Digital Commons Network^™

A Comparison Of Instructor Audio-Video With Text-Based Feedback Versus Text-Based Feedback Alone On Students' Perceptions Of Community Of Inquiry Among Rn-To-Bsn Online Students, Marie K. Lindley

Dissertations

In order to meet the healthcare needs of the US population, Registered Nurses (RNs), with Bachelor of Science in Nursing degrees, are needed. This descriptive posttest study, with independent samples, examined the use of audio-video with text-based feedback versus text-based only feedback on student's perceptions of the community of inquiry (COI) among RN-BSN online students (n=125), enrolled in one course at one university. The COI survey performed reliably with Cronbach's alpha .94 on the pretest and .98 on the posttest. No statistically significant difference was found between the groups on the pretest for teaching presence (p=.31), …

Exploring Students' Perceptions And Experiences Of Faculty Caring In The Undergraduate Classroom In A Traditional Baccalaureate Nursing Program: A Qualitative Descriptive Study, Sheila M. Garilli

Dissertations

Academic nurse educators' use of caring attributes in the classroom could impact students' educational journey. Educators are leaders who should model caring behaviors toward their students. This role modeling will empower students to demonstrate these caring behaviors toward their patients. A literature review discovered a gap surrounding the study of faculty caring in the classroom. This research study explored students' perceptions and experiences of faculty caring in the undergraduate classroom in two traditional baccalaureate nursing programs. This study utilized a qualitative descriptive method with purposeful sampling and in-person recruitment at two universities in a Northeastern state in the United States. …

Organizational Control And Technological Capabilities: The Moderating Role Of Family Influence On The Firm, Sean Leahy

Dissertations

This dissertation examines the influence of organizational controls on technological capabilities in privately owned U.S. corporations, with a specific focus on family-owned businesses. The primary objective of the study was to investigate how formal controls (process and outcome) and clan controls (informal practices) impact technological innovation and competence. Using a quantitative approach, data were collected from 177 individuals and analyzed through partial least squares structural equation modeling (PLS-SEM) path analysis. The findings indicate a significant relationship between formal controls and technological capabilities. However, the interaction of family influence on this dynamic was not supported. Results also revealed a robust association …

The Impact Of Hourly Safety Rounding On Pediatric Fall Rates, Natalie Doskal-Poe

Dissertations

The Impact of Hourly Safety Rounding on Pediatric Fall Rates

Abstract

Problem: Falls are a common adverse event in the inpatient pediatric setting and are a significant risk to patient safety. Environmental factors, such as unclear pathways, bed rails down, beds in high position, and call lights out of reach, are considered avoidable causes of patient falls. The site’s fall data in a 12-month period from January 2023 to January 2024 showed (n=9) patient falls occurred with (n=5, 55.6%) due to environmental factors. The purpose of this Quality Improvement (QI) pilot project was to assess the …

The Influence Of Misconceptions On Pedagogical Choices Of Secondary Science Teachers: An Embedded Case Study, Tracey Beyer

Dissertations

This case study, using phenomenography within science disciplines, examines how educators' experiences with misconceptions affect teaching methods in high school physics, chemistry, and biology. Based on constructivist and interpretive theories it highlights that personal experiences shape learning and involve continuously reconstructing knowledge. The shared misconceptions of 13 educators across science disciplines reveal how those experiences influenced both their content knowledge and instructional practices. The findings indicate that educators who openly acknowledge and learn from their past experiences with misconceptions are better equipped to recognize and address gaps in understanding, an asset to furthering student learning. This research highlights the importance …

The Impacts Of Authentic Learning On Student Outcomes, Evan Sheppard, Cameron Conner

