Digital Commons Network^™

Strategies To Improve Access To Clinical Informatics Specialist Consultations In An Acute Care Hospital System, Holli Miller

Walden Dissertations and Doctoral Studies

Access to clinical informatics specialist (CIS) consultations is essential for optimizing electronic health record (EHR) use in acute care hospital systems. Limited availability of CIS support contributes to clinician burnout, workflow inefficiencies, and patient safety risks. The purpose of this integrative review was to identify strategies to improve access to CIS consultations in acute care settings. A comprehensive literature search across multiple databases yielded 656 articles, with 24 meeting inclusion criteria based on relevance and methodological rigor, evaluated using the Johns Hopkins Nursing Evidence-Based Practice appraisal tools. These studies, published between 2019 and 2024, underwent thematic analysis guided by the …

Rurality’S Impact On Alaska Native Elders’ Levels Of Physical Activity And Obesity, Jessie Doherty

Walden Dissertations and Doctoral Studies

While there have been studies on obesity levels and physical activity levels across many populations and age groups, few studies have focused on Alaska Native Elders. The purpose of this study was to examine rurality (urban vs. rural counties), physical activity, and obesity level while controlling for sex, self-reported loneliness, and self-reported stress. The theoretical foundation for this study was based on the socio-ecological model (SEM), and the research questions in this study explored how rurality impacted obesity levels and how rurality impacted physical activity levels in Alaska Native Elders. The methodology of this study was a quantitative cross-sectional design …

Improving Icu Nurses’ Knowledge Of Early Mobility Through An Educational Intervention, Mohini Chand

Walden Dissertations and Doctoral Studies

This doctoral project sought to close a critical knowledge gap in the implementation of early mobility (EM) practices among intensive care unit (ICU) nurses. Guided by the ADDIE instructional design model, the initiative centered on developing and delivering a six-week educational intervention aimed at enhancing nurses’ comprehension and application of EM strategies for critically ill patients. Despite robust evidence supporting EM’s role in mitigating ICU-acquired weakness, reducing delirium, and improving functional outcomes, its clinical adoption remained inconsistent prior to this intervention. The project was anchored by the practice-focused question: “To what extent does an educational intervention improve ICU nurses’ knowledge …

Perceptions Of Whole Plant-Based Diets And Weight Among Hispanics In Miami, Florida, Zoraida Powell

Walden Dissertations and Doctoral Studies

Being overweight or obese poses major public health concerns and contributes to the development of chronic illnesses. While researchers have explored how a total plant-based diet impacts excess body weight or obesity, there is still a lack of clarity about how Hispanics living in Miami, FL, perceive or understand this diet concerning overweight and obesity. Using a generic qualitative approach, this study was conducted on how Hispanics in Miami, FL, understand and view a whole plant-based diet (WPBD) for preventing and reducing overweight and obesity. Through interviews with 14 diverse Hispanic participants, the study revealed that they see WPBD as …

An Examination Of Successful Reentry And Recidivism For Drug-Involved Offenders In Rural Areas, Jacqueline Cottle

Walden Dissertations and Doctoral Studies

In rural communities, treatment and supportive resources are limited, putting ex-offenders (EXOs) at an increased risk for relapse or recidivism. The purpose of this qualitative study was to understand, through semistructured interviews, the experiences of EXOs who completed the court residential treatment center, intermediate sanction facility, or substance abuse felony punishment facility, and returned to a rural county in Texas, along with the perspectives of 11 community supervision officers who worked closely with the EXOs. This study was guided by Agnew’s general strain theory, which posits that drug-involved offenders achieve successful reentry in rural areas when positive supports are present, …

Staff Education Program On Perceived Stress Scale, Juliana Mutua

Walden Dissertations and Doctoral Studies

This project was a staff education program conducted at a mental health and rehabilitation center in the United States. The program was designed to address a critical gap in practice of limited staff knowledge of using standardized stress assessment tools to assess patient stress, leading to poor patient outcomes. The practice-focused question was: Does staff education on the Perceived Stress Scale (PSS) improve staff knowledge as compared pre- to post-education? The purpose was to enhance staff knowledge on the application and interpretation of the PSS. The Johns Hopkins nursing evidence-based practice (JHNEBP) model was used to organize and evaluate the …

