Digital Commons Network^™

Reducing Emergency Department Length Of Stay By System Change, Brian Dale Haybarker

Walden Dissertations and Doctoral Studies

Emergency departments (ED) are exceeding the Centers for Medicare and Medicaid Services and The Joint Commission's recommended 4-hour door-to-admission and 2-hour door-to-discharge for patients. The purpose of this project was to look for factors that decrease door-to-admission and door-to-discharge times and offer recommendations to the Patient Flow Committee (PFC) at the health care facility that may reduce overcrowding, diversion, and patient boarding. The 7-step Iowa model of evidence-based practice (EBP) was used to concentrate on problem-focused triggers that initiate the need for change. The project focused on decreasing door-to-admission and door-to discharge times: by opening an observation unit run by …

Strategies To Minimize The Impact Of Supply Chain Risk On Business Performance, Jonathan Opata

Walden Dissertations and Doctoral Studies

The exposure of companies to turbulence, uncertainty, and vulnerability in their supply chain results in supply chain disruption with an estimate cost of $10 million for each supply chain disruption. The purpose of this case study was to explore the strategies supply chain managers use to mitigate supply chain disruption on business performance in a pharmaceutical company in Maryland. Contingency theory of fit formed the conceptual framework for this study. Participant perceptions were elicited in interviews with 11 supply chain managers regarding strategies to mitigate risks associated with supply chain disruptions. Data from interviews and supporting documents were processed and …

Media Literacy Education Exposure Related To Self-Esteem, Body Esteem, And Sociocultural Ideals In College Students And Graduates, Tammy Stargardt

Walden Dissertations and Doctoral Studies

The prevalence of eating disorders (ED) in the United States has increased while the media consistently presents thinner representations of the body. Scholars have found media to negatively influence factors associated with the development of EDs. The purpose of this quantitative nonexperimental cross-sectional survey design study was to explore relationships between exposure levels to MLE and self-esteem, body esteem, and the internalization societal appearance ideals. Participants included undergraduate students or recent graduates majoring in either communications or an alternative major with comparatively less MLE curriculum. The Body Esteem Scale, Sociocultural Attitudes towards Appearance Questionnaire-3, and Rosenberg Self-Esteem Scale Surveys were …

Fukushima Nuclear Disaster Response Impact On Graduate Students, Sean Eric Kil Patrick Gay

Walden Dissertations and Doctoral Studies

The roles that universities played in the response to the Fukushima nuclear disaster were significant and varied; however, there was limited study on participating graduate students. The purpose of this study was to understand the impact of disaster response on graduate students' personal and academic development. This study examined research questions about the perceived impact on academic and personal identity development. Empowerment, cognitive content engagement, general systems theory, and utilitarianism formed the theoretical foundation. This study used a transcendental phenomenological approach to examine the subjects' experiences in the context of involvement in disaster response. The primary source of data was …

Assessing Spirituality Among Hospice Patients: A Phenomenological Study Of Hospice Nurses, Isabel Esther Kaufman

Walden Dissertations and Doctoral Studies

The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when …

Fall Prevention Quality Initiative: Implementation Of A Unit Safety Champion (Usc), Susan Lynn Rednak

Walden Dissertations and Doctoral Studies

The literature supports that a Unit Safety Champion (USC) may reduce falls among hospitalized patients. The purpose of this project was to determine if the implementation of a USC would assist in reducing falls on an acute unit in an urban hospital environment. The frequency of patient falls on the unit was collected from the hospital's quality department 3 months before and 3 months after the implementation of the USC. The average number of falls for 3 months before implementation was 5.0 per month (SD = 2.65) and involved a total of 15 individual patients. The average number of falls …

Factors Affecting Emergency Manager, First Responder, And Citizen Disaster Preparedness, Tiffany Cooks

Walden Dissertations and Doctoral Studies

Despite the increased frequency of natural and man-made disasters, there is a problem in the level of preparedness of emergency managers, responders, and citizens to address them. The purpose of this grounded theory study was to explore the factors that affect these groups' preparedness to inform the development of better emergency plans to handle emergency incidences. The conceptual framework for the study was knowledge management, which was used with a grounded theory approach. The study was guided by primary research questions that focused on understanding psychological, material, temporal, organizational, and other factors that affect the preparedness of emergency managers, first …

Evidence-Based Mentorship Program: Overview, Review Of Evidence, And Approach, Elizabeth Villanueva

Walden Dissertations and Doctoral Studies

Nurses comprise the largest segment of the healthcare workforce. Adequate numbers of

nurses help to ensure sufficient and safe nursing care in all settings. The current nursing shortage poses a barrier to optimum nursing care, and the nature of recruitment and retention of nurses has generated research interest because of its association with the labor shortage. The purpose of the project was to develop a nurse mentorship program for possible adoption by a northern state correctional facility. Goals are to aid recruitment and improve retention of nurses in the facility. This quality improvement project was informed by Jean Watson's theory …