Dissertations

This dissertation explores the evolving American education system, emphasizing the role of authentic learning in bridging the gap between schooling and employment, especially in the context of the modern post-pandemic student. Authentic learning, characterized by hands-on activities and real-world applications, is posited as a solution to the skilled labor shortage impacting the economy. This study delves into the history and current practices of authentic learning, examining various programs and strategies implemented in educational settings. Utilizing a phenomenological approach, qualitative data was collected through interviews with recent high school graduates to assess the impact of authentic learning on their post-secondary trajectories. …

Evaluation Of Reported Level Of Clinical Confidence In Student Nurses Using Deliberate Practice, Leslie Kirkwood

Dissertations

Critical thinking and clinical reasoning, which support confidence in clinical decision-making of nurses, are still being developed during pre-licensure education. Nursing faculty in higher education are tasked with the challenge to increase the level of practice undergraduate nursing students experience during their program. The research question guiding this project was what effect does the use of deliberate practice with medication administration have on medical-surgical nursing II students regarding clinical confidence? The purpose of this quantitative, quasi-experimental study was to determine if the use of deliberate practice with nursing students by implementing weekly medication administration simulations would increase the level of …

Ethical Leadership And Moral Foundations Congruence, Sarah Willey

Dissertations

Research has examined follower perceptions of ethical leadership, but rarely accounts for the (mis)alignment between a follower’s sense of ethics and morality and that of a leader. This research examined the effects of a leader’s expression of each of the five Moral Foundations dimensions on ethical leadership perceptions, moderated by the respondent’s preferences for each of these foundations. To address this question, a policy capturing design was used to manipulate leaders’ high and low levels of each of the five foundations. The results of multilevel analyses indicate that at least for some dimensions of Moral Foundations, a follower’s evaluation of …

Development And Evaluation Of A Nurse Practitioner-Directed Mindfulness Initiative Among Patients Diagnosed With Generalized Anxiety Disorder In An Outpatient Psychiatric Practice, Keilah B. Ford

Dissertations

This quality improvement project presents the impact of mindfulness intervention, such as guided meditation on anxiety levels in adult patients in a psychiatric outpatient practice.

Department Of Defense Project Management Team Leaders: Team Dynamics And Teamwork Strategies During Complex Construction Projects, Shane Frey

Dissertations

Purpose: This qualitative multi-case study explored the challenges, strategies, and recommendations that DOD project management team leaders experienced as they made complex decisions leading successful construction projects based on Parker’s (2008) model.

Methodology: A qualitative multi-case study research design described the challenges, strategies, and recommendations Department of Defense project management team leaders used as they made complex decisions leading successful construction projects.

Findings: Close examination of data collected from interviews and artifacts yielded 117 frequencies for DOD project management team leader's team characteristics, and six themes regarding the lived experiences, challenges, strategies, and recommendations. Five key findings and one unexpected …

Describing Nursing Care Of Severely Obese Patients In Critical Access Hospitals Using Total Quality Management Theory: A Qualitative Study, Amy M. Blankenship

Dissertations

The purpose of this study was to explore nurses' perceptions and experiences regarding caring for severely obese patients and factors that affect quality care of these patients in Critical Access Hospitals (CAHS).

Improving Hypertension For Veterans Utilizing Measure Properly, Assessment Of Pharmacology, Alternative Therapy Interest, Routine Outreach, Partner With The Veteran Protocol (Maarp): A Pilot Study, Alyssa S. Dudley

Dissertations

The purpose of this quality improvement (QI) project was to create a hypertension control protocol for the patient aligned care teams (PACT) to follow when a Veteran presents to the primary care clinic (PCC) with uncontrolled hypertension. Despite past interventions, uncontrolled hypertension was still problematic in the Department of Veteran Affairs (VA) Healthcare System. Past and present research suggested that the Veteran population was at higher risk of developing hypertension than those of the civilian population. In hopes to reduce uncontrolled hypertension in the VA's PCCs, the Measure Properly, Assessment of Pharmacology, Alternative Medication Interests, Routine Outreach, and Partner with …

