Digital Commons Network^™

Taking A Transformative Leadership Approach To Stakeholder Trust, Christopher Roszak

Walden Dissertations and Doctoral Studies

Business leaders struggle with the application of appropriate leadership models to retain stakeholder trust. The purpose of this phenomenological study was to explore the lived experiences of mortgage and investment leaders and stakeholders on applying various leadership models to restore stakeholder trust. Stakeholder and stewardship theories formed the conceptual framework of this study. A purposive sample of 20 stakeholders from the investments and mortgage industry in central Colorado participated in semistructured interviews. The research questions were on a leader's application of various leadership traits to restore stakeholder trust. Six themes emerged following coding and reduction using a modified van Kaam …

One Hospital's Patient Satisfaction Plans In Response, Valerie A. Smart Shoup

Walden Dissertations and Doctoral Studies

Recent changes in the Centers for Medicare and Medicaid Services (CMS) reimbursement programs resulted in $1 billion in payments to hospitals based on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Approximately 50% of the 3,000 hospitals currently receiving Medicare supplements may receive increases in reimbursement payments while 50% will receive decreases in payments. This case study explored how one hospital team in North Texas achieved high HCAHPS scores. The primary provider theory, Deming's model of plan-do-study-act (PDSA), and disruptive innovation theory framed the study. The data collection process included administrator interviews (n = 7), hospital document analysis …

Borrower Experiences With Subprime Mortgage Loans In Gwinnett County, Georgia, Terence Palmer

Walden Dissertations and Doctoral Studies

When purchasing a home, buyer considerations include price of the home, credit rating, mortgage type, and lending agency. The purpose of this phenomenological study was to explore the loan options successful business leaders consider when shifting loan lending from prime mortgage loans to subprime mortgage loans. Systems theory formed the conceptual framework for the study. A purposive sample of 20 participants from Gwinnett County, Georgia completed semistructured interviews and described their personal experiences. Data analysis incorporated van Kaam's technique to code and cluster information into topics. The following themes emerged from the analysis indicating what these business leaders considered when …

The Impact Of A Multifaceted Intervention On Student Math And Ela Achievement, Olivean Strachan

Walden Dissertations and Doctoral Studies

Closing the achievement gaps in mathematics and English language arts (ELA) is an ongoing challenge for most New York City Public school administrators. One New York school experiencing this problem implemented a broad intervention including (a) the Children First Intensive (CFI) program, which includes using data to inform instructional and organizational decision-making; (b) added baseline and post assessments; and (c) differentiated instruction including student conferences. The effects of the intervention had not been evaluated within the context of implementation. The purpose of this quantitative study was to evaluate the impact of the multifaceted learning gaps' intervention on 6th grade student …

Nurse-Physician Communication Tools To Enhance Use Of Nursing Evidence-Based Protocols, Tochi Onyenwe Ubani

Walden Dissertations and Doctoral Studies

Nurse-Physician Communication Tools to Enhance use of Nursing Evidence-Based Protocols

by

Tochi Onyenwe Ubani

MSN, Walden University, 2011

BSN, Chamberlain College of Nursing, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

In the current health care environment, consumers are demanding collaboration among clinicians even when traditional attitudes minimize nurses' input on the direction of clinical care. Compounding this problem is that nursing practices have not always been derived from randomized clinical trials, but instead from personal experiences. The purpose of this study was to explore the perceptions …

Meaningful Use Of Electronic Medical Recording To Improve Diabetic Treatment Compliance Of American Diabetic Association Treatment Standards, Tamara Ann Parrish

Walden Dissertations and Doctoral Studies

Diabetes affects approximately 10% of the American population with an annual expenditure of approximately $174 billion dollars. The utilization of electronic medical records (EMR) combined with the meaningful use (MU) initiative may ensure that diabetic patients receive the recommended preventative care. Dorthea Orem's self-care deficit theory and the transtheoretical model of behavior change was utilized to design this quality improvement project. Medical professionals at a small private practice received education on American Diabetic Association (ADA) treatment standards and how to use the EMR system to track patients receiving the recommended diabetes care. The project question examined the effectiveness of provider …

