Digital Commons Network^™

Relationship Between Medicare Alternative Payment Methodology And Hospital Program Service Revenue, Sandra J. Gubbine

Walden Dissertations and Doctoral Studies

Medicare paid $388.7 billion to acute care hospitals in 2014 representing the largest portion of the health care sector in the United States. Medicare implemented an innovative reimbursement model called Value Based Purchasing (VBP) to ensure hospitals provide quality care for the dollars spent. This correlation study used the VBP theoretical framework developed by Dudley as the foundation for the reimbursement model implemented by Medicare in 2013. The data used for this study came from the Centers of Medicare and Medicaid, as well as from Guidestar. The data focused on acute care, nonprofit hospitals located in New Jersey, New York, …

Bedside Reporting: Improving Practice, Lori Wichman

Walden Dissertations and Doctoral Studies

Bedside reporting is one way to improve communication among the health care team. At the study site, at least 50% of bedside reporting was being conducted at the door of the patient's room instead of at the patient's bedside. The project question addressed whether a computer-based education and training video on bedside reporting and a standardized bedside reporting checklist would increase the rate of bedside shift-to-shift reporting among a medical surgical unit (MSU) to 100%. The project addressed the implementation of standardizing bedside reporting through education and training using Agency for Health Care Research and Quality's (AHRQ) Guide to patient …

The Relationship Of Moral Reasoning And Ethical Decision Making Among It Employees, Karen J. Stockton-Tillman

Walden Dissertations and Doctoral Studies

There has been a rise in the last decade of documented unethical business behavior by information technology (IT) employees. Over the last several years, business managers have tried to address this area of concern to find a solution to this growing problem, but they have struggled with the metrics to identify unethical behavior in IT employees. The purpose of this study was to examine the role of 3 employee constructs-ethics training (ET), education level (EL), and employee's perception of their organizations' ethical leadership (EP)-on whether an IT employee would behave in an unethical manner. The theoretical framework for the study …

Relationship Quality Associations Family Values For Online Graduate Students With Intimate Partners, Tracy J. Jones-Garcia

Walden Dissertations and Doctoral Studies

Previous research found that relationship quality (RQ) for intimate couples may be adversely effected in times of stress, potentially decreasing marital satisfaction up to 36% during a four-year period for high stress couples. Previous research indicated family values (FV) may mediate RQ in stressful times; however, no research has examined this relationship for online/blended program graduate students. Students in these programs experience unique stress, change, and at times, physical distance from an intimate partner. Coombs's theory on values consensus postulated that the more alike family values are in a relationship, the better the RQ will be. The purpose of this …

Resisting Democratic Transition Through Terrorism: A Case Study Of Post Saddam-Hussein Iraq, Kellie Rourke

Walden Dissertations and Doctoral Studies

Democracy building operations in foreign nations in Iraq and Afghanistan have been met with resistance and at great cost in terms of dollars and lives. Reducing these costs requires understanding why individuals choose to resist the transition to democracy, yet current research in the field does not address the issues of a previously nonviolent population turning to terrorism to resist transition to democracy. The purpose of this single case study was to use rational choice theory and Crenshaw's 3 levels of causation to understand what factors influenced members of the Sunni sect to resist democratic transition following the 2003 invasion …

Comparing The Effectiveness Of Masters-Prepared And Non-Masters-Prepared Nurse Leaders, Subha Narasimha Chari

Walden Dissertations and Doctoral Studies

The complex nature of healthcare requires nurse leaders to be skilled in professional practice, communication, teamwork, and problem solving to improve staff satisfaction and patient outcomes. The American Association of Colleges of Nursing and Institute of Medicine promotes graduate education for nurse leaders to enhance the delivery of quality care to the nation's diverse patient populations. Guided by the diffusion of innovation theory, this project explored the differences in nursing care hours, staff turnover, nurse quality indicators, as well as leadership characteristics on units lead by masters-prepared and non-masters-prepared nurses. Forty-eight nurse leaders completed the impact of graduate education among …

Motivating Allied Health Students To Successfully Complete Core Courses, Lisa Renee Trusclair

Walden Dissertations and Doctoral Studies

This project study addressed the problem of a decline in retention of students at a local allied health college. The need for allied health professionals is projected to exceed the availability by 2020, so it is important to identify strategies to help allied health students succeed. The purpose of this case study was to explore perceptions of students and faculty about motivating factors and learning strategies that foster successful progression in allied health programs. Ryan and Deci's self-determination theory, focused on the relationship between motivation and success, served as the framework for the study. Research questions addressed intrinsic and extrinsic …

