Digital Commons Network^™

Improving Clinical Alarm Fatigue And Alarm Management Competency Among Critical Care Nurses By Implementing A Unit Based Alarm Management Bundle, Stephanie Bosma

Dissertations

Clinical alarms are designed to signal an unsatisfactory patient physiological state, alert staff to malfunctioning medical equipment or systems, and warn the operator of potential hazards to the patient. While alarms interrupt the patients healing process, alarms also induce a crippling fatigue among nurses, known as alarm fatigue. The concept of alarm fatigue and clinical alarm management competency remains a common problem among nurses who work in the acute care setting. In the Surgical Intensive Care Unit (SICU) at a teaching hospital in Northeast Florida, alarm fatigue, consistent alarm management skills, and competency surrounding the use of the Philips physiologic …

A Constructivist Grounded Theory Of Spiritual Competencies Development In Counseling Supervision, Emmanuel Javert Nnadozie

Dissertations

Developing religious and spiritual competencies is paramount in the training of counselors to become effective in addressing clients’ religious and spiritual issues in counseling. Clinical supervision in practicum and internship courses is key to the development of these competencies, but questions as to how best they might be infused in counselor training remained. The purpose of the study was to create an explanatory theory of the process of the development of religious and spiritual competencies in clinical supervision. Utilizing grounded theory, experts in the field of supervision and spirituality were interviewed. The ways paradigm was used as a sensitizing concept …

How Exemplary Female Superintendents In Orange, Riverside, San Bernardino, And San Diego Counties In Southern California Lead From The Heart, Jeanine Wulfenstein

Dissertations

Purpose: The purpose of this phenomenological study was to describe how exemplary female superintendents in Orange, Riverside, San Bernardino, and San Diego counties in Southern California lead from the heart using the four principles of Mark C. Crowley’s work, by demonstrating how they build a highly engaged team, connect on a personal level, maximize employee potential, and value and honor achievement within their organizations.

Methodology: This phenomenological study explored and identified the lived experience of eight California public school superintendents in Orange, Riverside, San Bernardino, and San Diego counties in Southern California. Study participants were selected for interview participation based …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Bisexual+ Women Of Color And Microaffirmations, Zori Paul

Dissertations

In the last decade, there has been an interest in exploring affirming identity factors for bisexual+ (bisexual, pansexual, queer, fluid, etc.) individuals that would promote positive mental wellbeing. However, there is a dearth in the current research that focuses on bisexual+ women of color and affirming factors unique to their intersecting racial/ethnic, sexual, and gender identities. By understanding what potential affirming factors, including bisexual microaffirmations, protect bisexual+ women of color from binegativity (bisexual specific discrimination), mental health professionals can provide and advocate for bisexual+ specific affirming care. This dissertation contains three studies: the first study explores how the experiences of …

Factor Structure And Construct Validity Of A Hospital Survey On Patient Safety Culture Survey Using Exploratory Factor Analysis, Maureen Falcone

Dissertations

Abstract

Objective: The purpose is to explore the underlying factor structure of the Hospital Survey on Patient Safety Culture Survey (HSOPS^®), to evaluate correlations between the factors, and to extend past work by further estimating its construct validity in a large sample.

Methods: A secondary data analysis using EFA and the AHRQ HSOPS^® database (December 2017 to October 2020), from nurses who shared their perceptions about hospital cultures of safety in the reporting of adverse events. Data were collected from 191,977 hospital nurse respondents in 320 U.S. hospitals.

