Digital Commons Network^™

Exploring Strategies For Implementing Barcode Medication Administration Systems, Julie A. Frederick

Walden Dissertations and Doctoral Studies

The number of medication errors associated with preventable deaths in healthcare facilities remains at a high rate for healthcare leaders. Practices of medication delivery remain similar to those 10 years ago. Hospitals that have implemented barcoding medication administration systems have reported a decrease in medication errors ranging from 60% to as high as 93%. Despite this utility of barcoding, only 50% of U.S. hospitals have implemented barcode medication administration. This comparative case study explored the strategies hospital leaders used to implement barcode medication administration systems, utilizing the sociotechnical theory for a conceptual framework. Face-to-face, semistructured interviews were used to identify …

Perceptions Of Home And Small Business Owners On Insurance In Accra, Ghana, Helen Stevens-Benefo

Walden Dissertations and Doctoral Studies

Insurance is a prudent option to mitigate business risk and property loss caused by natural disasters. The current study took place in Accra, Ghana, and was prompted by the low adoption of insurance and limited understanding by home and small business owners of its risk mitigation value. The purpose of this multiple-case study was to explore information insurance companies' need to motivate investment in weather-related insurance. The interview questions of the study served to explore the reasons business owners and homeowners purchase or decline insurance, including their understanding of and receptivity to insurance. The theoretical underpinning of this study included …

The Distribution Of Type 1 Diabetes Onset In The United States By Demographic Factors, Margaret Beckstrand

Walden Dissertations and Doctoral Studies

Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene …

Health Literacy And The Level Of Hypertension In Urban Latinos, Marlene Rosetta Glashen

Walden Dissertations and Doctoral Studies

Health literacy (HL) plays a significant role in health care communication and patient compliance. Low health literacy leads to noncompliance with health instructions, poor health choices, failure to participate in recommended health screenings, frequent hospitalizations, and higher health care costs. Using the health belief model (HBM) as the conceptual framework, this quantitative, cross-sectional study addresses a gap in the literature related to the research questions of this study. The research questions are: (a) Is there a relationship between HL and the level of hypertension (HTN) in hypertensive urban Latinos?, and (b) Will HL predict the level of control of HTN …

An Examination Of Tribal Nation Integration In Homeland Security National Preparedness, Donald J. Reed

Walden Dissertations and Doctoral Studies

Research has established that national homeland security policy requires a whole community or all-of-nation approach to national security preparedness. What is less clear is whether all stakeholders are integrated into or benefit from this collective effort. This narrative policy analysis examined the relationship between a federally-recognized group of Native American tribal nations and homeland security national preparedness to explore whether tribal nations are effectively integrated with the collective effort for national preparedness. The theoretical framework stemmed from a convergence of social contract theory and conflict theory. Interviews (n = 21) were conducted with preparedness authorities from government agencies, and from …

Medical Academia Conflict Of Interest Policy And Potential Impact On Research Funding, Michael Keith Maahs

Walden Dissertations and Doctoral Studies

The partnership between medical academia and the pharmaceutical industry has been scrutinized for issues associated with research bias. As a result of this scrutiny, the Institute of Medicine (IOM) issued policy recommendations in 2009 directing academia to adopt comprehensive conflict of interest (COI) policies. During the same time, a slowdown of funded research into academia occurred, and it is not clear whether the IOM recommendations contributed to this problem. The purpose of this case study was to determine the extent to which compliance with the IOM policy resulted in a reduction in funded research. The Advocacy Coalition Framework (ACF) was …

The Relationship Between Middle School Configurations And Student Success, Asia Ali-Hawkins

Walden Dissertations and Doctoral Studies

Public schools have used varying school configurations for middle grades-typically K-8 or traditional middle school arrangements-to improve students' academic outcomes. A small Northeastern school district was experiencing problems with student achievement, suspensions, and truancy, and was considering school configuration as a potential method of improving student performance. The purpose of this quantitative study was to explore the associations between school configuration and student achievement, suspensions, and truancy. Erikson's psychosocial theory of development and Dickinson's middle school philosophy guided this study since both address the needs of adolescents. Five years of archival data were collected from 2 demographically comparable Northeast school …

