Digital Commons Network^™

Human Factors Analysis And Classification System Interrater Reliability For Biopharmaceutical Manufacturing Investigations, Roberto Cintron

Walden Dissertations and Doctoral Studies

Human errors are an expected result of operations performed by individuals and frequently lead to accidents and other catastrophic events. The problem is that the current process used to investigate and mitigate human errors in the biopharmaceutical manufacturing industries is not effective, as it does not include the effects of human factors found to be effective in aviation and nuclear power organizations. The human factors and classification system (HFACS) was created for the investigations of accidents using the Swiss cheese model of accident causation as a theoretical framework. The purpose of this quantitative, inter-rater reliability study was to demonstrate the …

Social Disorder And Level Of Engagement Of Small Business Owners In The Virgin Islands, Saul Santiago

Walden Dissertations and Doctoral Studies

The U.S. Virgin Islands is experiencing an economic recession, manifested through social disorders such as abandoned and vandalized houses. Research points to social disorders and lack of community engagement as key factors inhibiting community development efforts. In order to strengthen these struggling communities, research has highlighted the need for public-private partnerships. Guided by Ajzen's theory of planned behavior, which posits that attitudes can predict behaviors, this study examined the relationship between social disorder and engagement of small business owners in community development. Small business owners in the U.S. Virgin Islands received an Internet or paper survey; a total of 79 …

Nonattendance Rates And Barriers To Health Care In Outpatient Clinic Settings, Susan Louise Geiger

Walden Dissertations and Doctoral Studies

Lower socioeconomic status, ethnicity, and race are associated with reduced health care use in the United States. Patients who continually miss their appointments suffer significant negative results, including a disruption in continuity of care, complications with their chronic illnesses, and an increase in hospital readmissions. The health belief model was used as the theoretical support for this project that investigated the underlying causes of no-shows at an urban hospital-based outpatient clinic in the United States. It used a quantitative, descriptive design and examined a minority, underserved, and underinsured population that was receiving care at the research site and had a …

Hispanic High School Dropouts: Their Unheard Voices, Cheryl Ann Clayton-Molina

Walden Dissertations and Doctoral Studies

America is in the midst of a high school dropout crisis that will cost $3 trillion in lost wages over the lifetime of the 12 million students who are predicted to drop out. Each year, in an America's northern states, approximately 10,000 students drop out of high school; the majority of these students are Hispanic. Guided by Ogbu's cultural-ecological theory of academic disengagement, the purpose of this phenomenological study was to understand the experiences of Hispanics who dropped out of high school and their rationales for dropping out.. Eight Hispanic dropouts in a local community were interviewed. The interviews were …

Computer Anxiety And Computer Self-Efficacy Of Older Adults, Elizabeth Diane Cooper-Gaiter

Walden Dissertations and Doctoral Studies

Many older adults (aged 55 and older) need training to acquire computer knowledge and skills. Using computers and the Internet could provide access to vital resources for improving older adults' health and maintaining their connections with family and society. This study examined 2 psychological constructs--computer anxiety and computer self-efficacy--that have been shown to impact a person's successful use of computers and related technology. Guided by Bandura's self-efficacy theory, which emphasizes the importance of adult learners being motivated and taking charge of their learning, this study examined the impact of a computer knowledge and skills workshop on older adults' computer anxiety …

Associative Factors Of Acculturative Stress In Latino Immigrants, Sam Kedem

Walden Dissertations and Doctoral Studies

For the past 200 years, Latinos have comprised the largest, consistent category of immigrants in the United States. This influx has created a need for culturally competent psychological treatment of a population that suffers from acculturative stress, defined as the stress a minority member experiences while trying to adjust to the culture of the majority. Researchers have studied Latino immigrants' enduring trials as they adjust to life in the United States. Nevertheless, there is limited research on the quantification of factors contributing to acculturative stress. Based on the conceptual framework of bidimensional acculturation and Latina/o critical race theory, predictors of …

Sociodemographic Predictors Of Medication Nonadherence Among Latinos Diagnosed With Diabetes Type Ii, Bianca L. Tristan

Walden Dissertations and Doctoral Studies

Latinos of low socioeconomic status are disproportionately affected by diabetes Type II complicated by poor adherence to diabetes Type II medications and management programs. Self-management of diabetes Type II is a tool used to teach health education to patients with diabetes. The objective of this retrospective quantitative study was to explore if there are predictors of nonadherence to diabetes Type II medications and programs among Latinos with diabetes Type II. Data from 200 patient records from a community clinic in Fresno County California were analyzed using both bivariate and multivariate analysis. Selected sociodemographic independent variables were age, gender, income, migrant …

Women's Experiences With The Follow-Up System For Cervical Cancer In A Developing Country, Christine Carol Richards

