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Bupivacaine With Fentanyl To Treat Labor Pain: A Quality Improvement Initiative, Irvin Lee

Walden Dissertations and Doctoral Studies

Epidurals used for labor are common regional anesthesia techniques that are easily placed and controlled, while providing the most reliable method of pain relief in obstetrics for parturient women. Local anesthetics, narcotics, and/or combinations of the two are administered through epidurals to treat labor pain. Hence, the choice of medication is important, as it can highly influence outcomes of pain relief. The purpose of this DNP project was to evaluate the effectiveness of a new service line medication, bupivacaine 0.1% with fentanyl 2mcg/ml, to treat labor pain in parturient women at a rural community hospital in southern California guided by …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Assessing Nurses' Demographic Cardiovascular Risk Factors And Pharmacogenetic Testing Knowledge And Acceptance, Stella Chibuzor Ohanuka

Walden Dissertations and Doctoral Studies

The lack of knowledge of pharmacogenetic testing for cardiovascular disease (CVD), coupled with their increased risk for CVD, may impair nurses' cognitions and attitudes toward pharmacogenetic testing for CVD. The purpose of this quantitative cross-sectional correlational study, conducted with 230 RNs without CVD who worked in acute-care settings in Georgia, was to determine if their years of education, years of experience, and gender significantly influenced their perceived risk for CVD (Questions 1-3) and their perceived knowledge of pharmacogenetic testing for CVD (Questions 4-6), and if their perceived risk for CVD significantly influenced their acceptance of pharmacogenetic testing for CVD (Question …

The Impact Of Racial Stereotyping On Juror Perception Of Criminal Offenders, Tameka T. Price

Walden Dissertations and Doctoral Studies

For decades, research has consistently demonstrated that minorities are overrepresented in the prison population, yet relatively little is known about whether juror perceptions about race and criminal culpability may impact this problem in the United States. Using Hill's folk theory of race and racism as the theoretical foundation, this cross sectional study examined the relationship between perceptions of the race of the defendant and the verdicts to be handed down. Data were collected from a convenience sample of 25 people who self-reported having served on a jury or were eligible for jury service within the past 5 years in a …

Students' Decision-Making After Florida Senate Bill 1720: Guiding Students Through Math Placement, Rebecka Jo Sare

Walden Dissertations and Doctoral Studies

After Senate Bill (SB) 1720, exempt students enrolling in colleges in Florida no longer have to take a college placement test or enroll in developmental education courses before enrolling in college-level classes. SB1720 caused Florida colleges to find new methods of placement for incoming students, a concern because incorrect placement can have detrimental effects for the student and institution. Bounded rationality theory and Bahr's interpretation of student typology informed this study. The purpose of this survey study was to compare the exempt students who enrolled in remedial math to those who enrolled in college-level math. Research questions asked what differences …

The Role Of Prenatal Care And Systematic Hiv Testing In Preventing Perinatal Transmission In Tanzania, 2011-2012, Nkembi Lydie Bianda

Walden Dissertations and Doctoral Studies

In 2012, Tanzania, the prevalence of HIV infection among Tanzanian women was 6.3%; that same year, 18% of Tanzanian children were born already infected with HIV. The purpose of this study was to determine the importance of prenatal care attendance on comprehensive knowledge of HIV mother-to-child transmission (MTCT), and HIV testing and counseling, as well as awareness of HIV testing coverage services, in Tanzania. The study population was Tanzanian women of childbearing, aged 15 to 49 years old. Guided by the health belief model, this cross-sectional survey design used secondary data from the 2011-2012 Tanzania Demographic Health Survey. Independent variables …

How Improved Training Strategies Can Benefit Taxpayers Using Vita Programs, Jaclyn Marie Barkow