Systematic Review Of Retention Of Direct-Care Workers In Long-Term Care Facilities, Regina Evonne Goins

Walden Dissertations and Doctoral Studies

Turnover among direct-care workers in long-term care (LTC) facilities is high, and has a significant impact on residents, leaders, and owners of LTC facilities. The overall turnover costs are also substantial and constitute a significant financial burden in LTC facilities. This systematic review of the literature examined, retention strategies for direct-care workers in the LTC workforce. The information may be used to develop and provide practice recommendations that will help improve retention rates among direct-care workers in LTC facilities. The project design involved a systematic examination of English-only studies from 2001-2004, retrieved from 3 major databases: CINAHL with Medline simultaneous, …

Multiple Regression Analysis Of Factors Concerning Cardiovascular Profitability Under Health Care Reform, Gordon Brian Wesley

Walden Dissertations and Doctoral Studies

Cardiovascular (CV) patients receive one-third of the care and account for $444 billion of the health care costs in the United States. The cardiovascular service line (CVSL) in hospitals contributes to the profitability influenced by elements of resource dependence theory (RDT). The purpose of this study was to understand whether the regression model of hospital characteristics and outcomes would predict profitability in a CVSL through the cost-to-charge ratio (CCR). The use of a general linear model and multiple regression analysis to examine the 2012 National Inpatient Sample from the Healthcare Cost and Utilization Project allowed estimates from a weighted sample …

Investigating The English Language Arts Placement Of Struggling High School Freshmen, Pamela Burke-Haug

Walden Dissertations and Doctoral Studies

This qualitative case study addressed a suburban school district's placement of academically at-risk English language arts (ELA) 9th graders as the district transitions from the New Jersey Assessment of Skills and Knowledge (NJASK) to use of the unfamiliar and controversial Partnership for Assessment of Readiness for College and Careers (PARCC). Based on the theoretical frameworks of the zone of proximal development, cognitive apprenticeship, and Bandura's model of self-efficacy, the purpose was to understand the characteristics of struggling (labeled 'academic') ELA students, placement practices and perceptions of these practices, and placement improvements. A purposeful sample was recruited of 7 staff members …

Marketing Strategies For Profitability In Small Independent Restaurants, Wanda Y. Jenkins

Walden Dissertations and Doctoral Studies

The restaurant industry is the second largest employer in the United States; however, only 33% of restaurants are successful during the first 3 years of operation. The purpose of this exploratory multiple case study was to determine what marketing strategies small independent restaurant owners need for profitability. Aaker's brand equity model was the conceptual framework used to ground this study. Using a purposeful criterion sampling technique and semistructured interviews, 12 individuals (2 managers and 2 employees from 3 restaurants in Philadelphia) participated in the study. Data collected from interviews and archival business records were analyzed to generate themes, also allowing …

Inflammatory Markers Associated With Disease Progression Of Cardiorenal Syndrome, Srikanta Banerjee

Walden Dissertations and Doctoral Studies

An increase in cellular inflammatory biomarkers directly increases the risk of cardiovascular disease (CVD). Using the social ecological and biomedical theories, the study examined quantitatively how specific inflammatory biomarkers are associated with cardiorenal syndrome (CRS), a potential complication of hypertension and diabetes, and how sociodemographic factors modify this association in the U.S. adult population. A retrospective secondary data analysis of the data collected from National Health and Nutrition Examination Survey (NHANES) 1999-2010 was utilized to evaluate these hypotheses. High sensitivity C-reactive protein, homocysteine (hcy), and fibrinogen had a modifying effect on Type 4 (chronic reno-cardiac etiology), Type 2 CRS (chronic …

A Policy Guide To Decrease The Use Of Continuous Passive Motion Machines, Rosa M. Cooper

