<p> Cyberattacks have occurred for many decades, but some organizations are not implementing measures to reduce the risk of these threats. The healthcare industry has had more than 30 years' worth of cyberattacks, yet many healthcare organizations do not have adequate measures against these risks. The problem addressed by this study was that healthcare organizations are vulnerable to cyberattacks, yet leadership at few healthcare organizations actively implement adequate cybersecurity practices. The purpose of this qualitative multiple case study with in-person interviews was to identify how employee motivation affects cybersecurity implementation in healthcare facilities in Southeast Michigan and Mid-Michigan areas. The researcher used protection motivation theory to explore how employee motivation affects cybersecurity implementation in healthcare facilities. A qualitative multiple case study with in-person interviews was used to collect the data. The study population was employees at healthcare facilities. The study sample was five employees from each of two healthcare facilities in Southeast Michigan and Mid-Michigan areas. Participants expressed knowledge regarding the seriousness of the threats and implemented some safeguards, but they do not believe the threat likelihood is severe enough to motivate any additional action or interest. Most participants believed current preventative measures were effective, however since the threats were unlikely there was no motivation for additional preventative measures. The literature review indicated that most companies had experienced cyberthreats, creating a potential disconnect with these participants' perceptions.</p><p>

<p> <b>Objectives:</b> This research identified the potential predictors of medication adherence and studied the impact of medication adherence on healthcare utilization and costs among elderly with diabetes who were enrolled in a State Pharmaceutical Assistance Program (SPAP). </p><p> <b>Methods:</b> Pharmaceutical Assistance Contract for Elderly (PACE) programs&rsquo; database was used to identify study population and estimate medication adherence as proportion of days covered (PDC) for 12-months post-index observation period (adherent: PDC &ge; 80%; nonadherent: PDC &lt; 80%). Healthcare utilization and costs for the study period were estimated using Pennsylvania Health Care Cost Containment Council&rsquo;s hospital inpatient discharge records. Healthcare utilization measures included all-cause, diabetes-specific, diabetes-related and diabetes-specific &amp; related number of inpatient hospital admissions and length of stay (LOS). Multiple regression analyzes were performed to determine the predictors of medication adherence and to assess the association of medication adherence with risk of hospitalization, hospital service utilization and costs. </p><p> <b>Results:</b> Among 9,497 elderly PACE enrollees with diabetes, 81% were adherent and 21% were hospitalized. Race, marital status, number of unique medications and out-of-pocket payment were the significant predictors of medication adherence. The odds of being hospitalized were higher for nonadherent patients by the factor 2.030 than adherent patients (95% CI: 1.784&ndash;2.310). After controlling for covariates, non-adherent patients had significantly a greater number of all-cause (IRR 1.2727; 95% CI 1.1937&ndash;1.3569), more diabetes-related (IRR 1.2210; 95% CI 1.0492&ndash;1.4210) and more combined diabetes-specific &amp; related (IRR 1.2106; 95% CI 1.0495&ndash;1.3965) hospital visits than adherent patients. After adjusting for covariates, LOS for non-adherent patients was longer for all-cause (IRR 1.2388; 95% CI 1.1706&ndash;1.3111), diabetes-related (IRR 1.1341; 95% CI 1.0415&ndash;1.2349) and for diabetes-specific &amp; related (IRR 1.1271; 95% CI 1.0357&ndash;1.2267) hospitalization than adherent patients. GLM models showed that medication nonadherence was associated with significant increase in all-cause hospitalization costs ($22,670 vs $16,383; p &lt; 0.0001) and diabetes-related hospitalization costs ($13,518 vs $12,634; p = 0.0003). </p><p> <b>Conclusions:</b> Medication nonadherence was associated with an increased risk of hospitalization, greater number of hospital visits, longer hospital LOS and substantial hospitalization costs among elderly SPAP beneficiaries with diabetes. Utilization of our findings to develop interventions or policies to improve medication adherence would significantly impact the US healthcare system particularly while allocating limited healthcare resources.</p><p>

