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Evaluation Of The Effectiveness Of The Implementation Of A New Workflow Process On The Incidence Of High Blood Culture Contamination (Bcc) Rates In The Emergency Department, Angelita Rodgers

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice Project was to evaluate the effectiveness of a quality improvement (QI) initiative to reduce blood culture contamination (BCC) rates in the emergency department (ED) of a large healthcare organization in the southeastern United States. Evidence-base sources indicated that high blood culture contamination (BCC) rates compromised diagnostic accuracy, leading to unnecessary treatments, increased hospital stays, and elevated healthcare costs. The project was guided by the evidence-based practice question: “How does the implementation of a new workflow process influence the incidence of high blood culture contamination (BCC) rates in the emergency department?” To address …

Military Spouses’ Perceptions Of Family Stress And Resilience During Multiple Relocations, Mauranda Nikki Jones

Walden Dissertations and Doctoral Studies

The purpose of this qualitative transcendental phenomenological study was to increase understanding of military spouses’ perceptions of family stress and resilience during multiple relocations. On average, active-duty military families relocate every 2 to 4 years, placing additional stress on them. It has been argued that military spouses, because of their central roles, are uniquely positioned to demonstrate resilience, thus providing an important perspective for this study. Understanding specific risks and resiliency from the perspectives of service members’ spouses can enrich knowledge from which human service professionals can learn. The study was grounded in the resiliency model of stress, adjustment, and …

Teachers’ Perceptions Of Job Stress And Its Meaning On Intent To Remain At A Title I School, Salmata Saaka-Lyons

Walden Dissertations and Doctoral Studies

The shortage of teachers in Title I schools undermines educational equity and quality in underserved communities, necessitating concerted efforts from educators, policymakers, and local communities. The purpose of this qualitative phenomenological study was to explore the lived experiences of Title I teachers regarding job stress and its meaning on their decisions to remain in the profession and within Title I environments. Grounded in Lazarus and Folkman’s transactional theory of stress and coping and Bakker and Demerouti’s job demands-resources model, the study explored how perceived job stress shapes teachers’ commitment to their roles. An interpretative phenomenological analysis was employed to analyze …

Coping With And Surviving Domestic Violence Among African American Women In A Rural Community, Kimberly Evonne Wimbush

Walden Dissertations and Doctoral Studies

Domestic violence (DV) or intimate partner violence is a widespread public health problem in the United States that knows no boundaries. Previous researchers have found that in the United States, African American women experience more severe effects from DV than women in other ethnic groups. The purpose of this generic qualitative study was to identify the coping strategies used by African American women who have survived DV living in rural areas where there are limited professional resources. Premises from the superwoman schema and adult resilience theory guided this research. Semistructured audio-recorded interviews, conducted via Zoom and face-to-face, were used to …

How Native American Parents Support Their Children’S Literacy Skill Development, Rita Faye Wilburn

Walden Dissertations and Doctoral Studies

Researchers have noted that Native American (NA) children are entering kindergarten with lower literacy scores on the Kindergarten Readiness Assessment than their non-native peers. This study explored how NA parents support their prekindergarten children at home with early literacy skills and what resources they need to help increase their children’s literacy skills. The conceptual framework that guided the study combined Bronfenbrenner’s bioecological systems theory and the parenting and learning at home components of Epstein’s model for parent involvement. This study addressed two research questions focusing on how NA parents support their prekindergarten children at home with early literacy skills and …

Effective Strategies Nonprofit Leaders Use To Reduce Employee Turnover Costs, Amy Carroll Kreidemaker

Walden Dissertations and Doctoral Studies

Nonprofit agencies face increased financial stress because of employee retention challenges. Nonprofit leaders worry about rising turnover costs, as retaining staff effectively is crucial for stability, reducing financial burdens, and maintaining program continuity. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative single case study was to identify and explore effective strategies nonprofit leaders used to retain staff and reduce subsequent financial costs. The participants comprised six purposefully sampled organization leaders of a central Massachusetts nonprofit who successfully implemented strategies to retain staff and reduce subsequent financial costs. Data were collected using semistructured interviews and a review of organizational …