Walden Dissertations and Doctoral Studies

A Policy Guide to Decrease the Use of Continuous Passive Motion Machines

by

Rosa M. Cooper

MSN, Walden University, 2009

BSN, Immaculata University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

This project was conducted at a post-acute rehabilitation hospital that served post-acute orthopedic, stroke, brain injury, cardiac, and skilled nursing patients. On the orthopedic unit, there were 5 practicing physicians, 3 of whom consistently used continuous passive motion (CPM) therapy on total knee arthroplasty (TKA) and 2 of whom did not. As a result of discussions …

Exploring The Meaning Of School Bullying Among Parents Of Victimized Children, Mildred Peyton

Walden Dissertations and Doctoral Studies

Bullying in American schools has increased to what some have considered an epidemic and is a major problem among youth. Bullied youth experience poorer mental health and lower school performance, in comparison to those who are not bullied, and the growth of bullying has raised concerns from parents, schools, policy makers, and human-services professionals interested in prevention and intervention of bullying behaviors. The purpose of this study was to explore how parents whose children experienced school bullying perceived school administrators, teachers, antibullying school policies or programs, and their family's dynamics, to better understand the parents' internal experiences. The theoretical framework …

An Interpretative Phenomenological Analysis Of Caregivers' Support For Their Preschool Children's Language And Social Skills Development, Sheri Stein Blum

Walden Dissertations and Doctoral Studies

Some children have difficulty communicating due to a lack of age-appropriate language and social skills. Researchers have explored how music and language share features that shape language processing. The purpose of this interpretive phenomenological analysis was to explore the experiences of caregivers of preschool children who participated in a music-based program and to understand their perspectives related to children's language and social skill development. Learning style and sensory integration processing theories were used as framework to provide foundations of skills in this study. Research questions addressed caregivers' choices related to this program for their children, their experiences of their children's …

Factors Motivating Employee Participation In Employer-Sponsored Health Awareness Programs, Markanthony Henry

Walden Dissertations and Doctoral Studies

Employers adopt worksite health promotions to reduce the incidence of preventable diseases, reduce healthcare costs, reduce absenteeism and presenteeism, and improve productivity. The purpose of this qualitative phenomenological study was to explore the motivational factors affecting employee participation in employer-sponsored health awareness programs. The theory of planned behavior grounded the study and formed the conceptual framework. Data collection occurred through semistructured interviews with 24 participants in the northeastern United States with lived experiences in worksite health promotion. Participants answered open-ended interview questions regarding the motivations for engaging in health promotions. Data were transcribed and coded for trends and themes. During …

A Mixed Method Study Of Diagnostic And Adaptive Functioning Challenges In African American Preschool-Aged Children With Autism Spectrum Disorders, Douglene Jackson

Walden Dissertations and Doctoral Studies

Children with Autism Spectrum Disorder (ASD) are known to experience performance and participation challenges, with early diagnosis being critical for improved outcomes. Children from ethnic minority backgrounds tend to receive their diagnoses later, even when symptomatology is similar. This mixed methods study explored symptom severity, functional difficulties, and age at diagnosis for ASD and to describe the functional challenges encountered by preschool-aged children with ASD of African American descent. The International Classification of Functioning, Disability, and Health along with the Model of Human Occupation were the theories used for this study to conceptualize functional challenges and other potential factors. Research …

Examining Biopsychosocial Factors In The Drive For Muscularity And Muscle Dysmorphia Among Personal Trainers, Beau J. Diehl

Walden Dissertations and Doctoral Studies

This cross-sectional quantitative study was conducted to assess the presence of muscle dysmorphia (MD) and a drive for muscularity (DFM) in 1,039 personal trainers using the Muscle Dysmorphia Inventory (MDI) and the Drive for Muscularity Scale (DMS). Muscle dysmorphia is considered a subtype of body dysmorphic disorder that can be exacerbated by an intense DFM, which may in turn lead to negative psychobehavioral outcomes. Because personal trainers are an unresearched population with regard to these 2 constructs, a multidisciplinary framework was used to ground the present research study. Independent variables were structured using a biopsychosocial foundation where the biological dimension …