Results: EFA obtained six factors with an eigenvalue >1 …

Exploring Psychological And Situational Factors That Influence Female College Students' Participation In Oral Sex, Margaret Bergeron

Dissertations

Although sexually transmitted infections (STI) are not officially reported via the route of transmission, the CDC (2016) reports that individuals who provide fellatio have the highest risk of oral transmission of a STI. Therefore, females who engage in fellatio are at risk for acquiring a STI. The majority of research studies on young adult heterosexual female sexual activities primarily focus on vaginal sex and the associated risks of pregnancy and sexually transmitted infections. Limited research exists on the oral sex behaviors of female college students and their understanding of the risk for contracting an STI through fellatio. The purpose of …

Factors Associated With Household Contacts' Tuberculosis Testing And Evaluation, Elvy G. Barroso

Dissertations

Contact investigation (CI) is one of the core elements of tuberculosis (TB) control. It is intended to achieve early identification of contacts who may have been exposed to a patient with infectious active TB and contacts who may benefit from treatment for latent tuberculosis infection (LTBI). LTBI is an infection in which the Mycobacterium tuberculosis organisms cause no signs and symptoms but the infection can be reactivated and develop into full-blown active TB disease. Failure to be identified as a contact is the primary reason for disease development in more than half of TB patients, thus a complete and timely …

The Lived Experience Of Being A Caregiver For A Family Member Dependent Upon Hemodialysis, Christine Kearney Turner

Dissertations

An identified gap in the literature exists regarding studies using an inductive approach that allow caregivers to describe the lived experience of caring for family members dependent upon hemodialysis for managing end stage kidney disease. This study used a purposive sample of six caregiver participants, male and female, with an average age of 36 using a descriptive, phenomenological approach designed to share experiences of providing care to a family member dependent on hemodialysis. The representative sample was recruited from a mid-sized hospital in the mid-Atlantic region of the United States. The investigator conducted face-to-face, semistructured interviews with participants. Using the …

Sexual Minority Thriving: Bouncing Beyond Adversity, Debra Crawford

Dissertations

Sexual minority individuals continue to face prejudice and discrimination due to their sexual minority identity. However, despite these negative experiences, many sexual minority individuals display resilience and thrive. Most of the literature on sexual minorities focuses on negative aspects of identifying as a sexual minority, rather than the positive qualities that these individuals possess that allow them to persevere. In a sample of 303 sexual minorities, this dissertation contained two studies. Study one investigated if posttraumatic growth mediated the relationship between resilience and thriving and if identity pride and existential anxiety moderated the relationship between resilience and thriving in a …

The Effect Of Self-Management Support Interventions For Adults With Mild Traumatic Brain Injury And Family Caregivers, Ann Thaiudom

Dissertations

Purpose: This study aimed to examine the effect of a self-management support program for individuals with mild traumatic brain injury (mTBI) and their family caregivers.

Design: The study design was a two-group randomized control trial.

Method: A total of 73 mTBI patients and their primary family caregivers were randomly assigned to either the intervention group (n=36) receiving the self-management support program plus usual care or the control group (n=37) receiving only usual care. The self-management program was developed based on the Individual and Family Self-management theory, and relevant clinical practice guidelines. The program consisted of self-management support assessment at …

A Quantitative Study Of The Relationships Among Psychological Safety, Collaborative Capacity, And School Climate In Middle-Level Schools, Karen Brownfield

Dissertations

This quantitative study was conducted to investigate possible relationships between psychological safety, collaborative capacity, and school climate in middle level schools in order to identify specific leadership behaviors to increase collective efficacy. School leaders’ knowledge of the positive effect collective efficacy has on student learning is not enough (Donohoo & Katz, 2019; Parrett & Budge, 2020). Leaders must also be aware of functional behaviors to foster collective efficacy, thus increasing student learning (Donohoo & Katz, 2019). Based on the theoretical work of Bandura (2000, 2012), as well as DeWitt (2017), Garmston and Wellman (2013), Hattie (2017, 2019), and Rock (2013), …

The Effect Of Using The Adaptive Crawler™ On The Development Of Infants With Spina Bifida, Age 6-12 Months, Margaret E. Williams

