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Development Of Assessment And Screening Tool To Assist With Prevention And Identification Of Charcot Foot In Type 2 Diabetics, Louise S. Wade

Walden Dissertations and Doctoral Studies

Abstract

Development of Assessment and Screening Tool

to Assist with Prevention and Identification of Charcot Foot in Type 2 Diabetics

by

Louise Wade MSN, RN

MS, West Texas A&M University, 2010

BS, West Texas A&M University, 2010

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2016

Abstract

According to the World Health Organization, up to 50% of type 2 diabetic patients

develop neuropathy, which may cause major infections, amputation, and Charcot foot due

to impaired sensation. Early recognition and care is essential for treatment of Charcot

foot and prevention …

The Impact Of Transportation Infrastructure On Nigeria's Economic Developmeny, William A. Agbigbe

Walden Dissertations and Doctoral Studies

The United Nations Development Programme (UNDP) described Nigeria's road networks as one of the poorest and deadliest transportation infrastructural systems in the world. Data from the UNDP and the World Bank (WB) show that Nigeria has suffered transportation infrastructure deficits; these data also illustrate Nigeria as one of the lowest indices in economic development in the last decade. This qualitative case study addressed the impact of a lack of investment in transportation infrastructure in the form of road networks on Nigeria's economic development. The purpose of the study was to understand the relationship between the investment in road networks and …

Promoting Annual Depression Screening In A Federally Qualified Healthcare Center, Denise Lesley Alleyne

Walden Dissertations and Doctoral Studies

According to the World Health Organization, depression affects about 350 million people worldwide. In 2014, only 50% of the adult patients were screened for depression in the community-based Federally Qualified Healthcare Center (FQHC) for which this doctorate of nursing practice (DNP) project was developed. In an effort to meet the 100% benchmark set nationally for the screening of adult patients in the primary care settings, the FQHC's quality improvement team now requires that 80% of adult patients in the clinic be screened for depression. Framed within the Iowa model of evidence-based practice, the purposes of this project were to: (a) …

Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi

Walden Dissertations and Doctoral Studies

Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …

Cross-Age Peer Mentoring To Improve Sixth-Grade Student Reading, Christina L. Belotti

Walden Dissertations and Doctoral Studies

In a middle school in the southern United States, administrators and teachers are concerned that approximately 40% of sixth-grade students are reading below grade level despite intervention programs. The purpose of this mixed-methods case study was to inquire whether a cross-age peer mentoring program would improve sixth-graders' reading achievement and motivation to read. The theoretical framework for the study was Vygotsky's constructivist theory, with a focus on scaffolding. Research questions focused on sixth-grade students' perception of their participation in a cross-age peer mentoring program and the effect of the program on reading achievement and motivation. Data were collected through pre- …

High School Teachers' Perceptions Of Mental Health And Adolescent Depression, Christine Ann Breuer

Walden Dissertations and Doctoral Studies

Adolescents have a high rate of untreated mental health issues, specifically related to depression. Current literature does not indicate the impact of teachers' attitudes toward mental health on their decisions to refer students for services. This study provides understanding specifically, how teachers' beliefs about mental health, as well as their age, gender, ethnicity, years of education, and years of teaching, were analyzed to determine the impact each these characteristics had on the decision to refer a student for services. 92 high school teachers participated in this quantitative study by completing a survey measuring their attitudes of mental health, and then …

Fall Safety Bundle, Baili Denise Campbell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services (CMS) report thousands of falls in hospitals each year. The CMS does not reimburse hospitals for fall related injuries, costing the hospital system organization for which this DNP project was designed millions of dollars each year. Framed within the Iowa model of evidence-based practice and using a team approach, the purpose of this project was to develop an evidence-based (EB) fall safety bundle for use by nursing staff and a curriculum to educate staff on prevention strategies. The components of the EB fall bundle kit were approved by the stakeholder committee. Evaluation of …

Single Mothers Of Young Children And Continuing Education, Jackiethsha Lynette Fluellen

Walden Dissertations and Doctoral Studies

The number of households headed by single mothers living in poverty exceeds that of all other categories of poverty-stricken households, and poverty impacts the children negatively in various ways. When single mothers choose not to continue their education, they lessen their chances of finding higher paying jobs and raising their families out of poverty. The purpose of this phenomenological study was to better understand why some single mothers decided to continue into higher education. The study considered the decisions of 6 single mothers of young children in Montgomery County, Texas, and the obstacles they overcame while completing their education. The …

Integrated And Reducing Re-Entry Into The Criminal Justice System, Scott Huntington