Walden Dissertations and Doctoral Studies

Although Grenada has an extensive health care infrastructure and cervical cancer screening rates are relatively high, Grenada also has a disproportionate rate of morbidity and mortality from cervical cancer. The aim of this study was to explore factors that contribute to these disproportionate rates in Grenada. Using a phenomenological qualitative approach, Andersen's behavioral model of health care utilization and a systems based model for assessing care were used as a guide to explore Grenadian women's follow-up experiences with Pap test and cervical cancer screening. Purposive sampling was used to recruit 8 women for semi-structured in-depth interviews. Data were collected on …

Factors Associated With Graduation Among Latino Male High School Students, Judyann Watson

Walden Dissertations and Doctoral Studies

High dropout rates for minority students require additional educational research to understand and implement changes that will increase graduation rates. The purpose of this nonexperimental study was to examine factors that may be associated with graduation for Latino male students. Guided by Tinto's work, which holds that students remain in school when they feel academically or socially connected to an institution, this study addressed the impact of social factors, academic factors, and small learning communities (SLCs) on graduation rates. The research study used archival data and bivariate logistic regression to analyze the data for Latino male participants (n = 208) …

Assessing Value Added In The Use Of Electronic Medical Records In Nigeria, Isaiah Gbenga Abimbola

Walden Dissertations and Doctoral Studies

Electronic medical records (EMRs) or electronic health records have been in use for years in hospitals around the world as a time-saving system for patient record keeping. Despite its widespread use, some physicians disagree with the assertion that EMRs save time. The purpose of this study was to explore whether any time saved with the use of the EMR system was actually devoted by doctors to patient-care and thereby to improved patient-care efficiency. The conceptual support for this study was predicated employing the task-technology fit theory. Task-technology theorists argue that information technology is likely to have a positive impact in …

Secondary Principals Who Are Mothers: Balancing Home And Career, Turina Parker

Walden Dissertations and Doctoral Studies

Working mothers who are school leaders face challenges as they attempt to manage competing time demands and personal and professional responsibilities. A need exists for existing school leaders, as well as women aspiring to school leadership, to understand the coping strategies used by mothers who are also school principals. To that end, the purpose of this phenomenological study was to examine the experiences of mothers who are school principals. Strategies used to navigate multiple roles were examined through a role conflict lens. Three overarching research questions guided this study to focus on how female principals with children accommodate their dual …

Bedside Nurses' Influence On Patients' Continuum Of Care Through Effective Discharge Teaching, Mary Ann Whicker

Walden Dissertations and Doctoral Studies

The evolution of person-centered healthcare reinforces the need for nursing to provide effective patient education. Literature suggests nurses desire to provide strong discharge education to patients, but are challenged by knowledge gaps and other barriers. This DNP project developed a plan for integrating teach-back on a 30-bed cardiac unit, focusing on heart failure patients. Following a logic model, the process improvement plan to implement teach-back includes education on teach-back, empowerment of unit champions to support the project and evaluation of effectiveness of the education plan and impact on heart failure patients. The sample size of 15 cardiac nurses provides a …

Employee Wellness Model For Obesity, Barbara Siebold

Walden Dissertations and Doctoral Studies

Obesity, a condition of having a body mass index (BMI) greater than 30, is a universal epidemic with the greatest prevalence in the United States. The greatest concern with this epidemic health problem is that it presents with many comorbidities and is a risk factor for other chronic diseases. Employee wellness programs (EWP) have been in place for years and incorporate programs on weight management, nutritional education, and smoking cessation to reduce risk factors associated with chronic diseases. These programs utilize the concept of empowerment, often guided by Pender's self-management theory, to encourage employees to take onus for their health …

The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo

Walden Dissertations and Doctoral Studies

Recent multicenter, randomized, double blind clinical trials have shown no association between HIV preexposure prophylaxis (PrEP) and increased sexual risk behavior among high-risk men who have sex with men (MSM). However, little research has been conducted under natural conditions devoid of clinical trial controlled environment to confirm the lack of association between PrEP and increased sexual risk behavior. Also, research has shown conflicting associations between sociodemographic characteristics and sexual risk behavior among MSM. In this cross-sectional, web-based, primary data analysis, MSM who reside in United States of America (USA) and who make use of PrEP for HIV prevention were examined …

Community College Leaders' Experiences In Adapting To Changing Student Demographics, Joyce Hewett

Walden Dissertations and Doctoral Studies

The demographics of community colleges are rapidly changing. The culture composition of the student population in community colleges has expanded, and includes larger percentages of African Americans, Asian/Pacific Islanders, Hispanic Americans, and Native Americans than are found in other higher education institutions. The purpose of this phenomenological study was to examine the lived experiences of 10 community college leaders, consisting of 4 administrators, 5 faculty members, and 1 faculty/administrator, in their attempt to adapt to the changing demographics of the student population. Multicultural lens, the conceptual framework for the study, helped guide leaders in assessing their levels of multicultural sensitivity …

