Digital Commons Network^™

Development Of An Evidence-Based Protocol For The Management Of Acute Vertebral Fragility Fractures, Shannon De Ann Carey

Walden Dissertations and Doctoral Studies

Vertebral fragility fractures are common, affecting approximately 50% of all postmenopausal women and 33% of men over the age of 50, and are the most common type of fracture seen in osteoporosis. The management of vertebral fragility fractures in the acute care setting is lacking in standardization, in the use of evidence-based practice, and in addressing the underlying cause of osteoporosis. The purpose of this project was to develop an evidence-based protocol to standardize the care of the vertebral fragility fracture in the acute care setting. This protocol included patient education, fall risk assessment, screening for osteoporosis, and follow up …

Nurse Practitioner Navigator Policy And Procedure Protocols In Private Practice, Wendy Grose

Walden Dissertations and Doctoral Studies

In 2010, the Patient Protection and Affordable Healthcare Act (PPACA) implemented changes to reduce healthcare spending that incorporated Centers for Medicare and Medicaid (CMS) incentive programs to reduce 30-day readmission rates in seniors with heart failure. This project includes a policy and procedure for private practice using a nurse practitioner navigator (NPN) led multidisciplinary team (MDT) for the patient-centered medical home (PCMH) to improve communication between hospitals and PCMH to decrease readmission rates in seniors with heart failure (HF). This practice change will provide an implementation and evaluation plan along with plans for future expansion. Meetings were held twice weekly …

Studying The Prevalence Of Depression Among Diabetic Patients In Primary Care, Lanita Rochelle Hood

Walden Dissertations and Doctoral Studies

Abstract

The prevalence of diabetes in the United States in 2015 was 30.3 million people; which is the equivalent of 9.4% of the population. It is a major contributor to morbidity and mortality. Depression is often underdiagnosed in these patients, which contributes to poor self-management and poor health outcomes. In a large primary-care practice on the East Coast, there is no guideline for depression screening in the diabetic population. Focusing on this specific primary care setting, the research question addressed the underdiagnoses of depression in diabetic patients. The project evaluated the prevalence of depression among patients diagnosed with diabetes by …

Defining The Scope Of Practice For Nurse Practitioners In Miam, Samantha Lucero

Walden Dissertations and Doctoral Studies

Minimally invasive aesthetic medicine (MIAM) is a relatively new field, which lacks a clearly defined scope of practice. The purpose of this project was to clarify the scope of practice for nurse practitioners in MIAM in California. Without a clearly defined scope of practice, nurse practitioners are unable to practice to the full extent of their license which causes them to be underutilized and face liability issues. This project sought to answer the question: What is the scope of practice of the nurse practitioner in MIAM in the state of California? The model of professional nursing practice regulation was the …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Coping And Work-Related Correlates Of Burnout For Counselors Of Sex Offenders, Sonya A. Adams

Walden Dissertations and Doctoral Studies

Burnout affects mental health workers both personally and professionally. Identifying variables that lead to burnout, such as poor coping skills, may assist organization in preventing burnout among mental health workers. Most researchers studying burnout in the mental health field have focused on human service workers in general. There is a gap in the literature concerning job burnout among counselors of sex offenders. The theory of cognitive appraisal and coping was the theoretical foundation for this study. The purpose of this quantitative study was to examine whether problem-focused coping and emotion-focused coping, genders, years of experience, and caseload size predict job …

Senior Students' Experiences, Perspectives, And Attitudes Of Technological Competencies In Nursing Education, Patricia C. Bennett

Walden Dissertations and Doctoral Studies

Technological standards appear to be needed in undergraduate nursing education, as existing research has yet to establish technological standards for undergraduate nursing students. The purpose of this qualitative study was to examine the lived experiences of senior nursing students with respect to their perceptions regarding exposure to and abilities gained in the areas of information management, information literacy, and computer literacy. The framework of the study was based on Bandura's theory of self-efficacy and the Dreyfus model of skills acquisition. Using a phenomenological approach, in-depth face-to-face interviews were used with a purposive sample to collect data about the technological competencies …

Violence Against Nurses, Terri Lynne Declerck

Walden Dissertations and Doctoral Studies

Workplace violence against nurses causes stress, job dissatisfaction, injury, and financial burden. The purpose of this project was to examine training for nurses on violence, risk factors and on reporting workplace violence. The practice-focused question was designed to examine the effectiveness of educating nurses regarding violent patients and how to report episodes of violence. Benner's novice to expert theory guided the skill acquisition training of a convenience sample of 25 Midwestern medical nurses. The nurses participated by completing a survey prior to and following a violence simulation. A qualitative design was used with the 25 nurse participants who completed the …

