Digital Commons Network^™

Reducing Maternal Morbidity From Peripartum Hemorrhage In Cesarean Delivery, Jennie Lee

Dissertations

Background/Purpose: Maternal hemorrhage is the second highest cause of direct maternal death and the leading cause of morbidity and mortality in the United States. This public health crisis is highlighted by the economic burden of over $30.8 million annually in the United States. The greatest tragedy in the review of maternal mortality is that 84% of pregnancy-related deaths were determined preventable. Identifying trends of factors that predispose women to hemorrhage can mitigate rates of severe maternal morbidity and mortality. This study describes relationships among demographic factors (maternal age, race, and ethnicity), clinical and physiologic factors, which include coexisting medical conditions …

Evaluating Effective Communication Of Baccalaureate Nursing Students, Christine N. Brockway

Dissertations

The purpose of this mixed methods study was to determine how communication evaluation by clinical faculty compared in a clinical setting versus a simulation setting for Bachelor of Science in Nursing (BSN) students. Fifty (50) BSN students from three different schools of nursing were scored using the Interprofessional Situation, Background, Assessment, Recommendation Nurse to Physician Rubric in both clinical and simulation settings by seven nursing faculty. Scoring for each student occurred in both settings during one semester. Following the evaluation, students and faculty were asked to participate in a focus group to discuss their experience. Results from this study showed …

The Effect Of Guideline Education On Anticoagulatin Management And Professional Collaboration In Ecmo Patients, Luis E. Farfan

Dissertations

This project aims to assist nurses and advanced practice nurses in preventing thrombosis and bleeding during ECMO treatment. It suggests following established anticoagulation guidelines, providing comprehensive education, and promoting teamwork among healthcare professionals. This approach can enhance patient outcomes by increasing knowledge and collaboration, ultimately leading to optimal administration of unfractionated heparin. Over approximately 20 weeks, the project was undertaken to enhance knowledge pertinent to anticoagulation management in patients undergoing Extracorporeal Membrane Oxygenation (ECMO). This initiative involved facilitating educational sessions tailored for nurses and Advanced Practice Providers (APPs) and focused on improving collaborative processes between these healthcare professionals.

Exploring Moral Distress In Icu Nurse Practitioners: A Descriptive Phenomenological Study, Steven L. Bocchese

Dissertations

Nurse Practitioners (NPs) working in the intensive care environment experience clinical and operational anxiety, such as moral distress. Moral distress occurs when an individual knows the ethically correct action but cannot take it due to internal or external constraints or violation of their professional core values. Historically, nurses have experienced moral distress at higher levels than other healthcare professionals, especially those in intensive care units (ICUs). This phenomenological study aimed to describe the lived experience of moral distress in ICU NPs, specifically emphasizing its effect on their personal and professional lives. Research on moral distress has demonstrated that individuals who …

Exploring Drivers Of Sex-Based Disparities In Relapsing Multiple Sclerosis, Stephanie Buxhoeveden

Dissertations

Females are three times more susceptible to relapsing multiple sclerosis (MS) and males typically have more severe disease, but the molecular underpinnings of these sex-based disease disparities are unknown and represent a critical knowledge gap.

Concept-Based Debriefing And Concept Mastery: A Pilot Study Linking Debriefing To Nursing Concept Mastery, Crystel L. Farina

Dissertations

Increases in patient acuity and comorbidities in acute care settings require students to possess a greater depth and breadth of knowledge compared to decades ago. Additionally, there is an urgency to adapt nursing education to meet current healthcare trends. Simulation is a pedagogical strategy to enhance critical thinking and clinical decision-making in nursing education. Simulation scenarios are a psychologically safe environment where nursing students may practice patient care and learn from their mistakes (Rudolph et al., 2014). The debriefing following the simulation scenario provides opportunities for self-reflection on actions taken during the simulation scenario. Currently, five debriefing methods support students' …

Development And Evaluation Of A Teamstepps® Program Among Cardiac Procedural Unit Staff In A Mid-Atlantic Community Hospital To Improve Teamwork And Patient Safety, Dawn K. Mutchko

Dissertations

Communication and teamwork between members of the non-provider patient care team in the cardiac procedural unit were observed to be unbalanced and at times ineffective. Team members additionally expressed concerns regarding efficiency and accuracy in patient handoff, specifically between units. The goal of this study was to improve teamwork and communication among the staff of the cardiac catheterization and electrophysiology lab. Participation in this initial, single-unit phase would include the non-physician staff of that unit.

