Digital Commons Network^™

Assessing Knowledge Of Evidence-Basedpractice Among Nurses, Suja Merin John

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is used worldwide to improve the quality of patient care to provide cost-effective care. EBP is a mandate for nursing practice combining individual clinical judgment with available expertise to generate a positive outcome for the patient. Investigators have documented that nurses have varying degrees of confidence and knowledge about EBP. The purpose of this project was to improve knowledge of EBP among registered nurses (RNs). The ACE Star Model of Knowledge transformation was used as the conceptual model. The key project question was to assess the level of knowledge and confidence about EBP among RNs in a …

Development Of A Practice Guideline For Dnp Prepared Nurse Practitoners Working In Long-Term Care Facilities, Ashley M. Marshall

Walden Dissertations and Doctoral Studies

Clinical evidence-based practice guidelines providing recommendations for health care decision making have become vital components of long-term health care practice in the United States. Frequently changing guidelines have complicated nurse practitioners' (NPs) efforts to implement evidence-based practice into the daily care that they provide to patients. The purpose of this project was to develop an evidence-based practice guideline for doctoral-prepared NPs working in long-term care facilities. This project is important because practitioners use practice guidelines to provide patients with the most appropriate, evidence-based care. Kolcaba's comfort theory was used to guide this project. Kolcaba's theory holds that comfort exists in …

Elementary General Education Teachers' Knowledge Of And Experience Teaching Students With Disabilities In Science And Social Studies, Diane Rice

Walden Dissertations and Doctoral Studies

In Grades 3 to 5 at a suburban southeastern elementary school, the percentage of students with disabilities (SWDs) who do not meet state standards in science and social studies is greater than that of their nondisabled peers. To address this disparity, district administrators required that proficiency ratings increase for SWDs without providing general education (GE) teachers with training. A qualitative bounded case study was used to understand how GE teachers constructed their knowledge of and met SWDs instructional needs and to understand GE teachers' needs as they worked toward meeting the district goals. Piaget's constructivist learning theory served as the …

A Phenomenological Study Of Single Fathers Of Children With Autism In Trinidad, Merisha Shirwell Margaret Seepersad

Walden Dissertations and Doctoral Studies

With an increase in diagnosis rates of autism in Trinidad, more parents of children with autism, especially single fathers, face numerous challenges on a daily basis. There is a lack of research on this topic and therefore an inadequate understanding of the experiences of Trinidadian single fathers as primary caregivers for children with autism. The purpose of this phenomenological study was to explore and depict the lived experiences of single fathers of children with autism. Social support theory was the guiding conceptual framework to explore and understand how single fathers effectively manage their daily challenges. Ten single fathers from Southern …

Childhood Attention Deficit Hyperactivity Disorder: A Stress Factor For African Immigrant Mothers, Helen Agatha Awatefe

Walden Dissertations and Doctoral Studies

Children between the ages of 6-17 years suffering from childhood attention deficit hyperactivity disorder (ADHD) need constant attention as they are more likely to be accident proned, hospitalized, disruptive, and educationally challenged. The constant attention required for children with ADHD may impose stress on mothers and primary caregivers, yet this stress has not been sufficiently studied. The objective of this study was to fill a gap in literature by studying the stress experienced by African immigrant mothers living in the United States who are living with and caring for a child with ADHD, and then comparing the level of stress …

Relationships Among Administrative Computerization, Hospital Size, And Administrative Expenses, Pamela J. Gallagher

Walden Dissertations and Doctoral Studies

The healthcare industry is computerizing administrative functions in an attempt to reduce expenses and remain competitive. This correlational study of 3,088 Medicare-certified, short-term, acute-care hospitals in the United States was based on a general systems theory framework; it sought to examine the relationships among the independent variables of hospital size and administrative computerization and the dependent variable of administrative expenses. Secondary data from Health Information Management Systems Society's surveys and cost reports from the Centers for Medicare and Medicaid services were used. Correlation analyses with an alpha of .05 were used to test 3 of the 4 hypotheses; regression analysis …