Walden Dissertations and Doctoral Studies

Many volunteer income tax assistance (VITA) sites experience inaccuracy in the taxes prepared according to audits conducted by the treasury inspector general for tax administration (TIGTA). Effective training strategies may influence the accuracy rates of tax returns prepared at VITA sites. Following the conceptual framework of the human capital theory, this multiple case study described the training strategies used by 4 VITA site coordinators in northwest Indiana. An Internal Revenue Service (IRS) representative overseeing the VITA sites identified the 4 site coordinators as achieving an exceptional accuracy rating. Data were collected from semistructured interviews, the annual VITA site coordinator's manual …

Systems Of Support For Elementary School Principals: A Case Study, Jennifer Francone

Walden Dissertations and Doctoral Studies

Principals need support throughout their careers in order to lead effectively and promote continuous improvement. However, some elementary school principals of small, rural schools lack access to structured systems of support that could increase their knowledge and skills as instructional leaders. The purpose of this study was to examine a central California school district's existing system of support for elementary school principals to learn the essential features that could be used to provide support for principals of small, rural schools. Informed by the Principal Support Framework provided by the University of Washington's Center for Educational Leadership, the guiding questions for …

Improving The Quality Of Nursing Documentation In Home Health Care Setting, Chidiadi Obioma

Walden Dissertations and Doctoral Studies

Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the quality of documentation of patient care in nurses' notes in a home health agency in central Texas. A retrospective audit of quality of nursing documentation using the Nurse and Midwifery Content Audit Tool (NMCAT) was done. A pre- and posttest design was used. A convenience sample of de-identified nurses' notes …

Women In Stem: The Effect Of Undergraduate Research On Persistence, Jodi Christine Wilker

Walden Dissertations and Doctoral Studies

The underrepresentation of women in science, technology, engineering, and math (STEM) careers constitutes a major issue in postsecondary science education. Perseverance of women in STEM is linked to a strong science identity. Experiential learning activities, such as undergraduate research, increase science identity and thus should help keep women in STEM. Most studies on research program development are from 4-year institutions, yet many women start at community colleges. The goal of this study was to fill this gap. Science identity and experiential learning theories provided the framework for this case study at a local institution (LECC). Semistructured interviews determined college science …

The Influence Of Cardiovascular Disease Risk Factors On Exercise Participation, Chadrick Cooper

Walden Dissertations and Doctoral Studies

The study's purpose was to analyze whether the control (sustained healthy level) of independent cardiovascular disease risk factors could be used to significantly predict aerobic exercise status. The health belief and ecological model helped describe health awareness, autonomy, and ecological influences that could also influence the control of each risk factor. Multiple logistic regression analysis of behaviors and demographics was utilized to assess relationships of met aerobic recommendations to hypertension, diabetes, obesity, tobacco/alcohol use, diet, physical activity limitations, mood, and socio-economic status. The study consisted of 340 African American participants (37% male 63% female), between the ages of 30-64 who, …

Post Advanced Technology Implementation Effects On School Psychologist Job Performance, Rana Dirice Hobson

Walden Dissertations and Doctoral Studies

The technology acceptance model (TAM) has been widely used to assess technology adoption in business, education, and health care. The New York City Department of Education (NYCDOE) launched a web-based Individualized Educational Program (IEP) system for school psychologists to use in conducting evaluations and reviews. This quantitative study examined the relationship between school psychologists' TAM factors associated with the web-based IEP system's perceived usability and usefulness measured by a TAM Instrument with individual job performance assessed by the Job Performance Ratings Measure. A random sample of 69 NYCDOE school psychologists participated in this study, and a regression analysis addressed the …

The Association Between Medical Marijuana Laws And Maternal Marijuana Use, Joseph Timothy Jones

Walden Dissertations and Doctoral Studies

Marijuana is the most common illicit drug that is abused by pregnant women, and recently many states have adopted various levels of relaxed marijuana policies. The purpose of this study was to evaluate a potential association between residing in a state that allows medical marijuana use and maternal marijuana usage. Grounded in the theory of planned behavior, this study evaluated the prevalence and extent of maternal marijuana use in states that allow and states that do not allow medical marijuana use using the National Survey of Drug Use and Health (NSDUH). It was anticipated that more lenient subjective norms toward …