Dissertations

During the timeframe of crawling, age 6--12 months, infants typically interact independently with their environment and their parents in order to perform certain developmental tasks. However, many infants with spina bifida are unable to crawl, as would typically developing infants. The inability to crawl may place these infants at a distinct disadvantage during this developmental timeframe. As a result of the developmental disadvantage, the parent-infant relationship may be negatively affected. For this study, the Adaptive Crawler™ assistive technology infant mobility device was designed, and a prototype created, to promote independent mobility and exploration of their environment by infants with spina …

Clinical Nursing Faculty Perceptions Of Undergraduate Baccalaureate Nursing Student Stress In The Clinical Environment, Catherine A. Stubin

Dissertations

High stress levels are experienced by student nurses throughout their professional education, with the chaotic ever-changing clinical environment being a predominant source of stress. Clinical nursing faculty have a critical role to recognize the stress their students experience in the clinical environment and understand its significance.

A qualitative descriptive design was used to provide a rich description of clinical nursing faculty perceptions of undergraduate baccalaureate nursing student clinical stress. A purposive sample of 14 clinical nursing faculty with at least 4 semesters of clinical nursing faculty experience from accredited, generic baccalaureate nursing programs in the Northeast region of the United …

Advanced Nursing Education: Critical Factors That Influence Diploma And Associate Degree Nurses To Advance, Rose L. Mcghie-Anderson

Dissertations

Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of the nurse as educator, manager, nurse leader, and researcher who will effect policy changes and assume leadership roles as revolutionary thinkers in addition to implementing paradigmatic shifts.

This grounded theory study sought to unearth the critical factors that motivate nurses to advance academically. The study aimed to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance their nursing education.

Leaders Of Change: An Exploration Of Relationships Between International School Administrators’ Mindsets And Their Preferred Leadership Styles, Joe Brogan

Dissertations

At the heart of educational leadership is the ability to manage change. Leaders who can successfully manage change invariably will be more effective. This is especially true in the often-transient world of international schools, where change happens frequently in response to evolving internal and external environments.

K-12 international schools that use the English language as the medium of instruction have proliferated since the end of the Cold War. There has been exponential growth, especially in China, India, and other developed and developing nations. The quality of leadership in these schools is extremely important to stakeholders, especially students, and, consequently, it …

Emotional Responses And Mother-Infant Interactions Of Mothers With Early-Preterm, Late-Preterm, And Full-Term Infants In Malawi, Kaboni Whitney Gondwe

Dissertations

Malawi has the highest preterm birth rate in the world and preterm birth contribute to more than one-third of the neonatal deaths annually. Malawi is also faced with limited resources, both human and material. The lack of incubators led to the adoption of Kangaroo Mother Care (KMC) as routine care for preterm infants. Families also provide support, physical and emotional during this entire period. Evidence from developed countries has shown that preterm birth contributes to maternal emotional distress (depressive, anxiety, and posttraumatic stress symptoms and maternal worry about child's health) and fewer maternal and infant interactive behaviors. The majority of …

The Relationship Between Nursing Unit Culture And The Use Of Evidence-Based Practice Among Nurses In Hospitals, Jin Jun

Dissertations

Evidence-based practice (EBP) has been the gold standard for clinical practice. However, the use of EBP by healthcare providers, including nurses, has remained at suboptimal rates. Though researchers have examined various factors that influence nurses' use of EBP, studies of more complex organizational factors are limited. Nursing unit culture, which encompasses unique shared values, beliefs, and assumptions, may be one of the driving forces in determining nurses' behavior, leading to variation in the use of EBP. The purpose of this study was to examine the association between nursing unit culture and the use of EBP among nurses in hospitals under …

An Examination Of Summer Melt For Trio Talent Search And Upward Bound Alumni, Jasmine D. Clay, Jasmine C. Lewis