Influence Of Leadership Style On Leaders' Transition From Private To Public Sector, Lorinda Lee

Walden Dissertations and Doctoral Studies

Leadership can improve the quality of work through motivation or degrade work through pressure. Leadership effectiveness depends on style and work environment. Differences in work environment may create challenges for leaders transitioning from private to public organizations. The purpose of this quantitative correlational study was to examine the relationship between leadership styles and ease of transition from private to public organizations. The study included the full-range leadership model as the theoretical foundation. Seventy-seven public sector employees in Ontario, Canada, participated in a survey to measure leadership style and effectiveness of transition from private to public sector. Results of multiple linear …

Relationship Between Active Learning Methodologies And Community College Students' Stem Course Grades, Cherish Christina Lesko

Walden Dissertations and Doctoral Studies

Active learning methodologies (ALM) are associated with student success, but little research on this topic has been pursued at the community college level. At a local community college, students in science, technology, engineering, and math (STEM) courses exhibited lower than average grades. The purpose of this study was to examine whether the use of ALM predicted STEM course grades while controlling for academic discipline, course level, and class size. The theoretical framework was Vygotsky's social constructivism. Descriptive statistics and multinomial logistic regression were performed on data collected through an anonymous survey of 74 instructors of 272 courses during the 2016 …

Facial Emotional Perception, Psychosis, Antisocial Traits, And Violence In Schizophrenia, Clarita Villafranca Hipol Ligot

Walden Dissertations and Doctoral Studies

Compromised social cognition, psychosis, and antisocial traits are associated with violence in individuals with schizophrenia. Facial emotional perception (FEP) has been used to measure social cognition in schizophrenia, but its relationships to psychosis, antisocial behavior, and violence have not been explored. Archival data from a sample of 38 participants ages 18-55 with schizophrenia were analyzed in a quasi-experimental design using a 2-way analysis of variance to determine the relationship of psychosis, antisocial traits, and FEP. The main factors of the analysis were psychosis, classified as either high or low, and antisocial traits, classified as high or low. The dependent variable …

Strategies For Crisis Preparedness Of Tourist Destinations, Carrine V. M. Todman-Lewis

Walden Dissertations and Doctoral Studies

Billion-dollar disasters are projected to increase at a statistically significant rate of 5% annually. Crises affect the viability and lucrativeness of tourism business and implicate destinations in the process. Crisis preparedness is vital to improving outcomes and reducing consequential effects in the tourism industry-a key contributor to socioeconomic progress and infrastructural development worldwide. The study was an exploration of the strategies used for crisis preparedness to reduce business interruptions and improve the image of destinations affected by large-scale natural disasters and human-induced crises. A multiple case study was conducted based on the cycle of preparedness framework. Data were gathered from …

Development Of A Quality Improvement Initiative To Screen For Postpartum Depression, Renee Traube

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is a mood disorder affecting approximately 20% of women within 6 months of delivery. Untreated PPD diminishes a woman's functioning and may result in short and long-term consequences for her infant. Screening with evidence-based tools can identify prenatal and postpartum women at risk for PPD, ensure early treatment, and limit adverse maternal and infant effects. Using Rosswurm and Larrabee's evidence-based practice model, a multidisciplinary team of 7 key stakeholders, including directors and a nurse from the departments of OB/GYN, Pediatrics, and Primary Care, a psychiatrist specializing in women's health, and a member of nursing leadership, formed to …

Improving Fall Prevention Strategies In An Acute-Care Setting, Sylvia B. Boye-Doe

Walden Dissertations and Doctoral Studies

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program …

Strategies For Retaining Employees For Call Centers, Kimberly M. Combs

Walden Dissertations and Doctoral Studies

Voluntary employee turnover has several adverse consequences for call center managers, including lowered productivity and decreased profitability. The purpose of this descriptive multiple case study was to explore strategies used to reduced voluntary employee turnover among 2 call center managers in the southern United States. These managers had been recommended by the human resource directors of the organizations because of their implementation of strategies to reduce voluntary employee turnover. The conceptual framework for this study was Herzberg's motivation-hygiene theory. Data were collected from semistructured face-to-face interviews and employee handbooks. The data analysis consisted of compiling the data, disassembling the data …