Interrupting The Sepsis Process With An Evidence-Based Education Intervention, Martha Olson

Walden Dissertations and Doctoral Studies

Interrupting the Sepsis Process with an Evidence-Based Education Intervention

by

Martha Olson

MSN, Walden University, 2013

MS, Southwest Minnesota State University, 2003

BSN, The University of Iowa, 1998

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

May 2015

Abstract

Sepsis is a concern, especially for the vulnerable populations. The early signs of sepsis are vague and often difficult to detect, but when detected early, are treatable with antibiotics and fluid resuscitation. When a nurse is unaware of the early signs, treatment is delayed and multiorgan failure may progress quickly. To …

Internal Attributes That Mitigate Perceived Job Insecurity: Improving Employee Satisfaction, Shelly Leigh Rogers-Sharer

Walden Dissertations and Doctoral Studies

Employee satisfaction has been found to have a strong relationship with perceived job security. This study explored job insecurity in an unstable global economy. Specifically, it examined internal attributes of employees, hypothesizing that such attributes would enable employees to better cope with work-related stressors such as job insecurity. Specific attributes of personality and employability were assessed as potential moderators of job satisfaction and security, utilizing the theory of work adjustment and person-environment correspondence as theoretical frameworks. The specific attributes included facets of conscientiousness and neuroticism as well as dispositions of employability including openness to change at work, work and career …

Impact Of Fiscal Decentralization On Quality Financial Reporting At The Districts In Ghana, Abdul-Malik Seidu Zakaria

Walden Dissertations and Doctoral Studies

This study examined the impact of fiscal decentralization on quality financial reporting at the local government level in Ghana. The study is important because it provides development partners with the assurance that Metropolitan, Municipal, and District Assemblies (MMDAs) funds are used for their intended purposes. The study was based on the theory of local public expenditures, which posits that fiscal decentralization may enhance local capacities for service delivery. The key research question examined the extent to which fiscal decentralization has influenced quality financial reporting at the local level. The research design was quantitative, randomly sampling stakeholders in the local government …

Crash Risk Associated With Cellular Phone Use While Driving, Tiffani Ann Fordyce

Walden Dissertations and Doctoral Studies

There are inconsistencies in the published literature on the effect of cellular phone use while driving. The objective of this study was to estimate an adjusted nationwide crash rate associated with cell phone use while driving and to compare statewide crash rates prior to and following the implementation of legislation banning cell phone use while driving. Crash rates in nationally representative databases were calculated based on imputed values for cell phone use using the propensity score method. The imputed nationwide crash rate for fatal crashes (1.61 per 100 fatal crashes) and all crashes (1.409 per 100 crashes) represented a 2 …

Social Inequality: Cultural Racism As A Predictor Of Collegiate Academic Success, Natasha L. Ball

Walden Dissertations and Doctoral Studies

The economic sustainability of an area is largely dependent on the education level of its population, yet little is known about the role cultural racism may play in academic success. The purpose of this correlational study was to evaluate the theory of cultural racism, defined as, the establishment of cultural institutions by whites/Europeans to the detriment of non-white people, as it relates to academic success at the college level. Data were collected from 100 participants from 3 predominately African American high schools in the Atlanta, Georgia area to explore whether the presence of cultural racism existed from the perspective of …

Contextual Factors And Direct Exposure To Hiv: Influences On Youth Sexual Intention, Hadiza Ladidi Osuji

Walden Dissertations and Doctoral Studies

Youth are having sexual intercourse at an early age and as such, are engaging in risky behaviors that are associated with adverse health outcomes, including HIV infection. Little research has been undertaken to examine the influence of contextual factors on youth intentions to delay sexual involvement. To address that gap, this study aimed to examine the influence of age, gender, race, immigration status, HIV knowledge, HIV-related stigma, concern about HIV, direct exposure to HIV/AIDS, peer pressure, and religious influence on youth intentions to delay sexual involvement. Delayed sexual involvement was conceptualized as youth attitudes towards abstaining from sex, their knowledge …

Agencification As A Strategy For Implementing Public Policy In Trinidad And Tobago, Sandra Juanita Wall Agarrat

Walden Dissertations and Doctoral Studies

Trinidad and Tobago is one of 15 small developing states that comprise the regional integration grouping known as the Caribbean Community. Several agencies were recently created outside of the government using a strategy known as agencification to support the implementation of public policy in the Republic of Trinidad and Tobago. However, there is little available information explaining the rationale for the choice of the strategy, no evidence-based scholarly evaluation found on the effectiveness of these types of agencies, and therefore limited information on whether this strategy results in effective public policy. The purpose of this case study was to gain …

