Ageing changes in cerebellar acetylcholine-mediated blood pressure response

Staffing Standards and Care Outcomes in For-Profit and Not-For-Profit Religious-Based Nursing Homes by Omotayo O Omotowa MSN, Walden University, 2012 BSN, Lewis Clark State College, 2007 MA, University of Idaho, 2001 MPA, University of Ilorin, Nigeria, 1997 BSc, Obafemi Awolowo University, Nigeria, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing Walden University November 2017 Abstract Vulnerable older adults residing in nursing homes continue to experience poor care outcomes due to nurse staffing levels that are below the levels required for maintaining their well-being. Studies have shown that patient care outcomes in nursing homes are related to nurse staffing standards/levels, which are affected by profit maximization on adherence to registered nurses and licensed nurse staffing standards. The purpose of thisVulnerable older adults residing in nursing homes continue to experience poor care outcomes due to nurse staffing levels that are below the levels required for maintaining their well-being. Studies have shown that patient care outcomes in nursing homes are related to nurse staffing standards/levels, which are affected by profit maximization on adherence to registered nurses and licensed nurse staffing standards. The purpose of this descriptive study was to determine if there was a relationship between adherence to staffing standards and care outcomes in for-profit (FP) and not-for-profit religious-based (NFPRB) nursing homes using the profit maximization theory. Research questions focused on the relationships that profit maximization and nurse staffing standards had on the quality of care outcomes measures and the differences between the nursing homes on these variables. Secondary data were collected from public database and analyzed using the descriptive and inferential statistics, nonparametric tests, and binary logistic regression. Findings showed that profit measures were not related to staffing standards and care outcome measures in the NFPRB. There was a significant relationship between FP nursing homes and standards to care outcomes in FP but not in the NFPRB nursing homes. FP nursing homes did worse than NFPRB on care outcomes. Further research, using qualitative and mixed methodologies, is needed to study the effects of profit measures on nursing home care outcomes. The results of this study can effect positive social change by informing policy makers and healthcare professionals/leaders, and, by reducing adverse events, untimely death, and positively affecting the quality of care and life of the frail and vulnerable older adults residing in nursing homes. Staffing Standards and Care Outcomes in For-Profit and Not-For-Profit Religious-Based Nursing Homes by Omotayo O Omotowa MSN, Walden University, 2012 BSN, Lewis Clark State College, 2007 MA, University of Idaho, 2001 MPA, University of Ilorin, Nigeria, 1997 BSc, Obafemi Awolowo University, Nigeria, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing Walden University November 2017 Dedication To God be the Glory for the Grace He Bestowed upon me during this process. To my late loving father who believed in me and hoped that I would attain greatness in education. Big thanks to my mother, who made the sacrifice and gave me the gift of high education when and where many did not believe in girls’ education, I am very grateful mom. And, to my late loving father-in-law who used his educational experience, position, and substance to inspire and help many in his community to attain higher education. I love you, dad. Acknowledgments First, and, very importantly, I acknowledge my committee members, Drs. Leslie Hussey and Janice Long, for their time, efforts, support, and guidance through this dissertation journey. I am grateful for your quick responses to my work and encouragement during the hard times. Thank you. I, also, appreciate Dr. Eileen Fowles’ contributions to the successful completion of my dissertation. Thank you. I acknowledge my husband, Dr. Bamidele A. Omotowa, who provided the needed family support for me and our children when mommy could not; the past three years were rough for us all, but we did it together. I am grateful to our sons and daughters, Olaoluwa, Ibukunoluwa, Araoluwa, and Ilanaoluwa; their love, hugs, kisses, and words of encouragement and assurances kept me going through the endeavor. I love you all. My appreciation also goes to my big sister, T.O.B Folarin, who cared for me like her own child during the foundational years of my education and Mr. Akano, my teacher. And, to my three late maternal aunties, I am grateful for your hard work in educating your children, including your girls. You were a motivation in the right direction. To Bosen, J. and Ebiekuraju, O. I say thank you for the technical support you provided to help me access the Medicare Cost Report. I want to appreciate Drs. Denner, P., and Htway, Z. for their efforts in guiding me through the statistical analysis of this dissertation. Finally, I appreciate Drs. McNeil, B., Nies, M., Kehinde, J., Stinson, L., D’Arcy-Evans, M., Flynn, T., Renn, N., Professors Hibbard, A., Keatts, E., and Fonnesbeck, B. for being my professional mentors, role models, encouragers, and support in my professional development.