<p> In the United States, type 2 diabetes mellitus (T2DM) has been categorized as a major health-threatening problem affecting a wide cross section of people. About one third of the population is unaware that they have the disease; however, early recognition of symptoms would lead to prevention, diagnosis for a better prognosis, and, in some cases, the reversal of the disease. Researchers have shown that late diagnosis leads to high mortality, morbidity, disability, loss of productivity, and high costs of health care to individuals, families, and the government. The main purpose of this study was to establish a new model mechanism for the detection and prevention of T2DM using the lived experiences of the primary care physicians. This qualitative study investigated the lived experiences of seven primary care physicians from the Northern California Bay area community. The primary data collection method was by interview through e-mail correspondences and the data were organized, coded, and analyzed on the responses to the interview questions and research questions. The research study resulted in four major themes: (a) lifestyle choices to reduce T2DM, (b) desire to improve the lives of patients, (c) government involvement, and (d) shared perception of T2DM. Recommendations were developed based on the compiled data from this study and future studies could involve health-care accessibility and treatment interventions of T2DM for patients with low socioeconomic status and use of the new model mechanism to improve early detection and prevention of T2DM.</p><p>

<p> In response to the growing need for early disease detection and diagnosis, Mastergene aims to provide genetic testing services ranging from new born screening to diagnostic screening for individuals up to 65 years of age to gain insight into their genetic information &amp; understand their own health &amp; personal information. This information will assist individuals in making treatment decisions for healthy living. Through Indian healthcare market analysis, it is evident that there exists a huge gap between hospitals and patients when it comes to understanding genetic testing and its benefits. Mastergene, with its innovative in-house laboratory, will arise awareness amongst the general population and will facilitate early detection of highly prevalent diseases in the Indian community. As a stand-alone diagnostic laboratory, Mastergene will outsource genetic testing kits from a supplier, send it to its patients on order and obtain patient&rsquo;s sample in that genetic test kit for testing purposes. In conclusion, Mastergene will bring this enormous breakthrough to diagnose the disease from its root cause rather than symptoms alone.</p><p>

<p> The purpose of this research was to examine how the transformational healthcare information technology (IT) leader perceives the influence of informal social networks and team commitment on business-IT alignment. Business-IT alignment has become crucial to organizations in today&rsquo;s fast-paced environment where technology has become an integral component of any product offerings. Although many types of alignment exist, this study specifically focused on social alignment between business-IT for two reasons: it is the basis for other types of alignment, and there is little research in this area. Eighteen leaders in healthcare, who scored 3 or more on the Multifactor Leadership Questionnaire (MLQ), participated in the study. The informants had titles ranging from manager to chief information officer (CIO). The research used a generic qualitative inquiry method to describe and interpret the subjective opinions, attitudes, and reflections of the study&rsquo;s informants. Data used in the study were primarily interviews, with visual and aural observation where available. The study identified three major findings. First, transformational healthcare IT (HIT) leaders identified and encouraged individuals who proactively developed social capital between the business and IT, and who positioned themselves centrally between the business and IT bridging the divide between the two functions. These boundary-spanning individuals exhibited a lack of homophily and a high degree of trust with their customers. Second, transformational HIT leaders focused on socializing individuals to the organization, while building a culture of transparency with a high degree of information flow. Finally, transformational HIT leaders codevelop the IT strategy with their staff and business, which allows for distributed decision making and a shared ontology, supporting a lean and Agile IT function.</p><p>

<p> Due to the deinstitutionalization movement, many mentally ill individuals have left asylum treatment centers and have had no safe housing. The purpose of this grounded theory study was to explore the attitudes and opinions of homeless, mentally ill people regarding the community resources they consume and how they perceive and navigate those resources. The research questions focused on homeless, mentally ill individuals' shared experiences accessing health care, psychiatric care, and housing services as well as, barriers that impacted homeless, mentally ill individuals' use of these services, and their needs to address these barriers. Data were collected using face to face, semi structured interviews with 12 homeless individuals. The thematic analysis consisted of open and axial coding. Axial coding was used to assign and like categories and subcategories of codes according to their properties and dimensions. Emergent patterns were identified from the data to explain the lived experiences of mentally ill homeless people and their opinion and attitudes towards navigating of mentally ill homeless programs. The responses expressed the needs that were unmet: lack of mental health assistance, food needs, hygiene needs, safety concerns and survival needs. In order to make positive social change outreach predicated on increasing clear communication between outreach workers and the homeless mentally ill allows for developing a trusting relationship necessary in establishing contact and credibility in providing on going impactful treatment for the homeless mentally ill population. </p><p>

<p> The disparities in healthcare and the challenges of healthcare leaders in achieving positive health outcomes are a priority in America. Much discourse and policy is currently evolving in the legislative and executive branches of government. The United States has the highest health expenditures in the world and is classified as one of the unhealthiest countries. Many factors contribute to the disparities. These factors include socioeconomic, cultural competency, social determinants, policy, and health leadership. The challenge for health leaders is to identify strategies to improve the trends and e the status of health quality and well-being for all Americans. This study employed qualitative research using a phenomenological approach; surveying healthcare leaders in the United States. Data collection employed in-depth interviews of healthcare leaders with at least two years of experience in their current role. This qualitative study identified challenges of leaders in health care, best practices of successful healthcare leaders to improve patient access, narrow the gap of health-related disparities, and evaluated techniques and methods to improve health outcomes across racial and ethnic groups.</p><p>