An Investigation Of Teacher Librarians' Use Of Interactive Whiteboard Technology For Literacy Instruction, Judith Carroll Stanton

Walden Dissertations and Doctoral Studies

Although school systems have made investments in technology with the intention of raising student scores on state and national tests, improvements in student achievement have not always followed. The purpose of this study was to investigate teacher librarians' use of interactive whiteboards to improve student literacy. This qualitative case study was guided by the theory of social constructivism, wherein individuals learn through interaction with peers and knowledgeable others. The research questions were focused on how teacher librarians integrated multi-literacies and technological skills into pedagogical goals. Data were collected from a 4-member focus group interview, a questionnaire delivered to a subset …

Attachment Style, Leadership Behavior, And Perceptions Of Leader Effectiveness In Academic Management, Rehema Underwood

Walden Dissertations and Doctoral Studies

Organizational effectiveness is related to both effective leadership styles and to having leaders with secure attachment styles. Transformational and charismatic leaders often have secure attachment styles. However, the relationships between insecure attachment styles and leadership styles remain unclear. The purpose of this study was to examine whether insecure attachment in leaders (fearful, preoccupied, and dismissing attachment styles) is related to transformational, charismatic, transactional, and laissez faire leadership. A quantitative, non experimental approach was taken in this study. Participants included those in leadership positions (college deans, chairpersons, and provosts) (n = 18) and instructors (subordinates) (n = 36) from local community …

Exploring The Risk Factors That Influence The Parental Dental Deferment Decision, Megan White

Walden Dissertations and Doctoral Studies

When caregivers defer their personal routine dental care (RDC) in order to provide RDC for their children, they risk detrimental consequences in their personal health and the health of their children. The purpose of this qualitative case study was to identify the risk factors that led to the parental dental deferment decision. The oral health and personal care services conceptual models guided the development of the research questions, facilitated the selection of risk factors on the decision-making process, and provided the basis for the data analysis thematic categories. Ten caregivers who made the decision to defer their personal RDC for …

Frequent Superintendent Succession: The Impact On Personnel Trust And Morale, Edgar Byrum Davis Camacho

Walden Dissertations and Doctoral Studies

A superintendent is vital to the success of school districts. Stability of an individual in this position is important for building trust and morale for district personnel over time. Small school districts in a large southern state have experienced increased rates of voluntary or involuntary superintendent succession, having had 2 or more superintendent changes within a 6-year period. Participative leadership theory served as the framework for this study. The guiding questions for this study investigated the impact of frequent superintendent succession in small school districts and the levels of trust and morale among district personnel. The variables for the study …

Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss

Walden Dissertations and Doctoral Studies

Weight bias exists in some health-related degree programs. Overweight and obese persons who experience weight bias in health-related services often delay or avoid medical attention altogether. Guided by the attribution theory, the purpose of this sequential explanatory study was to examine weight bias among health majors at a southwest regional university to illuminate how attitudes can affect the level of care provided to overweight persons. The Attitudes toward Obese Persons (ATOP) scores from a convenience sample of 184 health majors revealed that participants' scores were found to be significantly lower than the midpoint (60) of the ATOP scale, M = …

Exploring Strategies For Retaining Information Technology Professionals: A Case Study, Shannon J. Thomas

Walden Dissertations and Doctoral Studies

In the 21st century, retaining information technology (IT) professionals is critical to a company's productivity and overall success. Senior IT leaders need effective strategies to retain skilled IT professionals. Guided by the general systems theory and the transformational leadership theory, the purpose of this qualitative exploratory case study was to explore the retention strategies used by 2 senior IT leaders in Atlanta, Georgia to retain IT professionals. Semistructured interviews were employed to elicit detailed narratives from these IT leaders on their experiences in retaining IT professionals. A review of company documents, as well as member-checking of initial interview transcripts, helped …