Developing An Educational Program To Educate Nurses About Sickle Cell Disease And Vaso-Occlusive Episodic Pain, Margaret Sih Buo-Frundi

Walden Dissertations and Doctoral Studies

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Evaluation Of The Effectiveness Of The Implementation Of A New Workflow Process On The Incidence Of High Blood Culture Contamination (Bcc) Rates In The Emergency Department, Angelita Rodgers

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice Project was to evaluate the effectiveness of a quality improvement (QI) initiative to reduce blood culture contamination (BCC) rates in the emergency department (ED) of a large healthcare organization in the southeastern United States. Evidence-base sources indicated that high blood culture contamination (BCC) rates compromised diagnostic accuracy, leading to unnecessary treatments, increased hospital stays, and elevated healthcare costs. The project was guided by the evidence-based practice question: “How does the implementation of a new workflow process influence the incidence of high blood culture contamination (BCC) rates in the emergency department?” To address …

Improving Care For Dementia Patients: Music Therapy As An Alternative To Medication, Kristy Haschke

Walden Dissertations and Doctoral Studies

The incidence of dementia in long-term care facilities has been increasing due to early identification and screening. This staff education topic was brought to further attention due to a trend in requests for chemical restraints in the dementia/cognitive impaired patient population by staff had increased. This staff education project was presented to the rehab center based on evidence-based practice to offer training on music therapy as an alternative therapy to medication in dementia patients. The practice-focused question identified was, “Will a staff education module on an evidence-based alternative treatment, music therapy, for dementia patients versus chemical or physical restraints increase …

Experience Of Stress And Coping Among Male Police Officers In Trinidad And Tobago, Coryse Penco

Walden Dissertations and Doctoral Studies

Police officers in Trinidad and Tobago face highly stressful environments due to increasing violent crimes and threats to their lives. Organizational stress contributes to emotional exhaustion, highlighting the need for research on stress and coping among these officers. The purpose of this basic qualitative study was to explore job-related stressors and coping strategies that male police officers in Trinidad and Tobago use to deal with their everyday job demands. Han Selye’s theory of stress and Lazarus’ transactional model of stress and coping were used as theoretical frameworks for this study. Semi-structured interviews were conducted with 12 male police officers from …

Mitigating Compassion Fatigue, Sylvia Lee Christian-James

Walden Dissertations and Doctoral Studies

Compassion fatigue is the physical, emotional, and spiritual result of chronic self-sacrifice and/or prolonged exposure to difficult situations that renders a person unable to love, nurture, care for, or empathize with another’s suffering. The attributes that led nursing leadership to believe compassion fatigue (CF) was an issue for registered nurses (RN) at the project site facility included increased RN turnover, vacancy rates, absenteeism, and dissatisfaction. The project was to develop a clinical practice guideline (CPG) for the RN staff of an inpatient psychiatric hospital. The practice question was as follows: Does the evidence support usability of a standardized practice guideline …

Executive Summary: Staff Education Project, Jacquelynn Hays

Walden Dissertations and Doctoral Studies

Ineffective communication in health care can lead to negative outcomes for patients, including medication errors; delayed or missed treatments; delayed or missed testing; poorer health outcomes, including death; and poor patient satisfaction. The project site, a hospital-based outpatient oncology clinic located in the Midwest, had an identified practice gap in the staff’s current perceptions of effective intradisciplinary communication. The purpose of this project was to develop, implement, and evaluate an education program on effective communication. The practice-focused question centered on whether health care staff demonstrated a change in their perceptions of effective intradisciplinary communication. Twelve registered nurses on staff voluntarily …

Professional Development Strategies For Nonprofit Organizations To Retain Key Talent, Anderline Celestin