Primary Factors Affecting Breastfeeding In African American Communities, Lowest Jefferson

Walden Dissertations and Doctoral Studies

Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful …

Genome-Wide Association Study On The Sleep Symptom Of Post Traumatic Stress Disorder, Tammy Pooler

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a psychiatric condition that presents with 3 main symptoms're-experiencing, avoidance/numbing, and hyper arousal'after an individual experiences a traumatic event. Recent evidence suggests a potential genetic basis for PTSD and a sub symptom of hyper arousal, sleep, as a potential pathway for PTSD development, but no study has identified candidate genes associated with specific symptoms such as sleep difficulty. Based on a conceptual framework in which specific genes are associated with the onset of PTSD, this study used a genome-wide association

study (GWAS) method with a case control study design to compare the genomes of individuals …

The United Nations Training Of The Liberia National Police: Effectiveness, Results, And Future Implications, Yarsuo Laezee Weh-Dorliae

Walden Dissertations and Doctoral Studies

After the United Nations' mission in Liberia (UNMIL) ends on September 30, 2015, effective policing will be a security concern for Liberians. Liberians have expressed fear that conflict could return if ongoing police training programs do not sustain public safety. The purpose of this mixed methods study was to understand how UNMIL's training affected public confidence in the Liberia National Police (LNP). The theoretical bases for this study included public choice theory and liberal democratic theory. Quantitative data were used to address impact of UNMIL's police training on the maintenance of law and order. These data were collected through a …

Mental Health Treatment Adherence And Minority Clients' Perception Of Clinician Cultural Awareness, Patricia Parker

Walden Dissertations and Doctoral Studies

Psychological counseling is known to be an effective option for people in need of emotional support. Previous research has shown counseling to be valuable among various age, sex, religious, socioeconomic, and racial groups. Despite its successes, members of certain demographic groups reportedly end supportive psychological therapies early. The purpose of this study was to investigate the experiences of 10 self-identified African American and Hispanic clients who prematurely terminated therapy. A particular focus of this investigation was the clients' perceptions of clinician cultural awareness. This phenomenological study yielded descriptive data in a context sufficient for analysis with the use of broad …

Government Senior Executives' Perceptions Of Brain Drain On Leadership In The United States Virgin Islands, Shurla Jeffers-Knight

Walden Dissertations and Doctoral Studies

Highly qualified individuals are leaving the Caribbean and relocating to the United States and other developed countries. Researchers describe this resulting flight of human capital, or brain drain, from the Caribbean as a problem which has no clear definition or immediate solution. This phenomenological study explored perceptions of government senior executives in the United States Virgin Islands (USVI) of the cause and impact of brain drain. Burns' and Bass's transformational and transactional leadership theories were used as the framework for this study. Data were collected through a demographic questionnaire and semistructured interviews with a snowball sample of 10 participants. Data …

The Experiences Of Successful Small Business Owners In Ghana, Michael Tetteh Alimo

Walden Dissertations and Doctoral Studies

There is a high failure rate of small and medium enterprises that results in high unemployment rate and poverty in Ghana. The purpose of this phenomenological study was to explore the experiences of small business owners in Ghana. The conceptual framework was based on the theory of disruptive innovation. Disruptive innovation describes a method that enables business owners to create a new market. Data were collected through interviews from 20 participants who owned small businesses and succeeded beyond 5 years in Accra, Ghana. Member checking was used to strengthen the credibility and trustworthiness of the interpretation of the participants' responses. …

The Influence Of School Leadership Practices On Classroom Management, School Environment, And Academic Underperformance, Lorna Novlette Wilson Morgan

Walden Dissertations and Doctoral Studies

The Influence of School Leadership Practices on Classroom Management, School Environment, and Academic Underperformance

by

Lorna Novlette Wilson Morgan

MSc, Florida International University, 2006

BSc, University of Technology, 2000

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Walden University

April 2015

School leadership requires the collaborative efforts of principals, teachers, parents, students, and other community members to achieve academic success. The purpose of this correlational study was to examine the influence of school leadership practices on classroom management, school environment, and academic underperformance in Jamaica. The research was based upon distributive leadership theory. …

Resilience Among Immigrant Adult Learners: Experiences In Postsecondary Education--A Mixed-Methods Study, Sandra Lee Samuels

Walden Dissertations and Doctoral Studies

A human being's resilience refers to his or her abilities to combine internal and/or external resources effectively in response to significant contextual challenges in order to best succeed in a given environment. As such, this concept is vital across the lifespan and has been widely researched. However, few researchers to date have studied resilience as it relates to adult learners, and, significantly, those with immigrant status. Immigrant adult learners are facing compounded risks, which create challenges in various societies to identify this group's unique needs and/or to fully understand their experiences in diverse contexts, such as the Cayman Islands. Informed …