Digital Commons Network^™

Pharmacy Service Quality Strategies To Mitigate Prescription-Only Medicines Stockouts, Martin Mulomba

Walden Dissertations and Doctoral Studies

Some patients in Lusaka, Zambia experience adverse health outcomes when pharmacists are not able to fill life-saving, prescription-only medications (POMs) because of supply-chain shortages. Important to pharmacists are strategies to improve POMs supply and mitigate out-of-stock occurrences. Grounded in the SERVQUAL theory as the conceptual framework, the purpose of this qualitative multiple case study was to explore the service quality strategies pharmacists employ to mitigate shortages and enhance patient care. The participants were eight pharmacists who successfully mitigated POMs shortages for improved customer service. Data were collected using semistructured interviews and publicly available documents. Data were analyzed thematically and six …

Promoting Equitable Early Childhood School Readiness Through Prevention And Advocacy In A Rural Community, Teri Kimberling

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The goal of this Social Change Portfolio is to promote healthier developmental outcomes for young children in our rural community by increasing access to early childhood readiness supports that prevent social-emotional and behavioral difficulties in kindergarten.

Significant Findings

Early childhood school readiness is a significant public health and mental health concern in the rural coastal community of Lincoln County, Oregon. A large number of children enter kindergarten without any school readiness, whether it was in a formal preschool or just done at home. This can be due to many factors, including socioeconomic disparities, such as high poverty rates, …

Strategies To Improve Team Cohesion Among Hybrid And Remote Teams To Improve Customer Satisfaction, Leslie Collins

Walden Dissertations and Doctoral Studies

A lack of team cohesion among hybrid and remote teams can negatively affect customer satisfaction. Customer service leaders require effective strategies to improve team cohesion in increasingly flexible work environments; however, limited understanding exists regarding the strategies these leaders use to foster cohesion in hybrid and remote work settings. Grounded in the composite conceptual framework of theories of group development and customer focus, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies that some leaders in the South Central region of the U.S. customer service organizations use to improve team cohesion among hybrid and remote …

Staff Education For The Management Of Chronic Pain In Patients With Mental Health Disorders, Jude Osagie Ukpebor

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a practice-focused quality improvement staff education initiative designed to address a gap in nurses’ knowledge related to chronic pain management in patients with mental health disorders. Chronic pain frequently coexists with psychiatric conditions, yet nurses often lack formal education on biopsychosocial, trauma-informed, and non-pharmacologic pain management approaches, contributing to fragmented and inequitable care. Addressing this gap is essential to improving patient outcomes and advancing evidence-based nursing practice. The practice-focused question asked whether implementing a targeted nurse education program would improve nurses’ knowledge related to chronic pain management in patients with mental health disorders. …

Executive Leadership System Improvement Mobile Lung Cancer Screening, Tracy Holladay

Walden Dissertations and Doctoral Studies

This doctoral project is an evidence‑based practice initiative to develop a mobile lung cancer screening program that expands early detection services in rural Arkansas. The practice problem involves low screening rates, high mortality, and access barriers that delay diagnosis for high‑risk individuals, making this work essential to nursing roles in prevention, coordination, education, and population health. The practice focused question examined whether creating a Mobile Lung Cancer Screening Unit proposal will support timely referrals and treatment. The purpose of the project was to design a feasible, evidence informed model aligned with organizational capacity and equitable access goals. Analytical strategies included …

Staff Education To Enhance Psychiatric Medication Adherence In Psychiatric Care, Emmanuel Nusta

Walden Dissertations and Doctoral Studies

Medication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play …

Staff Education To Emergency Nurses On Improving Handoff Communication Using The I-Pass Tool, Lekeyna Gleason

Walden Dissertations and Doctoral Studies

Effective communication during nurse-to-nurse handoff remains a critical determinant of patient safety in high-acuity emergency settings, where rapid decisions and fluctuating clinical demands can lead to inconsistent structure, omission of critical information, and inefficient transitions of care. The practice gap identified was a lack of standardized knowledge and consistent use of a structured bedside handoff tool among emergency department (ED) nurses. The practice-focused question guiding this project was, Does educating ED nurses on using the I-PASS bedside handoff tool improve knowledge of structured bedside reporting as measured by pre- and post-implementation surveys? The ADDIE framework and the Johns Hopkins evidence-based …

