Date of Conferral
9-2-2026
Date of Award
September 2026
Degree
Doctor of Healthcare Administration (D.H.A.)
School
Health Sciences
Advisor
Sheryl Richard
Abstract
Strokes are costly and the leading cause of disability and a leading cause of death in the United States. Stroke management has improved through a partnership between The Joint Commission and The American Heart Association, which established stroke care center certifications for hospitals nationwide. Despite this progress, North Carolina (NC) remains within the Stroke Belt due to the high prevalence of stroke there. In some areas of NC, the stroke mortality rate is 40% higher than the national average. Guided by the Donabedian model, this quantitative correlational study investigated the association between stroke center designation levels and the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) scores for nurse communication and hospital discharge instructions to determine their impact on stroke outcomes. A point- biserial correlation coefficient was performed using the 2023 NC HCAHPS datasets to compare nursing performance across 56 different stroke center designation levels. Results revealed no significant correlations between stroke designation levels and nurse communication and discharge instructions. The findings suggest that further research into the NC stroke mortality rate is required for better identification of the factors influencing stroke outcomes. This study may promote positive social change by exposing socio-economic, accessibility, and educational factors necessary to improve outcomes.
Recommended Citation
Frederick, Donna Lee, "Level of Stroke Center Designation and the Association With HCAHPS Nurse Communication Scores and HCAHPS Discharge Instruction Scores in North Carolina Hospitals in 2023" (2026). Walden Dissertations and Doctoral Studies. 20782.
https://scholarworks.waldenu.edu/dissertations/20782