Examining Nurse Satisfaction With A Bedside Handover Report Process, Imelda C. Principe

Walden Dissertations and Doctoral Studies

Nurses' job satisfaction affects work performance at the point of care in hospitals. The incoming nurses who are able to receive a comprehensive patient report at shift change are more prepared in comparison to incoming nurses who are not able to receive a comprehensive patient report to provide care that is safe. The purpose of this project, guided by the theory of organization change, was to explore whether the use of a bedside handover process impacts nurses' satisfaction in an adult postoperative orthopedic and spine unit. A post-implementation survey of the bedside handover process was conducted after one month and …

Rapport Development And Native Language Use Between U.S. Advisors And Afghan Counterparts, Sean Ryan Ryan

Walden Dissertations and Doctoral Studies

Advisory activities form a central element of the U.S. National Security Strategy to mitigate the need for employment of large military formations. The commitment of large U.S. combat formations has resulted in more than 6,000 fatalities since September 11, 2001; poor relationship skills were cited as contributing factors in 51 or more fratricide-murders of U.S. soldiers by Afghan compatriots in 2012. Informed by social exchange theory, servant leadership theory, and role theory, the Army conceptual rapport framework provided a lens for this phenomenological symbolic interactionism study of rapport between Afghan counterparts and U.S. advisors. Participants included 15 English-speaking Afghan soldiers, …

Retention Of Minority Students In A Bridge Program: Student Perceptions On Their Successes And Challenges, Chadwick Biermeier

Walden Dissertations and Doctoral Studies

This study was an examination of the minority student retention rate in a year-long bridge program. The retention rate of these students is 25%. University administration was concerned about the retention rate and its impact on future enrollment. Using Jack Mezirow's transformative learning as a framework of understanding, the purpose of this study was to identify successes and challenges that minority students experienced in the bridge program and how those experiences affected future decisions on retention. A qualitative case-study design was implemented and 9 of the 140 bridge students were purposefully selected for individual interviews. Data analysis was conducted using …

Parental Perspectives On Vaccinating Children Against Preventable Childhood Diseases, Karen Charles

Walden Dissertations and Doctoral Studies

Childhood immunization has been one of the most important public health measures in the 20th century. In the United States, 95% of avoidable childhood diseases have been prevented through vaccinations. However, there have been growing concerns around the safety of vaccines, and this increased uncertainty has led to decreases in vaccination participation and increases in cases of preventable diseases. As such, is it important to understand why parents are not vaccinating their children. A qualitative approach was utilized to conduct this study. Flyers to recruit participants were distributed by healthcare providers and were posted in church facilities. Ten parents of …

Academic Achievement In Schoolwide Title 1 Elementary Schools, Kelli K. Cronin

Walden Dissertations and Doctoral Studies

Title I federal funds are provided to schools with high percentages of children from low-income families to help ensure that all students meet academic standards. Despite this and other efforts by the federal government to assist low-income families with the problems associated with poverty, the minimum proficiency levels required by the No Child Left Behind Act have not been met by all students. Little research has been conducted to assess performance of South Dakota schools receiving federal funding under Title 1 to alleviate these deficits in academic achievement. The purpose of this study was to determine whether Title 1 had …

A Toolkit To Support Nurse-Patient Communication Through Nurse-Expressed Empathy, Jessica Delano Holden

Walden Dissertations and Doctoral Studies

Empathy is the ability of a person to understand what another is experiencing from the receiver's perspective and the ability to communicate that understanding to the receiver. In nursing, empathy is believed to be a necessary component to the nurse-patient relationship. Evidence shows a decline in empathy specifically noted over time in nursing students who are preparing to graduate and enter the workforce. The practice focused question for this project asked whether an experiential learning toolkit for development of nursing empathy can improve sophomore nursing student empathy as measured via the Jefferson Scale of Empathy. This project was guided by …

