Digital Commons Network^™

A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy

Walden Dissertations and Doctoral Studies

Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …

How Women Experience And Respond To Singlism: Stereotyping And Discrimination Of Singles, Lisa Lynn Hancock

Walden Dissertations and Doctoral Studies

Society views and treats women who are single differently than women who are not single. This practice of stereotyping and discrimination towards singles is called singlism. The purpose of this qualitative study was to use grounded theory methodology to explore and explain how women experience singlism and what explains how women experience singlism. Social constructionism, cognitive dissonance theory, and social identity theory were used as conceptual foundations in explaining how society constructs the status of single women, how single women are viewed and treated, and how single women manage their single social identity. The participants of the study included women …

Nursing Staff Responsiveness To Patients And Hourly Rounding, Lucretia Wilson Wilson

Walden Dissertations and Doctoral Studies

The Center for Medicare/Medicaid Services reduced the hospital's reimbursement by $500,000 due to patient care linked to the poor outcomes of marginal fall rates and low patient satisfaction survey scores as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The scores for fiscal years 2013 and 2014 for the medical-surgical unit fluctuated between 40-42.9%, without significant improvement, while the house-wide scores were 63.17%. To address the problem, a quality improvement project (QIP) was implemented. An evidence-based (EB) hourly rounding intervention was initiated following an education program for nursing staff (n=47) tailored to enrich patient communication. The …

Care Coordination For Better Outcomes, Chad Dunavan

Walden Dissertations and Doctoral Studies

A deficiency of care coordination and delayed discharge planning has contributed to increased lengths of stay for telemetry patients and has pressed staff to discharge patients expeditiously, potentially leading to increased 30-day readmissions. Rushing the discharge process on the day of discharge has resulted in breakdowns in communication and lack of collaboration amongst the health care team of this study, contributing to extended lengths of stay, increased readmissions, and low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores. This project highlighted a patient-centered care coordination team approach with 2 clinical registered nurses and a social worker who coordinated …

The Survival Of Small Businesses In Northeastern Florida After A Natural Disaster, Harry Kemp

Walden Dissertations and Doctoral Studies

Many small business owners lack strategies needed to prevent permanent business closure in the wake of extreme natural disaster situations. After a natural disaster, small businesses suffer financial losses in millions of dollars related to damage and destruction that disrupt their lives, families, and communities. This multiple case study explored strategies that 5 small business owners in northeastern Florida used to avoid permanent business closure in the aftermath of a natural disaster. The theory of planned behavior and vested interest theory were the conceptual frameworks used in this multiple case study. In-depth interviews with purposively selected small business owners were …

Association Between Physician Characteristics And Surgical Errors In U.S. Hospitals, Obumneke A. Amadi

Walden Dissertations and Doctoral Studies

The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home …

Using Music Intervention To Reduce Anxiety And Agitation For Dementia Residents In Long Term Setting, Sonia Brown

Walden Dissertations and Doctoral Studies

Abstract

Dementia is one of the degenerative conditions that present in old age with a decline in cognitive function resulting in changes in personality and the ability to carry out activities of daily living and social functions. Dementia is usually associated with behavioral disturbances that include anxiety and agitation that pose a challenge for family members or caregivers in an alternate home or care-related facility. The purpose of this project was to design and implement a quality improvement program to evaluate music therapy intervention for residents in a long-term care who have dementia. The aim was to evaluate if music …

Leadership Styles And Employee Motivation In Qatar Organizations, Anas Al Haj

Walden Dissertations and Doctoral Studies

Organizations in the public sector in Qatar have a reputation for delivering inefficient services. Leaders lack an understanding of motivational factors affecting public sector employee performance. The purpose of this correlational research was to examine the relationship between leadership styles and employee motivation in public companies in Qatar. The independent variables were the transformational, transactional, and passive-avoidant leadership styles. The dependent variable was employee motivation. The moderator variables were employee age and salary. A sample of 92 employees from 4 public sector organizations in Qatar responded to the online survey. The full range leadership theory served as the theoretical foundation …

Examining U.S. Policy Makers' Conceptions Of Liberty In Drafting The Affordable Care Act, Louis Altobelli

