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Pressure Injury Prevention In An Urban Surgical Intensive Care Unit, Kayma P. Ricks

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure injuries (HAPIs) affect approximately 2.5 million patients in the

United States, annually. Prevention requires surgical intensive care unit (SICU) nursing staff to

effectively use evidence-based risk assessment measures to appropriately identify patients at risk

for developing HAPIs and to prevent poor patient outcomes. The Braden Scale risk assessment

tool has demonstrated reliability and validity in the prediction and assessment of patients at risk

for the development of HAPIs. The purpose of this Doctor of Nursing Practice (DNP) project

was to improve nurses’ knowledge of the appropriate use of the Braden Scale risk assessment

tool in the SICU of …

Relationship Of Complementary Modes Of Agency In The Self-Management Of Diabetes, Andrew Romo

Walden Dissertations and Doctoral Studies

Effective control of type-2 diabetes mellitus (DM2) is essential for minimizing the likelihood of developing comorbidities that result from poor glycemic control. Extensive self-management considerations are required of people with DM because they must actively participate in their own care and engage with other socially-based sources of self-management support. The purposes of this quantitative study were to determine if there is an association between (a) the extent that the individual mode of human agency is employed and quality of diabetes control among adults who have been diagnosed with DM2 for at least one year and (b) the extent that the …

Relationship Between Clostridium Difficile Testing Method, Antibiotic Treatment, And Clinical Symptoms, Jennifer L. Sanguinet

Walden Dissertations and Doctoral Studies

Clostridium difficile (C. difficile) infection is a leading cause of morbidity and mortality in the United States, making the infection a top public health priority. Early and accurate identification of disease is a critical factor in successful management, including clinical symptomology. The testing methods for C. difficile have improved in efficiency and sensitivity, which potentially causes over- or underprescribing behavior. Guided by the symbolic theory, the purpose of this study was to examine the association between C. difficile testing method by case year (2015 and 2018) and antibiotic treatment with the potential moderation of clinical symptoms. The secondary correlational analysis …

Nursing Students' Perceptions About Membership In Professional Organizations, Kimberly Ann Seaman

Walden Dissertations and Doctoral Studies

The importance of developing professionalism in the new nursing graduate has been discussed in the nursing literature and identified as a goal in the Future of Nursing competencies. However, the understanding of undergraduate nursing students'perceptions of membership in professional organizations is unknown. This study was conducted to better understand nursing students' views of membership. Social identity theory was used to explain how membership in a professional organization promotes exposure and adaptation of preferred professional behaviors. Novice-to-expert theory was selected to explain the maturation process of professionalism in the new graduate. Twelve nursing students enrolled in an undergraduate nursing program participated …

How Feminist Beliefs Relate To Self-Objectification In African American Females, Ashton Shelby

Walden Dissertations and Doctoral Studies

Sexual objectification has consistently been found to significantly influence self-objectification in women. Self-objectification has been linked to a number of adverse effects in women including depression, sexual dysfunction, and disordered eating. All females are vulnerable to sexually objectifying experiences and thus, developing self-objectifying behaviors and issues. Although extensive research explores both forms of objectification with Caucasian females, less is known about females in minority groups. In addition, little research has explored potential moderating variables. In other research related to investigating women’s mental health, feminism is one variable that has been found to have a positive effect on women’s issues. This …

Inpatient Stays Involving Mental Illness And Substance Use Disorders, Latonya Smith

Walden Dissertations and Doctoral Studies

Nearly one-third of Americans suffer from a mental illness. Twenty-three million people are affected by substance use or a dependency issue and the length of stay for patients enrolled in treatment services is rising. Mental health issues and substance use are rising within the United States and are associated with increased healthcare costs and the need for healthcare services. The purpose of this quantitative study was to determine the association between inpatient services, residential, outpatient, age, and payer source on substance use and mental health services using the 2017 Substance Abuse and National Mental Health Services Administration survey. The Donadebian …