Borderland Voices: Exploring The Educational Journey Of Transfronterizx Students, Families, And Educators For Enhanced Engagement And Empowerment, Sobeida Velazquez

Dissertations

Transfronterizx students and their families cross the U.S.–Mexico border for academic, economic, social, cultural, and linguistic reasons. Socioeconomic disparities, deportation, and work have propelled some families to live in Mexico and enroll their U.S.-born children in U.S. schools to provide more socioeconomic opportunities in the United States. Educators of transfronterizx students are uniquely tasked to work with these nontraditional students. Moreover, transfronterizx students and their families have distinct needs in U.S. schools; as such, there is a need for further research on the transfronterizx experience in the U.S. K–12 system. This qualitative narrative inquiry study aimed to understand the experiences …

Black School Leader Truth: How Black School Leader Epistemology Influences Liberatory Mindset Development In Their Staff, Orpheus Williams

Dissertations

Black students in the United States have consistently been denied access to empowering, culturally affirming, and responsive learning experiences in the traditional public system. The epistemological and pedagogical beliefs embedded in a liberatory mindset can subvert this pattern of disempowerment (Shujaa, 1998). Black school leaders (BSLs) who understand the systemic and institutional pressures Black children may face and have to overcome, having undergone similarly racialized experiences in school, are uniquely placed to create liberatory spaces for Black students by recruiting and developing these liberatory mindsets in their staff. This instrumental case study used qualitative research methods of front-porch pedagogy (McTighe …

Ripple Of Hope: Understanding The Lived Experience And Academic Achievement Of Latinx Students At Arrupe College And Dougherty Family College: A Case Study, Richard P. Virgin

Dissertations

One of the most common and important entry points into higher education for Latinx and other underrepresented students is through community college. However, national completion rates for Latinx community college students have been trailing their white peers. This gap in academic achievement has prevailed since the 1990s. The trailing rates of degree completion for Latinx students can lead to lower lifetime salary earnings, lack of career advancement, greater risk of losing employment, and an increased chance of living in poverty. However, a successful community college model may be seen as a disruptor in the educational sector due to its much …

Navigating The Bow Wave Of Change: The Felt Experience Of Belonging To The United States Naval Academy's First Gender-Integrated Class, Peter Shaner

Dissertations

On July 6, 1976 the United States Naval Academy (USNA) admitted its first-ever gender-integrated class. I was a member of that class, along with 81 female classmates who entered USNA with the class of 1980 (USNA ‘80). Those classmates were pioneers, though few of them realized at the time just how long and how hard their journey would be. The numerous challenges faced by USNA ‘80 on their journey through the Academy have been well documented (Gelfand, 2008). But there has been far less research on the lived experience of that pioneering class. This study fills a gap between historical …

Who We Are Is How We Lead: Storytelling As An Intervention In A Manager Development Program, Brittany Grieb

Dissertations

Leadership development programs (LDPs) have long been recognized as a means for organizations to develop their leaders, yet studies on their efficacy or use of creative interventions are limited. Despite the plethora of leadership studies that exist today, research is still seeking to answer the question: what is the best way to develop leaders? This qualitative study sought to investigate how storytelling can be used as an intervention for leadership development in a manager development program (MDP), an LDP for entry-level to midlevel managers at a biotechnology corporation. Using storytelling as an Indigenous model for knowledge cocreation as a framework, …