An Evaluation Of Service Learning For Associate Degree Nursing Students, Valerie Marie Pauli

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate outcomes of the service-learning requirement in the Associate of Science in Nursing (ASN) curriculum at the local college. The problem addressed in this study was that the local ASN program lacked formal evaluation of the service-learning requirement. Guided by Kolb's model of experiential learning, a goal-based, summative evaluation employed as a qualitative case study explored the perceptions of 20 stakeholders including graduates, faculty members, and key community informants. The research questions focused on how service learning influenced a student's learning of cultural competence and the impact service learning had on the community. …

The Experience Of Being Unsheltered In Atlanta, Ikeranda Smith

Walden Dissertations and Doctoral Studies

In the United States, it is estimated that millions of adults are homeless. Some individuals choose not to use homeless shelters or are ineligible for their use. Researchers have indicated that many unsheltered homeless are men over the age of 45 years. The purpose of this phenomenological study was to examine the experiences with social services providers among unsheltered men. Understanding the social networks of unsheltered homeless and the use of spirituality or faith as a resource for coping was also examined, as a significant gap exists in the research on unsheltered homeless. Face-to-face, in-depth interviews were conducted with 8 …

The Role Of Problem Behaviors In The Pathway From Abuse To Prostitution, Shante Williams

Walden Dissertations and Doctoral Studies

Research has suggested that behaviors beginning in childhood or adolescence may play a mediating role in the relationship between childhood maltreatment and involvement in prostitution. It is currently unknown how poor self-concept and low self-efficacy play a mediating relationship in this association. The primary purpose of this correlational study was to evaluate early youth problem behaviors such as poor self-concept and reduced self-efficacy as possible mediators in the association between childhood abuse/neglect and participation in prostitution during young adulthood. The central research questions explored the association between childhood maltreatment and involvement in prostitution, as well as how self-concept and self-efficacy …

The Implementation Of Governance To Counter Islamist Militancy In Pakistan's Khyber-Pakhtunkhwa Province, David Robert Diorio

Walden Dissertations and Doctoral Studies

Militancy inspired by Islamists is escalating globally, and government action is necessary to protect vulnerable populations. Security professionals generally agree that governance may complement the use of force to defeat militants; however, current doctrine does not address the concurrent integration of governance in a comprehensive strategy. This interpretive case study explored Pakistan's application of governance during the 2009 Khyber operation in Swat Valley, code-named Operation Rah-e-Rast. The central research question focused on how governance activities were integrated with military operations to subdue militancy. Data were collected through interviews with 6 planners, Pakistani secondary source survey data, and government artifacts. Data …

Exploring The Influence Of Management Communication Behaviors On Employee Engagement, Alicia J. Hart

Walden Dissertations and Doctoral Studies

An engaged workforce can increase organizational productivity and decrease employee turnover. Current research on employee engagement exists, yet little research exists on how the communication behaviors of management affect employee engagement. Guided by the conceptual framework of systems theory and communications theory, an exploration of the influence of management communication behaviors on employee engagement was conducted. A descriptive research design helped explore the influence of management communication behaviors on employee engagement within local, government entities of the Tidewater, Virginia, area. Data included semistructured interviews with 23 participants (11 managers and 12 employees). Data analysis occurred using the modified van Kaam …

Analysis Of How Newly-Hired Nurses Are Educated To Provide Customer Service, Patricia Mcafee

Walden Dissertations and Doctoral Studies

As part of healthcare reform through the Affordable Care Act of 2010,

hospitals across the United States are being held accountable for

providing a positive patient experience and will lose up to 2% of

their reimbursement by 2017 if they fail to reach targeted scores.