Walden Dissertations and Doctoral Studies

Some leaders of nonprofit organizations lack effective strategies for implementing professional development programs that could improve the retention of key talent. Retaining experienced, high-performing employees is a top concern for nonprofit leaders, as these individuals are vital to the organization's success and overall performance. Grounded in the human capital theory and Herzberg’s two-factor theory, this qualitative pragmatic inquiry was conducted to explore the strategies employed by nonprofit organization leaders to implement successful professional development programs aimed at increasing the retention of key talent. The participants were eight business leaders from nonprofit organizations in the United States who have professional development …

Readmissions And Death Rates In Patients With Chronic Obstructive Pulmonary Disease At Veterans Affairs Medical Centers, Adam Ikli

Walden Dissertations and Doctoral Studies

Readmissions and death rates can serve as indicators of performance in healthcare organizations and can reflect a lapse in staff performance particularly for patients with chronic obstructive pulmonary disease (COPD). The purpose of this quasi-experimental quantitative study was to determine the extent to which readmissions and death rates within 30 days of discharge for patients with COPD at selected Veterans Affairs (VA) medical centers, differed between 2015 and 2018. The transitions theory served as the theoretical framework for this study. The research questions evaluated readmissions and death rates for patients with the chronic obstructive pulmonary disease at VA medical centers …

K-8 Teachers’ Experiences Using Trauma-Informed Strategies, Nichelle Ahmaddiya

Walden Dissertations and Doctoral Studies

K–8 teachers struggle to implement trauma-informed instructional strategies (TII) in their classrooms. A lack of TII can affect student learning, attendance, disciplinary referrals, and suspension rates and is related to adverse social-emotional and behavioral outcomes. Grounded in the National Child Traumatic Stress Network framework for understanding TII strategies and Bandura's social cognitive learning theory, the purpose of this basic qualitative study was to explore 12 K–8 teachers’ experiences using TII strategies in instruction. Teachers who received TII training and currently use TII in their classrooms in the northeast United States were purposefully selected to participate in semistructured interviews. Interview data …

Mitigating Compassion Fatigue, Sylvia Lee Christian-James

Walden Dissertations and Doctoral Studies

Compassion fatigue is the physical, emotional, and spiritual result of chronic self-sacrifice and/or prolonged exposure to difficult situations that renders a person unable to love, nurture, care for, or empathize with another’s suffering. The attributes that led nursing leadership to believe compassion fatigue (CF) was an issue for registered nurses (RN) at the project site facility included increased RN turnover, vacancy rates, absenteeism, and dissatisfaction. The project was to develop a clinical practice guideline (CPG) for the RN staff of an inpatient psychiatric hospital. The practice question was as follows: Does the evidence support usability of a standardized practice guideline …

Readmissions And Death Rates In Patients With Chronic Obstructive Pulmonary Disease At Veterans Affairs Medical Centers, Adam Ikli

Walden Dissertations and Doctoral Studies

Readmissions and death rates can serve as indicators of performance in healthcare organizations and can reflect a lapse in staff performance particularly for patients with chronic obstructive pulmonary disease (COPD). The purpose of this quasi-experimental quantitative study was to determine the extent to which readmissions and death rates within 30 days of discharge for patients with COPD at selected Veterans Affairs (VA) medical centers, differed between 2015 and 2018. The transitions theory served as the theoretical framework for this study. The research questions evaluated readmissions and death rates for patients with the chronic obstructive pulmonary disease at VA medical centers …

Mitigating Compassion Fatigue, Sylvia Lee Christian-James

Walden Dissertations and Doctoral Studies

Compassion fatigue is the physical, emotional, and spiritual result of chronic self-sacrifice and/or prolonged exposure to difficult situations that renders a person unable to love, nurture, care for, or empathize with another’s suffering. The attributes that led nursing leadership to believe compassion fatigue (CF) was an issue for registered nurses (RN) at the project site facility included increased RN turnover, vacancy rates, absenteeism, and dissatisfaction. The project was to develop a clinical practice guideline (CPG) for the RN staff of an inpatient psychiatric hospital. The practice question was as follows: Does the evidence support usability of a standardized practice guideline …

Focused Education On The Roles And Responsibilities Of The New Nurse During A Patient Emergency, Jeanette Canderozzi

Walden Dissertations and Doctoral Studies

Staff Education Project aimed to measure the knowledge and self-efficacy gained from a comprehensive telemetry educational program as part of the onboarding process for nurses. Purpose of this project was to evaluate the effectiveness of the focused training for the novice nurse as it relates to their knowledge and confidence of their roles and responsibilities in a clinical emergency by using the pre-and postsurvey.