The Cultural Dimension Of Structural School Reforms: The Case Of Schedule Changes, Maylen Sullivan

Dissertations

The four-by-four (4x4) schedule—a type of high school block schedule—presents promising prospects for improving teaching and learning. Using a qualitative, single case study methodology, I investigated a school transitioning from a traditional six-period schedule to a 4x4 schedule during its 2nd and 3rd year of implementation. The study aimed to understand the factors that influenced the transition, the stakeholders’ responses to the decision, and the factors that influenced their responses. Some of the main considerations that motivated the decision included the desire to provide more opportunities within the school day for students to meet A/G college eligibility requirements, allow students …

Leadership And Teacher Agency For Inclusive Classrooms: Insights About Integrating Students With Disabilities Into Inclusive Classrooms From Teachers And School Leaders In Three International Schools, Chad Wood

Dissertations

As international schools continue to flourish, they must consider how to be inclusive and meet the needs not only of multicultural populations of students, but also the needs of students with diagnosed learning difficulties (i.e., students with special needs). Promoting teacher agency is a potentially important component in successfully implementing inclusive practices given that teachers are key actors in the implementation process. Currently, however, there is limited empirical evidence regarding the interconnectedness of teacher agency and inclusion of special needs populations in international schools.

This qualitative research explores the role of school leaders in promoting teacher agency to support the …

Understanding Ethical Leadership In Intelligence: Themes In Accountability, Self-Development, And Communication Among Cia Leaders, Caroline Walsh

Dissertations

This dissertation elucidates the concept of ethical leadership within the Central Intelligence Agency (CIA). Based on interviews with ten former senior-level officers from across different departments, the study analyzes how these leaders understand issues of accountability, self-development, and communication. The research also provides insights into their processes of sense-making and their methodologies for fostering ethical conduct amidst the complexities of intelligence operations.

Against the backdrop of the CIA's mission, structure, and norms, the study sheds light on the challenges and tensions inherent in the organization's operations. Through a thematic analysis of participant narratives, themes of moral cognition, personal values, and …

Intercultural Perspectives On Managing Organizational Change In Response To Government Policy Reform: A Case Study On The Leadership Of New Oriental Education, Yihe Yang

Dissertations

In 2021, a policy aimed at addressing educational inequality triggered a significant upheaval in the private tutoring sector of China by fundamentally transforming prevailing business models and financial viability within the industry. New Oriental Education & Technology Group Inc. (New Oriental Education), one of the preeminent private tutoring enterprises in China, attracted considerable attention for its subsequent organizational change. This study explored the leadership dynamics and organizational change efforts implemented by New Oriental after the policy enactment.

The theoretical framework synthesized organizational change theory, organizational culture, and transformative leadership approaches from both Western and Chinese perspectives. It elucidated effective practices …

Vital Voices From The Digital Divide: Testimonies Of African American Women Leadership Across Tech, Vinsche' Gray

Dissertations

Many organizations seek to highlight diversity, equity, and inclusion efforts, but African American women are still significantly underrepresented in leadership roles within the workplace (McKinsey, 2023). Within the technology (i.e., tech) space, there is concern regarding the inclusivity of African American women in leadership positions. A hostile and unsupportive environment raises concern for the future of African American women being able to attain key leadership roles. (McGee, 2018).

This study explored multifaceted experiences of eight African American women leaders in for-profit tech organizations. Black feminist thought and organizational culture and belonging were conceptual frameworks that shed light on the persistent …

Convergence And Divergence: Comparative Analysis Of Procedural Rule Changes Of The Hong Kong And Singapore International Arbitration Centers Within The Framework Of Neo-Institutional Theory, Phillip Hoang Tran