The purpose of this quality improvement project was to review the

process used by a Georgia hospital to educate newly-hired nurses

about customer service expectations and to provide recommendations

for process improvement. Theoretical foundations supporting

customer service included the caring philosophy of Mayeroff; the

caring theories of Watson, Leininger, Boykin, and Nyberg; and

Roy's adaptation …

Factors Influencing The Use Of Physical Restraints On Children Living In Residential Treatment Facilities, April M. Minjarez-Estenson

Walden Dissertations and Doctoral Studies

The use of physical restraints in residential treatment centers for children has been shown to be detrimental to both staff and the children. Although there have been nationwide initiatives to reduce or eliminate the use of physical restraints on children, to date, researchers have not yet identified the organizational factors that predict the likelihood of using physical restraints on children. Based on the two-factor theory, in which two different types of predictors of motivation and behavior in the workplace were identified, the purpose of this quantitative non-experimental study was to examine whether satisfaction with pay, a hygiene factor, and satisfaction …

An Analysis Of Investments By Multilateral Development Banks In Central America, Jose Lopez Rojas

Walden Dissertations and Doctoral Studies

Multilateral development banks (MDBs) are under increased pressure to justify their allocation of donor resources. These funds help produce growth in developing regions such as Central America (CA), where wealth inequality limits individuals' access to basic services and increases the prevalence of crime and corruption. MDB leaders are not always confident the allocation of limited resources creates optimal value. The capital asset price model (CAPM) was the theoretical framework of this correlational study. Archival data consisting of annual reports and audited financial statements were used to draw a sample (N = 66) of USD $4.857-asset valued loans made by MDBs …

Response To Intervention Teachers' Perspective Of Tier 2 Intervention Fidelity, Doretha Meissner

Walden Dissertations and Doctoral Studies

In an urban Texas school district, teachers and administrators were concerned about students' achievement and the teachers' knowledge and implementation of Response to Intervention (RTI) Tier 2 interventions with fidelity. This study addressed teachers' perceptions of the reliability of the application of Tier 2 interventions at the study site, its influence on student achievement, and the appropriateness of current professional development at the targeted campus. The constructivist concept of how people learn and the implementation theory of scaffolding instruction, meaningful experiences, and active learning provided the framework for this study. The educators provided perspectives of how the quality and frequency …

Impact Of Sense Of Community, Ideology, And Religiosity On Post Traumatic Stress Disorder Symptomatology From Chronic Terror Attacks, Nuriel Shalom Mor

Walden Dissertations and Doctoral Studies

Since 2000, the southern Israeli town of Sderot and a neighboring rural region, Otef Aza, have been frequently exposed to nearly identical terror attacks by Hamas. While only a small minority of Otef Aza residents have been diagnosed with post-traumatic stress disorder (PTSD), more than a third of Sderot residents have been diagnosed with PTSD. Factors such as social cohesion and ideology may be the unique factors that protect Otef Aza kibbutzim residents from PTSD; however, a gap in the literature exists as to how these same factors might affect PTSD symptomology in Sderot residents. Orthodox religiosity has also been …

Risk Of Maternal Smoking On Breastfed Infants And The Development Of Otitis Media, Judith C. Ogbonna

Walden Dissertations and Doctoral Studies

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while …

Standardized Assessment Results As A Predictor Of Student Reading Success In New Brunswick, Canada, Gregory David Paterson

Walden Dissertations and Doctoral Studies

Many Canadian school districts use standardized reading achievement data to support reading instruction. Over 30% of 9th-grade students in the Anglophone School District-South (ASD-S) have not met targets for the English Language Proficiency Assessment (ELPA), a graduation requirement in New Brunswick, Canada. This study compared archival reading scores of 6th-grade students from 2009-2012 with the same students' scores in 9th-grade from 2012-2015, to determine if 6th-grade scores were a predictor of 9th-grade results. Rendering the impact illiteracy plays on society, this study applied the theoretical framework of social theory from Bourdieu's (1977, 1984, 1986) view of social mobility and Turner's …

