Digital Commons Network^™

Improving New Nurses' Transition To Practice, Merri Morgan

Walden Dissertations and Doctoral Studies

Almost 30% of new nurse graduates leave the position within the first year of practice, and almost 60% leave within 2 years. When new nurse graduates do not effectively transition into practice, nursing satisfaction is affected, and additional costs are incurred by their organizations through continual hiring of nurses. The purpose of this project was to develop a comprehensive, evidence-based nurse residency program (NRP) for new nurse graduates working in a 16-bed intensive care unit (ICU) of a 160-bed community hospital in the mid-Atlantic region of the United States. Using a team approach, Rosswurm and Larrabee's model of evidence-based practice …

Financial Strategies Of Small Businesses To Gain Access To Capital, Atta Boateng Owusu

Walden Dissertations and Doctoral Studies

In the United States, total small business outstanding loans declined by 2.5 % in 2013, compared to a 10.4% increase in 2012. Scholars and business practitioners have indicated that small business entrepreneurs experience constraints in accessing capital to grow their businesses. Many small firm owners lack the financial strategies for gaining access to capital to sustain their businesses. Building on system functionality theory, the purpose of this exploratory multiple case study was to explore the financial strategies among 3 purposefully-selected small business owners in Washington DC metro area who successfully overcame the financial constraints. Six themes emerged from the thematic …

Religiosity As A Predictor Of Hpv Awareness And Knowledge, Karen Adelheid Reiner

Walden Dissertations and Doctoral Studies

The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of …

The Strategic Prevention Framework: Effectiveness Of Substance Abuse Prevention System, John Jinoh Park

Walden Dissertations and Doctoral Studies

The strategic prevention framework (SPF) is a data-driven operating system to assist designing evidence-based substance abuse prevention programs. The study performed here was to assess the effectiveness of the SPF as a prevention planning system. One purpose of this study was to determine the implementation fidelity of the programs that used the SPF process; the other purpose was to assess effectiveness of the SPF process. This study utilized a set of data collected by the national cross site evaluation team on all jurisdictions that implemented the SPF. A subset of communities collected and reported at least 2 pre-implementation and at …

Direct Care Provider Perceptions Of Factors Influencing Treatment Motivation Of Dual-Diagnosed Female Offenders, Cara Renee Tilbury

Walden Dissertations and Doctoral Studies

Dual-diagnosed female offenders (DDFOs) present direct care providers with complex psychosocial needs and challenges that result in a serious lack of motivation to attain, sustain, and continue treatment after release from prison. Unsuccessful treatment of DDFOs represents a significant public health and safety risk including continuing criminal acts, increased health care costs, accidents related to substance abuse, and poor reintegration. Through in-depth semistructured interviews with direct care providers, this phenomenological study's focus was on examining the motivational facilitators associated with treatment adherence, barriers to treatment adherence, and approaches for enhancing treatment motivation. Nine major themes emerged from this research, including …

Consensus In Anesthesia Handoff Reporting, Robin Lee Anselm

Walden Dissertations and Doctoral Studies

Despite some improvement, no consensus exists to perfect quality in anesthesia handoff practice and policy. This quality improvement project was designed to assist a local anesthesia and perioperative workforce questioning the quality of its current handoff. Theories and models used to inform the project included the Inter-Professional Team Collaborative, Lewin's change theory, the continuous quality improvement theory, and the knowledge to action model. The communication assessment tool (CAT) functioned as a needs assessment yielding a gap in handoff practice of 25 participants. The CAT also served as the post project evaluation survey. The situation, background, assessment, and recommendation (SBAR) tool …

U.S. Military Psychologists' Contemporary Lived Experiences Of Burnout, Rui Heng Babilonia

Walden Dissertations and Doctoral Studies

Currently, the high level of burnout among military psychologists resulting from contemporary military service is gaining attention. However, there is insufficient knowledge of their lived experiences of burnout. The purpose of this phenomenological study was to explore burnout, based on the military occupational mental health, military job demand-resources models, and biopsychosocial models. Eleven active duty and prior service military psychologists were recruited for interviews using snowball sampling. The first phase of data analysis employed NVivo software. The second and third phase used the 7-step modified version of the Van Kamm method, resulting in 7 themes and 1 discrepant case. The …

Voluntary Employee Turnover: Retaining High-Performing Healthcare Employees, Jesse J. Boyd

Walden Dissertations and Doctoral Studies

Voluntary employee turnover in the healthcare industry is one of the most expensive and disruptive business problems that healthcare organizations encounter. Healthcare organizations can expect employee replacement costs to represent up to 150% of a departing employee's annual salary in new employee acquisition and decreased productivity. Guided by the leader-member exchange theory, the purpose of this single case study was to explore the strategies healthcare managers used to retain high-performing healthcare employees. Using semistructured interviews, the targeted population encompassed 6 healthcare managers from a healthcare organization in Central Texas who have demonstrated successful strategies for retaining high-performing healthcare employees by …