Dissertations

International commercial arbitration (ICA) plays an essential role in resolving disputes between companies engaged in complex, cross-border business transactions. It offers an efficient, neutral, and enforceable mechanism for resolving disputes across different legal and cultural backgrounds. ICA is generally conducted at international arbitration centers located throughout the world. According to the extant literature, there is convergence of procedural rules among these centers. Sabharwal and Zaman (2014), for example, claim increasing convergence of procedural rules among all the major arbitration centers. Similarly, Sharma (2021) proposes that this convergence helps build the international arbitration system. However, there is a near absence of …

Movin’ On Up: The Lived Experience Of Women Of Color In Leadership And The Supports That Helped Them Make It To The Top, Rozina Kapadia

Dissertations

Purpose: The number of women of color in leadership continues to be significantly lower than the number of men. The lack of opportunity combined with the lack of support results in less women of color in leadership. The purpose of this phenomenological study was to explore the lived experiences of women of color in their roles as leaders in corporate environments with respect to the support (personal supports, organizational supports, cultural supports, and stereotypical supports) received. Specifically, the research examined the stories of female leaders of color to understand how their experiences have supported or hindered their growth in leadership. …

A Phenomenological Study On The Perceived Impact Of Bass's Four I'S Of Transformational Leadership, Yarissa Marn

Dissertations

Purpose: The purpose of this phenomenological study was to identify and describe World of Warcraft game leaders’ perceptions of the impact on their guilds regarding Bass’s 4 I’s of transformational leadership.

Methodology: This qualitative study interviewed 13 World of Warcraft game leaders who have led their guild members for at least one year. The main source of data collection was semi-structured open-ended interview questions with other resources to include artifacts. The researcher coded and analyzed data for themes and patterns.

Findings: Several domains of Bass’s Four I’s Transformational Leadership framework were found to have an impact on World of Warcraft …

The Use Of Personal Disruption Strategies By Female Executive Ministry Leaders For Career Advancement, Neko Green

Dissertations

Purpose: The purpose of this explanatory mixed methods research study was to identify and describe the perceived impact of Johnson and Mohr’s (2019) five disruptive career skills on females in church executive leadership.

Methodology: This mixed methods study highlighted eight women in executive ministry positions in the United States and the impact that disruptive behaviors had on their advancement to executive leadership positions.

Findings: Analysis of the mixed methods data from the eight female ministry executives revealed that females found it difficult to challenge authority in ministry. They understood preparing and the benefit of improvisation. They were humble in self-promotion …

One Tiger, Many Lions: Uneven Adoption Of China's Political And Economic Investment Among Democracies In Sub-Saharan Africa, Tommy Callan

Dissertations

This dissertation examines how unique qualities of democracies in Sub-Saharan Africa and their foreign policy decision making processes affect their ability to exercise state agency. Specifically, democratic qualities affect a state’s receipt of investment from China and how well those investment projects fare once accepted. It is hypothesized that a strong executive branch leads to decreased or inconsistent Chinese investment while a strong legislature may have the opposite effect. A strong executive may also lead to an increased chance of project success while a strong legislature may have the opposite effect. High levels of party contestation may lead to decreased …

A Comparison Of Emotional Intelligence And Resilience Between Bachelor's Degree And Associate Degree Nursing Students, Natalie Board

Dissertations

Emotional intelligence and resilience are essential proficiencies critical for nurses to deliver safe and quality patient care. In the healthcare industry, nurses are exposed to numerous complex circumstances in demanding and high-stress environments. The quality of patient care a nurse can deliver depends on one's capacity to handle certain situations effectively. Emotional intelligence and resilience were potentially important variables in improving clinical practices and patient outcomes (Cleary et al., 2018). With the nursing shortage in the US, all nurses became necessary and required on the front lines of patient care during this time of dire need, regardless of their levels …

Addressing Barriers To Medication Adherence: An Evidence-Based Screening Instrument Validation Study, Donna Washburn