Effects Of Social Support On Cardiac Recurrence Among African Americans, Yolanda Phillips

Walden Dissertations and Doctoral Studies

Heart disease is the leading cause of death among African Americans. Despite advances in treatment modalities, based on better understanding of the disease's pathology and access to health care, African Americans continue to die from heart disease at rates significantly higher than other races. The available literature on cardiovascular disease among African Americans does not adequately explore how social support affects heart health in this group. The purpose of this study was to examine the effects of social support on cardiac recurrence among African American adults. Cohen's ISEL support system variables: tangible, appraisal, belonging, and self-esteem; and five demographic variables: …

Evaluating Positive Psychology Curriculum Among Nontraditional Students In A Foundational Course, Ruth Hilton Rhodes

Walden Dissertations and Doctoral Studies

Positive psychology emphasizes growth, adaptive functioning, and human potential. The present study contributes to this literature by examining the impact of exposure to a positive psychology curriculum among nontraditional students taking foundational courses in a career college. Mixed methods were utilized to assess changes in student well-being and goal setting quantitatively through pre- and post-tests of the Authentic Happiness Survey and the Satisfaction with Life Scale as well as identifying emergent themes from qualitative analysis of student reflections and written assignments over a 9-week term. Twenty-five students participated in foundational courses, which placed an emphasis on positive psychology. Paired samples …

The Underuse Of Hospice Care In The African American Military Beneficiary Population, Wanda Castleberry Richards

Walden Dissertations and Doctoral Studies

Hospice services provide a holistic approach to end-of-life care to terminally ill patients though there is some evidence to suggest that African American military beneficiary populations may not access hospice care as often as expected. The purpose of this nonexperimental study was to evaluate reasons for the low use of hospice care among the terminally diagnosed members of this population, between the ages of 18 and 64. Kolcaba's comfort theory provided the theoretical framework for this study. The research explored whether a statistically significant difference exist among African Americans military beneficiaries population as compared to non-Hispanic Whites pertaining to their …

Evaluation Of Intervention To Increase Exercise Among A Group Of Hispanic Patients In South Florida, Rene Beltran Rodriguez Elias

Walden Dissertations and Doctoral Studies

Despite knowledge regarding the need for regular physical exercise, little is known about the most effective ways to encourage and maintain regular physical activity among primary care patients. New approaches to education about and support of physical activity are needed for everyone, but especially for groups susceptible to diseases related to sedentary lifestyles. This project evaluated a web-based educational intervention guided by the health belief model to address the lack of regular physical activity among 25 Hispanic patients in a South Florida clinical practice. The physically inactive patients were identified through the clinic's electronic medical records and consented to participate. …

College Transition Experiences Of Homeschooled Women, Jeanine L. Sanclemente

Walden Dissertations and Doctoral Studies

During the past 40 years, the U.S. homeschooling population rose exponentially. The results of homeschooling need to be studied further so that parents, legislators, and higher education leaders can make prudent and well-informed decisions regarding homeschooled students. No studies have been completed that focus on the unique experiences of homeschooled women as they transition to college in terms of academics, forming new relationships, and individuating from their families. The purpose of this phenomenological study was to explore academic and relational processes during the transition to college. In this qualitative dissertation based on constructivist design and in the conceptual framework of …

Improving Bedside Swallow Screening In Acute Stroke Patients: An Evaluation Plan, Juliette Segree

Walden Dissertations and Doctoral Studies

A stroke is a life-changing event for a patient and his or her family. The acute stroke patient is at risk for developing aspiration pneumonia, whether silent or overt. Prevention of pneumonia in this population requires timely completion and documentation of the bedside swallow screen to identify those patients at risk for aspiration pneumonia; however, anecdotal data from the emergency department at the site of this project suggested that completion and documentation of the screening were inconsistent. Guided by the quality caring model adopted by the project site as well as the logic model, the aim of this project was …