Strategies Some Business Leaders Use To Implement Technological Innovation For Increasing Performance, Judy Muiruri

Walden Dissertations and Doctoral Studies

Abstract Incorporating technological innovation is essential for maintaining organizational performance. Company executives in software-as-a-service (SaaS) enterprises who do not incorporate technological innovation risk reduced organizational performance and profitability. Grounded in Rogers' Diffusion of Innovations (DOI), the purpose of this qualitative pragmatic inquiry project was to explore strategies employed by business leaders to effectively implement technological innovation and, in turn, increase organizational performance. . The participants consisted of fifteen business leaders who successfully incorporated technological innovation designed to improve organizational performance and profitability. The data collection process incorporated both semi structured interviews combined with a review of publicly available documents about …

Attribution Of Behavior And Misdiagnosis In Mental Health Evaluation Of Primary School Children, E’Mon Ambers

Walden Dissertations and Doctoral Studies

The problem of misdiagnosis of mental health conditions in primary school aged children because of attributions related to misbehavior is a significant issue. The purpose of this qualitative multiple case study was to explore a selected sample of educators’ and mental health professionals’experiences and perceptions of the risks of attribution errors in mental health misdiagnosis among primary school-aged children in Richmond, VA. The research questions addressed how stakeholders perceive the role of attribution errors in professional practice contributing to misdiagnosis, as well as what practice-based and systemic changes stakeholders propose to enhance diagnostic accuracy. Narrative data was collected from educators …

Students’ Motivation For Online Learning Of English As A Second Language Through The Lens Of The Self-Determination Theory, Wajeeh Daher, Ahlam Anabousy, Ahmad Amer, Nael Issa

Higher Learning Research Communications

Learning English as a second language (ESL) can be challenging for students, so it is essential to keep them motivated. One way to motivate students is through electronic programs (e-programs) that can enhance their motivation to learn. This research examined student learning motivation through the lens of the self-determination theory (SDT), with 39 preparatory-year students participating and learning in a blended context. Nine students were interviewed regarding their motivation to learn English using the electronic program, and both quantitative and qualitative research methods were used to examine participants’ motivation to learn English in that context. The quantitative results indicated that …

Digital Trust Recovery: Effective Data Breach Management Approaches, Milbert Flores Dacayana

Walden Dissertations and Doctoral Studies

In the digital economy, organizations face an increasing number of data breaches that compromise sensitive information and erode consumer trust. Some organizational leaders are concerned about the lack of effective strategies to manage data breaches and restore stakeholder confidence, which threatens organizations’ reputation and financial stability, and long-term trust in digital systems. Grounded in cybersecurity risk management theory (CRMT) and situational crisis communication theory (SCCT), the purpose of this qualitative pragmatic inquiry was to explore the strategies employed by data managers in Virginia, Maryland, and Washington, DC, to manage data breaches and rebuild consumer trust. Participants were 10 experienced data …

An Assessment Of New Employee Training In A U.S. Government Agency, Kisaana Fernanders

Walden Dissertations and Doctoral Studies

This study evaluated the utility of a newly developed employee training initiative within a U.S. government disaster recovery agency. The purpose of the professional administrative study was to examine the existing training architecture and recommend improvements aligned with the agency’s mission. A general qualitative approach was employed, using interviews and surveys with government personnel to elicit their perceptions of the training’s effectiveness. The research aimed to identify key elements to incorporate into a revised employee training program, with the goal of enhancing disaster response readiness and policy implementation. It also sought to recommend strategies for continuous improvement. The study was …

Implementation Of Structured Nursing Leadership Rounding To Improve Hospital Policy Adherence, Irma Rose Maize

Walden Dissertations and Doctoral Studies

Variability in nursing policy compliance contributes to inconsistent clinical practice and compromises the delivery of standardized care. Limited leadership presence, support, and accountability have been identified as significant contributors to this practice gap. This Doctor of Nursing Practice project focused on educating nurse leaders about the importance and benefits of consistent unit-based leadership rounding as a strategy to support frontline nurses and reinforce policy adherence. A structured leadership rounding checklist was developed to guide purposeful, consistent check-ins with nursing staff, facilitating real-time support and identification of barriers to practice. Implementation of the checklist promoted increased leadership accessibility, improved communication, and …