Dissertations

College access programs provide middle and high school students with essential skills to prepare them for a successful transition to postsecondary education. TRIO Talent Search (TS) and Upward Bound (UB) are federally funded programs established to strengthen the likelihood that students from underserved groups will graduate high school and pursue higher education. Both programs offer support to low-income and first-generation students to ensure equitable access to higher education. While these programs offer a holistic approach to student development, including personal and professional support, some students from underserved groups experience challenges during the summer months that prevent them from enrolling in …

The Wheels On The Bus Go Round And Round: Rethinking The St. Louis Busing Program, Tango Walker, Ketosha Harris

Dissertations

This autoethnography shares our personal experiences and counter-narratives in the St. Louis busing program. Through our mission we expound on experiences and real-life situations as seen through our lens as a student and a mother in the St. Louis busing program. Critical race theory (CRT) was used as an essential framework allowing us to focus on the following four tenets: counter-stories, permanence of racism, whiteness as property, interest convergence. (Anderson, et al., 2017). Critical race theory (CRT) is the framework in social sciences that examines society and culture as it relates to categorization of race, law and power (Lynn & …

Predictors Of Early Rehospitalization Among African American And Caucasian Women Hospitalized With Heart Failure, Carolyn B. Sue-Ling

Dissertations

Heart Failure remains a complex clinical syndrome that affects all races and backgrounds. Periodically individuals with a heart failure diagnosis will require hospitalization during the course of the disease progression. Consequently, early and repeated rehospitalizations for acute exacerbations presents additional social and economic difficulties. Prior research demonstrated that elderly African-American and Caucasian women account for a large proportion of the population at risk for future heart failure hospitalizations along with readmissions within 60 days of discharge. Unfortunately, the literature remains unpredictable or largely non-existent regarding the unique associations between risk predictors for heart failure and early (31 to 60-day) heart …

Heart Rate Variability Following Treatment For Ptsd: Testing The Polyvagal Theory, Brittany F. Goodman

Dissertations

Posttraumatic stress disorder (PTSD) has been linked to lower heart rate variability (HRV), including measures of vagal tone. Treatments targeting the autonomic nervous system (ANS) have demonstrated efficacy in improving vagal tone, but it is less clear whether similar effects can also be achieved with cognitive therapies. The polyvagal theory has suggested that symptoms of social dysfunction are linked to vagal tone through a phylogenetically organized response to stress. HRV was collected during rest, reactivity (exposure to personalized trauma scripts), and recovery using a scripted imagery paradigm in female PTSD positive physical and sexual assault survivors (N = 41) …

Breadwinner Mothers Of School-Aged Children During Covid-19: An Interpretative Phenomenological Analysis, Rebecca D. Miller

Dissertations

Working mothers have long faced myriad challenges to optimal work-life balance, with evidence of negative consequences to their physical and mental wellbeing. During the COVID-19 pandemic, working mothers reported unprecedented difficulties, though inquiry into breadwinner mothers’ experiences remained lacking. This research focused specifically on the experiences of breadwinner mothers of elementary school-aged children who navigated remote working and remote schooling during the COVID-19 pandemic. A diverse sample of 12 breadwinner mothers across the United States completed semi-structured interviews focusing on the impact of the pandemic on their daily lives, as well as how they understood their experiences in light of …

Postpartum Patient Teaching Success: Implications From Nursing And Patient Perspectives, Dawn Day

Dissertations

A recent examination of postpartum patient satisfaction scores in an inner-city hospital revealed decreased satisfaction of discharge teaching practices. Guided by Knowles' model of andragogy and Donabedian's model of structure-process-outcome, the purpose of this study was to gain an understanding of how the structure and process of discharge teaching practices impact successful postpartum teaching. This mixed-method, concurrent study examined the structure, process, and outcome of postpartum patient discharge teaching practices. A convenience sample was used to obtain 138 patient surveys, observations of 15 nurses completing discharge teaching, and 15 face-to-face patient interviews. Data analysis included the use of Spearman's rho, …

Which Attributes Separate Top-Performing Outside Salespeople From The Rest?, Paul Niemann