Project Risk Management Strategies For It Project Managers, John Stephen Cabral

Walden Dissertations and Doctoral Studies

Utilizing information technology (IT) to enable new organizational capabilities to achieve near-term objectives and long-term sustainability is a top priority for many business leaders seeking to maintain or increase market share. However, organizational leaders face significant challenges to their strategy execution because the percentage of challenged IT projects has remained relatively static for decades. The purpose of this qualitative case study was to explore risk management strategies used by 7 purposely selected IT project managers (PMs) from a pharmaceutical company located in the northeastern United States who have effectively managed IT project performance by using risk management strategies, leading to …

Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe

Walden Dissertations and Doctoral Studies

Obesity is a national health problem with serious medical, psychological, and economic outcomes. Nurses and nurse practitioners (NPs) are frequently the first point of patient contact and play an essential role in the management of obesity. The current literature noted that practitioners working in primary care settings demonstrate inadequate knowledge related to evidence based practice (EBP) strategies to treat obesity, including diet modification and physical activity. The purpose of this DNP project was to develop and validate an EBP provider educational module related to diet modification and physical activity education for adult patients diagnosed with obesity in a primary care …

Colorectal Cancer Screening For The Vietnamese American Population In Iowa, Michael H. Le

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a primary cause of cancer-related mortality in the United States. Asian Americans have the highest CRC mortality rates. CRC screening tests can reduce CRC incidence, yet Asian Americans, specifically the subgroup of Vietnamese Americans, underuse CRC screening. The purpose of this phenomenological study was to understand why Vietnamese Americans, ages 50 to 75, underuse CRC screening. The health belief model constructs of susceptibility, severity, benefits, barriers, and self-efficacy were the framework for understanding this population's health-related behaviors. Three research questions focused on how knowledge, language, and cultural beliefs and perceptions affect Vietnamese Americans' CRC screening decisions. …

Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch

Walden Dissertations and Doctoral Studies

While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …

Successful Ethical Decision-Making Practices From The Professional Accountants' Perspective, Tammy Tanner Webster

Walden Dissertations and Doctoral Studies

Unethical behavior includes all decisions and actions counterproductive to an organization's mission and can cause irrevocable damage to the organization's professional reputation. The Securities and Exchange Commission reported 807 ethical violations in 2015. This study was underpinned by the ethical leadership theory, which emphasizes leadership decision making based on fair and just practices, for all involved parties. The purpose of this qualitative multiple-case study was to explore the ethical decision-making best practices that not-for-profit accounting managers in the Washington, DC, metropolitan area needed to strengthen the ethical decision-making process in their organizations. Data were collected through semistructured interviews from 5 …

Tier 2 Interventions For Students In Grades 1-3 Identified As At-Risk In Reading, Jennifer S. Ray

Walden Dissertations and Doctoral Studies

The majority of Grade 4 students in the United States do not read at the proficient level. In response to this problem, which has persisted for decades, the United States Congress in 2004 mandated response to intervention as a multitiered classroom support system designed to improve reading skills for students in K-12 public schools. However, little research has been conducted about how classroom teachers use diagnostic assessments, provide small group instruction, and monitor progress in reading interventions. The purpose of this qualitative study was to examine how teachers used assessments and instruction in reading interventions for students in Grades 1-3 …

Examining Venous Thromboembolism Post-Operative Orthopedic Care Using Electronic Order Sets, Kelly Remancus

Walden Dissertations and Doctoral Studies

Venous thromboembolism (VTE) is a serious health concern of patients undergoing orthopedic surgery. Analysis of the study site semiannual reports from January 2014 through March 2015 indicated 10 VTE events in 546 orthopedic cases. The community hospital was classed as an outlier performing in the bottom 10th percentile when compared to other hospitals. To standardize the ordering of VTE prophylaxis, the hospital developed a postoperative electronic VTE order set. The purpose of this project was to assess the difference in orthopedic VTE occurrences in the postoperative total hip arthroplasty (THA) patients before and after the implementation of the electronic VTE …

Understanding How The Army's Informal Leader Bonds Formal Leadership And The Complex Environment, Keith Laurence White