Dissertations

Adherence to a prescribed medication regimen is often critical to successful disease management. Cancer diagnoses often further complicate control of the comorbid diseases. Older cancer patients with multiple comorbidities receiving chemotherapy treatment are at increased risk for adverse health outcomes from uncontrolled disease when nonadherent to their medication regimen. The intent of this pilot study was to test the validity of an evidence-based screening instrument designed to identify patients at risk for medication nonadherence and uncontrolled illness. The W-BMA (Washburn-Barrier to Medication Adherence) screening criteria were applied to retrospective data of cancer patients with multiple co-morbidities. SPSS was used to …

Pain Interference In Chronic Musculoskeletal Pain: Examining A Resilience Model Of Dispositional Optimism, Coping Responses, And Mind-Body Practices, Trey Heffernan

Dissertations

Chronic musculoskeletal pain is the leading cause of disability in the United States. Pain interference, or the ways chronic pain negatively interferes with everyday life, is the biggest problem impacting individuals with chronic musculoskeletal pain. Although previous research has targeted risk factors associated with poor health outcomes, the adaptive functioning of some patients with chronic pain highlights a need for research investigating resilience factors. The purpose of this study was to investigate the direct and indirect relationships between resilience factors of optimism, coping responses, and mind-body practices on pain interference for individuals with chronic musculoskeletal pain. Specifically, the resilience model …

Distance Caregiving A Parent With Advanced Cancer, Polly M. Mazenec

Dissertations

Distance caregiving, which is the experience of providing instrumental and/or emotional support to an ill loved one who lives a long distance from the caregiver, is a recent caregiving phenomenon. Although much is known about caregiving a family member with cancer, there has been almost no research describing the experience of caregiving from a distance and intervention studies are non-existent. The purpose of this study was to investigate the effect of distance on caregiver reaction (benefit and burden) and to explore predictors of caregiver psychological well-being (depression, anxiety, and distress) in distance caregivers of parents with advanced cancer. A conceptual …

Expediting Stroke Transfers: Improving Door-In Door-Out Times In A Community Hospital Emergency Department, Susan E. Maynard

Dissertations

Patients with acute ischemic stroke are at high risk for death and disability without rapid treatment. Thrombectomy is a time-sensitive procedure that can restore blood flow to the brain.

Psychosocial Determinants Of Suicidal Ideation Among Thai Women, Raya T. Albataineh

Dissertations

According to a Thai Public Health Ministry spokesman, more than 300 Thai individuals commit complete suicide per month, making Thailand the nation with the third-most suicides in the world. Despite the high rates of suicidal ideation in Thai adult women, the predictors associated with suicidal ideation rates are still unknown. Thus, the purpose of this study was to examine those predictors, specifically the extent to which quality of life, intimate partner violence, social support, employment status, partnership status, and parenthood status predict suicidal ideation in this population.

Relationships Among Self-Care Behaviors And Professional Quality Of Life In Oncology Nurses, Susan M. Politsky

Dissertations

Oncology nurses distinguish themselves as providing strength and support for their patients who are receiving treatments to combat the diagnoses of cancer. Nurses are affected by the act of their honest caring and the compassion they provide to their patients. This caring and compassion can unintentionally lead to positive or negative outcomes for the nurse. Caring for oneself is often not a priority of oncology nurses. Introducing and incorporating self-care behaviors may have a direct impact on the well-being of oncology nurses. The purpose of this study was to explore the relationships among the components of self-care behaviors and the …

Phenomenological Research Examining Administrators And Special Education Teachers' Perception, Experience & Knowledge Of The Mississippi Special Education Growth Rubric, Tricia Pittman

Dissertations

In the current era of accountability, public school administrators’ responsibilities may include evaluating special education teachers and providing them with feedback and support to improve their effectiveness. The problem that exists is that administrators who do not have a background in special education are charged with the responsibility of evaluating special education teachers, resulting in special education teachers not getting the support or feedback necessary to improve their instructional practice.

In addition to administrators not having the background knowledge necessary to effectively evaluate and support special education teachers, the problem of developing an effective evaluation model to evaluate special education …