Readmissions And Death Rates In Patients With Chronic Obstructive Pulmonary Disease At Veterans Affairs Medical Centers, Adam Ikli

Walden Dissertations and Doctoral Studies

Readmissions and death rates can serve as indicators of performance in healthcare organizations and can reflect a lapse in staff performance particularly for patients with chronic obstructive pulmonary disease (COPD). The purpose of this quasi-experimental quantitative study was to determine the extent to which readmissions and death rates within 30 days of discharge for patients with COPD at selected Veterans Affairs (VA) medical centers, differed between 2015 and 2018. The transitions theory served as the theoretical framework for this study. The research questions evaluated readmissions and death rates for patients with the chronic obstructive pulmonary disease at VA medical centers …

Childless Mothers: Lived Experiences Of Black Mothers Who Lost An Only Child, Arielle Jordan

Walden Dissertations and Doctoral Studies

This qualitative study, grounded in hermeneutic phenomenology, explores the experiences of Black mothers who have lost their only child, addressing a topic often overlooked in counseling training programs. Many counselor educators and supervisors are unprepared to train counselors on how best to support these mothers through their unique grief journeys. This study outcomes fill that gap by providing a deeper understanding of their experiences, intending to shape better counseling practices. The central question guiding this research is: What are the lived experiences of Black mothers who have survived the loss of their only child? To answer this, in-depth interviews were …

Teaching Motivational Interviewing To Staff In A Mental Health Clinic To Improve Retention Rates Among The Homeless, Barry Godwin, Chinemerem Uzoechi

Walden Dissertations and Doctoral Studies

Summary Poor treatment retention rates are significant problems in mental health, with adverse outcomes being more profound for vulnerable populations, such as individuals experiencing homelessness. The current project was vital because the lack of engaging strategies in working with individuals experiencing homelessness contributes to high rates of treatment dropout. The purpose of the project was to equip mental health clinical staff with knowledge and skills in motivational interviewing (MI) to use MI in clinical settings to improve treatment retention for homeless populations. The practice-focused question that guided the project was: For staff in a mental health clinic, will training on …

African American Children’S Risk Of Long Covid-19 Syndrome Based On Daily Intake Of Fruits And Vegetables, Christopher Joseph Waskewich

Walden Dissertations and Doctoral Studies

Although the Covid-19 pandemic emerged in 2020, limited information about how the virus affects adolescents regarding long-term health risks is available. This quantitative study focused on the effect of U.S. adolescents' daily diet, race/ethnicity, levels of income, access to health care, age, and comorbidities on the risks of long Covid-19 syndrome. The constructs of the health belief model were used to understand the impact of those variables. The results of the online survey (n=298) with the parents of adolescent children (ages 11-17) from New York City found that adolescents whose daily vegetable consumption was more than the daily recommendations had …

Intrinsic Motivation And Career Satisfaction Among Immigrant Health Care Workers, Michelle Marie Henderson-Darling

Walden Dissertations and Doctoral Studies

Caribbean immigrants are vital to the U.S. health care workforce, yet they face barriers that often hinder their career satisfaction and well-being. This qualitative study aimed to explore how intrinsic motivations, specifically competence, autonomy, and relatedness, shape the career experiences of Caribbean immigrants in health care. Using self-determination theory as the theoretical framework, this study addressed the research question of how these intrinsic motivations shape immigrant experiences in the U.S. health care sector. Data were collected from 10 Caribbean immigrants who were naturalized U.S. citizens using semistructured, audio-recorded interviews. The data were thematically analyzed to detect patterns and themes. The …

Perceptions Of Women With Cardiovascular Disease Who Chose Conservative Therapy Over Advanced Therapy, Vanessa Pugh