Development Of A Church-Based Educational Program To Increase Prostate Cancer Screening For Black Men 40 And Older, Dawn Marie Silvera-Ndure

Walden Dissertations and Doctoral Studies

Prostate cancer is the most common cancer among men in the United States and is one of the leading causes of cancer death among men of all races. However, African-American men are at particularly high risk. These men are diagnosed more often with prostate cancer, are diagnosed later, and are more than twice as likely to die from prostate cancer than are Caucasian men. A strategy to address this inequity was to develop a community based program that would reach this at risk population. The goal of the project was to develop an evidence-based, theory-supported education and referral program to …

School Community Members' Perceptions Regarding Lgbt-Based Bullying, Harassment, And Violence, Steven W. Street

Walden Dissertations and Doctoral Studies

In Tennessee, a majority of students who identify as Lesbian, Gay, Bisexual, or Transgender (LGBT) do not feel safe due to bullying and harassment that is targeted toward them by their peers. Schools, such as MTS school (a pseudonym), are not required to specify protection for LGBT students, causing the LGBT bullying to continue without being reported and resulting in higher absences, lower achievement, greater mental health issues, and in some cases, suicidal ideation among LGBT students. Through confidential personal interviews that were transcribed and coded, this case study's purpose was to better understand how MTS adult stakeholders perceive (a) …

Evaluation Of The Intervention Efficacy Of Lions Quest Skills For Adolescence, Jennifer Lee Switzer

Walden Dissertations and Doctoral Studies

Adolescence is characterized as a time of impulsivity, emotional decision-making, and peer influence; thus, interventions targeting the development of effective psychosocial skills are imperative. Improved psychosocial functioning can equip adolescents for successfully overcoming future life challenges. There are few studies that have examined how adolescents' psychosocial skills could be improved in the context of substance abuse prevention program participation. The purpose of this study was to examine changes in psychosocial skills in a group of adolescents who participated in 2 of 10 Lions Quest Skills for Adolescence (Lions Quest SFA) programs being used in central Virginia middle schools. This study …

Case Study Of Stakeholders' Views On Retention And Self-Efficacy In Texas Nursing Programs, Durcilla Kay Williams

Walden Dissertations and Doctoral Studies

Retention of students through the completion of the nursing degree is a problem that exists at local Texas nursing programs, adding to the nursing shortage at local Texas hospitals. The purpose of this qualitative research study was to identify the best practices used by a local Texas college with graduation rates above the benchmark of 85% set by the Texas Higher Education Coordinating Board. The study framework was based on Bandura's theory of self-efficacy and Tinto's theory of student retention. The research questions for the study focused on reasons the college maintained a high retention rate, best practices currently used, …

Teachers' Perceptions Of School Violence: A Case Study, Jessica Anderson

Walden Dissertations and Doctoral Studies

School violence has gained attention in recent years with the rise of aggressive behavior in schools across the United States. With increased understanding of this problem, school district administrators might implement prevention strategies or assess current school violence policies and programs. Using the conceptual framework of general strain theory, a case study was conducted in an urban school district in the northeastern United States that was experiencing increased student violence. The purpose of this case study was to explore teachers' perceptions of school violence to increase the understanding of the problem at the study site. All certified teachers in the …

Reducing The Use Of Indwelling Urinary Catheters During Cesarean Deliveries, Michelle Renee Borland

Walden Dissertations and Doctoral Studies

One concern for medical professionals and women experiencing cesarean deliveries is the use of indwelling urinary catheters, which is associated with a delay in first void time, slower ambulation time, increased discomfort, longer hospital stays, and an increased risk for urinary tract infections. The purpose of this project was to determine if a practice change regarding the use of urinary catheters among pregnant women decreases the number of women receiving a catheter prior to having a cesarean section in a small community hospital. The knowledge to action and Rosswurm and Larabee's models were used to guide this project, which was …