Independent Retail Business Owners' Perceptions Of The Patient Protection And Affordable Care Act., Bradley A. Hall

Walden Dissertations and Doctoral Studies

Passage of the Patient Protection and Affordable Care Act (PPACA) in 2010 prompted the question of how independent businesses may react to the employer mandate in the PPACA. The law is based on the theory of managed competition and it is more likely to affect businesses with fewer employees than to affect larger businesses that already offer health insurance. The purpose of this quantitative, pre-experimental study was to examine the strategic responses of independent retail business owners in Hillsborough County, Florida, regarding their perceptions of the employer mandate in the PPACA. Before 2014, there was a great deal of non-peer-reviewed …

Demographic Characteristics Predicting Employee Turnover Intentions, Tracy Machelle Hayes

Walden Dissertations and Doctoral Studies

In 2012, more than 25 million U.S. employees voluntarily terminated their employment with their respective organizations. Demographic characteristics of age, education, gender, income, and length of tenure are significant factors in employee turnover intentions. The purpose of this study was to determine if a relationship existed between age, education, gender, income, length of tenure, and employee turnover intention among full-time employees in Texas. The population consisted of Survey Monkey-® Audience members who were full-time employees, residents of Texas, over the age of 18, not self-employed, and not limited to a specific employment industry. For this study, a sample of 187 …

The Influence Of On-Site Surgical Pathology Services In Rural Hospitals On Physician Satisfaction, Belinda D. Presley

Walden Dissertations and Doctoral Studies

Abstract

There is limited information regarding physician satisfaction as it relates to the presence of a surgical pathology department in rural hospitals. Physician satisfaction directly influences the quality of patient care. The theoretical frameworks that informed this study included institutional theory and population ecology. The research questions addressed differences in levels of physician satisfaction between physicians who have access to an on-site surgical pathology department and physicians who do not have such access. The research also examined differences in satisfaction between physician specialties that have or do not have access to an on-site surgical pathology department services. A quantitative, cross-sectional …

Financial Performance Outcomes Following System Replacement In The Insurance Industry, Trevor James Owen

Walden Dissertations and Doctoral Studies

Enterprise system replacement projects within the property and casualty insurance industry are costly, high-risk undertakings that carry a significant risk of project failure. The decision to replace policy administration systems for companies with over $250 million in direct written premium is a multimillion dollar investment for corporate strategic decision makers. This study examined the financial impact of enterprise policy administration system replacement in the property and casualty insurance industry by comparing financial performance results for companies that performed policy administration system replacements with those that did not. Insurance industry financial results for the years 2009 through 2014 were used for …

Designing Professional Development For Elementary School Teachers, Simon F. Quattlebaum

Walden Dissertations and Doctoral Studies

Within a Northeast urban school, there is little empirical evidence to indicate the effectiveness of the district professional development (PD) program. Elementary teachers at the study site reported that they encountered problems accessing professional development programs applicable to their needs. The purpose of this case study was to examine teacher perceptions of district PD programs and to discover teacher perceptions of PD best practices. Knowles' adult learning theory provided a frame of reference for this study. The research questions assessed teachers' perceptions of the format, content, and process of professional development programs and examined how teachers applied new knowledge, concepts, …

Increasing Productivity Of Retained Employees After A Workforce Reduction, Jason Michael Matyus

Walden Dissertations and Doctoral Studies

There is an increased use of downsizing across telecommunications in the northeast United States, and organizational leaders are challenged to motivate the productivity of the retained employees. Guided by systems theory, the purpose of this single case study was to explore successful downsizing strategies of a small group of organizational leaders and managers in the operations of telecommunications in the northeast United States. The study participants, chosen for their motivation success in motivation after downsizing, consisted of 2 purposefully selected business leaders who completed individual, face-to-face interviews and a focus group of 5 managers. The coding of data and word …

Teachers' Perceptions Of The Influence Of Professional Development On Music Integration, Marcy Thurmond Simmons

Walden Dissertations and Doctoral Studies

International Baccalaureate (IB) schools are focused on a school-wide approach to developing inquiring students who are motivated to succeed. The problem explored in this case study was based on a local IB elementary school's response to a reform model to integrate music into other content areas. The curriculum lacked an interdisciplinary approach to music education even though teachers had participated in some professional development (PD) to help them integrate music into content areas. The purpose of this study was to investigate the perceptions of elementary teachers regarding the influence of professional development on music integration at the IB elementary school. …