The Effectiveness Of Educational Methods On Medication Adherence, Prema David

Walden Dissertations and Doctoral Studies

Nonadherence to medications for chronic illnesses is a public health problem that requires education related to its illnesses and medications in order to reduce morbidity, mortality, and health care costs, and to improve quality of life. Scholars have identified that morbidity and mortality are much higher among African Americans due to poor medication adherence when compared to Euro-Americans. This study focused on African Americans to increase their medication adherence with chronic illnesses. The purpose of this study was to analyze the effectiveness of using different educational methods to enhance medication adherence. The social cognitive theory and the theory of planned …

Uric Acid Level Is Associated With Postprandial Lipemic Response To A High Saturated Fat Meal, Roy Gail Cutler

Walden Dissertations and Doctoral Studies

Hyperlipidemia caused by a diet high in saturated fat can lead to visceral fat weight gain, obesity, and metabolic syndrome. Being over-weight from visceral fat has been linked to increased risk of developing most age-related diseases and disability, along with a lower income potential and quality of life. However, researchers are just beginning to understand the biological mechanisms that regulate the conversion of excess calories into visceral fat storage rather than glycogen or muscle. Epidemiological studies have repeatedly shown a comorbid association between age-related diseases involving hyperlipemia and circulating levels of uric acid, but not a direct association. This study …

Psycho-Social Resilience And Risky Hiv Behaviors Among Black Males Who Have Sex With Males, Wilson Osaro Iyokho

Walden Dissertations and Doctoral Studies

The incidence rate of HIV among Black males having sex with Black males (BMSM) is high compared to that of other racial groups. Researchers have established the association between inappropriate sexual practices, age, income, and environmental determinants and HIV positive status among BMSM. Guided by resilience theory, the purpose of this study was to examine the relationship between HIV risk behavior and resiliency with the goal of identifying a new intervention to mitigate the HIV infection rate in the BMSM community. The theoretical framework used for this study was the resilience theory. This theory is concern with the phenomenon of …

The Impact Of Implementing Bedside Report To Transition Patients Across Units, Tonya Johnson

Walden Dissertations and Doctoral Studies

Evidence supports bedside report as a mechanism to improve communication, patient safety, quality of report, and nurse and patient satisfaction when implemented in a closed unit. The purpose of this project was to examine the impact of implementing a bedside report process to transition patients from the emergency department to a medical-surgical unit. Specifically, the goal was to analyze the impact of a bedside- reporting process on patient progression and on nurse and patient satisfaction. Lewin's change model provided the theoretical framework for this quasi-experimental study. Patient progression data consisted of 706 patient transitions from the emergency department to the …

Steps To Reducing Heart Failure Hospital Readmissions Through Improvement In Outpatient Care, Paticia Laubach Dunn

Walden Dissertations and Doctoral Studies

The outpatient care of the heart failure (HF) patient is fragmented due to the lack of evidence-based practice guidelines use. The primary goal of this project was to improve the care of the HF patient in the outpatient arena through use of clinical pathways using the logic model as the project framework. The intervention was carried out over a 4-week period on a convenience, random sample of patients (n = 80) attending a cardiology practice. The patients were recruited from 2 physicians' patient populations and were selected based on an adult diagnosis of HF, reduced ejection fraction of <40% at some point in time, and the New York Heart Association (NYHA) functional class II-V. Comparisons were made in the documentation of care between patients on or off the pathway. The intervention included documentation of patient education, care follow-up, medications, NYHA functional class, and symptom exacerbation, documented in the electronic medical record. The quality of care data were evaluated based on 3 of the Joint Commission core measures for outpatient care of the HF patient. Additional data were collected regarding use of the clinical pathway based on provider and week of implementation. Data were analyzed via a Chi-square test of independence comparing pathway use by provider and use of pathway as study progressed. The comparative results show statistically significant differences in use of the pathway by provider and a statistically significant increase in use during the project . The quality of care results varied in statistical significance. The pathway utilization increased over time and provided a method for standardizing documentation of care for the HF patient in this outpatient clinic, a benefit for HF patients and providers in this cardiology practice and beyond.