Strategies For Reducing Civil Servant Turnover Within The U.S. Federal Government, Tewanda Leshae Wooten

Walden Dissertations and Doctoral Studies

Voluntary turnover has increased in the United States federal government in recent decades. Employees are voluntarily leaving organizations sooner than expected, leaving the remaining employees to complete their tasks and posing a possible loss of revenue until the employee is replaced or retrained. The purpose of this study was to understand the reasoning behind the upward trend in turnover rates within the federal government and assist with strategies to retain government employees in the future. Herzberg’s two-factor theory was used as the theoretical framework to heighten understanding of the high levels of turnovers within the federal government. The primary research …

Child Marriage: Parents' Lived Experience Of Decision-Making Processes And Consequential Health Effects, Hadiza Yakub

Walden Dissertations and Doctoral Studies

Child or early marriage is increasingly recognized as a public health concern that poses significant health challenges for a young bride. This qualitative research explored child marriage among Hausa-Fulani ethnolinguistic communities in Northeastern Nigeria. Qualitative interviews were conducted with parents who married off their underage children. The central research questions relied on a theoretical foundation of social values theory and interpretative phenomenological analysis. The study results provide an in-depth understanding of the child marriage phenomenon by exploring parents' lived experiences and the role of a child bride's health in the decision-making process and illustrates how social values and norms drive …

Strategies To Retain Mental Health Workers In Community Mental Health Clinics, Debbie L. Young

Walden Dissertations and Doctoral Studies

In 2017, the United States employee turnover rate for mental health workers with 2 or more years of experience was more than 50%. High turnover rates among these mental health workers are associated with inadequate quality of care for patients with mental health issues in community mental health clinics. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple case study was to explore retention strategies used by health care administrators to retain their mental health workers with more than 2 years of experience. The participants consisted of 6 health care administrators who successfully implemented strategies to minimize high …

Teachers’ Perspectives Of Preschool Reading Fadeout And Strategies To Prevent It In Low-Performing Schools, Jacquelyn Blanton

Walden Dissertations and Doctoral Studies

Third-grade reading scores on some U.S. state tests revealed that children who attended a state-funded preschool program were not proficient readers. Reading gains made in preschool faded by the time the children reached third grade. The purpose of this basic qualitative study was to examine teachers’ perspectives regarding the causes of preschool reading fadeout and the strategies they used to prevent preschool reading fadeout in low-performing schools. The conceptual framework included the dynamic skill-building theory and skill formation theory to examine the development of reading skills. Nine state-certified teachers who taught reading in preschool through third grade shared their perspectives …

Teacher Preparedness, Stress, And Subjective Well-Being In Alternative And Traditional Certification Route Teachers, Shuchemia Nicole Bradley

Walden Dissertations and Doctoral Studies

Many educators who enter the teaching profession via the traditional route leave the profession early. As a result, many school districts rely on alternative certification programs to fill the teacher shortage. Though the traditional route of teacher certification contains instruction parallel to pedagogical theories and produces candidates with the opportunity to gain experience through practicums, the alternative route allows candidates to move directly into the classroom to fill teacher vacancies. The purpose of this study was to examine possible differences in teacher job-related stress and teacher subjective well-being as a function of teacher certification route. In addition, possible differences in …

Eating Disorders And The Gap Of Education, Sara Jane Camden

Walden Dissertations and Doctoral Studies

Eating disorders are described as excessive dieting, limiting food intake, and withholding of food. Over 30 million people suffer from eating disorders. Some people may also have preconceived notions that this disease is easily fixable and that eating more and stopping dieting will solve the problem. Registered nurses struggle with having preconceived ideas, a lack of confidence in their assessment skills, and fear of using the eating disorder diagnosis. Barriers that have surrounded the eating disorder mental health disease need to be addressed. The staff development project was based on the question if nursing knowledge would improve on eating disorders …

Therapeutic Communication Skills For Nurses Working With People Living With Hiv, Charaine Ferguson