Improving Nurse Adherence To Medication Reconciliation During Patient Admissions To Reduce Medication Errors Through Targeted Education, Wendy J. Marlowe

Walden Dissertations and Doctoral Studies

Medication reconciliation errors are a significant clinical concern because they have the potential to result in serious or even life-threatening harm to patients. Implementing risk-reduction strategies through targeted education and systematic processes for medication reconciliation is crucial to enhancing patient safety and mitigating the risk of errors. Over 40% of medication errors occur during patient transitions, such as admissions, which are mainly due to inadequate medication reconciliation. The project addressed a practice-focused question to increase patient admission medication reconciliation by improving nurse knowledge by 20% and reducing medication errors by 60% within 2 months. I employed a pre-/posttest design in …

Teacher Perspectives On Challenges To Close The Reading Achievement Gap For African American Students, Miriam Aliyya Moore

Walden Dissertations and Doctoral Studies

The problem addressed through this study was that African American students score lower than White students in reading across grade levels, demonstrating a gap in teaching practice in early childhood education. The purpose of this basic qualitative study was to explore early childhood teachers’ perspectives on challenges to increase African American students’ level of reading proficiency and what they believed they needed to close the African American-White student achievement gap in reading. The conceptual framework was Ladson-Billings’s culturally relevant pedagogy. Semistructured interviews were conducted with 10 kindergarten through third grade teachers who were currently teaching reading to African American students …

Effective Organizational Succession Planning Strategies For Retaining Knowledge From Retiring Employees, Rodriquez Tremayne Brown

Walden Dissertations and Doctoral Studies

A lack of succession planning to retain critical knowledge from retiring employees poses significant risks to organizational revenue and long-term survival. Organizational leaders are particularly concerned about succession planning because failure to capture employee knowledge threatens organizational performance and survival. Grounded in the 7-step model for succession planning theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective succession planning strategies that some organizational leaders use to retain knowledge from retiring employees to avoid a negative impact on organizational revenue and survival. The participants included eight senior human resource managers from different organizations in the …

Fema Public Policy Impacts On Emergency Preparedness In Florida, Sara Sambolin

Walden Dissertations and Doctoral Studies

Older adults are at an increased risk of mortality during hazardous emergencies; therefore, it is crucial to comprehend how current emergency preparedness policies are related to preparedness perceptions of older adults. Findings in recent literature identified the underrepresentation of older adults in Emergency Preparedness studies across all areas and Counties of the state of Florida as a gap that needs to be addressed. The purpose of this quantitative correlational study was to examine the relationship between the 2023 FEMA policy on emergency preparedness and the self-reported degree of preparedness among Florida’s older adult residents in urban and rural areas across …

Early Childhood Special Education Teachers’ Perspectives Of Teaching Social-Emotional Skills During The Covid-19 Pandemic Virtual Learning Period, Dalena Lynette Lafferty

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, early childhood special education teachers struggled to virtually teach social-emotional skills to their students when schools were closed, and all students were moved from face-to-face to virtual learning. The purpose of this basic qualitative study was to explore early childhood special education teachers’ perspectives on teaching social-emotional skills to their students during the COVID-19 pandemic virtual learning period. Vygotsky’s sociocultural theory was used as the conceptual framework for this study. Data were collected through semistructured interviews with 10 early childhood special education teachers from the United States who had experience with teaching social-emotional skills virtually during …

Implementation Of The Patient Health Questionnaire-9 As A Screening Tool For Depression, Nathalie Teboh Njofri Bih

Walden Dissertations and Doctoral Studies

Depression is a common mental health issue that is often misdiagnosed or underdiagnosed in primary care practice due to a lack of appropriate screening. The practice problem addressed by this project was the inconsistent use of standardized tools, like the Patient Health Questionnaire (PHQ-9), which hinders timely and accurate depression diagnosis. The practice-focused question was: Does educating staff impact their knowledge of the recommended use and interpretation of the PHQ-9 and their confidence in administering the tool? I aimed to enhance depression screening practices by educating nursing staff on administering, scoring, and integrating the PHQ-9 into routine patient care. For …

