Digital Commons Network^™

An Educational Intervention To Increase Nurses’ Knowledge And Confidence Of Patient Mobility, Debbie Ann Pytak

Walden Dissertations and Doctoral Studies

Immobility is a significant concern given that nearly half of all hospitalized adults are immobile during their hospitalization, placing them at increased risk for adverse outcomes. As a result, it is critical for nurses to implement strategies that promote safe, structured patient mobility. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an educational intervention focused on patient mobility and standardized mobility tool utilization increased knowledge and confidence among nursing staff in an acute care setting. Ten participants volunteered to attend the educational intervention. The average age of the participants was 44.30 years (SD …

Strategies Higher Education Leaders Use To Improve Job Satisfaction Among Administrative Staff, Jerrod Jaquii Pass

Walden Dissertations and Doctoral Studies

Organizational change initiatives in higher education often lead to decreased job satisfaction among administrative staff. Higher education leaders are concerned with maintaining employee job satisfaction during such periods because disengagement among administrative staff can reduce performance and increase turnover. The purpose of this qualitative pragmatic inquiry was to explore strategies higher education leaders use to improve administrative staff job satisfaction during organizational change. Lewin’s change management theory served as the foundation for the capstone research project. Data were collected through semistructured interviews with a purposive sample of six higher education leaders in the United States who had implemented change initiatives …

Dementia De-Escalation Staff Education Program, Gretchan Edwards

Walden Dissertations and Doctoral Studies

Behavioral and psychological symptoms of dementia (BPSD), including agitation and aggression, present significant challenges in acute care settings and contribute to increased staff injury risk and inconsistent patient care. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the impact of a structured dementia de-escalation education program on staff knowledge, confidence, and perceived ability to manage dementia-related behaviors. The guiding PICOT question asked: In acute care staff, how does participation in a structured de-escalation training program that incorporates environmental modifications and organizational support, compared with no formal de-escalation training, affect staff knowledge, confidence, and perceived impact …

Assistant Principals’ Perceptions Of Their University Training, District Provided Orientations, And Professional Development, Claudette Nicole Agbonkhese Parker

Walden Dissertations and Doctoral Studies

Existing evidence shows that instructional leadership activities are an increasingly demanding aspect of school leaders’ roles, and assistant principals (APs) often enter the position without the preparation or support needed to navigate these complex expectations. The problem addressed was the struggle encountered by some APs in their capacity as instructional leaders within a Florida Public School District (FPSD). Guided by the balanced leadership framework, the purpose of this generic qualitative study was to explore the perceptions of current and former FPSD APs regarding their university training, district provided orientations, and professional development (PD). Semistructured interviews were conducted with 10 current …

Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson

Walden Dissertations and Doctoral Studies

Gypsy, Roma, and Traveller women (GRT) in the United Kingdom face persistent maternal health disparities and show poor engagement with healthcare services. Exclusion, discrimination, and a lack of cultural competence from healthcare professionals contribute to poor health outcomes including preterm births; and GRT women have more babies born with congenital anomalies than non-GRT women in the United Kingdom. The purpose of this focused ethnographic qualitative study was to explore how self-identified GRT women living in the United Kingdom experienced maternal care and how cultural identity and social structures influenced their interactions with healthcare providers based on Madeleine Leininger’s cultural care …

Beyond Social Media: Effective Innovative Strategies For Small Cleaning Services To Engage Decision-Makers And Secure Contracts, Danielle Edwesa Gaskins

Walden Dissertations and Doctoral Studies

Small cleaning service businesses often encounter challenges when attempting to reach decision-makers and obtain commercial contracts. Small cleaning service business leaders are concerned with securing contracts because the continual acquisition of agreements underpins both business stability and growth. Grounded in the service-dominant logic, the purpose of this qualitative pragmatic inquiry was to explore strategies small cleaning business leaders use to engage decision-makers and win contracts without relying on the use of social media marketing. The participants were five leaders from small cleaning businesses in the United States who had successfully secured contracts through alternative engagement strategies. Data were gathered using …