Dissertations

For decades, sales organizations have faced the ongoing challenge of attaining the maximum sales results from their salespeople. Whether a salesperson has plenty of skill but lacks the will to reach their potential or has the will to become a top salesperson but lacks the necessary skills to reach their potential, the failure of sales organizations to obtain maximum results from their salespeople is a problem. Some salespeople have plenty of skill but lack the will to reach their potential, while others have the will to become a top salesperson but have not yet acquired the necessary skills to reach …

Modifiable Cardiovascular Risk Factors In The Early Adolescent Period, Julia A. Greenawalt

Dissertations

The purpose of this study is to describe patterns and relationships among the modifiable cardiovascular risk factors of smoking behavior, overweight, physical inactivity and poor dietary behaviors within a ninth grade population. Four modifiable cardiovascular risk factors; smoking behavior, overweight, physical inactivity and poor dietary behavior were analyzed from the 2003 Youth Risk Behavior Surveillance System (YRBS) to explore associations in early adolescents, a critical developmental time frame. The specific aims of this study were to: 1) conduct a factor analysis of questions selected from the 2003 YRBS to represent the constructs of smoking behavior, physical inactivity and poor dietary …

Perioperative Experience Of Adolescents, Janean Carter Monahan

Dissertations

Research has shown that preoperative stress is associated with poorer health outcomes in adults and young children, but there is little in the literature about the stress experienced by adolescents. Clinical experience, however, has shown that adolescents behave differently throughout the perioperative experience than either adults or children. For example, common behaviors of adolescent's emerging from anesthesia include combativeness, thrashing, and crying. To promote adolescent health and to provide adolescents with appropriate interventions that will support a positive surgical outcome, research is needed to discover the perceptions and meanings adolescents attribute to the perioperative experience.

The purpose of this hermeneutic …

Student Attitudes Towards Graduation: A Comparison Of Motivation Factors For Greek Life And Non-Greek Life Undergraduate Students, Crystal Sanders

Dissertations

Greek life is an activity that is part of student involvement on a college or university campus. Student involvement allows students to increase their knowledge outside of the classroom through interaction with their peers and faculty, which will hopefully lead to graduation. The creation of Greek life engaged students in activities outside of the classroom. Unfortunately, Greek life has carried negative references and has been associated with morally wrong activities. Colleges and universities received negative impacts from such activities and behaviors. Most research about Greek life conveyed dedication to focusing on hazing, academics, and graduation rates. Revealing the motivational influences …

Research And Relationship-Based Curriculum – Exploration Of How Research And Relationship Experiences In Undergraduate Education Impact Students’ Employability, Graduate Education Intention, And Entrepreneurial Acumen, Michelle Pipes

Dissertations

After decades of shrinking financial research support (Smith, 2004), continuously rising tuition and student debt (Beal et al., 2019), and the induction of numerous alternatives (Garrett, 2021), traditional higher education is struggling to provide the value that students are demanding (Woodall et al., 2014). Student engagement has been positively linked to increased retention (staying in school until completion of a degree) and reduced dropout (leaving school and not returning) rates (Finn & Rock, 1997; Reschly & Christenson, 2012), both of which contribute to how students perceive the value of higher education (Alves, 2011). The purpose of this study was to …

Addressing Racial Trauma In Counseling: Perspectives And Lessons From The Field, Claire Martin

Dissertations

Racism has permeated all aspects of American life (Bell, 1992) and many Black communities suffer racial trauma as a result. Mental health professionals have an ethical responsibility to develop strategies to serve the needs of diverse communities. The purpose of this qualitative study was to explore the experiences of Black mental health professionals who serve individuals experiencing racial trauma. Using Critical Race Theory as a theoretical framework and qualitative Thematic Analysis as a methodology, twenty-three (23) Black mental health professionals were asked the following questions: (1) What are the experiences of Black mental health professionals working with clients who have …