Walden Dissertations and Doctoral Studies

Numerous studies have focused on the effectiveness of integrated treatment services for people with cooccurring disorders (CODs) within the criminal justice system (CJS). However, there has been a paucity of research on the effectiveness of community-integrated treatment services with CODs and influences on decreasing their interaction within the CJS. This study quantitatively examined the possible relationships between integrated treatment services and CODs and their effect on decreasing interactions within the CJS. The sample (N = 320) consisted of people with CODs from a community-based facility. The statistical analysis was a 2-way (2 x 2) and 3-way (2 x 2 x …

Improving Communication Between Cancer Patients And Providers During A 15-Minute Office Visit: A Systematic Review Of The Literature, Dr. Tammy Elizabeth Manganelli

Walden Dissertations and Doctoral Studies

Patients undergoing chemotherapy treatments for cancer often experience adverse side effects, including cognitive deficits. These deficits impact the patient's ability to communicate effectively with their oncology provider. Ineffective communication can adversely affect patient outcomes and decrease patient-provider satisfaction. The resulting poor communication can contribute to poor patient outcomes. This systematic literature review focused on assistive communication tools that could be used in an outpatient oncology setting to improve patient-provider communication. The literature review findings led to the development of a resource for providers that includes 15 communication tools that can be used to assess and improve communication in cancer care. …

Professional Development Of Head Start Teachers In Emotional And Instructional Support, Marilyn Mcleod Harris

Walden Dissertations and Doctoral Studies

In the southwest region of Tennessee, a local Head Start program classroom assessment scoring system's (CLASS) scores fell in the lowest 10% among national Head Start programs in emotional and instructional support. Since 2012, the Office of Head Start has released reports showing that the average Head Start program has low performance CLASS emotional and instructional support scores. The purpose of this exploratory case study was to investigate the professional development of local Head Start teachers with low CLASS scores in emotional and instructional support. Knowles's adult learning theory of andragogy was the overall conceptual framework and the concentrated theory …

Retention Of Direct Care Professionals Supporting Intellectually Disabled Individuals, Melanie Opalka-Bentler

Walden Dissertations and Doctoral Studies

In the health and human service industry, employee turnover affects business practices and causes disruption of the lives of vulnerable individuals with intellectual disabilities receiving support. Using a human capital conceptual framework perspective, the purpose of this multiple case study was to explore strategies used to increase employee retention. The criteria for participation included organizational leaders from 3 Pennsylvania human service agencies that supported individuals with intellectual disabilities, tracked employee turnover for at least 2 years, and developed strategies to increase employee retention. Organizational leaders volunteered to participate and the first 3 organizations meeting the criteria were selected. Data collection …

Perception Of Cervical Cancer Screening Among Immigrant African Women Residing In Houston, Texas, Esther Ifeomadiniru Orji

Walden Dissertations and Doctoral Studies

Perception of cervical cancer screening among Immigrant African women residing in Houston, Texas

Esther I. Orji

M.Ed., University of Lagos, 2002

B. Ed, Abia State University, 1998

A.C. E. University of Benin, 1990

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

August 2016

Disparities in cervical cancer screening participation still exist especially among immigrant and minority women compared to non immigrant populations. Research investigators through multiple studies have explored reasons for non participation in cervical cancer screening among immigrant and minority women. However, there was limited research specifically on …

A Phenomenological Study Of The Roles Of Principals In Special Education, Sarah Marie Parker

Walden Dissertations and Doctoral Studies

At the time of this study, there is intensified awareness of the importance of special education and the appropriate implementation of supports and services for the students identified as having special needs. In the United States, understanding special education laws, the needs of students with special needs who are served in the school building, and effective ways to interact with staff members and families about special education are important components of principal leadership success. Principal supervisors and others who provide training and ongoing professional development for principals and potential school leaders need to understand more about issues principals face in …

Measuring Knowledge And Attitudes Of Clinicians About Motivational Interviewing With Troubled Adolescents, Sophia Joseph Parrilla

Walden Dissertations and Doctoral Studies

Adolescents with acting-out behavior have an increased risk of dropping out of high school, incarceration, and early mortality. Researchers have indicated the need for studies using motivational interviewing (MI) to promote behavioral change. There is a gap in the literature about the efficacy of MI with adolescents and clinicians' knowledge of, and attitude toward, MI. Using self-determination theory as the grounding theory, this study examined the knowledge and attitudes of 73 clinicians on the island of St. Croix, Virgin Islands, about knowledge and attitudes of MI and whether it predicted the use of MI as a therapeutic intervention for adolescents …

A Multiple Case Study On Leader Support, Breastfeeding, And Work Commitment, Lisa Marie Rancourt