Staff Education To Increase Knowledge And Awareness Of Cultural Sensitivity Among Providers, Stephanie Chiamaka Anyanwu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project aimed to enhance cultural sensitivity among healthcare providers through an educational intervention in a local organization. With the U.S. foreign-born population exceeding 47 million, the need for culturally competent care has become paramount. The study involved nine participants who underwent a pretest and posttest assessment to evaluate their knowledge and awareness of cultural sensitivity. Results indicated a significant increase in knowledge, with pretest and posttest scores improving from a mean of 4.33 to 8.56 (p < 0.01). Awareness in key areas such as patient-provider relationships, cultural beliefs, and language barriers also showed marked improvement. These findings further support the necessity of ongoing cultural sensitivity training to enhance patient care and outcomes, highlighting the potential for broader application across healthcare institutions.

Self-Stigma Of Seeking Help, Psychological Safety, And Employee Assistance Program Use In Nurses, Latisha Lenee Marshall

Walden Dissertations and Doctoral Studies

Employee assistance programs (EAPs) remain underutilized across various U.S. work sectors, including nursing. There are several barriers that impede nurses from using EAP services, including self-stigma of seeking help (SSOSH) and psychological safety (PS). The purposes of this study, which used the health promotion model as its theoretical framework, were to determine (a) if there was a difference in the level of SSOSH in nurses who have used EAPs and those who have not used EAPs, (b) if there was a difference in the level of PS in nurses who have used EAPs and nurses who have not used EAPs, …

Staff Education To Improve Nurses' Knowledge And Confidence In Suicide Risk Assessment, Sherica Mcbride

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice staff education project was to strengthen nurses’ knowledge and confidence in suicide risk assessments. Suicide remains a crucial patient safety issue, and nurses report uncertainty in early recognition and intervention; therefore, brief, practice-proximal training is essential. The practice-focused question that informed this project’s purpose was whether a short education module with pre- and post testing improves nurses’ knowledge and confidence in suicide risk assessment. Three nurses participated in a structured session covering risk factors, warning signs, standardized screening, and safety planning. I then used descriptive analysis to compare their pre- and posttest …

Predicting Perceived Immigrant Threat To National Identity Based On Christian Nationalism, White Racial Centrality, And Social Dominance Orientation, Anna Caroline Kinney

Walden Dissertations and Doctoral Studies

Immigrants remain frequent targets of anti-immigrant hate speech, often amplified by right-wing media. Demographic factors such as Christian nationalism (i.e., the desire to preserve Christian symbols, beliefs, and policies preserved as the established religion of the United States), White racial centrality (i.e., an automatic association between the self and the White ingroup), and social dominance orientation (i.e., support for group-based hierarchies and inequality) significantly shape perceptions of immigrants as a threat to national identity. Although prior research has examined these factors independently, their relative importance in predicting perceived immigrant threat remains limited. Informed by intergroup threat theory, this quantitative study …

Reflective Parenting, Psychological Needs, And Parental Interpretation Of Children’S Negative Emotions, Julia Pappas

Walden Dissertations and Doctoral Studies

Parents’ ability to understand and respond effectively to children’s negative emotions plays a critical role in children’s emotional development and regulation. However, it remains unclear whether parents interpret negative emotions as potential signals of underlying psychological needs. Based in the conceptual framework of parental reflective functioning and basic psychological needs theory, and grounded in interpretivist- constructivist paradigm, the purpose of this basic qualitative study was to examine how parents interpret children’s negative emotions and how their meaning-making processes relate to basic psychological needs. Semistructured interviews were conducted with parents of children between ages 3 and 9 years old (N = …

Strategies Leaders In Structured Alternative Academic Environments Use To Improve Resource Management, Operational Efficiency, And Program Sustainability, Sean D. Clark