When Does Six Sigma Reduce Defects And Increase Efficiencies?, Richard Jay Sands

Walden Dissertations and Doctoral Studies

A field research-based statistical study was used to investigate successes and failures of Six Sigma methodologies based projects. Six Sigma methodologies require that projects be designed, planned, and implemented using techniques specifically designed to achieve desired benefits that are based on the method's key drivers for project success. This study addressed an identified gap in the literature that Six Sigma projects do not fail because of Six Sigma methodologies, but that the projects can fail because of deficient support processes. Six Sigma projects that do not achieve the desired benefits are often labeled as "fads". Research questions related to management …

Exploring Teacher Perceptions Of Blended Learning, Jill I. Sorbie

Walden Dissertations and Doctoral Studies

Although research supports the blended learning methodology as a way to personalize and engage students, research also documents the widespread hesitation among educators when it comes to embracing technology. District leaders believe that such is the case in an upper Midwest school district where all high school students are provided devices, yet these leaders note that few teachers are fully exploiting the tools. Framed by the connectivism and social constructivism theories, this qualitative case study focused on teachers' views of blended learning, its influence on their teaching practices, and how they see it helping students to learn. The guiding research …

Developing Strategies For Hiring Managers: A Case Study On Hiring Employees, Sylvia Gholston

Walden Dissertations and Doctoral Studies

Gaining information about competency within hiring practices is critical for hiring managers seeking to hire skilled workers, improve employee fit, and lower hiring cost. Employee replacement cost ranges from 30% of an entry-level engineering or aeronautical employee's salary to 400% for a high-level employee in those fields. Guided by the transformational leadership theory and the decision-making theory, the purpose of this qualitative exploratory case study was to explore the hiring strategies used by 4 hiring managers to hire employees for organizational fit. The managers work within the aeronautics and engineering fields within the Southeast region of the United States, which …

Improving Math Performance In Adult Female Community College Students: An Evaluation Of Project Independence, Robin Tim Frodsham

Walden Dissertations and Doctoral Studies

Project Independence (PI) is a community college immersion program dedicated to assisting women returning to college. The focus of this study and associated summative evaluation was to understand how the PI program addresses anxiety and other learning deficiencies associated with math. Knowle's andragogical models portray adults as motivated and self-directed, and the American college campus fosters a culture of independence. This culture is foreign to many minority, first-generation, and working class adults who learn through interdependence. This qualitative instrumental case study and evaluation is the first to examine the efficacy of PI. The guiding questions of this study concern early …

Impact Of Environmental And Individual Risk Factors On Pregnant And Parenting Teenagers, Lakeasha Thrasher

Walden Dissertations and Doctoral Studies

Teenage pregnancy is both a social and a public health problem in the United States, with approximately 750,000 young women between the ages of 15 and 19 becoming pregnant each year. In addition, teen pregnancy is more prevalent in the African American (15%) and Hispanic (14%) communities than it is in White communities (5%). The purpose of this study was to identify risk factors contributing to teen pregnancy among racially diverse teenagers 15 to 19 years of age living in the rural south. This study, guided by social cognitive theory, used a quantitative, cross-sectional research design to determine whether living …

Laying The Foundation For New Approaches In Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change, Rina Marie Prosser

Walden Dissertations and Doctoral Studies

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the …

Adhd And Multiple Intelligences: Does A Pattern Exist?, Kathleen Mettler

Walden Dissertations and Doctoral Studies

Attention Deficit Hyperactivity Disorder (ADHD) has typically been treated with a deficits-based response while most research has ignored any intelligence differences between the subtypes, despite differing symptomology. This quantitative study explored whether or not a distinct pattern of intelligences existed within each of the subtypes or presentations of ADHD: inattentive (IT), hyperactive (HT), and combined (CT). Using Gardner's multiple intelligences theory, data were collected via an online, self-administered survey from a sample of 132 participants, over 18 years of age, with IT, HT, and CT ADHD. The goal was to identify the most predominant of 8 different strengths or intelligences. …

Payroll Fraud: Effects Of Ghost Names On The Government Wage Bill In Ghana, Gilbert Nyaledzigbor

Walden Dissertations and Doctoral Studies

Policy makers believe that there are ghost workers, persons who do not work yet receive salaries, on Ghana's public sector payroll. However, little is known about the factors that create opportunities for ghost workers. The purpose of this quasi-experimental study was to extend Cressy's conceptualization of the fraud triangle theory to test the applicability of Reinikka and Svennson's graft estimation model by using nonprobability quota sampling to select 85 heads of public agencies for participation in a cross-sectional survey. The research questions focused on the relationship between size of government agency, the estimated number of opportunities for ghost workers, and …