Implementation Of Home Blood Pressure Monitoring, Sarah Gutzke

Dissertations

Approximately 48.1% of adults in the United States have high blood pressure. Providers may encourage patients to monitor and log their blood pressure at home. Still, patients often fail to bring this information to appointments, leading to reliance on less comprehensive in-office measurements. This quality improvement project aimed to increase adherence to home blood pressure logs using a Blood Pressure Toolkit. A descriptive, observational design was utilized to record patient adherence of taking home blood pressure measurements and increase the number of patients who brought their blood pressure logs to their healthcare provider visits over two months. A convenience sample …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

A Guideline-Based Approach To Increase Early Mobilization In The Pediatric Patient Following Cardiothoracic Surgery, Kayla Keeven

Dissertations

A Guideline-Based Approach to Increase Early Mobilization in the Pediatric Patient Following Cardiothoracic Surgery

Problem: Prolonged bedrest during the post-operative period contributes to complications that lengthen hospital stay and increase mortality and medical costs. Early mobilization is recognized as safe and feasible in critically ill children. However, there is no standardized procedure nor method of identifying patients who are safe to mobilize in a pediatric cardiac intensive care unit (ICU).

Method: The quality improvement (QI) project employed a descriptive observational design utilizing a retrospective-prospective method to assess the effects of implementing an early mobilization guideline in a pediatric cardiac ICU. …

Management Of Post-Extubation Dysphagia Using The Yale Swallow Protocol, Nicole West

Dissertations

Abstract

Problem: Post extubation dysphagia (PED) increases the patient’s risk for long term complications contributing to increased healthcare cost. Intensive care settings rarely use standardized swallow screening assessments for patients post extubation leading to variation in the evaluation of PED. Variation in the assessment of swallowing post extubation can lead to the missed diagnosis of patients with dysphagia.

Methods: This quality improvement (QI) project was a prospective cohort study implementing an evidence-based swallow screening protocol, the Yale Swallow Protocol (YSP), in an intensive care unit. This study was conducted over four months, which included a pre survey, education, implementation, and …

Neonatal Hyperbilirubinemia And Phototherapy: The Implementation Of Seminal Clinical Practice Guidelines, Christina Coleman

Dissertations

Problem: On a postpartum care and pediatric unit from February 2022 to December 2023, the average monthly percentage of neonatal patients greater than 35 weeks gestation with hyperbilirubinemia who were treated with phototherapy before it was medically supported by the current guidelines was 42.855% (N=668). The department’s goal was to decrease this number to 10%. Initiation of phototherapy with a subthreshold bilirubin level exposes many infants to an unnecessary treatment modality which can prolong the infant’s length of stay in the hospital and can be associated with adverse effects, such as maternal-infant bonding and breastfeeding rates.

Methods: The …

360 Degree Clinical Competence Evaluation For Pediatric Hospitalist Advance Practice Provders, Elizabeth A. Schickler

Dissertations

Problem: Advanced practice provider (APP) peer reviewed clinical competencies is an expected part of professional, organizational, and The Joint Commission (Joint Commission) requirements, however, is not well defined and subject to organizational application and interpretation. Providers favor peer review as a means to improve professional practice. There is a lack of data to support frequency of feedback and method of feedback to support readiness to change practice and comfort giving and receiving feedback.

Methods: The quality improvement project utilized an analytical experimental design.

The Cardin Hospitalist Advanced Practice Provider - Readiness Assessment (CHAPP-RA) tool was implemented to a convenience sample …

Implementation Of The Process Improvement Toolkit For Hospital Acquired Pressure Injuries, Christina Bearden

Dissertations

Problem: Approximately 2.5 million people within the United States receiving inpatient medical care will develop a pressure injury each year (Padula & Demarmente, 2018). Pressure injuries (PI) are a multifactorial complication that can often be avoided with general prophylactic measures. Despite this, inpatient settings around the United States continue to see a rise in PIs.