<p> <b>Purpose:</b> The purpose of this DNP quality improvement project was to increase primary care provider knowledge about indications for adolescent depression screening. </p><p> <b>Background:</b> Approximately 13.3% of adolescents experienced depression in the past year. In Oklahoma alone, rates are increasing, with depression totaling 60% of all mental health illness among adolescents. Primary care providers see approximately 75% of adolescents; however, mental health conditions are missed 84% of the time. Current clinical guidelines recommend screening for adolescent depression during wellness visits or when risk factors are present. </p><p> <b>Methods:</b> The providers of interest were nurse practitioners, physicians, and physician assistants providing primary care to children between the ages of 12 and 17 in a private pediatric practice group consisting of three clinics. The Model for Improvement guided the process of developing, implementing, and evaluating an educational intervention through use of a pre-test/post-test quantitative design. An email invited participants to complete an anonymous pre-test survey to evaluate knowledge and beliefs surrounding adolescent depression, then view an educational presentation on adolescent depression and screening guidelines, then complete a post-survey to evaluate any changes in knowledge and intention to screen. Results were shared with clinic representatives to help refine the education for future testing cycles and other clinic sites. </p><p> <b>Results:</b> Data collection took place over one week. Five providers completed both the pre-test and post-test surveys. Provider knowledge scores significantly increased 29% after participating in the education and self-reported knowledge on screening increased. </p><p> <b>Conclusions:</b> DNP quality improvement projects like this help develop strategies to increase best practices, leading to improved patient outcomes. Nurse-led improvement programs like this contribute to healthcare literature and the advancement of the nursing profession by developing patient-centered interventions applicable to a wide variety of providers. Results may be used to develop strategies to increase and align provider practices with best standards to help promote early identification and treatment of adolescents with depression. </p><p>

<p> Healthcare quality measurement and care reimbursement have become a central focus for leaders and administrators of healthcare organizations. The provision of high-quality healthcare is contingent on the skills and abilities of leaders and clinical staff who support evidence-based clinical practice through implementation strategies. The problem defined in this qualitative exploratory multiple-case study was concerned with the frequency of unplanned hospital readmissions occurring in the state of Florida specifically, in healthcare facilities located in Broward, Miami-Dade, and Monroe Counties (tri-county area). Healthcare stakeholders working in organizations located in the tri-county area report hospital readmission rates of 23%, that resulted in higher financial penalties. The purpose of this qualitative exploratory multiple-case study was to explore the reasons for higher than expected unplanned hospital readmissions in healthcare facilities located in the tri-county area of south Florida to help hospital administrators to improve healthcare quality through reducing unplanned rehospitalizations. Thirteen participants contributed to this study: 4 (31%) healthcare leaders, 4 (31%) clinicians, and 5 (38%) registered nurses. Through the collective experiences of healthcare stakeholders, two primary and two secondary themes emerged to provide a clearer understanding of the contributing factors related to unplanned hospital readmissions. Four themes namely, education, population, and cultures and resources supported existing literature and provided new knowledge related to the importance of executive leader knowledge, nurse educational and skill levels, patient literacy and language, and cultural elements when applying evidence-based clinical practices in complex healthcare environments. </p><p>

<p> Stress in the Intensive Care Unit (ICU) and the leadership style of the nurse manager are predictors of job satisfaction, which is linked to intent-to-leave and increased turnover rates among ICU registered nurses. This quantitative correlational study determined that authentic leadership behaviors of transparency, self-awareness, balanced processing, and internalized moral perspective of the nurse manager significantly correlated with job satisfaction and predictor of stress among ICU RNs. A Pearson correlation was used to analyze the data from a stratified random sampling of ICU RNs from the four different not-for-profit hospitals in the northwestern United States. The positive relationship between the nurse authentic leadership behaviors of transparency, self-awareness, balanced-processing, and ethical/moral behaviors and job satisfaction and stress among ICU registered nurses recommends for the nursing leaders to have an authentic leadership training. The information gathered through this study provided the nursing leaders a better understanding of authentic leadership theory to promote a healthy work environment. Thus, a satisfying leadership behavior fosters trust, enhance job satisfaction, and supports a less stressful working situation for the ICU staff nurses.</p><p>