Walden Dissertations and Doctoral Studies

Leaders of structured alternative academic environments often struggle to sustain operations because of limited resources, fragmented leadership, and high staff turnover. This business problem is important to leaders of structured alternative academic environments because ineffective resource management and operational inefficiencies threaten program sustainability and continuity of services for at-risk student populations. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry was to explore the strategies leaders in structured alternative academic environments use to improve resource management, operational efficiency, and program sustainability. The participants were six leaders from structured alternative academic programs in southeastern New Mexico. Data were …

Leadership Strategies Used By Entrepreneurial Ecosystem Resource Providers To Support Entrepreneurial Success, Sarah Niehaus

Walden Dissertations and Doctoral Studies

Failure to collaborate effectively within entrepreneurial ecosystems remains a significant concern for leaders of entrepreneurial ecosystem organizations. Without clear, actionable collaboration strategies, these leaders may struggle to support entrepreneurial success and make informed decisions that enhance financial performance. Grounded in Mockler’s complex adaptive systems theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies some leaders within entrepreneurial ecosystem organizations use to collaborate in a manner that supports entrepreneurial success. Participants included seven leaders of entrepreneurial ecosystem organizations located in the Midwest United States with successful experiences using such strategies. Data were collected from semistructured …

Educational Design Models In Transition: A Comparative Review, Tofan Stofiana, Yeti Mulyati, Andoyo Sastromihardjo, Dadang Sunendar

Journal of Educational Research and Practice

A persistent gap between educational theory and classroom practice underscores the need for methodological approaches that are reflective, participatory, and context responsive. This study provides a comparative review of four major educational design models, including research and development (R&D); Analysis, Design, Development, Implementation, and Evaluation (ADDIE); design-based research (DBR); and educational design research (EDR), to examine their theoretical orientations and contemporary applications. A systematic literature synthesis and bibliometric mapping were conducted on 80 peer-reviewed journal articles indexed in Scopus between 2020 and 2025. The findings reveal that ADDIE remains the most frequently applied framework due to its procedural clarity and …

Prevention And Resilience: Addressing Thc Use In Little Elm, Denton County, Texas, Luci Papanastassiou

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

The goal of this Social Change Portfolio is to design a collaborative, community-level primary prevention program for adolescents in the Little Elm, Denton County, Texas area to mitigate the mental health and cognitive risks associated with THC use while strengthening protective factors across the entire community (County Health Rankings & Roadmaps, 2018; Smith, 2024; Substance Abuse and Mental Health Services Administration, 2025).

Significant Findings

The Little Elm, Denton County, Texas area is an area of growth and development that also faces the need for mental health professionals, especially with the current situation of THC use with adolescents (Substance …

Caribbean Early Childhood Educators, Primary Educators, And Student Teachers' Perceptions Of Visual Literacy And Visual Images Across The Curriculum, Monica Yvonne Hines-Graham

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study is the gap in knowledge about the integration and evaluation of visual literacy and visual images across the curriculum of early childhood educators, primary educators, and student teachers, despite it being a requirement for teachers in the Caribbean education system. Grounded in Hall and Hord’s concerns-based adoption model, the purpose of this study was to explore the perceptions of early childhood educators, primary educators, and student teachers with the integration and evaluation of visual literacy and visual images across the curriculum. For this basic qualitative design, semistructured interviews with 12 participants from …

Strategies To Reduce The Physician Documentation Burden In Adult Primary Care, Glenda Cascalla

Walden Dissertations and Doctoral Studies

Primary care physicians face high rates of burnout, with electronic health record (EHR) documentation identified ass a significant contributing factor. EHR systems consume substantial physician time, diverting attention from meaningful patient interactions toward administrative tasks and increasing documentation burden. The purpose of this study is to identify and evaluate best practices for minimizing the documentation burden on primary care providers. The review question centered on how best practices can be implemented by healthcare administrators to reduce the physician documentation burden in primary care. This integrative review used the sociotechnical systems theory framework to identify and evaluate effective strategies to alleviate …

Implementing Emotional Intelligence To Enhance Leadership Abilities In A Skilled Nursing Home, Nkechi Amaechina