Acculturation Stress And The Coping Strategies Of Nigerian Immigrant Women In The United States, Oluwatoyin Mofoluwaso Adewunmi

Walden Dissertations and Doctoral Studies

Nigerian women who migrate to the United States are faced with complex social challenges as they acculturate to a new society. Stressful conditions and acculturation experiences may threaten the overall mental health of these immigrant women. The purpose of this study was to explore the acculturation experiences of Nigerian immigrant women living in the United States, identify stressors associated with the process, and highlight the coping strategies they employed. Stress and coping theory provided the theoretical framework for the study and phenomenological inquiry guided the research questions and method. Data were gathered through face-to-face interviews. Content analysis and coding were …

A Case Study Of The Effectiveness Of A Summer Transition Program For First-Time Ninth Grade Students, Jonathan Wickert

Walden Dissertations and Doctoral Studies

High schools have undertaken numerous approaches to reduce the number of first-time 9th grade students who do not move to 10th grade with their cohort. The purpose of this study was to determine if a summer program successfully transitioned 9th grade students from middle school to high school environments. Guided by the stage-environment fit conceptual framework, this study explored the effectiveness of a summer transition program at acclimating first time 9th grade students to physical, social, and academic environments. A mixed-method design was used in the study. A t test was used with a sample of approximately 400 archival 9th …

Human Factors Analysis And Classification System Interrater Reliability For Biopharmaceutical Manufacturing Investigations, Roberto Cintron

Walden Dissertations and Doctoral Studies

Human errors are an expected result of operations performed by individuals and frequently lead to accidents and other catastrophic events. The problem is that the current process used to investigate and mitigate human errors in the biopharmaceutical manufacturing industries is not effective, as it does not include the effects of human factors found to be effective in aviation and nuclear power organizations. The human factors and classification system (HFACS) was created for the investigations of accidents using the Swiss cheese model of accident causation as a theoretical framework. The purpose of this quantitative, inter-rater reliability study was to demonstrate the …

Social Disorder And Level Of Engagement Of Small Business Owners In The Virgin Islands, Saul Santiago

Walden Dissertations and Doctoral Studies

The U.S. Virgin Islands is experiencing an economic recession, manifested through social disorders such as abandoned and vandalized houses. Research points to social disorders and lack of community engagement as key factors inhibiting community development efforts. In order to strengthen these struggling communities, research has highlighted the need for public-private partnerships. Guided by Ajzen's theory of planned behavior, which posits that attitudes can predict behaviors, this study examined the relationship between social disorder and engagement of small business owners in community development. Small business owners in the U.S. Virgin Islands received an Internet or paper survey; a total of 79 …

Computer Anxiety And Computer Self-Efficacy Of Older Adults, Elizabeth Diane Cooper-Gaiter

Walden Dissertations and Doctoral Studies

Many older adults (aged 55 and older) need training to acquire computer knowledge and skills. Using computers and the Internet could provide access to vital resources for improving older adults' health and maintaining their connections with family and society. This study examined 2 psychological constructs--computer anxiety and computer self-efficacy--that have been shown to impact a person's successful use of computers and related technology. Guided by Bandura's self-efficacy theory, which emphasizes the importance of adult learners being motivated and taking charge of their learning, this study examined the impact of a computer knowledge and skills workshop on older adults' computer anxiety …

The Perceptions And Experiences Of General Education Teachers Toward Cotaught Inclusion Classes, Beth Milhoan Feustel

Walden Dissertations and Doctoral Studies

This project study addressed the low rate of general education teachers volunteering to coteach inclusion classes at a large urban high school in southeastern Georgia. This low volunteer rate caused administrators at this school to assign general education teachers, who did not opt in, to coteach inclusion classes. Teachers' efficacy was negatively impacted when they were required to teach classes that they did not volunteer to teach. The model of cooperative teaching advanced by Bauwens, Hourcade, and Friend's work served as the conceptual framework for this intrinsic case study. The purpose of the study was to examine how general education …

Bedside Nurses' Influence On Patients' Continuum Of Care Through Effective Discharge Teaching, Mary Ann Whicker

Walden Dissertations and Doctoral Studies

The evolution of person-centered healthcare reinforces the need for nursing to provide effective patient education. Literature suggests nurses desire to provide strong discharge education to patients, but are challenged by knowledge gaps and other barriers. This DNP project developed a plan for integrating teach-back on a 30-bed cardiac unit, focusing on heart failure patients. Following a logic model, the process improvement plan to implement teach-back includes education on teach-back, empowerment of unit champions to support the project and evaluation of effectiveness of the education plan and impact on heart failure patients. The sample size of 15 cardiac nurses provides a …