental Health showed that out of every 6 suicide-related deaths in Anoka Regional Treatment Center in Minnesota, 4 are of African descent. The purpose of this quantitative study was to investigate the cultural view of depressive symptoms as possible predictors of attitude toward seeking professional psychiatric help. The theory of reasoned action/ theory of planned behavior provided the framework …