Walden Dissertations and Doctoral Studies

Internalized stigma experienced by people living with HIV (PLWH) has been associated with numerous untoward health outcomes. Nurses' and healthcare professionals’ ability to effectively communicate can significantly affect the experience of stigma in PLWH. The practice-focused question was whether an interactive educational project could improve the knowledge and intent to use collective communication skills in nurses. This project uses concepts from Peplau's interpersonal relationship theory, principles of therapeutic communication, and unconscious bias. Online training content included patient testimonials related to stigma, discussions of unconscious bias by the Institute for Healthcare Improvement and Mayo Clinic professionals, review of Harvard University’s Implicit …

Leadership Strategies To Maintain Hospital Business Office Productivity During A Merger, Scott Alan Hughes

Walden Dissertations and Doctoral Studies

In 2017, healthcare system mergers in the United States set a record with 115 deals made and 11 involved sellers with net revenue of at least $1 billion; however, it is common for hospital business office productivity to suffer during a merger. Grounded in the theory of business process re-engineering, the purpose of this qualitative single case study was to explore strategies hospital leaders in the southeastern United States used to maintain business office productivity as they completed a merger. A review of documentation from archival records supplemented in-depth interviews with 7 purposively selected hospital leaders. Yin’s 5-step analysis guided …

Supply Chain Leaders’ Strategies For Selecting Performance Measures, Elizabeth Brush Nohe

Walden Dissertations and Doctoral Studies

There is a performance gap between supply chain leaders versus laggards in critical areas such as service and shareholder value. Although research indicates that the reasons for the performance differences are choosing the wrong performance measures and setting goals too low, there remains a lack of knowledge and understanding regarding the decision-making strategies used by supply chain leaders in selecting key performance measures and goals for their respective organizations. The purpose of this descriptive phenomenological study was to improve the understanding of the decision-making strategies used by supply chain leaders in their selection of key performance measures and associated goals. …

Ethics Of Collection And Use Of Consumer Information On The Internet, Thanh M. Pham

Walden Dissertations and Doctoral Studies

Consumer online activities can generate massive volumes of data that private companies may collect and use for business purposes. Consumer personal data need to be protected from unauthorized access and misuse. The specific problem is that consumers have little control regarding their data being collected and used by private companies. The purpose of this qualitative archival research was to explore business practices involving collection and use of consumer data without an individual’s consent. This study used the big data ethical conceptual framework to focus on various privacy issues, including those related to ownership, transparency, ethics, and consumer privacy laws. Archival …

Coping And Support Strategies Portrayed In Rheumatoid Arthritis Illness Blogs, Folasade Bolanle Alagbada

Walden Dissertations and Doctoral Studies

The symptoms of rheumatoid arthritis (RA), such as pain, fatigue, stiffness, and inflammation, limit individuals’ abilities to care for themselves, participate in social events, and complete tasks associated with gender norms. RA is a chronic and debilitating disease that people struggle to cope with physically, mentally, emotionally, socially, and financially, but many have not established effective coping and support strategies. The purpose of this hermeneutic phenomenological qualitative study guided by a combination of Orem’s theory of self-care and Watson’s theory of the human caring was to explore the coping mechanisms and support strategies of women and men with RA as …

Experiences Of Parents Interacting In An Urban Preschool Outreach Program, Sonya Renee Baines-Corey

Walden Dissertations and Doctoral Studies

AbstractParental engagement supports children academically. However, African American parents engage at lower levels than other parents. The purpose of this generic qualitative study was to understand the experiences of urban preschool parents in a blended parental engagement program. A combination of critical race theory, experiential learning, social learning theory, and andragogy served as the conceptual framework. Data were collected through semi structured face-to-face interviews with eight African American parents, observational field notes, and an archival review of preschool documents in a Southeast U.S. state’s innovative parental engagement program that incorporates technology. Findings from inductive thematic analysis indicated three major themes. …

Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays

Walden Dissertations and Doctoral Studies

Medicare reimbursement penalties are a financial concern for health care leaders when hospitals underperform in the specific measures of hospital performance defined by the Hospital Value-Based Purchasing Program. Grounded in the general contingency theory, the purpose of this correlational study was to determine the relationship between the measures of hospital performance, clinical care, person and community engagement, safety, efficiency and cost reduction, and Medicare reimbursement penalties. Secondary data from the Centers for Medicare and Medicaid Services were collected from 420 acute care urban hospitals designated as teaching facilities with a bed size between 100–299 beds for the fiscal year 2019. …

Environmental Barriers To Accessing Tertiary Prevention Among Hispanics Diagnosed With Type 2 Diabetes, Stella B. Biira

Walden Dissertations and Doctoral Studies

In the United States, Hispanics diagnosed with type 2 diabetes (T2DM) have not accessed tertiary level prevention, which is critical in diabetes management and the prevention of further complications. The purpose of this quantitative study was to examine the association between neighborhood crime, the absence of community health centers, the lack of culturally competent providers, the lack of public transportation, the residential setting, the distance to T2DM education classes, and access to tertiary prevention among Hispanics diagnosed with T2DM. The research was guided by the Andersen behavioral model. A sample size of N = 4,977 was used in the study, …

Technology Business Leaders' Strategies To Increase Employees' Engagement, Desmond J. L. Browne

Walden Dissertations and Doctoral Studies

AbstractEmployee disengagement is costly and reduces an organization's ability to meet its full potential to produce business results. Technology business leaders who have engaged employees can positively alter the company's rapid transformation to be more competitive. Grounded by the social exchange theory, the purpose of this qualitative single case study was to explore strategies 6 technology leaders in the Atlanta metropolitan area use to engage employees. Data were collected through semistructured interviews and company documents. Data were analyzed using Yin's 5-step data analysis process. Three themes emerged: communicate with transparency, provide offerings for training and rewards, and identify and implement …

Relationship Between Transformational Leadership Style And Financial Sustainability, Tameika R. Campbell

Walden Dissertations and Doctoral Studies

Only 50% of the U.S. small businesses opened in 2011 were able to maintain financial sustainability. Small business owners struggle with identifying the type of leadership style needed to increase financial sustainability. Grounded in the transformational leadership theory, the purpose of this correlational study was to examine the relationship between idealized influence, inspirational motivation, intellectual stimulation, individualized consideration, and financial sustainability. The participants consisted of 76 small business owners located in Arkansas, California, Louisiana, Maryland, Texas, and Virginia. The business owners completed a survey containing the Multifactor Leadership Questionnaire and the Financial Capability Scale. The data were analyzed using multiple …

Beyond Borders: Nigerian Diaspora, Men's Experiences Of Intimate Partner Violence, Christiana Ifeyinwa Chineme

Walden Dissertations and Doctoral Studies

Culture and social structures are factors in the way people view or think of intimate partner violence (IPV). A significant gap exists in the current literature regarding whether changes exist in IPV experience because of continuous and direct contact between individuals from different cultural origins. Despite the increasing emphasis on the social and structural determinants of IPV-related behaviors, research and interventions lag on how people view IPV while they live in their native country and when they migrate and are exposed to a different culture and social structure. The purpose of this qualitative phenomenological research was to explore the IPV …

Principals Managing The Expectations Of Instructional Leadership, Shonda Ham Collins-Richey

Walden Dissertations and Doctoral Studies

Researchers have shown that principals are second only to teachers in their impact on student learning. The problem studied was principals’ abilities to balance their responsibilities as operational managers while placing primary focus on instructional leadership. The purpose of this qualitative study was to explore the processes established by school principals to balance the expectation of managing their buildings while being instructional leaders and how their sense of self-efficacy influenced their ability to establish and adhere to those processes and structures. The theories of complexity self-efficacy guided this study. Data were collected using structured and semistructured interviews with six elementary …