Interactions Between Patterns Of Gamer Behaviors And Time-On-Task For Mathematics Remediation In A Game-Based Hive, Marvin Gene Fuller

Walden Dissertations and Doctoral Studies

As the presence of digital game-based learning increases in United States classrooms, understanding their impact on achievement is critical. Digital games for learning offer many potential benefits, including reducing the number of students trapped in a remediation cycle, a contributor to college dropout. Despite the recognized potential of game-based learning, few researchers have explored the relationships between specific patterns of behaviors and types of digital game-based learning environments. The underlying theory for this study was patterns of gamer behaviors may predict in-game behaviors. Archival, third-party data regarding The Lost Function - Episode 1: Sum of the Forgotten Minds by Advanced …

The Effect Of An Online Coping Skill Application On Relapsing-Remitting Multiple Sclerosis Sufferers, Jennifer H. Garrison

Walden Dissertations and Doctoral Studies

Many individuals with multiple sclerosis (MS) are classified as having relapsing-remitting MS (RRMS), a form of the illness that requires constant symptom management for suffers to achieve optimum outcomes. There are only a few community-based educational programs that exist to help RRMS sufferers cope with their illness; the effectiveness of those that have been fielded has not yet been adequately assessed. The research questions of this study were to determine if an online training development module would increase the coping skills of those affected by RRMS and if the online educational module would be more effective at improving the coping …

Impact Of Computer-Mediated Communication Duration On Adolescent Social Self-Efficacy, Social Anxiety, And Depression, Melaney Laine Davis-Mcshan

Walden Dissertations and Doctoral Studies

Research suggests that Internet and cell phone overuse may result in lower levels of social skills and encourage isolation from peers. Less clear is whether the duration of computer-mediated communication (CMC) influences adolescent perception of their social skills competency or emotional health. This research was guided by the social cognitive theory, which suggests that social self-efficacy (SSE), the belief that they have the skills to engage successfully with others in conversation and social activities, develops from mastery experiences that regulate thought, motivation, and action. This quantitative cross-sectional survey design utilized a convenience sample of 49 adolescents ages 11-19, living in …

The Relationship Between Compassion Fatigue And Self-Transcendence Among Inpatient Hospice Nurses, Donna Marie Johnson

Walden Dissertations and Doctoral Studies

Health care complexities have limited the understanding of nursing care and have jeopardized the "soft skills" or foundation of caring as the art of nursing. Hospice nurses provide a deeper, more spiritual and complex type of care for critically ill and end-of-life (EOL) patients, which place them at a high risk for compassion fatigue. Using Reed's middle range theory of self-transcendence, the purpose of this project was to examine the relationship between compassion fatigue and self-transcendence among inpatient hospice nurses. A descriptive, correlational research methodology guided this inquiry surveying a convenience sample of 42 inpatient hospice nurses at 4 hospice …

Experiences Teaching Stoichiometry To Students In Grades 10 And 11, Cynthia Denise Bridges

Walden Dissertations and Doctoral Studies

Many students have problems learning stoichiometry, a complex mathematical chemistry concept used to determine how much product will be produced or formed from a given quantity of reactants. The problem addressed in this study was teachers' lack of understanding of how to teach stoichiometry in a Midwestern urban school district. The conceptual framework of the study was based upon constructivist theory. A qualitative narrative approach was used to obtain the perceptions of 5 high school chemistry instructors related to their experiences, successful or unsuccessful, in teaching stoichiometry to students in Grades 10 and 11. Data were gathered through face-to-face interviews, …

Identifying And Mitigating Domestic Minor Sex Trafficking In An Urban Community, Anne Ellen Gresham

Walden Dissertations and Doctoral Studies

Human trafficking, domestic minor sex trafficking (DMST), and commercial sexual exploitation of children (CSEC) are complex and multifaceted occurrences in the United States. As the numbers of youth ensnared in sexually exploitive situations increase, organizations and communities are called upon to address the ramifications of this abuse; little research was located, however, that examined collaborative networks and partnerships that address victim identification and mitigation of DMST and CSEC. The purpose of this qualitative single case study was to determine whether strategic partnerships existed within the community under investigation. The theoretical framework was environmental theory, as first described by Florence Nightingale; …