An Educational Program For Nurses On Therapeutic Misconception In The Oncology Setting, Debra Magnanelli

Walden Dissertations and Doctoral Studies

A key component of informed consent to participate in research is the understanding that research is not the same as treatment and that scientific goals have priority over therapeutic ones. However, studies have found many research participants do not understand these important differences between research and treatment, a phenomenon termed therapeutic misconception (TM). The problem addressed in this project was research nurses' lack of education regarding the existence and concepts of TM, and their struggles to assess and address research participants' TM of clinical trials. Matutina's conceptual model of TM was used to guide this project. The purpose of this …

The Design, Implementation, And Evaluation Of A Professional Development Program, Ellen Riina Hirsch

Walden Dissertations and Doctoral Studies

Ineffective professional development is a longstanding problem in education. Locally, the school district in the study lacked a comprehensive system for evaluating their secondary level professional development programs. The purpose of this case study was to investigate the district's professional development program, specifically examining its perceived strengths and weaknesses. The conceptual framework of the study was systems theory and the adaptive schools reform model. The research questions examined the perceptions of various school personnel on their experiences with the current professional development program at the study district's high school. Individual interviews were conducted with a purposeful sample of 3 teachers, …

Relationship Between Stress Burden And Perceived Support Among Elderly Male Spousal Caregivers, Stephanie Fitzsimmons Sexton

Walden Dissertations and Doctoral Studies

As older couples age, often one partner becomes more competent and able to care for the other, in which case they are able to remain in their homes. In one township in the northeastern United States, the caregiving role had a significant effect on the lives of elderly men who care for their wives. The purpose of this quantitative project study was to determine the relationship between perceived stress burden and perceived level of social support services and between perceived stress burden and use of support services by elderly male spousal caregivers residing in active adult communities. Watson's theory of …

Sports Participation And Gpa For African-American Male Students, Demetrit Scott Rusin

Walden Dissertations and Doctoral Studies

Abstract

Improving the academic success and graduation rates of African-American males has been a major focus of both scholars and practitioners in the United States. Locally, African-American males at an urban Title 1 school were experiencing the lowest grade point averages, American College Test scores, and graduation rates in the district. In response to these academic declines, this study focused on the tenets of Bechtol's sports participation theory, which holds that students who play sports experience greater academic achievement and adult success in life. The purpose of this study was to examine the relationship between total hours of high school …

A Phenomenological Inquiry Into The Low Rates Of Influenza Vaccination Among Older African Americans, Delia Roxanne Howson-Santana

Walden Dissertations and Doctoral Studies

Influenza vaccination is recommended for persons with high-risk health conditions such as chronic diseases to prevent flu-related complications and death. African Americans 65 years and older have consistently been reported to have the lowest influenza vaccination rates compared to all other racial groups, despite having higher rates of chronic diseases. A review of the literature indicated that there is a dearth of qualitative studies examining the grounds for these low rates. In this study, 15 African Americans 65 years and older were interviewed to explore the factors that contribute to low rates of flu vaccination among this racial group. Research …

Complementary Alternative Medicine: Awareness And Perceptions Of Health Care Providers Who Provide Systemic Lupus Care, Carmen Ionie Bartley

Walden Dissertations and Doctoral Studies

The purpose of this study was to explore healthcare providers' awareness and perceptions of complementary and alternative medicine (CAM) use in providing systemic lupus erythematosus (SLE) care. This phenomenolgical study was built upon existing research indicating SLE patients' need to foster better communication about CAM use. Participants were recruited from the Long Island Rheumalogical Clinic in the State of New York. Individual in-depth semistructered interviews were conducted to explore the awareness and perceptions of a purposive sample of 10 healthcare providers who care for patients with SLE. Transcripts were analyzed, and categorical themes were developed. Guided by the use of …