Walden Dissertations and Doctoral Studies

The U.S. legislators may have incorrectly incorporated outlooks on liberty and natural law associated with the Patient Protection and Affordable Care Act (ACA) of 2010. The purpose of this case study was to use Kersch's conceptualization of declarationism and Hayek & Kamowy's construct of socialism to examine whether the ACA incorporates principles associated with the natural right of liberty as promoted by the Founders of the United States. The central research question that guided this study investigated whether U.S. lawmakers followed the intentions of the Founders in passing the ACA, as demonstrated in the legislation, related bureaucratic reports, and court …

Generational Communications In The New York City Public Sector Workplace, Nathasha Anita Brooks-Harris

Walden Dissertations and Doctoral Studies

Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Nathasha Brooks-Harris

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Mark Gordon, Committee Chairperson,

Public Policy and Administration Faculty

Dr. Michael Knight, Committee Member,

Public Policy and Administration Faculty

Dr. Michael Brewer, University Reviewer,

Public Policy and Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2017

There is a digital divide between Baby Boomers and Millennials in the way they communicate …

Introducing The Health Coach Method Of Motivational Interviewing To Medical Assistants To Improve The Patient Care Approach, Allison Marlene Souza

Walden Dissertations and Doctoral Studies

The emerging health care culture of accountability for patient outcomes compounds problems for already overwhelmed clinicians struggling to fit everything entailed in complicated office visits into 15-minute appointments. Unprocessed frustrations tempt clinicians to use ineffective and outdated methods for trying to get their patients to comply or adhere to their care plans, undermining effective health care management. The intention of this project was to evaluate whether educating medical assistants in the health coaching method of motivational interviewing can improve the patient care approach while simultaneously assisting clinicians struggling with insufficient time. Several individual scheduling conflicts limited the target population into …

Spiritual Leadership: Achieving Positive Health Outcomes In African-American Christian Churches, Cynthia Bracey

Walden Dissertations and Doctoral Studies

In the United States, African-American residents are an underserved population with evidence of higher health disparities than those associated with any other race, contributing to escalating health care costs. Despite the absence of health promotion and wellness training, pastors in predominately Black churches accept the responsibility for addressing more than the spiritual needs of their church members. The purpose of this qualitative grounded theory research study was to explore the perspectives of African-American Christian pastors on giving health guidance and their lived experiences as health promotion advocates. A total of 10 African-American Christian pastors were voluntarily recruited from 3 southern …

Marketing Strategies: How Small Restaurant Businesses Use Social Media, Tasheenia Bennett

Walden Dissertations and Doctoral Studies

Social media has changed the way businesses relate to their customers. Since the beginning of social media, traditional methods of communicating with customers have begun to decline. The purpose of this multicase study was to determine the strategies of 5 owners of small restaurant businesses in Western North Carolina who successfully used social media marketing for 1 year or more. Rogers's diffusion of innovation theory was the conceptual framework for this study. Data collection included semistructured interviews, documents pertaining to social media marketing strategies, and social media pages and websites from the participating restaurants. These data were analyzed following Yin's …

The Effects Of Hurricane And Tornado Disasters On Pregnancy Outcomes, Kenneth E. Christopher

Walden Dissertations and Doctoral Studies

Maternal prenatal exposure to hurricanes and tornadoes could contribute to an increased risk for adverse birth outcomes. Little is known about the effects of Hurricane Katrina of August 2005, on pregnancy outcomes in Mississippi. Additionally, little is known about the influence of the April 2011 Alabama tornado disaster on births in that state. The purpose of this study was to bridge this knowledge gap by examining the relationship between maternal prenatal exposure to these storms and adverse infant health outcomes. The theoretical framework guiding this retrospective, cross-sectional study was the life course approach. Data for this investigation included 2,000 records …

A Minority Perspective On The Public Health Response To The Obesity Epidemic, Rickey L. Ford

Walden Dissertations and Doctoral Studies

Obesity is currently viewed as one of the most important health concerns in the United States. Researchers have minimally investigated perspectives surrounding obesity within the African-American female population. This lack of research presented a gap in knowledge concerning the perceived social, environmental, and cultural influences of obesity within this population. The research questions asked African-American females about their views toward these influences. This research was guided by tenets of the social cognitive theory and the transtheoretical model for behavioral change. Thirteen African-American females participated in the interviews. The data collected were reviewed and coded using word frequencies and themes. Findings …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Exploring The Role Of Faith In Survival Of Breast Cancer, Franklin D. Lewis, Jr.