Parental Perceptions Of Mobile Device Learning For Students In Special Education, Persjha T. Conry

Walden Dissertations and Doctoral Studies

The purpose of this generic qualitative study was to explore parents’ perceptions of the use of mobile devices as tools for learning for their children in special education settings. Research literature on mobile-device use in special education indicates that little is known regarding parents’ perception of mlearning. While studies provided information on teachers’ perspectives of mlearning in their special education classrooms, parents’ perspectives on mlearning to support their children’s needs remained unexplored. The conceptual frameworks used included Rogers’s diffusion of innovation theory and Hoover-Dempsey and Sandler’s theory of parental involvement. Individual semistructured interviews of eight parents of elementary students in …

Importance Of Early Recognition Of Extrapyramidal Symptoms (Eps) In A Community Mental Health Clinic, Jamil E. Davis

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this project was to address the lack of knowledge of nurses in recognizing extrapyramidal symptoms during the early stages of clinical presentation in patients taking antipsychotic medication. Nursing staff need to be properly training to be effective. Maslow's hierarchy of human needs informed this project. The primary goal of this project was to identify if an instructional seminar regarding EPS symptoms and management would increase the knowledge of the nursing staff. The project had a sample size of 7 and the criteria for inclusion included licensed professional nurses working in the clinical setting of mental health. The …

Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano

Walden Dissertations and Doctoral Studies

The present work explored the role of family rejection on the sexual behavior of Latino gay men under the guidance of the minority stress model. Family rejection was analyzed as a distal stressor, self-esteem as a proximal stressor, and unprotected sex as the outcome. The hypotheses were tested using regression, mediation, and multiple regression of secondary data from the Latino men who have sex with men (MSM) community involvement project. The results suggested that family rejection is a weak predictor of low self-esteem and engaging in receptive unprotected sex with more partners. Low self-esteem did not mediate the relationship between …

Examining Health Care Providers' Perceptions Of The Bundled Payments For Care Improvement Initiative, Okey Felix Duru

Walden Dissertations and Doctoral Studies

AbstractThe goals of the modern health care system are in transition from volume of care to quality of care; as a result, the existing fee-for-service model may be outdated, and value-based systems such as bundled payment models should be evaluated. Accordingly, the purpose of the current study was to explore the perceptions of physicians and nurse practitioners regarding the effects of the Bundled Payments for Care Improvement (BPCI) initiative on the procedures for patient selection, care implementation, and quality measurement. The study was guided by a qualitative approach, a phenomenological design, three research questions, and the Donabedian framework for measuring …

Strategies To Identify And Implement Meaningful Measurements For Nonprofit Organizations, Michael Dillard

Walden Dissertations and Doctoral Studies

AbstractLeaders of nonprofit organizations lack strategies to identify and implement meaningful measurements to secure funding from their stakeholders. Nonprofit leaders who continue to face challenges with securing funding might fail to achieve their organization's missions. Grounded in the stakeholder theory and the Juran trilogy, the purpose of this qualitative single case study was to explore strategies three senior business leaders of a nonprofit organization in the mid-Atlantic region of the United States used to secure funding from their stakeholders. Data were collected from semistructured interviews, documents from the nonprofit organization, and public sources. Using Yin's 5-step thematic analysis process to …

Precursors To Human Trafficking, Aleta J. Eldridge

Walden Dissertations and Doctoral Studies

AbstractThe problem addressed in this phenomenological study was the lack of documentation of the supported lived experiences of the precursors that children exhibit prior to being groomed by a sex trafficker into human sex trafficking. The purpose of this study was to explore the lived experiences of adults, whom as a child, were groomed into sex trafficking due to being bullied, experienced familial abuse and had used illegal drugs, concurrent. Using Ostrom's institutional analysis theory (IAT) and Shaw and McKay's social disorganization theory (SDT), this study examined the three precursors of human trafficking that occurred, concurrently, prior and during the …