Effective Strategies Oil And Gas Business Organizations’ Project Managers Use To Complete Information Technology Projects, Kenneth Uwalaka

Walden Dissertations and Doctoral Studies

The inability to complete information technology (IT) projects remains a significant concern for project managers in oil and gas industry. These are keen on discovering effective strategies to successfully complete IT projects, as any failures could significantly impact their organization's revenue and future. Grounded in the strategic alignment model, the purpose of this qualitative pragmatic inquiry project was to identify and explore successful strategies project managers of oil and gas business organizations use to complete IT projects to avoid a negative impact on organizational revenue and survival. The participants included seven project managers from different oil and gas business organizations …

Dieticians’ Perceptions Of Pediatric Obesity Education In Children’S Hospitals Located In Northeast Maryland, Constance Bartu

Walden Dissertations and Doctoral Studies

Dieticians play a vital role in the fight against pediatric obesity in the United States. The purpose of this qualitative study was to explore dieticians’ perceptions of internal and external reinforcements and barriers to childhood obesity interventions in children’s hospitals within Northeast Maryland. The study was framed by the social cognitive theory described by Bandura. As applied to this study, the theory focuses on prevention and intervention strategies used by dieticians working in children’s hospitals while offering educational interventions and other health care services. Interviews were conducted with eight dieticians with a minimum of 4 years working in children’s hospitals …

Lived Experiences Of Obese Women In Mississippi Concerning The Role Of Psychosocial Factors In The Development Of Obesity, Temitope Olabode

Walden Dissertations and Doctoral Studies

One of the highest rates of obesity in the United States is in Mississippi, where middle- aged obese women deal with a variety of social, cultural, and personal issues, including shame, discrimination, and stigma based on weight, mental anguish, cultural norms, financial limitations, and restricted access to healthcare. This study investigated the psychosocial factors that contribute to obesity in women aged 40- 60 years, and the effects of obesity on body image, self-esteem, health behaviors, and quality of life. A qualitative phenomenological study using the social ecological model (SEM) framework looked at the individual, interpersonal, and policy levels of the …

Clubhouse Versus Ips Outcomes In Terms Of Hours Worked And Pay Earned, Daniel Scott Reynolds

Walden Dissertations and Doctoral Studies

Individuals balance personal needs and societal norms as they attempt to achieve self-fulfillment. However, those who have mental illness face marginalization from the workforce and diminished quality of life. Of the two prominent vocational programs – the Clubhouse and the Individualized Placement and Support (IPS) – that assist this population in integrating into the workforce, and therefore into society. It is unknown which program does better at helping the mental illness population meet their objectives of integration. Such a comparison is important because it will help these people to integrate into the workforce and into society, thereby increasing their quality …

Does Staff Education About Diabetic Self-Management Improve Knowledge And Intent To Educate Their Patients?, Bambi Lee Lane

Walden Dissertations and Doctoral Studies

This doctoral project was an education program for staff aimed at increasing their knowledge about diabetic self-management compliance. With improved knowledge, they will be better prepared to educate their patients. Diabetes is a highly complex disease that requires self-management care, including monitoring of blood glucose levels, control of diet, and medication adherence. Despite extensive pharmacology and diet counseling, irregularities between staff training and education program implementation have led to variable results in patients' compliance and control of glycemia at the project site. The significance of such an issue lies in its direct impact on patient morbidity, avoidable complications, and increased …

Addressing The Impact Of Workplace Violence On Staff Injury And Turnover Rates, Kia Denae Walker

Walden Dissertations and Doctoral Studies

This is an evaluation of a quality initiative (QI) project to determine the effectiveness of the 2023 workplace violence prevention training program in reducing workplace violence-related injures increasing the staff’s self-reported confidence in managing violence-related injuries and increasing the staff’s self-reported confidence in managing violent incidents during the six-month evaluation period. The objective of this QI evaluation project was to analyze the effectiveness of staff education intervention in reducing workplace violence and its costs. The level of increase in staff’s knowledge, level of compliance with safety measures, and number of violence-related cases and claims was the focus of the post-implementation …