Walden Dissertations and Doctoral Studies

In 2013, approximately 232,340 women were diagnosed with breast cancer, and an estimated 39,620 women would die as a result of breast cancer. Stage I breast cancer can often be treated, but Stage IV breast cancer presents more difficulties in treatment, as it spreads to the bones, liver, or other areas of the body. Consequently, women with Stage IV breast cancer have very low 18 month and 5-year survival rates. According to some statistics, 79.5% of the United States population claim to be Christian. Much of this segment of the population uses faith to guide most aspects of their lives, …

Implementation Of An Early Progressive Mobility Program In The Intensive Care Units, Rene Merced Rodriguez

Walden Dissertations and Doctoral Studies

In the United States, adult ICU patient care consumes $90 billion annually, or 1% of the gross national product. In the ICU, about 40% of the patients are mechanically ventilated resulting in an 11% greater length of stay (LOS) that requires 35% more resources. And, an estimated 60% of these patients are adversely impacted for as long as five years following discharge. Patient immobility while ventilated contributes to poor quality and financial outcomes. The Institute of Healthcare Improvement (IHI) reports on average early patient mobility (EPM) reduces a 4.5-day LOS by as much as 1.3 days; and reduces the risk …

Gaps In Family And Teacher Involvement Beliefs, Malia Decourcy Sakamoto

Walden Dissertations and Doctoral Studies

Studies have shown an increase in student achievement when educational partnerships between families and schools exist. At the elementary school that was the focus of this study, there had once been a thriving family involvement program; however, the number of family-school partnerships had declined in recent years. Students, families, and teachers needed improved knowledge of the types of family involvement programs that everyone would be willing to participate in to increase student learning and achievement. The purpose of this case study was to determine whether the types of involvement currently offered to families at the elementary school matched the types …

Active Shooter Event Severity, Media Reporting, Offender Age And Location, Philip Joshua Swift

Walden Dissertations and Doctoral Studies

Following the 1999 Columbine High School shooting, it was hypothesized that offenders used knowledge gained from news media reports about previous events to plan mass shootings. Although researchers have studied active shooter events, little research has been conducted on the factors that influence an active shooter's decision and ability to carry out such events. The purpose of this study was to evaluate the relationship between the rate of news media reporting about an active shooter event and the casualty rate of the ensuing event in the United States. The bracketed time of this assessment was between April 20, 1999, and …

Identifying Stressors Experienced By Single Fathers Who Are Parenting In New York City, Stacey Theresa Melhado

Walden Dissertations and Doctoral Studies

Fathers face difficulties when taking on the single parent role, including having to prove their ability to care for their children alone. Existing research does not address issues concerning single fathers and the stressors they experience in raising their children. This study addresses these issues and helps researchers understand single fathers by using a qualitative approach to understand their perception of parenting. Fourteen participants from New York City participated in semi-structured interviews to elicit information about this phenomenon. This study focused on experiences the men have while being a single parent, the impact of living in New York City on …

Perceptions Of Childhood Obesity Among African Americans In A Low-Income Community, Cotella Wilkes Wilkes

Walden Dissertations and Doctoral Studies

Childhood obesity is a prevalent chronic condition affecting millions of children and adolescents in the United States and is rising in record-breaking numbers among African Americans in low-income communities. Guided by the social cognitive theory, the purpose of this evidence-based project was to understand the impact of an educational intervention on parents' perceptions of childhood obesity risk factors, weight status, and prevention strategies in a rural South Carolina community. A convenience sample of parents who attended a church-based community health promotion service in a low-income area (n = 10), aged 28 to 54, completed The Childhood Obesity Perceptions survey before …

Playing The Game Of Health: Best Practices For Health Optimization In A Worksite Setting With A Case Study Of A Real World Example, Patrick Dunn, Scott Conard, Lauren Kirschner

Walden Faculty and Staff Publications

While there have been multiple efforts to improve the health of the population, and simultaneously reducing the cost of healthcare and improving the quality of care, there is no single model for improving population health. Worksite health is a microcosm of the health of the nation and the results of been mixed. This paper considers the best practices associated with key worksite health. These best practices include the type of worksite intervention, attention to health literacy, engagement, onsite clinics, coaching and care plans, a digital platform, social support, population health, performance excellence, performance improvement, and an evaluation strategy. While each …

Surfing The Web With A Cave-Man Brain, Or Art Appreciation 40,000 Bce, W. Sumner Davis

Walden Faculty and Staff Publications

Methods: The study was conducted on individuals 20 years or older in the United States that live below the 130% Federal Poverty Level. We assessed food insecurity utilizing the Household Food Security Survey Module in NHANES survey between years 1999-2010 with mortality follow-up. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine relationship of food insecurity on CRS.