Method: The quality improvement initiative utilized a descriptive, observational design. The turn team toolkit was implemented and monitored over a two-month period. Patient descriptors and quantitative data were collected through a retrospective chart review. The primary data collected was on pressure injury rates and staff …

Implementation Of Quantitative Blood Loss In Cesarean Section Births, Madeline Skelton

Dissertations

Problems: Postpartum hemorrhage is a major complication following birth. Although some bleeding is normal after birth, excess bleeding can lead to maternal morbidities including, but not limited to, blood transfusions, admission to the ICU, emergency hysterectomy, and potential death. Postpartum hemorrhage is responsible for approximately 11% of maternal deaths in the United States and is a leading cause of death occurring on the same day as delivery (ACOG, 2019). Lastly, 54-93% of deaths occurring from postpartum hemorrhage are preventable (ACOG, 2019).

Methods: Quantitative blood loss was initiated in a large, midwestern, suburban hospital to increase identification of postpartum hemorrhage, decrease …

Evaluation Of A Smoking Cessation Program In Primary Care, Yolanda Duncan-Watt

Dissertations

Abstract

Problem: The adult tobacco smoking rate exceeds 12.5%. The problem is the insufficient attention given to smoking cessation education in low socioeconomic status(SES) communities. There is a lack of access to and awareness of smoking cessation programs for low-income populations.

Methods: This quality improvement (QI) study will use a descriptive, observational approach. A retrospective medical record review will be conducted to determine the rate of individuals who got the smoking cessation intervention and the rate of those who successfully quit one month after the intervention. Data was collected throughout the spring of 2024, during primary care visits and phone …

Developing Expertise And Multiculturally Informed Supervision Practices, Mary Martha Abernathy

Dissertations

The American Counseling Association (Media Kit, 2023) records state that 62% of their membership is made up of master’s level clinicians, with 18.92% holding a doctorate and another 5.07% enrolled in a doctoral program. Membership is largely skewed toward master’s level professionals and only 7.44% of ACA members report working in a counselor education setting (Media Kit, 2023). However, most research regarding supervision is based on supervisors practicing in an academic setting (Cook et al., 2018; Jones et al., 2019; Kemer et al., 2014; Kemer et al., 2017; Kemer, 2020). The objective of these studies is to understand how master’s …

Implementation Of Quantitative Blood Loss Following Cesarean Section Birth, Layna Victoria Schultz

Dissertations

Problems: Postpartum hemorrhage (PPH) is a significant problem due to potential harm and is a main contributor to maternal morbidity (ACOG, 2019). According to ACOG, of maternal deaths in the United States, 11% are caused by PPH and 54-93% of the deaths related to PPH could be prevented (ACOG, 2019). When institutions adopt quantitative blood loss (QBL) protocols for improved accuracy in blood measurement, PPH can be identified sooner, allowing for earlier intervention. Inaccurate estimation of obstetric blood loss by health care providers is a primary cause of delayed staff response to PPH (ACOG, 2019).

Methods: This quality improvement (QI) …

Disambiguation Of Aerococcus Urinae Species Diversity, Brian Ian Choi

Dissertations

Aerococcus urinae is an uncommon inhabitant of the human urogenital tract. The Gram-positive bacterium has been implicated in a wide range of urinary tract diseases that, if left untreated or undiagnosed, can progress to severe disease such as infective endocarditis. Comparative analysis of 115 A. urinae isolates from infection episodes of urinary tract infection, bacteremia, infective endocarditis, urgency urinary incontinence, stress urinary incontinence, interstitial cystitis / painful bladder syndrome, and asymptomatic individuals reveal substantial diversity with respect to predicted virulence factors, metabolism, and observed biofilm behavior. Through whole genome sequencing analysis, these strains can be reorganized into six new taxonomic …

A Quantitative Content Analysis On Juvenile Crime Rates In Comparison To Student Outcome Data In A Saint Louis Metropolitan High School Setting, Arron Nakia Whitt Sr.