Walden Dissertations and Doctoral Studies

In the United States, over 50% of women return to paid work after becoming mothers. Mothers who breastfeed are more likely to stop working than peers who chose to use infant formula. The purpose of this research was to explore work commitment among new mothers during the first year of their infant's life. Many of these mothers had skills that were imperative to organizational success, making their retention a priority. The relationship between leadership support for dual roles as mothers and employees had not received attention previously in the literature. This multiple case study analyzed the perceptions of new mothers …

Algebraic Content And Pedagogical Knowledge Of Sixth Grade Mathematics Teachers, Mariyam Shahuneeza Naseer

Walden Dissertations and Doctoral Studies

Algebra test scores of the Maldivian students from grade 6 through 12 are the lowest compared to any other area of mathematics. Algebra is a fundamental topic in mathematics and lays the foundation for mathematical reasoning and complex problem-solving. Research shows that strengthening algebra instruction could improve student achievement. This concurrent mixed methods study examined the algebraic content and pedagogical knowledge of 5 sixth grade mathematics teachers who teach in 5 different schools across the Maldives. Shulman's major categories of teacher knowledge and Ball, Thames, and Phelps' domains of mathematical knowledge for teaching guided this study. The research questions examined …

The Relationship Between School Type And Mental Health Of Lesbian, Gay, Bisexual, Transgender, And Questioning Young Adults, Steven Vincente Spencer

Walden Dissertations and Doctoral Studies

Gay-straight alliance (GSA) clubs may positively affect mental health for lesbian, gay, bisexual, transgender, and questioning (LGBT) students, but little research has studied schools that primarily enroll LGBT students. Guided by neofunctional and sexual stigma theory, the purpose of this study was to determine if graduates of LGBT high schools have better mental health than LGBT and heterosexual graduates of mainstream high schools. A snow ball sample, of 183 graduates of high schools in the United States and 95 graduates from high schools in other countries, 80% who identified as LGBT, completed an online survey consisting of 5 short mental …

Examining Nurse Practitioners' Perceptions And Beliefs Regarding Hospice Referrals For African Americans, Karen Jackson Mcclary

Walden Dissertations and Doctoral Studies

Terminally ill patients often have difficult choices at the end-of-life, and electing to receive hospice services is one of them. Hospice has been linked to improved quality of life and death and is accessible to terminally ill patients. Despite the accessibility, African American patients often make the decision to forgo hospice services. The purpose of this descriptive study was to explore perceptions and beliefs of nurse practitioners (NPs) regarding the lack of utilization of hospice for African American patients and the feasibility of NPs for initial referral for terminally ill African American patients. The research questions addressed whether an NP's …

Accounting Strategies For Small Business Law Firms' Sustainability, Karen Ann Adams

Walden Dissertations and Doctoral Studies

Small business family law firms generate jobs within the local community, but often fail because of suboptimal accounting strategies. A multiple case study was used to research the accounting strategies small business family law firm owners use to succeed in business beyond 5 years. The population for this study was three small business owners of family law firms located in West Chester, Pennsylvania. The small business family law firm owners had achieved and maintained profitability of their businesses for a minimum of 5 years. Financial literacy theory and the leadership skill model comprised the conceptual framework for this study. Data …

Effects Of Information Technology Risk Management And Institution Size On Financial Performance, Shaun D'Olene Kecia Barrett

Walden Dissertations and Doctoral Studies

A negative relationship exists between unmanaged IT risk and financial performance of institutions of varying sizes. The purpose for this quantitative correlation study was to examine the relationship between IT risk management, institution size, and the financial performance of credit unions in Jamaica. Information Systems Audit and Control Association (ISACA) risk IT model provided the theoretical framework for the study. Audited financial statements and a web-based survey provided data for this study. One hundred and thirty employees from 13 credit unions in Jamaica participated in the study. Results of the multiple regression tests confirmed a statistically significant relationship between IT …

An Evaluation Of Champs For Classroom Management, Vernessa Evans

Walden Dissertations and Doctoral Studies

Teacher education programs focus on preparing teachers to instruct students, but they usually do not focus on preparing teachers to manage students’ behavior, which may prevent teachers from providing effective instruction. This project study evaluated a classroom behavior management model, CHAMPS, designed to help teachers manage student behavior so they can focus their time and energy on instruction and student success. Positive Behavior Systems (PBS), used in the field of behavioral management, served as the theoretical foundation for this study. The evaluation design followed Stufflebeam’s (2003) Context, Input, Process, and Product (CIPP) by employing the outcome-based approach, which evaluated the …