A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long

Walden Dissertations and Doctoral Studies

The emergence of illicitly manufactured fentanyl has increased clinical uncertainty during buprenorphine induction in medication-assisted treatment for opioid use disorder. The purpose of this quantitative, retrospective cohort study, guided by the Transtheoretical Model (TTM), was to examine whether prescriber-level buprenorphine induction practices and experiences with precipitated withdrawal were associated with reported buprenorphine induction challenges, and whether county-level fentanyl prevalence contributed to these challenges after accounting for geographic clustering. Secondary, de-identified archival data were obtained from the National Institute on Drug Abuse Clinical Trials Network study CTN-0134 and included 64 prescribers practicing in fentanyl-endemic settings. Buprenorphine induction challenges were operationalized as …

Education To Improving Prediabetes Management And Preventing Progression To Diabetes In The Primary Care Setting, Irene Mah Mebune

Walden Dissertations and Doctoral Studies

Prediabetes is a significant public health concern in the United States, as many individuals remain undiagnosed or inadequately managed, which increases the risk of progression to type 2 diabetes and associated complications. Primary care settings are essential for early identification and prevention. However, gaps in staff knowledge and inconsistent application of evidence-based guidelines frequently hinder effective management. This Doctor of Nursing Practice (DNP) staff education project aimed to enhance healthcare staff knowledge and confidence in screening for and managing prediabetes within a primary care clinic. The central question guiding this project was whether evidence-based staff education could improve healthcare staff …

Mapping Serial Killer Life Pathways With Behavior Sequence Analysis, Morgann Lynn Brafford

Walden Dissertations and Doctoral Studies

Although adverse childhood experiences (ACEs) are known to influence criminal behavior in adulthood, their potential influence on serial killer actions has not been scrutinized. This study was an investigation of how ACEs might affect serial killer actions later in life. The trauma-control model provided a conceptual framework for the investigation. Marono et al.’s research featuring behavior sequence analysis (BSA) was broadened to examine the impact of psychological abuse, sexual abuse, physical abuse, violence against animals, head injury, and bullying serial killer behaviors like stalking or sexual assault. The participants were 364 anonymized male serial killers from the Radford/Florida Gulf Coast …

A Quality Assurance Framework For Maintaining And Enhancing Academic Standards Of Ai-Infused Higher Education: Insights From Gcc Faculty Perspectives, Nina Abdul Razzak

Higher Learning Research Communications

Objectives: This study addresses the gap in research on maintaining and enhancing the quality of artificial intelligence (AI)–infused higher education in a structured and systematized way by proposing a comprehensive quality assurance (QA) framework fit for that purpose.

Methods: The study employs a qualitative research design approach in the form of a constructivist or interpretive investigation, exploring in depth faculty members’ different perspectives and experiences in relation to AI implementation. The study combines a textual analysis of the international literature on the topic, with insights from four focus groups involving faculty members from various disciplines and colleges across the Gulf …

Leadership Practices To Influence Employee Satisfaction And Well-Being In The Behavioral Health Environment, Kandice Ferdon

Walden Dissertations and Doctoral Studies

The increasing complexity and competitiveness of today’s health care system require innovative leadership approaches that support both high‑quality patient care and a healthy workforce. Although concerns about clinician burnout have grown, limited research has examined how leadership practices within behavioral health settings influence employee well‑being and satisfaction. This qualitative case study explored how behavioral health leaders shape workplace well‑being by integrating physical and psychological safety into daily practice. Methodological triangulation—combining survey data, organizational outcomes, and interview responses—strengthened the validity of the findings and provided a multidimensional understanding of leadership impact. Leaders emphasized that employee well‑being depends on both physical safety …

Foster Parents' Experiences Faced With Older Foster Children During Covid-19, Tisha S. Nicholson

Walden Dissertations and Doctoral Studies

The COVID-19 virus was a new virus that caused a worldwide pandemic. There was not much information about what the virus was, what caused it, or how to stop its spread. Vulnerable populations such as those in foster care were especially affected because the foster children had no place to go. The purpose of this qualitative study was to explore the lived experiences of foster parents who had older foster children in their care during the COVID-19 pandemic. There was a lack of research specifically on foster parents and their personal lived experiences with the foster care system and foster …

Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal

Walden Dissertations and Doctoral Studies

Traumatic brain injury (TBI) is a major public health concern associated with long-term disability and high healthcare utilization. Evidence guiding post-acute rehabilitation for medically complex TBI populations remains limited, particularly in long-term acute care hospital (LTACH) settings serving medically unstable patients. This study examined clinical and system-level factors associated with functional rehabilitation outcomes among adults with moderate-to-severe TBI in LTACHs. Guided by the Socioecological Model, recovery was conceptualized as interactions across individual, clinical, and organizational levels. This dissertation included three manuscripts using cross-sectional logistic regression and CMS Section GG measures. In Manuscript 1, longer time from injury to LTACH admission …

Exploring The Perceptions Of Black Nurse Educators Regarding Antiracist Pedagogy In Nursing Education, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Racism remains a persistent issue in nursing, prompting calls to create more inclusive educational environments and confront racial disparities. Guided by an intersectionality and critical realism framework, this generic qualitative study examined how Black nursing educators perceive antiracist pedagogy, how they implement it, and what they believe is needed to strengthen its adoption in nursing education. Twelve Black undergraduate nursing educators participated in in‑depth, one‑on‑one interviews. Thematic analysis generated four themes: (a) implementing antiracist pedagogy in the classroom; (b) challenges and resistance within school environments; (c) racial marginalization norms in nursing education, and (d) advocacy and vision for institutional reform …

Exploring How Long-Term Residents Influence Environmental Policy Decisions In The Takushara Settlement In Abuja, Nigeria, Agbanusi Uchechukwu Jonathan

Walden Dissertations and Doctoral Studies

Rapid urbanization of Nigeria’s Federal Capital Territory (FCT) has increasingly marginalized indigenous communities, creating a significant disconnect between top-down environmental governance and how it affects residents. Previous research has found that this land swap displaces indigenous stewards and erodes their traditional ecological knowledge, endangering local livelihoods, food security, and sustainable management of natural resources. The purpose of this narrative qualitative study was to explore how long-term residents perceive and experience their influence in environmental policy decisions through the lens of the social-ecological systems framework and the theory of resilience. This study examined the systematic exclusion of long-term residents of the …

Effective Strategies For Sustaining Massage Small Businesses Beyond 5 Years, Steven Brian Glover

Walden Dissertations and Doctoral Studies

Ineffective business strategies can lead to premature closure. Small business owners who struggle to develop long-term strategies may experience failure as a result. Grounded in the resource-based view and dynamic capabilities theory, the purpose of this qualitative pragmatic inquiry research project was to identify and explore practical strategies used by massage therapy small business owners to sustain their businesses for more than 5 years. The participants were 10 massage therapy small business owners who had sustained their businesses for more than 5 years. Data were collected through semistructured interviews, business documents, and public records. Through thematic analysis, six themes were …

Staff Education To Improve Nursing Knowledge Of Catheter-Associated Urinary Tract Infection Prevention Practices, Maylin Fernandez

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice quality improvement project, I used a staff education intervention to address nursing knowledge gaps related to catheter-associated urinary tract infection (CAUTI) prevention in a large outpatient urology clinic in the southeastern United States. Registered nurses (N = 28) participated in a single, 45-minute, in-person education session comprising PowerPoint slides, facilitated discussion, and printed job aids based on national guidelines. I used a single-group pre-/posttest design to evaluate the effect of the intervention. The primary outcome was staff knowledge measured using a paper-based, 17-item knowledge test administered immediately before and after the session. The secondary …

Perioperative Pressure Injury Prevention Education Program, Stephanie M. Reed

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) are localized injury to the skin and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure including pressure associated from shear. Surgical patients are estimated to represent 42% of hospital acquired PIs. PIs result in poor patient outcomes, increase length of stay, add billions to heath care costs are no longer reimbursed by Centers for Medicare/Medicaid Services. Prevention of PI is different in the perioperative setting due to the complexities of surgery. This project focused on developing, delivering, and evaluating a robust education program for perioperative staff on PI prevention in the perioperative setting. The …

Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have been associated with adverse health outcomes in adulthood; however, less is known about their relationship with preventive health behaviors such as cervical cancer screening. The purpose of this quantitative, correlational study was to examine associations between selected ACEs and cervical cancer screening among women aged 18–65 in South Carolina. Data were drawn from the 2020 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and included 1,323 women. Binary logistic regression analyses were used to examine unadjusted and adjusted associations between ACE exposures and being up to date with Pap testing, controlling for age, race/ethnicity, income, …

Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher

Walden Dissertations and Doctoral Studies

Adolescent dating violence (ADV) is a significant public health issue that disproportionately affects youths in southern rural communities, yet these populations remain underrepresented in research. The purpose of this quantitative cross-sectional study was to examine the association between ADV and sociodemographic factors (gender, race, age, and education level), alcohol consumption, and bullying among adolescents in Alabama, Arkansas, and Mississippi using data from the 2021 Youth Risk Behavior Surveillance System. Guided by the social-ecological model, binary logistic regression analyses were conducted to assess relationships between ADV victimization and the selected predictors. Results indicated that females had significantly higher odds of reporting …

Psychologists’ Preparedness And Self-Efficacy In Serving Grieving Hispanics During Covid-19, Janet Salinas Sanchez

Walden Dissertations and Doctoral Studies

Mental health professionals working with Hispanic populations often face challenges in addressing grief, a culturally multifaceted experience influenced by traditions and familial and community practices. The purpose of this qualitative study was to examine psychologists’ self-efficacy and preparedness in managing grief among Hispanic individuals who have been affected by COVID-19, address cultural factors in grief management, and identify demographic or professional factors that predict higher self-efficacy in working with Hispanic clients. Data were collected at a single point in time from eight psychologists who were actively working or had worked with Hispanic populations during COVID-19 to explore psychologists’ self-efficacy, preparedness, …

Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray

Walden Dissertations and Doctoral Studies

Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological …

The Association Between Advanced Technology Use And Quality Of Life Among Those With A Disability, Sarah Antus

Walden Dissertations and Doctoral Studies

Advanced medical technology use among individuals with physical disabilities remains understudied, creating a significant gap in understanding its impact on quality-of-life (QoL) outcomes across demographic and age groups. Guided by the social ecological model, the purpose of this quantitative study was to examine associations between advanced medical technology use, disability status, demographic factors (age, gender, and race/ethnicity), and QoL outcomes using 2017–2018 National Health and Nutrition Examination Survey data. The sample included 9,254 individuals age 6 years and older with physical functional limitations and complete technology-use and QoL data. Advanced medical technology use was significantly associated with improved QoL (p < .001). Disability status demonstrated a statistically significant but modest association with technology use, OR = 0.84, 95% CI [0.83, 0.85], p < .001. Age-stratified analyses indicated that advanced technology use significantly predicted improved QoL among adults aged 20 years and older, OR = 6.90, 95% CI [6.89, 6.91], p < .001, but not among youths aged 6–19 years (p = .929). Gender was a significant predictor of technology use, with females having higher odds than males, OR = 1.07, 95% CI [1.06, 1.08], p < .001. Race/ethnicity was also significantly associated with technology use; compared with non-Hispanic White adults, Mexican American (OR = 0.43, 95% CI [0.42, 0.44], p < .001), other Hispanic (OR = 0.58, 95% CI [0.57, 0.59], p < .001), and non-Hispanic Black adults (OR = 0.79, 95% CI [0.78, 0.80], p < .001) had lower odds of advanced medical technology use. The study may inform health care stakeholders about strategies to promote equitable access to advanced medical assistive technologies for social change

Strategies To Improve Colorectal Cancer Screening In Rural Primary Care Clinics, Brenda Sue Holland

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) screening rates are lower in rural areas than in urban settings. Individuals in rural areas have lower screening rates due to geographic isolation, provider shortages, and socioeconomic barriers. The purpose of this integrative review was to identify and synthesize best practices for implementing evidence-based strategies to increase CRC screening rates in rural primary care clinics. A systematic literature search across multiple databases identified 24 relevant articles published between 2019 and 2025. The Johns Hopkins Evidence-Based Practice Model (JHEBPM) rated articles for evidence and quality, while the Theoretical Domains Framework (TDF) guided the analysis. Thematic analysis identified four …

Effective Postmerger Strategies To Enhance Shareholder Value In The Banking Industry, Olajide Farouq Adenrele