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death for women. Women with cardiovascular diseases are less likely to receive the available advanced therapies such as defibrillators, pacemakers, and left ventricular assist devices as part of their cardiovascular care plan when compared to their male counterparts. Kelly’s theory of personal constructs and his11 corollaries were used as the theoretical foundation for this basic qualitative study to help explore and understand the perceptions of women who chose a conservative therapy instead of a more advanced therapy for their cardiovascular disease. Social media platforms and snowballing technique were used to recruit the six …

Integrated Coordinated Care Policies In Alameda County For The Unhoused Population, Stacey R. Perry

Walden Dissertations and Doctoral Studies

Alameda County departments and organizations have continually provided varying services to members in the unhoused community to increase pathways to stabilization for those served, with little success for over 37 years. While there were studies that discussed the issues of high service utilization faced by unhoused behavioral health care recipients, there was little to no literature that discussed these issues in Alameda County, where the numbers of unhoused persons total more than 9,500. There was very little known as to what policy barriers, and conversely, facilitators and key stakeholders in clinical and penal institutions face in implementing integrated coordinated care …

Clinical Practice Guidelines For Fall Prevention In The Neurology Unit, Jorge Martin Fernandez

Walden Dissertations and Doctoral Studies

This clinical practice guideline (CPG) initiative addressed the rising patient fall rates at an inpatient general care neurology unit (GCNU) in North Carolina. Falls are a leading cause of preventable injury, yet the facility lacked evidence-based (EB) fall prevention practices. This doctoral project developed a CPG for GCNU fall prevention, which was evaluated by an expert panel using the AGREE II instrument. A literature review identified 20 studies assessed via the Johns Hopkins model, which informed the CPG. Expert review scored the CPG at 100% in all domains, leading to its approval for clinical use. Key recommendations include CPG expansion, …

Transformative Interactions: Chatgpt’S Role In Facilitating Professional Development Among Vietnamese English As A Foreign Language Teachers, Thi Thuy Tran, Trut Thuy Pham, Thanh Thao Le

Higher Learning Research Communications

Objective: This study delved into the integration of ChatGPT as a medium for English teacher professional development among Vietnamese English as Foreign Language (EFL) teachers.

Methods: Rooted in the Constructivist Learning Theory and the Technological Pedagogical Content Knowledge (TPACK) framework, the qualitative exploration employed semi-structured interviews with nine teachers categorized into novice, mid-career, and near-end career stages. The objective was to understand teacher experiences, perceptions, and insights regarding the role of ChatGPT in their professional journey.

Results: Key findings illuminated that ChatGPT facilitated enhanced personalized learning, bridged the gap between theoretical knowledge and its practical application, and even indirectly spurred …

Improving Employee Retention In The Virtual Workforce, Marissa Williams

Walden Dissertations and Doctoral Studies

The need for addressing employee retention in the virtual workforce is critical, particularly in the context of the U.S. General Services Administration (GSA) Region 4. High employee turnover rates can lead to significant disruptions and decreased organizational performance. This administrative case study involved identifying effective strategies to improve retention and engagement among virtual employees. The practice-focused question involved understanding key factors that influenced employee retention and developing actionable recommendations for the GSA. Insights can be applied across similar organizations facing virtual workforce challenges. Data were collected through in-depth surveys with employees that were hired between 2020 and 2023, focusing on …

Patrol-Level Law Enforcement Experiences With Gray Area Mental Health Crises, Stephanie Louise Schilling

Walden Dissertations and Doctoral Studies

Law enforcement officers (LEOs) often find themselves responding to mental health crises that are gray area situations that neither clearly warrant arrest nor hospitalization but still require intervention. This qualitative study involved addressing the critical issue of how patrol-level officers in California manage such crises despite limited mental health training and restrictive legal frameworks. The study involved filling a gap in literature by focusing on nuanced challenges officers face in these situations, rather than use of force or racial disparities. Grounded in Bronfenbrenner’s bioecological model, the research involved exploring lived experiences of six patrol-level officers using interpretative phenomenological analysis (IPA). …