Teacher Perceptions Of A Full-Service Community School Strategy For Language Arts Students, Jaclyn Marie Dorrman

Walden Dissertations and Doctoral Studies

Students of all abilities at a Full-Service Community School (FSCS) in northern New Jersey are not meeting federal and state accountability requirements in language arts. Research studies indicated that the FSCS strategy can improve instructional practices, which will improve academic success. For this qualitative case study, the purpose was to document and analyze the strengths and weaknesses of the FSCS academic component for language arts used by 8 teachers from kindergarten to 6th grade. The conceptual framework that guided this study was grounded in the central understanding of Vygotsky and the constructivist theory of Bruner. The perceptions of language arts …

Willingness Of Nurses To Respond After An Alaskan Earthquake: Systematic Literature Review, Jane Marie Luscumb

Walden Dissertations and Doctoral Studies

Nurses may share a commonality of issues which can affect their willingness and ability to respond as post-disaster emergency care providers. Guided by expectancy, locus of control, and chaos theory, a systematic literature review was conducted to identify the barriers which affect nurses' willingness and ability to report to their unit after a disaster occurs. Briggs methodology guided this systematic review, and Fineout-Overholt's and Melnyk levels of evidence were used to evaluate the reliability of information and effectiveness of their interventions. Fifteen articles meeting the inclusion criteria (addressed nurses' willingness to report to their unit or to contact the incident …

Strategies Information And Communication Technology Managers Use To Build Employee Competencies, Thulaganyo Arnold Rabogadi

Walden Dissertations and Doctoral Studies

The World Economic Forum (WEF) found that Botswana's information and communication technology (ICT) networked readiness index (NRI) had declined from position 89 in 2012 to 104 in 2015. A decline in Botswana's ICT NRI resulted in a modest gross domestic product (GDP) growth increasing from 4.2% in 2012 to 5.0% in 2015. The purpose of this qualitative multiple case study was to explore strategies ICT service provider managers use to build employee competencies to address ICT infrastructure performance deficiencies. The target population for this study consisted of over 120 managers from 2 ICT service providers located in Gaborone and Francistown …

Resisting Democratic Transition Through Terrorism: A Case Study Of Post Saddam-Hussein Iraq, Kellie Rourke

Walden Dissertations and Doctoral Studies

Democracy building operations in foreign nations in Iraq and Afghanistan have been met with resistance and at great cost in terms of dollars and lives. Reducing these costs requires understanding why individuals choose to resist the transition to democracy, yet current research in the field does not address the issues of a previously nonviolent population turning to terrorism to resist transition to democracy. The purpose of this single case study was to use rational choice theory and Crenshaw's 3 levels of causation to understand what factors influenced members of the Sunni sect to resist democratic transition following the 2003 invasion …

Patient Characteristics And Treatment Outcomes Among Tuberculosis Patients In Sierra Leone, Mohamed Lamin Sesay

Walden Dissertations and Doctoral Studies

Despite decades of the implementation of the directly observed therapy short-course (DOTS), Sierra Leone is ranked among the 30 highest TB-burdened countries. Several factors account for unfavorable treatment outcomes, among which are patient characteristics. Previous studies have only focused on treatment compliance without any consideration for the factors that lead to noncompliance to treatment. The purpose of this study was to investigate patient characteristics that are associated with treatment noncompliance (treatment not completed) among TB patients undergoing the DOTS program in Sierra Leone. A retrospective longitudinal quantitative design was used to analyze secondary data from the completed records of 1,633 …

Students' Mathematics Self-Efficacy, Anxiety, And Course Level At A Community College, Scott Reiner Spaniol