Alternative And Traditional Schooling On Sexual Risk Behaviors Among Alaska Native Youth In The Lower Kuskokwim, Nathaniel Hebert

Walden Dissertations and Doctoral Studies

Alaska Native youth experience disproportionately high rates of sexual risk, yet disaggregated data and school-contextual analyses remain limited. Understanding how school type (alternative vs. traditional) and individual factors influence sexual risk among Alaska Native youth is essential for informing targeted, culturally responsive health interventions and addressing ongoing health disparities. This quantitative study aimed to examine the association between three behaviors (condom use, multiple sexual partners, and substance use) by school type, controlling for gender, grade level, body mass index, and afterschool activity. Guided by the social-ecological model, this cross-sectional study provided new insights into the relationship between school type and …

Association Between Embedded No-Cost Materials And Student Success For Undergraduate Students In For-Profit Universities, Gaby Gabriela Johnson

Walden Dissertations and Doctoral Studies

Purchasing educational materials adds to college costs. The problem addressed in this study is the lack of research on the association between student success and the use of no-cost educational materials in for-profit universities. Grounded in Rawls’ principles of justice, the purpose of this quantitative study was to investigate the association between student success as measured by pass/fail outcomes and the use of embedded no-cost educational and open educational resources (OER) materials in undergraduate courses at a for-profit university. Academic outcomes of 751 undergraduate students across three courses were analyzed using the chi-square test of association. Results showed a weak …

Determinant Factors Of Iot Adoption For Smart Cities In The United States, Nathaniel Pleasant Crews

Walden Dissertations and Doctoral Studies

Even with the promise of efficiency, sustainability, and better services that IoT technologies bring, the adoption in U.S. smart cities remains uneven and hasn’t met expectations. This gap creates challenges for leaders and IT managers who depend on IoT for infrastructure, safety, and service delivery. To address this issue, it’s important to investigate the factors that impact adoption. Grounded in the unified theory of acceptance and use of technology (UTAUT) model, the purpose of this quantitative correlational study is to examine the relationship between stakeholders’ perceptions of ease of use, usefulness, user trust, security concerns, social influence, and adoption of …

Comparing Fall Champions Versus Standard Protocol To Enhance Fall Prevention In An Adult Medical-Surgical Unit, Lily Denney

Walden Dissertations and Doctoral Studies

I conducted this quality improvement (QI) initiative with the aim of reducing inpatient falls within an adult medical-surgical unit through the implementation of a Fall Champions model supported by structured education and decentralized nursing leadership. Inpatient falls pose a persistent threat to patient safety, often leading to injury, prolonged hospitalization, and increased healthcare costs. Internal audits conducted through VigiLanz reporting revealed inconsistent protocol compliance and minimal accountability, signaling the need for targeted practice reform. Framed by the guiding question of whether Fall Champions could reduce inpatient falls compared to standard protocols, I evaluated the role of frontline leadership in reinforcing …

Open Distance Learning’S Transformative Potential To Bridge Educational Disparities While Fostering Inclusive Growth, Khalid Ghoulam

Higher Learning Research Communications

In recent years—during and after COVID-19—the demand for flexible and accessible education surged across the continent, prompting numerous institutions to adopt and expand their Open Distance Learning (ODL) initiatives. This paper provides a comprehensive overview of ODL programs in African universities while exploring the state of ODLs and examining institutional strategies, technological advancements, and ODL’s impact on student accessibility and success. Using case study analyses, which contain data from African universities from various regions, this paper highlights current ODL insights and future directions. This paper also discusses ODL best practices and implementation challenges, and delves into the socioeconomic and cultural …

Suicide Prevention Through The Reduction Of Counseling Stigma In Fort Riley, Kansas, Yanni Kagiwada-Moya

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: The goal of this social change portfolio is to decrease the stigma of seeking mental help through addressing culture, norms, or systems within Fort Riley, Kansas, that contribute to stigma and suicide risk while using preventative measures to reduce suicide ideation and risk.