Dissertations

Mental health is one of the most polarizing topics of the 21st Century. Mental health affects those from all economic statuses, races, age ranges, and genders. Since mental health can affect the youth population, the researcher investigated two Saint Louis metropolitan school districts that were listed in provisional accreditation status with the Department of Elementary and Secondary Education (MoDESE).

The purpose of this research was to identify relationships between the graduation rates, dropout rates, and enrollment rates of high school students and compare these data to the crime statistics obtained from the Saint Louis metropolitan juvenile courts. The researcher gathered …

An Exploration Of Literacy Instruction In Higher Education Programs In Missouri, Melinda Odom

Dissertations

Literacy supports all content areas and is crucial to the academic achievement of all students (Birdyshaw et al., 2017). The International Literacy Association (ILA, 2017) posits that teachers are the most crucial factor in content and pedagogical achievement. The ILA (2019) stresses that students have a right to a highly effective and knowledgeable educator who can provide evidence-based reading instruction. Research illustrates that students who do not learn to read by the third grade continue to struggle throughout school (Rickenbrode & Walsh, 2013). Rickenbrode and Walsh (2013) confirm that most of these students will remain poor readers and are more …

What Are The Odds? Integrated Stem And Student Conceptual Understanding Of Genetics Dihybrid Inheritance, Jessica Cooper

Dissertations

Integrated Science Technology Engineering Math (STEM) education allows students to build conceptual understanding by connecting material to other content areas and real-world contexts. Strong conceptual understanding allows students to move beyond factual recall and instead synthesize and transfer their knowledge to new applications. In high school biology, students need to develop a strong conceptual understanding of genetic inheritance in the context of dihybrid inheritance. This qualitative case study was designed to understand the influence of an integrated STEM approach on student conceptual understanding of genetic dihybrid inheritance. The situated STEM learning and conceptual change theoretical frameworks guided the research design …

Inpatient Staff Perspective On Verbal De-Escalation Within A High Acuity Population, Giovanna Dezutti

Dissertations

This study explored inpatient staff’s perspective of verbal de-escalation within a high acuity population as well as the factors that make either a positive or negative impact on the effectiveness of verbal de-escalation as used in high acuity impatient settings. This phenomenological study used semi-structured interviews of 5 participants working in this setting. Participants were recruited through snowball sampling, and interviews were conducted via zoom. This study found that participants unanimously agreed that the training they received regarding verbal de-escalation was not sufficient and that employment of certain personality traits and behaviors were more effective than using only the methods …

A Qualitative Study Exploring The Management & Implications Of Power Differentials Experienced By Pre-Licensed Supervisees In Clinical Supervision Settings, Joyti Jariwala

Dissertations

The focus in this qualitative study was to explore how power differentials in supervision create positive and negative experiences between licensed psychologists and pre-licensed doctoral students. The study results provide insight into how supervisees navigate these dynamics during supervision, which typically involves experiential learning environments in which trainees discuss progress, receive feedback, and enhance their skills. The theoretical framework grounding the study was social learning theory, which is based on the idea that individuals learn from modeling, observation, and imitation in a social context (Bandura, 1986). Reflexive thematic analysis was used to recognize similarities in findings gathered via two sets …

Shattering The Mask: Unveiling The Destructive Force Of Misogynoir, Ledominique Hubbard

Dissertations

As a Black woman, my professional journey has been consistently marred by encounters with racism and gender bias. In this research, I employed autoethnography to shed light on my experiences and meticulously examine the challenges of misogynoir I faced while holding pivotal positions, including that of a detested team leader, an ingenious instructional teacher, and an anti-racist assistant principal across three distinct school campuses in two states. My narrative unfolds in various contexts, notably as the sole Black female teacher and team leader within nine elementary schools in a predominantly white, female-staffed rural district. Furthermore, I underscore my role as …