Geographical Effects On Adult Sickle Cell Disease Treatments, Morbidity, And Mortality, Paula Busbee

Walden Dissertations and Doctoral Studies

A small percentage of patients with sickle cell disease (SCD) have experienced an increase in life span by 10 years, while others with the same disease continue to die prematurely. The purpose of the study was to evaluate whether or not regional location was a barrier to care for adults with SCD in relation to emergency department visits and health outcomes at 16 and 21 years after the approval of hydroxyurea therapy as treatment. Secondary data were sourced and a retrospective quantitative correlational design was used to examine the effect of hydroxyurea treatment approval on emergency department visits and mortality …

Perceptions Of Employed People With Narcolepsy, Chantelle L. Jones

Walden Dissertations and Doctoral Studies

Many companies have used perceptions of their employees to understand how sleep disorders affect their working environment. Sleep disorders have had an undesirable effect on employee performance and often result in employee modifications to accommodate their condition in the workplace. Though information is available concerning employees' experiences pertinent to working with sleep disorders, research focusing on how employees with narcolepsy perceive their work environment appears to be missing from the literature. The purpose of this study was to gain understanding of perceptions of employees with narcolepsy about their work environment and strategies that may influence others to promote positive health …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Multimedia Technologies' Influence On Language Acquisition In English Language Learners, Larissa Karina Parrilla

Walden Dissertations and Doctoral Studies

English as a Second Language (ESL) learners at the upper elementary level have struggled to demonstrate the vocabulary required to read in English at grade-level. Although multimedia technologies have demonstrated positive effects as language acquisition educational tools at the university level, it remains unclear how useful they are for language acquisition at the elementary level. This quasi-experimental study used dual coding theory as a framework to examine the relationship between the level of reading comprehension upper elementary students developed and their construction of word meanings through use of multimedia technologies. The study utilized convenience sampling of 85 students divided into …

Same-Sex Relationships Among African American Women Previously In Heterosexual Relationships, Patricia Lynn Smith

Walden Dissertations and Doctoral Studies

In the United States, same-sex relationships have been a popular topic for the past decade, largely in relation to marriage. This phenomenological study examined the life experiences of African American women currently in same-sex relationships but previously in heterosexual relationships. Exploring the participants' experiences to the fullest extent was important to understand each person's journey through the stigma and biases that she faced when making life choices. Given the rarity of literature on the subject matter, professional practitioners and clinicians may not know how to assist these women. Queer and social identity theories were applied in exploring the directed research …

Success Strategies Saudi Entrepreneurs Used To Navigate Through Regulations In Jeddah, Farah Mehar Spencer

Walden Dissertations and Doctoral Studies

Saudi Arabian entrepreneurs face major difficulties with the country's complex regulatory system. Based on Schumpeter's theory of entrepreneurship, the purpose of this phenomenological study was to reveal the lived experiences of Saudi entrepreneurs in navigating regulatory procedures in Jeddah. Data were collected through prolonged, face-to-face phenomenological interviews with 22 Saudi businesspeople who started successful businesses. The van Kaam method and member checking helped validate the transcribed data, which were subsequently coded into 4 themes. Four themes emerged from the data analysis: (a) obstacles in regulatory processes, (b) lack of information, (c) cumbersome procedures and need for alternatives to stringent protocols, …

Patient Safety: Improving Medication Reconciliation Accuracy For Long-Term Care Residents, Annisa Leachman Stover

Walden Dissertations and Doctoral Studies

Patient Safety: Improving Medication Reconciliation Accuracy

for Long-Term Care Residents

by

Annisa L. Stover

MSN, Southern University, 2008

BSN, Our Lady of the Lake College, 2005

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2016

During transition of care, inaccurate medication reconciliation is associated with increased risk of adverse events for patients. Older adults are the population most often affected by medication errors, and long-term care facilities struggle to accurately document medication reconciliation. Errors are more common at hospital discharge, but the critical moment for detecting and resolving them …

Electronic Learning Management System Integration Impact On Tertiary Care Hospital Learners' Educational Performance, Ahmad Tassi

Walden Dissertations and Doctoral Studies

Technological innovations have been shown to improve the quality of health information and improve safety in health care systems. The purpose of this project was to offer hospital nurses a more flexible and practical alternative to education and training than the traditional face-to-face method, supporting nurse educators in overcoming many of the obstacles in responding to nurses' needs in the clinical areas. This project used a randomized, 2-group posttest-only experimental design to measure the effect of treatment at a targeted hospital. The experimental group received a new instructional approach using an Electronic Learning Management System (ELMS) and the control group …