Major Depressive Disorder: Precursors, Predictors, And Coping Mechanism Among Undergraduate Students, Grace Antia Bickham

Walden Dissertations and Doctoral Studies

Major depressive disorder (MDD) is common among college students. The disease perpetuates depressive symptoms and potentially leads to chronic depressive episodes. Existing literature has shown that students who use both cognitive and behavioral maladaptive coping skills are more prone to endure depressive symptoms and poorer academic performance. Despite these known associations, little research has examined the relationship between coping skills and self-efficacy in response to warning signs of MDD in college students. This study sought to fill the gaps in the research of MDD related to precursors, predictors, and coping mechanisms among undergraduate students in a national sample of U.S. …

Gay And Bisexual American Men In South Korea Who Reported Testing Hiv Negative, Tony Lionel Sessoms

Walden Dissertations and Doctoral Studies

Gay and bisexual men in the United States and South Korea have some of the highest HIV rates in their countries, and both have the fewest sex education programs and policies for gay and bisexual males in secondary and postsecondary school systems. Consequently, many South Koreans do not view HIV as a South Korean problem, and with American gay and bisexual men living in this type of environment, their HIV sexual protection knowledge and practices may be compromised. The purpose of this study was to gain more understanding and insight into the sex education experiences and sexual practices of gay …

Health-Related Beliefs Among Low-Income African American Women And Their Perceptions About Obesity, Cenora Kimberly Akhidenor

Walden Dissertations and Doctoral Studies

The aim of this study was to explore the health-related beliefs and perceptions of low-income African American women regarding obesity. Phenomenology served as the conceptual framework for this study. African American women, especially those in low-income brackets, have been shown to weigh more than women of other racial/ethnic groups. The consequences of these high rates are increased risks of developing chronic health disorders, such as type II diabetes and cardiovascular disease. The study sample consisted of 7 low-income obese African American women, ranging in age from 20 to 62, who resided in the Pacific Northwest. Recruitment for participation occurred via …

Predicting Post Traumatic Stress Disorder In Children With Prior Mental Health Diagnoses, Earnest E. Airhia

Walden Dissertations and Doctoral Studies

Hurricane Katrina devastated the U.S. Gulf Coast and subjected the city of New Orleans to disastrous flooding, which resulted in numerous after effects that impacted the children and adolescents of the city. The disaster contributed to high levels of stress, increased risk of psychological disorders, and was associated with an increased percentage of New Orleans children presenting symptoms of post traumatic stress disorder (PTSD). To help address these problems associated with hurricanes and other disasters, the current study investigated how age, gender, race, and pre-existing conditions increased or decreased the likelihood of a child being diagnosed with PTSD following Hurricane …

Post Hysterectomy Discharge Destination And Risk Of Hospital Readmission In Elderly Women, Ruth Ann Churley-Strom

Walden Dissertations and Doctoral Studies

In elderly women, discharge after gynecologic surgery is often associated with increased morbidity. Little information exists about elderly women's discharge destination after gynecologic surgery and the outcome of early hospital readmission. The purpose of this study, conceptualized using the quality health outcomes model, was to examine whether post hysterectomy discharge destination is an independent predictor of 30-day hospital readmission in women age 65 and older. Examination of covariates included patient age, race, medical comorbidity and complications of care, as well as surgical anatomic approach and operative technique. This study involved use of a retrospective cohort design and data from 10,598 …

Risk Factors And Food-Borne Illness: An Analysis Of Restaurant Violations In Georgia, Jovan Harris

Walden Dissertations and Doctoral Studies

Restaurant managers complete certification in food safety in order to ensure that food is handled and prepared in a manner that decreases risk factors associated with food-borne illness. However, the literature has been inconclusive concerning the connection between manager certification and the incidence of critical food-safety violations. The purpose of this quantitative study was to examine the relationship between the presence or absence of a certified food safety manager (CFSM) and the number of risk factors cited on food inspection reports and the food safety score. In addition, this study was designed to determine whether operation type (i.e., chain vs. …