Factors Related To Nursing Student Persistence In An Associate Degree Program, Patricia Ann Farley

Walden Dissertations and Doctoral Studies

The retention of nursing students remains a challenge in higher education, and the need for nurses in the United States is projected to increase. The purpose of this study was to investigate nursing student persistence in an associate degree program by examining differences in the presence of key social, environmental, and academic factors across 2 types of students: completers and non-completers of the 1st course in a registered nursing program. The study framework was based on Tinto's Student Integration Model and the Nursing Undergraduate Retention and Success Model, which identify key social, environmental, and academic factors as critical to student …

Science Technology Engineering Math (Stem) Classes And Females' Career Choices, Dr Reagan Lorraine Lavorata, Phd

Walden Dissertations and Doctoral Studies

Females have been discouraged from taking science, technology, engineering, and math (STEM) classes during high school and college, resulting in limited access to high-paying STEM careers. Therefore, these females could miss opportunities for these high-paying careers. The rationale of this research was to quantify the relationship between the number of STEM classes the sampled females took, the number of female role models they had during high school and college, their career choices, and salaries. The theoretical construct was based on Erikson's social developmental theory, which postulates a relationship between earlier life events and later life events, and Acker's masculinity theory, …

Impacts Of Observing Live Open Heart Surgery On Young Adults' Health Behaviors, Muhammad Musa Qarizadah

Walden Dissertations and Doctoral Studies

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open …

Sleep Among Young Adults Living In Rural Poverty, Susan Barber Skinner

Walden Dissertations and Doctoral Studies

Lack of restorative sleep is implicated in threats to public health and safety as well as negative individual health outcomes, which are more pronounced among those living in rural poverty. This study addressed the need for an approach to these problems that is sensitive to culture and community. The purpose of this phenomenological study was to explore the lived experience of sleep among young adults living in rural poverty to inform development of strategies to improve sleep behavior in this population. Research questions explored the lived experience of sleep, constructs of the theory of planned behavior which was used as …

Correlations Between Management Behaviors And Financial Indicators With Fda Compliance Leading To Medicine Shortages, Francisco Gutierrez-Perez

Walden Dissertations and Doctoral Studies

In the first 3 years of the Obama Administration, 2009-2011, the number of warning letters issued to pharmaceutical firms for manufacturing and quality issues increased by 81% to 49 letters. Only 9 letters were issued in the last 3 years of the George W. Bush Administration. Shortfalls in compliance and product quality led to medicine shortages that affected patients' treatment and health. This quantitative study sought to learn to what extent, if any, the independent variables, management behaviors and financial indicators at pharmaceutical firms in the United States, correlated with, or predicted, the dependent variable, compliance with the FDA regulations. …

Evaluation Of Automated Reminders To Reduce Sepsis Mortality Rates, Maria M. Lindo

Walden Dissertations and Doctoral Studies

Sepsis is still a leading cause of death in the United States despite extensive research and modern advancement in technology. Early recognition of sepsis and timely management strategies are important for effective reduction of sepsis-related morbidity and mortality. Guided by the logic model, the purpose of this project was to evaluate the effectiveness of electronic reminders in enhancing clinical decision-making among 30 nurses in 3 medical-surgical units. The practice-focused question addressed the effectiveness of electronic reminders for early recognition and initiation of goal-directed treatment of sepsis in hospitalized patients on medical-surgical units in an effort to reduce sepsis mortality rates. …

Identifying Communication Barriers And Trust Issues Of Black Women Seeking Preventive Health Services In Houston, Texas, Melissa E. Shelton

Walden Dissertations and Doctoral Studies

Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. …

Psychological Resilience In Correctional Officers: The Role Of Demographics, Manuel Chapa Villarreal

Walden Dissertations and Doctoral Studies

Correctional officers occupy an important societal role in maintaining safety and assisting in the rehabilitation of inmates; however, both their performance and mental health are highly susceptible to fatigue because of working in a high stress environment. This study investigated the relationship between correctional officers' demographic factors (level of education, marital status, gender, and race/ethnicity) and their psychological resilience. The Connor-Davidson Resilience Scale 10 (CD-RISC-10) was used to measure correctional officers' resilience when responding and or coping with stress. This study utilized the stress-vulnerability model as a framework to investigate protective factors against and risk factors for psychopathological symptoms. Participants …

Exploring Student Loan Personal Financial Management Decisions Using A Behavioral Economics Lens, Michael J. Wermuth