Strategies For Reducing Employee Absenteeism For A Sustainable Future: A Bermuda Perspective, Allison Nicola Simone Forte

Walden Dissertations and Doctoral Studies

Employee absenteeism results in billions of dollars in revenue losses and lost productivity annually. Given the consequences that organizations could face resulting from high levels of work absences, executives should develop strategies to manage absenteeism to support organizational growth and sustainability. Grounded in the theory of planned behavior, the purpose of the single case study was to explore strategies managers in the private insurance industry used to reduce employee absenteeism. The population consisted of 3 managers located in Bermuda who implemented strategies to decrease employee absenteeism from a Bermuda perspective. Data included semistructured interviews, results of the company's 2016 engagement …

Static-99, Mnsost-R, And Pcl-R In Predicting Recidivism Among Texas' Sexual Violent Predators, Diana Jefferson Jefferson

Walden Dissertations and Doctoral Studies

Recidivism within the sexually violent predator (SVP) population has gained worldwide attention because of the lack of protection offered to the victims that may lead to loss of life. Behavioral theory suggests that accuracy of predictive behaviors based on empirical judgement is more reliable than that based on clinical judgement. The purpose of this research was to see whether three actuarial assessment tools, Static-99, PCL-R, and MnSOST-R, could predict recidivism and whether the combination of the three-increased predictive value in the Texas SVP population. As yet, the literature provides no evidence. The Texas Open Record System provided assessment scores and …

Breastfeeding Perceptions Of First-Time African American Mothers, Deborah Annmarie Jarrett

Walden Dissertations and Doctoral Studies

Breastfeeding is associated with numerous health and social benefits. Although support for breastfeeding is promoted globally, disparities in breastfeeding rates and support continue. African American mothers have lower breastfeeding rates than do Hispanic and Caucasian mothers. Several researchers have focused on the benefits of breastfeeding support, but no available research has explained any specific ethnic group perceptions of breastfeeding. This study explored 10 first-time African American mothers' perceptions of the breastfeeding support they received from physicians, nurses, midwives, and lactation consultants. The purposeful criterion sampling strategy was used to recruit participants, and data were collected through semistructured telephone interviews. The …

Researchers', Stakeholders', And Investors' Perceptions Of U.S. Stem Cell Research Policy, Dorothy King-Moore

Walden Dissertations and Doctoral Studies

Federal support and funding for human embryonic stem cell (hESC) research in the United States lags behind stem cell programs in many countries because of the divisive debate over hESC research and the continually evolving federal policies that have hindered research efforts. The purpose of this phenomenological study was to explore the perceptions of stem cell researchers, stakeholders, and investors in the United States about the effects of the current federal stem cell policy on stem cell research in the United States, the moral disagreement with stem cell research, and their recommendations to improve stem cell research policy in the …

Parental Perception Of Mobile Device Usage In Children And Social Competency, Christin Topper

Walden Dissertations and Doctoral Studies

Parents in the 21st century are concerned with the ubiquity of mobile devices and their effects on the progression of social development. A review of the literature indicated that although digital interaction has become more prominent, limited empirical data existed on whether children who spend more time interacting in the digital realm would develop the necessary competency to handle social situations in real-life settings. Using social constructivist theory and the Schramm model of communication as the theoretical foundations, the present study examined the relationship between mobile device usage and the level of social competency in young children as perceived by …

Strategies To Sustain Positive Leader-Employee Relationships To Increase Productivity, Bont'e Twyman-Abrams

Walden Dissertations and Doctoral Studies

Senior executive leaders face ongoing challenges assessing whether their leadership teams have the competencies to respond to rapidly changing business conditions resulting from negative leader-employee interactions. The purpose of this qualitative single-unit case study was to explore strategies that team leaders at an online, for-profit high school education system located in Delaware, used to sustain positive leader-employee relationships to increase employee productivity. The population consisted of 5 current team leaders (faculty members and executives) at the study site who had experienced team member losses, yet had implemented effective strategies to sustain positive leader-employee relationships and increased employee productivity. The conceptual …

Structured Physical Activity And Dietary Education Program For Obese Adolescents: An Evaluation Of A Quality Improvement Project At A Rural Primary Care Clinic, Andrietta Wright Barnett