K-12 Teachers' Perceptions Of The Tesa Program And Its Impact On Teacher-Student Relationships, Kathy Rena Howard

Walden Dissertations and Doctoral Studies

Administrators in a school district in north central Kansas implemented the Teacher Expectation and Student Achievement (TESA) professional development program (PD) to address ineffective instructional practices of K-12 teachers. TESA PD was designed to build and promote teacher-student interactions, enhance students' academic performance, teach students self-discipline, and improve the class environment so that students can work and study in diverse settings. The purpose of this qualitative case study was to explore the classroom experiences and perceptions of 10 teachers who integrated teaching interactions from the TESA program into their daily lessons. Brophy and Good's expectation theory holds that teacher interactions …

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

Improving The Quality Of Care In An Acute Care Facility Through Reeducating Nurses About Managing Central Lines, Jacqueline Raffaele

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections continue to be some of the most deadly hospital-associated infections in the United States. Guided by Lewin's change theory which focuses on prior learning, rejection, and replacement, the purpose of this study was to improve the quality of care patients receive in an acute care facility by reducing life threatening central line infections. The research question examined whether additional education using Venous Access Nurse (VAN) customized newsletters and manager coaching of nurses in an acute care setting would improve the quality of care for patients with central lines. This was a quantitative nonexperimental descriptive retrospective study …

A Grounded Theory Study Of Working Adults Navigating Advanced Degrees, Charles Valent Slider

Walden Dissertations and Doctoral Studies

There is considerable body of research about adults navigating advanced degrees, but little regarding adults in graduate degree programs while in full-time educational careers. Guided by Mezirow's transformative learning theory, the purpose of this study was to develop a grounded theory (GT) that reflected the lived experiences of fulltime teachers within a school district as they progressed through advanced degrees. Fourteen adult learner participants were asked to talk about their experiences as both fulltime educators and graduate students. The constant comparative analysis method was employed to analyze the data to develop a theory entitled enduring driven succeeding. The theory explained …

Technological Factors For The Sustainability Of The Small Business Entrepreneur, Noghor Pessu

Walden Dissertations and Doctoral Studies

Technical innovation creates challenges for the small business entrepreneur who uses global activities in the marketplace. Information technology and the technological innovations of the World Wide Web are driving competitiveness in the marketplace with a loss of market share for the individual business owner. The purpose of this phenomenological study was to explore the lived experiences and perceptions of a purposive sample of 20 small business owners in the metropolitan Atlanta area regarding the effect of technology, technological insertion, and application for long-term sustainability. Rogers's diffusion of innovations theory served as the conceptual framework of this study. Data were gathered …

Combat-Related Posttraumatic Stress Disorder: Locus Of Control And Marital Satisfaction, Jesus Botello

Walden Dissertations and Doctoral Studies

Combat-related posttraumatic stress disorder (PTSD) is a psychological condition researchers have cited as a major cause of marital discord and divorce for veterans with PTSD. This study examined the psychological construct of locus of control among the wives of veterans diagnosed with combat-related PTSD and whether or not it was a predictor of marital satisfaction within this context. An extensive search of the current literature revealed no previous studies that had investigated this relationship. Utilizing the family systems theory to address this gap, this study sought to compare reported marital satisfaction in wives with an internal locus of control to …

Prehospital Staffing And Road Traffic Accidents: Physician Versus Trained Nonphysician Responders, Timothy A. Grant

Walden Dissertations and Doctoral Studies

Road traffic deaths, which affect people in their productive years, are projected to be the third leading cause of death by the year 2030. While most studies have focused on road infrastructure and vehicle safety, this study examined something new: the impact of prehospital response to road traffic accidents on the rate of death. Some countries send physicians to the scene of an accident; some send paramedics or registered nurses. The question this research sought to answer was whether the use of physician responders resulted in a lower rate of death compared to the use of nonphysician responders. The literature …