Walden Dissertations and Doctoral Studies

Bullying and toxic leadership in the U. S. Army disrupt bonding processes between leaders and subordinates, which may jeopardize military operations, threaten resiliency initiatives, inhibit leader development, and stifle innovation. Little research, however, has looked at the role of informal leaders who operate outside the formal power structure in military environments. Using social exchange theory as the foundation, the purpose of this case study was to explore the activities of informal leaders who mediated the normal and disrupted leadership bonding processes in an Illinois Army National Guard Infantry Brigade. The research questions explored the informal leaders' influence and behaviors to …

A Case Study Exploration Of Teachers' Perspectives On Children's Mental Health Service Needs In Title I Elementary Schools, Natalie Denise Yates

Walden Dissertations and Doctoral Studies

Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to …

Exposure To Hiv Prevention Messages On Social Media And Behavior Change Intent, Yoshika Shajuan Eason

Walden Dissertations and Doctoral Studies

African Americans living in the Southeastern region of the United States disproportionately contract sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Facebook and other social media sites are becoming a way to deliver health-related messaging to targeted populations. The purpose of this quantitative, cross-sectional study was to examine the association between selected demographic factors and impact of social media on intent to change sexual behaviors among 112 African Americans between the ages of 18 and 49 in the Southeastern United States who viewed STI/HIV prevention materials on Facebook within 1 year prior to the study. The theory of planned …

Screening For Opioid Misuse And Abuse In Chronic Pain Patients, Gloria Jean Farris

Walden Dissertations and Doctoral Studies

Abstract

In 2012, opioid prescriptions exceeded 250 million, which is equivalent to providing a prescription to every adult in the United States. Prescription opioids have contributed to over 100,000 deaths since the late 1990s with the greatest impact among adults 35 through 54 years of age. The purpose of this doctoral project was to introduce an evidence-based screening tool that will identify patients who are at risk of opioid misuse and aid in the development of the most effective treatment plan to manage chronic pain and avoid abuse. The Screener and Opioid Assessments for Patients with Pain (SOAPP), a screening …

Offshore Outsourcing Of The United States Semiconductor Manufacturing: Management Approaches And Strategies, Oscar Mostofi

Walden Dissertations and Doctoral Studies

The United States manufacturing employment decreased 33% from 1985 to 2014. During the same period, the United States semiconductor manufacturing, accounting for 1.7% of the total of the United States manufacturing workforce, lost 35% of its employees. The decline in semiconductor manufacturing jobs began in 1985 when semiconductor firms began offshoring product manufacturing overseas because of low cost of qualified labor force and facilities. This qualitative case study explored the analytical approaches and strategies business leaders of semiconductor firms that offshore manufacturing use in making informed strategic outsourcing and offshoring decisions conducive to sustainability and profitability of operations. The location …

Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell

Walden Dissertations and Doctoral Studies

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to …

Preschool Teachers' Views Of Literacy Instruction, Michelle Kimmy

Walden Dissertations and Doctoral Studies

Students in Pennsylvania are falling behind in reading proficiency. Early literacy skills are the foundation for future reading success and students who have not learned to read proficiently by the end of 3rd grade have an increased chance of failing to achieve academic success. The purpose of this quantitative correlational study was to investigate the relationship between preschool teachers' perceived self-efficacy for literacy instruction and preschool literacy assessment scores of students at local private preschool classrooms. The research question focused on the relationship between preschool teacher self-efficacy for literacy instruction and student literacy achievement. Bandura's self-efficacy theory served as the …

The Effect Of Two Modes Of Aerobic Assessment On Fifth Grade Students' Self Efficacy, Debra Roth

Walden Dissertations and Doctoral Studies

Declining youth physical activity levels and lack of aerobic fitness have been well documented with a corresponding rise in obesity levels and health issues. Based on Bandura's social cognitive theory, healthy physical activity levels and aerobic fitness are strongly connected to positive physical activity self-efficacy beliefs. This study examined whether student physical activity self-efficacy, motivation, and effort were different for the FitnessGram-® (FG) 1-Mile Run when compared to the 15-minute Aerobic Assessment Based on Improvement (AABI). A concurrent mixed method quasi-experimental approach measured 5th grade students' physical activity self-efficacy beliefs through a pretest and posttest survey while aerobic assessment scores …

Strategies Needed For Small Business Sustainability: A Case Study Of Thai Restaurants, Vanida Sirilarbanan

Walden Dissertations and Doctoral Studies

According to U.S. Small Business Association, the failure rates for small businesses in 2014 were as high as 50% to 80% within the first 5 years of establishment. Failure rates were especially high among restaurant businesses. The purpose of this study was to explore the strategies that small business owners needed to sustain their businesses beyond the first 5 years. Guided by entrepreneurship theory as the conceptual framework, a case study was conducted with semistructured interviews of 3 successful Thai restaurant owners in Salt Lake City, Utah. Member checking and methodological triangulation with field notes, interview data, company websites, customer …