Walden Dissertations and Doctoral Studies

There is a student loan debt problem in the United States. Seven million student borrowers are in default and another 14 million are delinquent on their loans. A high level of college loan debt leaves students with insurmountable payments and holds them back from starting a family, buying a home, or saving for retirement. The problem is that financial managers may not understand the student loan decision process well enough to help students make a loan decision that prevents an unmanageable level of debt. The purpose of this study was to explore and understand the student's loan decision process using …

Priority Schoolteachers' Experiences Of Professional Development To Improve Student Achievement, Joyce Wiggins Wiggins

Walden Dissertations and Doctoral Studies

The New Jersey 2011 Adequate Yearly Progress report revealed that 53% (n = 75) of state schools that failed to meet standards were put on a 'priority school' list. The 2015 priority school list consisted of 66 schools. In response, New Jersey created Regional Achievement Centers to provide collaborative professional development (PD) for effective instruction in the lowest performing schools. The purpose of this transcendental phenomenological study was to explore the lived experiences of priority schoolteachers regarding experiences with past PD initiatives and PD under the current Elementary and Secondary Education Act flexibility waiver focusing on collaborative approaches that include …

Executive Director Experiences With Consumer Operated Service Provider Governing Board Members, Merideth Mccallick Erickson

Walden Dissertations and Doctoral Studies

Consumer Operated Service Providers (COSPs) are programs that are directed and administratively controlled by mental health consumers for their peers. As such, many mental health consumers have been placed in the position of serving on a COSP and often with unclear descriptions and no training. As a result, there is often a disconnect between the will of the board and the vision of the executive director, leading to tension and the possibility of failed mission. Using servant leadership as the guide, the goal of this case study was to explore the experiences of executive directors who operate Consumer Operated Service …

Exploring Mission Drift And Tension In A Nonprofit Work Integration Social Enterprise, Teresa M. Jeter

Walden Dissertations and Doctoral Studies

The nonprofit sector is increasingly engaged in social enterprise, which involves a

combination and balancing of social mission and business goals which can cause mission

drift or mission tension. A work integrated social enterprise (WISE) is a specific type of

social enterprise that focuses on integrating hard-to-employ individuals, such as ex

offenders, back into the workforce, usually through producing goods or offering services.

Little is known about how WISE organizations manage mission drift, particularly given

the unique characteristics of this type of organization. Using institutional values theory

and resource dependence theory as the foundation, the purpose of this case study …

Gamification Techniques And Millennial Generation Philanthropy, Karen Kavanaugh Kavanaugh

Walden Dissertations and Doctoral Studies

Beginning in 2015 a major demographic shift in the majority income producers in the United States has moved from Baby Boomers to Millennials. At the same time, many nonprofits are not equipped to engage with Millennials and lack the knowledge and resources to tap into their philanthropic preferences. Using the theories of planned behavior, reciprocal altruism, social status, and warm glow theory, the purpose of this qualitative study was to explore opportunities for U.S. based nonprofit organizations to interact more effectively with members of the Millennial generation in terms of philanthropic behavior. Data were collected and analyzed using Q Methodology …

A Qualitative Case Study Evaluation Of A Government Workforce Training And Qualification Program, Walter Meeks Meeks

Walden Dissertations and Doctoral Studies

In response to a 1993 oversight board recommendation, the U.S. Department of Energy (DOE) created a technical training and qualification program to address concerns about a shrinking workforce at defense nuclear facilities. The DOE Technical Qualification Program (TQP) applies to federal employees tasked with oversight, direction, and assistance to contractors at defense nuclear facilities. The purpose of this study was to determine the effectiveness of the TQP by ascertaining program effectiveness, program applicability, program impact on behavior and performance, and program impact on safety, from the participant perspective. Guided by Kirkpatrick's 4-level training evaluation model as the conceptual framework, this …

How Does Organizational Culture Impact Rn Engagement, Veronica Anntionette Ruffin-Ellis

Walden Dissertations and Doctoral Studies

Lack of RN engagement in the acute care setting can result in poor staffing, nursing shortages, increased stress levels for nurses and decreased morale. When nurses are not engaged in their work setting, quality of care suffers. A wide range of literature focuses on the importance of RN engagement; however, few health care organizations have taken the initiative to implement programs that foster RN engagement, demonstrating a gap in practice. This study examined the relationship between the levels of RN engagement and their perceptions of their organizational culture. Kolcaba's humanistic approach to meeting the needs of RN staff was used …