Walden Dissertations and Doctoral Studies

Childhood obesity is a worldwide epidemic. In the United States, approximately 17% of adolescents are obese; and 13% of the general population is overweight. Obese adolescents are at threefold risk for developing chronic health conditions in adulthood, including type II diabetes, hypertension, and heart disease. The purpose of this project was to evaluate the results of a quality improvement program to reduce adolescent obesity as measured by BMI 5% over 18 months in a rural health primary care clinic. The health belief model and theory of planned behavior guided the project as adolescents need to first understand the risks associated …

Examining Adolescent Student Photography And Related Processes To Inform Day Treatment School Curricula And Behavioral Interventions, Jason Edward Gorbel

Walden Dissertations and Doctoral Studies

Adolescent students with psychiatric disorders who are educated in day treatment school classrooms manifest cognitive limitations, maladaptive behaviors, and social functioning deficits that often lead to academic failure, impeding their productivity when they become adults and causing them to run afoul of the criminal justice system. Informed by their students' interests and perspectives, day treatment schoolteachers can individualize existing curricular and behavioral interventions, or develop alternatives so that unwanted classroom behaviors decrease and academic performance improves. This qualitative case study used Roland Barthes' (1981, 1985) theory of semiotics as a conceptual framework for answering how an analysis of photographs taken …

Evaluating The Impact Of A Smoking Cessation Program., Gideon Eke

Walden Dissertations and Doctoral Studies

Forty-six million individuals in the United States used tobacco products. People who use

tobacco products attempt numerous strategies before giving up smoking habit altogether. The goal of this project was to evaluate the impact of a tobacco cessation program by evaluating pre-and post-cessation program data, and hospital records of participants attending the hospital smoking cessation program over a 6-month period to ascertain the degree of reduction in tobacco use and hospitalization from smoking-related diseases. The population sample comprised of both men and women between the ages of 18 years and above. The project question addressed whether the smoking cessation program …

How Heroin-Addicted Offenders Experience Sobriety Upon Release From Jail, Rebecca Lynn Foster

Walden Dissertations and Doctoral Studies

Heroin addiction is a growing epidemic in the United States. The need for proper treatment programs accessible by heroin users who wish to or are mandated to participate in recovery programs is a growing need, and pathways to sobriety for ex-offenders have presented in literature as understudied. The purpose of this study was to examine heroin-addicted offenders' experiences prior to and after release on their paths to sobriety. This study followed a qualitative phenomenological approach based on the theory of personal causation, which posits that individuals see events in life as either driven by themselves or caused by others, both …

Examining Intellectual Property Rights, Innovation And Technology Within The Caricom Single Market And Economy, Abiola Inniss

Walden Dissertations and Doctoral Studies

Caricom Single Market and Economy (CSME) firms operate under various laws and policies on intellectual property rights (IPRs), innovation and technology. International analyses and rankings rate the CSME countries' performance as poor in comparison with others at the same level of economic development. This results in negative impacts on the economic and social welfare of their communities. A paucity of data existed concerning the effects of policies on decisions by local firms to engage in innovation and technology activities. The purpose of this qualitative case study was to examine the effects of policies on IPRs, innovation, and technology on firms …

Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff

Walden Dissertations and Doctoral Studies

There has been a steady increase in the incidence of diabetes in the United States. The purpose of this study was to determine whether there was a difference in the daily hassles of African American adults with a self-reported diagnosis of type 2 diabetes compared to those of African American adults without a self-reported diagnosis of type 2 diabetes. The theoretical underpinning for this quantitative, descriptive study was the cognitive appraisal theory (CAT), but the concept of stress and the effects stress has on the body was the broad framework that connected all the variables. The CAT was used to …

Food Waste Reduction Strategies In Supermarkets: The Lived Experiences Of Perishable Food Managers In Michigan, Kelly K. Zimmermann

Walden Dissertations and Doctoral Studies

At the retail level, 25% of sellable food is wasted, and perishable foods account for 72% of food waste in the United States. The purpose of this qualitative phenomenological study was to explore the food waste reduction strategies used by supermarket perishable food department managers, which are covered under the Good Samaritan Food Donation Acts (state and federal). The participant population was comprised of 17 managers who are responsible for perishable foods departments (bakery, deli, meat, dairy, and produce) at local, regional, and national supermarkets in Midland, Michigan. Goal systems theory served as the conceptual framework lens for which the …

Patients And Nurses Attitudes To Hysterectomy And Postoperative Pain Management, Blessing Agu

Walden Dissertations and Doctoral Studies

Over 500,000 hysterectomies are performed yearly in the United States, and they often result in a moderate to severe amount of pain. Nurses play a significant role in postoperative pain management. However, studies have shown that despite technological advances and nurses' theoretical knowledge of pain, postoperative pain management remains a challenge among healthcare providers. The purpose of this study was to examine how nurses' and patients' attitude towards abdominal hysterectomy can impact postoperative pain management and hospital length of stay after a hysterectomy. Informed by the theory of reasoned action, the study examined the differences in the nurses' and patients' …