Regional Variation In Attitude Of Mental Health Professionals Towards Tackling Illicit Drug-Use And Drug-Related Disorders, Olubusayo Akinola, Wen-Hung Kuo, John Oswald, Olawunmi Obisesan

Walden Faculty and Staff Publications

This study sought to assess the attitudes of Mental Health Professionals (MHPs) towards tackling illicit drug use and drug-related disorders in Nigeria and to explore regional variations in attitude. Based on the validated Substance Abuse Attitude Survey (SAAS), a quantitative cross-sectional survey was conducted in a randomized sample of 292 MHPs practicing in neuropsychiatric hospitals and mental health departments of teaching hospitals from four geopolitical zones of Nigeria. A response rate of 81.1% was achieved. MHPs tended towards non-permissive, moralistic and stereotypic spectrum and exhibited distinctly defined attitude towards their professional role. The Kruskal-Wallis analysis established significant regional variation in …

Relationship Between Ethical Leadership And Sustainability In Small Businesses, David Amisano, Peter Anthony

Walden Faculty and Staff Publications

Since the 2008 financial crisis, business leaders have faced uncertainty regarding the impact of ethical leadership behaviors. Because small business leadership involves multiple facets of behavior and decision-making, small business leaders may have an insufficient understanding of the impact of ethical leadership behaviors on sustainability. The purpose of this study was to examine the relationship between ethical leadership and financial, social, and environmental sustainability in small businesses. The participants were 80 members of a Miami, Florida chamber of commerce. Correlation analysis and Bonferroni corrected calculation indicated significant relationships (p < .001) between ethical leadership behaviors and social and environmental sustainability.

A Guide To Common Skin Disorders While Pregnant, Debra Henline Sullivan, Virginia Sullivan

Walden Faculty and Staff Publications

During pregnancy, mothers strive to maintain good health and to promote the health of their babies. Having a chronic or acute skin condition during pregnancy could cause fear that treating these conditions could cause harm to their unborn child (American Academy of Dermatology [AAD], 2016). Women will need and seek guidance before and during their pregnancies as well as during lactation, when skin disorders affect them. The childbirth educator would benefit from a basic knowledge base to answer questions that may arise regarding various skin problems during the childbirth experience. This article will define and discuss treatment for some of …

Faculty Perceptions Of Online Teaching Effectiveness And Indicators Of Quality, Christine Frazer, Debra Sullivan, Deborah Weatherspoon, Leslie Hussey

Walden Faculty and Staff Publications

Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n=11) included nurse educators from an online university with an average of 15 …

The Relationship Between Parents' Value For Play And Kindergarteners' Mastery Of The Alphabetic Principle, Tamala S. Findley

Walden Dissertations and Doctoral Studies

Students who struggle with understanding the alphabetic principle often develop difficulties in reading. Play is known as a key element of early learning, but its perceived value among teachers and parents has declined over the years. This study investigated the relationship between parents' levels of agreement about the value of play and kindergarten students' levels of mastery of the alphabetic principle. The theoretical foundation included the views of Montessori and Piaget, who believed that a classroom with a play-based environment encourages independent thinking and learning. The study's research questions concerned the relationship between 53 parents' levels of agreement about the …

Relationship Between Assisted Reproductive Technology And Risk Of Stillbirth, Jeani Chang

Walden Dissertations and Doctoral Studies

Assisted reproductive technology (ART) is an infertility treatment used to assist women to become pregnant. Although the procedure is safe, there are gaps in understanding the association between treatment and adverse pregnancy outcomes (e.g., stillbirth) in the United States. The purpose of this study was to investigate the relationship between stillbirth delivery and ART. The 2 research questions addressed the association between methods of conception (ART versus non-ART) and the delivery of a stillbirth, and the association between multiple gestation pregnancy and risk of stillbirths. Retrospective cohort data from the States Monitoring ART collaborative were analyzed using Pearson's chi squared …