Walden Dissertations and Doctoral Studies

To meet dynamic changes in healthcare, effective leadership is necessary. A major problem with effective leadership is the lack of emotional intelligence (EI). The purpose of this integrative review is to identify strategies that enhance skilled nursing home leadership abilities using EI. The Leader-Member Exchange (LMX) theory was used, supported by Complex Adaptive Systems (CAS)Theory. LMX theory explains that leaders-members relationships affect an organization while CAS theory describes healthcare industry as ever-changing. The review question (RQ) that guided this integrative review is: what best EI strategies can be implemented to enhance leadership abilities in a skilled nursing home? Twenty-six articles …

Teaching Staff About Pressure Ulcers, Ann Maria Stewart

Walden Dissertations and Doctoral Studies

Pressure ulcers are local injuries to the skin and underlying tissue primarily caused by prolonged pressure, friction, or shear forces. These preventable complications are prevalent among immobile patients and can lead to poor patient outcomes and increased healthcare costs. Despite the availability of evidence-based prevention strategies, significant gaps in practice continue due to limited staff knowledge, ineffective communication systems, and inconsistent implementation of established guidelines. This Doctor of Nursing Practice (DNP) project focused on enhancing nursing staff knowledge through an evidence-based educational strategy designed to educate staff on strategies for preventing pressure ulcers. The education program included a PowerPoint presentation …

K-8 School Administrators' Implementation Of Positive Behavior Intervention And Support Systems To Reduce Out-Of-School Suspensions In A Southeastern U.S. School District, Chantell H. Walker

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study is that the implementation of positive behavior interventions and supports (PBIS) has not resulted in a consistent reduction in the use of out-of-school suspensions as a disciplinary consequence in K–8 schools in a Southeastern U.S. school district. Grounded in Horner and Sugai’s PBIS, the purpose of this qualitative study was to explore K–8 school administrators’ perceptions of their implementation of PBIS in a Southeastern U.S. school district. For this basic qualitative design, semistructured interviews were conducted with three principals and three assistant principals in the local school district. Thematic analysis using inductive …

Strategies Financial Institutions Use To Mitigate Security Breaches For Mobile Customers, Steven F. Knese

Walden Dissertations and Doctoral Studies

Mobile fraud attack rates are increasing rapidly. Financial institutions, cybersecurity managers, and regulators need effective strategies to reduce consumer financial harm and operational risk. Grounded in the cybernetics model, this qualitative, pragmatic inquiry identified the cybersecurity strategies that cybersecurity professionals use at financial institutions to mitigate data breaches for mobile customers accessing financial data. Data were collected from five cybersecurity professionals through semistructured interviews and from publicly available documents and guidance issued by financial institutions and standards bodies. Six significant themes emerged from thematic analysis: implementing multifactor authentication, deploying virtual private networks (VPNs), delivering user education, promoting regular account monitoring, …

Hiv Pre-Exposure Prophylaxis Uptake And Continuation Among 15-24-Year-Old Women In Mulago, Uganda, Dithan Kiragga

Walden Dissertations and Doctoral Studies

Young women in Uganda face disproportionately high HIV risk compared to the general population. While pre-exposure prophylaxis (PrEP) demonstrates proven effectiveness, poor uptake and nonadherence limit its potential impact. This study examined the relationship between perceived HIV susceptibility, PrEP benefits, behavioral risk factors, service delivery models, and PrEP uptake and continuity among young women aged 15–24 in Uganda, guided by the health belief model. Data were ed from surveillance records at Mulago National Referral Hospital’s STI clinic from January 2024 to September 2025. Of N=23,765 young women screened (median age 21 years; 98.9% single or separated; 48.7% with primary education), …

Mental Health Provider Perceptions Of Self-Efficacy Following Prison Budget Reductions, Angela Frankland

Walden Dissertations and Doctoral Studies

Burnout rates for mental health workers are impacted due to budget restrictions in treatment programs. Fiscal challenges and their impact on the experiences of mental health providers have yet to be explored within correctional settings. There is a lack of research concerning mental health professional’s self-efficacy beliefs when providing treatment services to inmates. The purpose of this qualitative, phenomenological study was to explore mental health professional’s self-efficacy beliefs in correctional systems with context towards diminishing fiscal resources. Self-efficacy theory and prison rehabilitation management theory are the theoretical frameworks used as the foundation for this study. The research question was designed …