Resilience Or Recovery: A Phenomenological Investigation Into Parental Bereavement, Anita Elderkin

Walden Dissertations and Doctoral Studies

Facing the death of a loved one is often a traumatic experience; when the deceased is one's own child, the loss may be the most stressful event of one's life. There has been very little research into the phenomenon of being a bereaved parent. This study is a phenomenological investigation into the lived experience of being a bereaved parent and whether resilience or recovery plays a role in how parents move through and eventually past such a loss to continue with their own lives. Previous research has indicated that adjustment to traumatic experiences can take multiple pathways or trajectories, depending …

Social Workers' Perceptions Of A Rural Emergency Mental Health Trauma Service, William L. Getz

Walden Dissertations and Doctoral Studies

Studies have shown that emergency mental health trauma (EMHT) services can significantly reduce the long-term effects of trauma after a disaster. However, rural municipalities may find they do not have the capacity to create such a service, or may not realize that their disaster planning includes no provision for emergency mental health care. Such was the case in a rural island community in the state of Washington, where, in 2014, several residents initiated a discussion that helped to identify the community's lack of EMHT services. This project, framed by action research and based on collaboration theory, sought to advance the …

Assessing Teachers' Confidence In Implementing Food Allergy Emergency Plans, Keturah Elizabeth Hawkins

Walden Dissertations and Doctoral Studies

Food allergies are an increasing health concern in the United States, affecting nearly 6 million children under the age of 18 years. Research has suggested that 18% of school-age children will have their first allergic reactions at school. Life-threatening allergic reactions experienced by children in the school setting are on the rise; however, little is known about how schools implement policies and practices in response to this issue. The purpose of this quantitative cross-sectional study was to narrow the knowledge gap by examining teachers' knowledge, ability, and confidence level caring for students with food allergies. Bandura's social cognitive theory, which …

The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori

Walden Dissertations and Doctoral Studies

Type 2 diabetes has more than doubled in the past decade among Black Americans. Researchers have suggested that Black Seventh-day Adventists, who follow a plant-based diet, are concerned about preventing the complications from this disease. The purpose of this qualitative ethnographic study was to explore the chance and perceptions of complications from type 2 diabetes among 10 purposefully sampled Black Seventh-day Adventists. The health belief model (HBM) served as the conceptual framework. Two constructs, education and income, were chosen for this study. Education was chosen to increase understanding about the chronic nature of the disease, and income was chosen because …

Stakeholder Influence In Promoting Environmental Sustainability In The Zambian Mining Industry, Helen Mbewe

Walden Dissertations and Doctoral Studies

Mining operations often cause environmental and social problems for communities. Efforts by major stakeholders in most developing countries to create and enforce an ethical framework for mining industry operations have been inconsistent. The purpose of this qualitative multiple case study, which was based on stakeholder theory, was to explore stakeholders' perspectives on the implementation of environmental policies and mining operations in Zambia. Data collection involved semistructured interviews with a purposeful sample of 24 research participants from a copper mining company operating in the Copperbelt Province of Zambia, the government ministry for mining, energy, and water development, the environmental protection agency, …

Educating Nurses How To Critique Research Reports, Jacqueline Carol Pinkowski

Walden Dissertations and Doctoral Studies

When bedside acute care nurses support their clinical practice with current best evidence, patient outcomes improve. Most bedside acute care nurses base their clinical decision-making on tradition and not the application of evidence based practice (EBP). The ability to appraise research is a critical component in the application of EBP and best care practices. The purpose of the DNP project was to obtain 5 content experts' evaluations of an education module for bedside nurses on how to analyze a research report, complete a literature review, and create a table of evidence (TOE). The theoretical framework guiding the project was the …

Role Of Midline Catheters In Patient Care, Tina K. Schlegel

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSIs) are responsible for 100,000 patient deaths per year, creating a critical need for prevention of these deadly infections that occur with central venous lines (CVLs). Alternative forms of IV access such as midline catheters (MLCs) may offer lower rates of infection than those seen with CVLs. MLCs were implemented at the practice setting in 2016; however, no evaluation of their effectiveness had been conducted. The purpose of this project was to evaluate the effectiveness of MLCs using a retrospective, pre- post- comparison of CLABSI rates and device utilization rates (DUR) obtained from the practice setting …

Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens

Walden Dissertations and Doctoral Studies

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General systems theory and the Donabedian model of health care quality provided the framework for the project. Electronic databases PubMed and the Cumulative Index of Nursing and Allied Health were searched for articles addressing electronic nursing documentation practices. The Cochrane systematic review methodology was used to analyze the articles. Articles were excluded if published before 2001 …