Significant Findings: This project focuses on reducing counseling stigma to prevent suicide among military personnel and veterans at Fort Riley, Kansas. Despite available mental health services, 44% of soldiers report fearing career impacts if they seek help, highlighting the need for cultural and systemic change (Irwin Army Community Hospital, 2024). Using the Social- Ecological Model …

Preventing Adverse Outcomes For Children With Autism Spectrum Disorder In Rural Areas, Angela Osakoda

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: The goal of this Social Change Portfolio is to prevent adverse outcomes for children at risk of Autism Spectrum Disorder (ASD) in rural communities who are unable to obtain a diagnosis or have limited access to services through parent coaching programs that connect caregivers with skills training, psychoeducation, and resources. Significant Findings: ASD impacts 4% of children nationwide (Data Resource Center for Child & Adolescent Health, n.d.). In rural areas, these children often face long waitlists to receive a diagnosis and limited access to services, making it difficult for them to receive the recommended amount of interventions (Boydston …

Reduction And Prevention Of Intimate Partner Violence In King County, Wa, Leta Whitney

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: The goal of my social change project is to reduce and prevent intimate partner violence in King County, WA, through educational awareness, training, and supportive resources for victims and perpetrators, as well as the communities in which they reside. Significant Findings: Intimate Partner Violence (IPV) is a preventable public health issue that affects millions of Americans and their communities, and it can occur across an entire lifespan. The National Intimate Partner and Sexual Violence Survey (NISVS) suggests that an estimated 8.5 million women and 4 million men in the United States have reported experiencing a level of IPV …

Identifying Coercion To Prevent Human Trafficking Of At-Risk Youth In Duval County, Florida, Maeve G. Coen

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: Preventing at-risk youth, adolescents, and teenagers from human trafficking victimization.

Significant Findings:Duval County faces the ongoing public health issue of human trafficking at-risk youth. At risk youth can be identified based on risk and protective factors identified through the social-ecological model. Individual risk factors may include child maltreatment, sexual abuse, and exposure to antisocial behaviors throughout childhood. Children with increased exposure to child abuse and maltreatment will escape their homes and engage in endangering behaviors with peers and adults exhibiting antisocial and coercive behaviors. Institutional, Community and Public Policy in Duval County has made advances in treating youth …

Alcoholism In Northampton County, Pa, Lauren Stack

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: The goal is to reduce alcoholism rates in Northampton County, PA by addressing stigma associated with alcohol use, providing age-appropriate education about alcohol in schools targeting youth, and supporting the creation of public policies that facilitate these prevention efforts.

Significant Findings: In Northampton County, the percentage of the population who report excessive alcohol use is higher than the national average (Lehigh Valley Health Network, 2022). Risk factors to alcoholism can include childhood trauma, lack of economic opportunities, and societal norms (SAMHSA, n.d b). Prevention can begin within our youth by implementing strategies that target societal norms. Male adults …

Resilient Families, Thriving Communities, Melanie Phillips

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: My goal as a future marriage counselor is to reduce the number of marriages that end in divorce in my community. I aim to achieve this through preventative measures designed to increase relationship resilience and promote the overall well-being of families and the community. Significant Findings: This paper explores the rising divorce rates in Thatcher, Arizona, and highlights preventative measures to strengthen marriages in order to reduce marital dissolution. Key findings suggest that proactive interventions, such as marriage education programs and the passing of pro-marriage public policies, are more cost-effective than addressing the consequences of divorce (U.S. National …

Suicide Prevention And Mental Health Advocacy Among Pre-Adolescents And Adolescents In Columbia County, Georgia, Savannah Lyons-Becker

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: The goal of this portfolio is to reduce the risk of suicide in Columbia County, Georgia by providing preventative psychoeducation, destigmatizing mental healthcare, and looking at how we can improve mental health in the community. Significant Findings: Suicide among pre-adolescents and adolescents in Columbia County, Georgia is a critical mental health concern in our community. Studies show we have a 16 per 100,000 suicide rate in our county, which is larger than both the state and national average (County Health Rankings & Roadmaps, 2025), and suicide is the leading cause of death among ages 10-14 in Georgia, which …