Strategies To Retain Revenue Management Analysts In The U.S. Airline Industry, Curtis Raynard Williams

Walden Dissertations and Doctoral Studies

The voluntary turnover of revenue management analysts in the U.S. airline industry is an issue, compelling revenue management leaders to implement retention strategies that successfully reduce employee turnover. The purpose of this qualitative single case study was to explore strategies revenue management leaders used within the last 15 years to retain revenue management analysts. The conceptual framework that grounded this study was Maertz's 8 motivational forces of job attachment and voluntary turnover. The targeted population was comprised of revenue management leaders at an airline in Dallas, Texas who had demonstrated successful strategies to reduce employee turnover. Using criterion-based sampling, 4 …

Vitamin D And Age-Related Macular Degeneration, Mandy Hemphill

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is the leading cause of vision loss in individuals aged 50 years and older and is estimated to affect as many as 11 million individuals in the United States. The purpose of this study was to examine the association between vitamin D and AMD disease progression. The life course epidemiology framework model was used to explore how vitamin D level as a risk factor may have an association to AMD disease through time. Data in the 2005-2008 National Health and Nutrition Examination Survey (NHANES) database were collected on vitamin D levels and identified stages of AMD …

Effective Educational Practices Regarding General Education Teachers And Inclusion Of Students With Autism, Chanda Rhodes Coblentz

Walden Dissertations and Doctoral Studies

Owing to the influx of students with autism to the general education classroom, the role of the educator has drastically changed. Limited training and negative perceptions among teachers of students with autism are concerning. A qualitative case study, based on Bandura's theory of self-efficacy as a conceptual framework, was used to gather information based on the preservice training and personal classroom experiences from 7 general education teachers who were purposefully selected based on their licensure in the state of Ohio and experience in teaching students with autism. Research questions for this study examined the types of training teachers received, perceptions …

Diversifying Funds To Enhance Financial Sustainability Of A County Library System, Francis Adetokunboh Adebola-Wilson

Walden Dissertations and Doctoral Studies

Existing research has focused on the financial challenges affecting public libraries and how to improve library efficiency and funding. However, it is unknown how financial diversification could improve the economic fortunes of public libraries. The purpose of this study was to illuminate the unique structural, legal, and operational dynamics associated with adopting a financial diversification strategy in the Clayton County Library System (CCLS), Georgia, and to explore what would support or hinder the implementation of such a strategy. Using modern portfolio theory, the research explored how the CCLS could diversify its funding sources. A qualitative single-case study was conducted to …

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

Walden Dissertations and Doctoral Studies

Since the 2008 financial crisis, business leaders' ethical behaviors have been under scrutiny. These leaders face uncertainty regarding ethical leadership behaviors and their impact. 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 the sustainability of their businesses. The purpose of this correlational study was to examine the relationship between ethical leadership and financial, social, and environmental sustainability in small businesses. Integrated social contracts theory was the theoretical framework. The participants consisted of 80 members of a chamber of commerce located in …

Understanding Financial Value Of Cloud-Based Business Applications: A Phenomenological Study, Victor Arthur Arthur

Walden Dissertations and Doctoral Studies

An understanding of opportunities and challenges in cloud computing is needed to better manage technology costs and create financial value. The purposes of this transcendental phenomenological study were to understand the lived experiences of minority business owners who operated business applications in the cloud and to explore how these experiences created financial value for businesses despite security challenges. Historically, minority business owners have experienced high rates of business failures and could benefit from information to help them manage business costs in order to position their businesses to grow and succeed. Modigliani-Miller's theorem on capital structure and Brealey and Young's concept …

Effects Of Temperature And Precipitation On Giardiasis In Missouri, Lori Michelle Calderas

Walden Dissertations and Doctoral Studies

Global Climate Change has empirical evidence to support the idea that CO2 levels may be affecting weather and health, including rates of infectious diseases. The Midwest region of the United States of America has had the highest increase in giardiasis rates in recent years, and Missouri was chosen for this study as a representative state in the Midwest. There is no definitive answer as to why the rates of giardiasis have changed from 2003 - 2013. The Theory of Climate Change was used as the theoretical framework for this study. The purpose of this research was to determine whether temperature, …