Walden Dissertations and Doctoral Studies

Bank mergers continue to produce unintended declines in shareholder value, posing risks to financial stability, customer confidence, and long-term competitiveness in the southeastern United States. This challenge is especially critical for senior banking leaders, who must ensure that postmerger activities strengthen rather than undermine institutional performance. The purpose of this qualitative pragmatic inquiry was to examine the business strategies used by bank leaders in the southeastern United States to mitigate the unintended negative effects of postmerger activities on shareholder value. The study, grounded in agency theory, involved six senior bank leaders responsible for merger integration in the region. Data from …

Staff Education To Improve Nursing Knowledge Of Follow-Up Adherence Support Strategies In A Large Outpatient Urology Clinic, Ivette Dieguez

Walden Dissertations and Doctoral Studies

Site monitoring identified inconsistent adherence to scheduled follow-up care as an operational concern, underscoring the need for standardized nursing strategies to enhance follow-up communication. This staff education project aimed to determine whether a focused educational intervention could improve nursing knowledge of adherence support strategies, with confidence measured as a secondary outcome. Guided by the ADDIE instructional design model and the Johns Hopkins evidence-based practice model, the project was implemented in a large outpatient urology clinic with 18 participating registered nurses. Participants completed anonymous paper-based pretests and posttests surrounding a single 45-minute, live group education session. Educational content covered common barriers …

Strategies To Address Employee Shortages In Allied Health, John O. Delozier

Walden Dissertations and Doctoral Studies

Continuing shortages of allied health (AH) workers have become a critical business challenge for health care organizations, driven by an aging population, rising service demand, and the lasting effects of the COVID 19 pandemic. AH leaders remain concerned about meeting essential staffing requirements, as persistent recruitment and retention difficulties threaten the delivery of high-quality health care. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative pragmatic inquiry was to explore strategies successful health care leaders used to recruit and retain skilled AH employees. The participants were seven Maryland health care leaders with experience successfully implementing recruitment and retention strategies …

Administrative Burden: The Hidden Costs Associated With Participating In The Department Of Veterans Affairs’ Disability Compensation Process, Christopher Anthony Campagno

Walden Dissertations and Doctoral Studies

The U.S. Department of Veterans Affairs (VA) has characterized the Appeals Modernization Act (AMA) as a procedural success, citing reductions in remand rates and increases in grant rates. However, VA’s reporting on AMA performance has generally focused on adjudicatory outcomes and has not addressed the administrative burden costs veterans incur while navigating the disability compensation process. Although current scholarship documents administrative burden in other public programs, little empirical work has examined how it manifests in VA’s disability compensation process. The purpose of this general qualitative study was to examine how veterans describe the learning, psychological, and compliance costs they experienced …

Long-Term Impact Of Covid-19 On Burnout, Turnover, And Job Satisfaction Among Hospital Nurses, Delaney Corona Martinez

Walden Dissertations and Doctoral Studies

Hospital industry workforce separation has remained a persistent concern in the United States, with uncertainty regarding how national hospital industry separation patterns changed following the COVID-19 pandemic. The purpose of this quantitative, nonexperimental retrospective study was to examine whether national hospital industry monthly separation rates differed between the prepandemic period (2018–2019) and the postpandemic period (2023–2024), whether separation rates demonstrated a statistically significant linear trend from 2018 through 2024, and whether separation rate variance differed between periods. The conceptual framework for this study was grounded in Maslach’s Burnout Theory and Herzberg’s Two-Factor Theory of Job Satisfaction, which explain how workplace …

Developing Nursing Education On The Assessment Of Asthma Patients With Symptoms Of Shortness Of Breath In Urgent Care, Abigail Akorfa Adase

Walden Dissertations and Doctoral Studies

This quality improvement project aimed to enhance the assessment of dyspnea in patients presenting with shortness of breath, particularly those with asthma, through a staff education program. At the practice site, staff primarily relied on SpO₂ readings to evaluate dyspnea, which often led to misassessment and delays in care. The project addressed this gap by providing urgent care staff with training on comprehensive assessment techniques, including evaluation of respiratory rate, work of breathing, ability to speak, patient history, and use of validated tools such as Borg’s scale and peak flow meters. Twenty triage staff members participated, including licensed practical nurses, …