Walden Dissertations and Doctoral Studies

Research suggests that student success in mathematics is positively correlated to math self-efficacy and negatively correlated to math anxiety. At a Hispanic serving community college in the Midwest, developmental math students had a lower pass rate than did college-level math students, but the role of math self-efficacy and math anxiety on these students' learning was unknown. This causal comparative, correlational study, guided by social cognitive theory and math anxiety research, hypothesized that students in developmental math would have lower levels of math self-efficacy and higher levels of math anxiety, and that significant correlations would exist between course level, self-efficacy, and …

The Role Of An Ombudsman In Mitigating Conflict, Evelyn Addison-Laurie

Walden Dissertations and Doctoral Studies

Bullying behavior is a contributing factor to hostile work environments, and can cause human consequences that affect morale, performance, and productivity. The purpose of this qualitative exploratory case study was to identify the strategies that ombudsmen and human resource managers (HR) use in mitigating workplace conflict. Corporate social performance was the conceptual framework that guided this research. Nine HR managers, an ombudsman representative, and 8 ombudsmen located in New York City and in other states were interviewed based on their experience in conflict mitigation. Data extracted from the participants' shared stories along with position description documents were synthesized thematically and …

Culturally Responsive Teaching Of Indigenous Students In Canada's Northwest Territories, Francis Amprako

Walden Dissertations and Doctoral Studies

The purpose of this qualitative narrative inquiry was to describe the teachers' perceptions of pedagogy and examine their cross-cultural strategies regarding culturally responsive

teaching of K-12 students. Indigenous students of the Northwest Territories (NWT) face academic challenges in a Eurocentric educational system. Tribal critical race theory and Eurocentric diffusionism provided the conceptual framework in this study. Six participants were interviewed and their narratives were triangulated by a 5-member focus group. The research questions focused on the teachers' strategies for building bridges between the Eurocentric and Native ways. Participants were interviewed and their responses created individual stories, which added to the …

A Case Study Of The Teacher Advancement Program On A Native American Reservation, Shing Aruguete Aruguete

Walden Dissertations and Doctoral Studies

A school district on a Native American reservation in the southwestern region of the U.S. decided to implement the Teacher Advancement Program (TAP) to improve teacher instructional effectiveness and student academic achievement. Although researchers have documented successes of the TAP in high-poverty urban school districts across the U.S., little is known regarding the TAP implementation in remote Native American cultural context schools. The purpose of this study was to investigate if the collaborative process of the TAP implementation changed the teachers' instructional practices. Using Vygotsky's social constructivism, which emphasizes that learning happens through interactions and cooperation of people in their …

Exploring Part-Time Teacher Professional Development And Best Practices On Adult Learners' Outcomes, Sandra Kay Brown

Walden Dissertations and Doctoral Studies

The issue of limited part-time teacher professional development and its effect on adult learners' success at an adult education center in the northeast United States was addressed in this study. At the research site, almost 50% of the teaching staff are adjuncts. Professional development opportunities have been limited, with only 1 opportunity recorded during the 2014-2015 school year. When teachers are provided appropriate and relevant support for the curriculum and student needs, they realize their own craft growth, with measureable student achievement as a result. Knowles's adult learning theory served as the conceptual framework and provided structure for exploring and …

Strategies Used By Manufacturing Hiring Managers To Recruit Skilled Workers, Cheryl Founchious Brown

Walden Dissertations and Doctoral Studies

Leaders in manufacturing industries are increasingly concerned with the lack of skills among applicants, emphasizing the gap that exists between employer expectations and skills of employees entering the workforce. Developing successful recruitment strategies is critical for hiring managers seeking to hire skilled workers. The purpose of this qualitative single case study was to explore successful strategies hiring managers used to recruit skilled production workers at a manufacturing company in Southeastern South Carolina. The human capital theory, which represents the knowledge individuals provide to enhance productivity, was the conceptual framework. Data were collected from face-to-face interviews with 3 hiring managers and …