Digital Commons Network^™

Strategies Small Construction Business Managers Use To Reduce Safety Incidents In Their Organization, Peggy Ann Mcknight

Walden Dissertations and Doctoral Studies

Globally the construction industry struggles to prevent injurious and fatal safety incidents. The purpose of this single case study was to explore strategies used by construction business managers that had significantly reduced the occurance of safety incidents in a Northwest Ohio construction company. Data were collected from organizational records and interviews with 6 construction managers. The conceptual framework for this research was the concept of safety management systems. Data were compiled and organized, disassembled into fragments, grouped, and then interpreted for meaning. Methodological triangulation and member checking were used to enhance reliability and validity. Four themes emerged from the data: …

Perceptions And Interpretations Of Posttraumatic Stress Disorder Among Cambodian Immigrant Community, Raksmey Arun Roeum Castleman

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) affects more than 60% of Cambodian immigrants in the United States. However, researchers do not yet know why less than 5% of Cambodian immigrants are accessing mental health services. This qualitative study involved investigation of participants' perceptions of how PTSD is manifested in the Cambodian immigrant community to understand barriers to mental health services access. The social ecological theory provided a frame for understanding how traditions, values, culture, and beliefs affect Cambodian immigrants' perceptions of PTSD and the mental health system. Data was collected from semi structured interviews of 13 participants, 18 to 70 years of …

Nurse Practitioners' Experiences With Role Transition: Supporting The Learning Curve Through Preceptorship, Viktoriya Y. Pleshkan

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role transition is difficult and ill-supported before and after graduation. Although preceptorships are essential in supporting a NP's role transition, there is a paucity of data on student and novice NPs' experiences with their role transition and how it is supported through preceptorships. The purpose of this hermeneutic phenomenological study was to understand and describe the meaning of NPs' role transition experiences while in a preceptorship before and after graduation. Schlossberg's transition theory and the cognitive apprenticeship models were used to guide the exploration of concepts of role transition and preceptorship. One face-to-face, 3 Skype, and …

Management Of Postoperative Pain In The Total Joint Replacement Patient, Angela Washington

Walden Dissertations and Doctoral Studies

Managing postoperative pain continues to be a challenging public health problem. The organization under study was experiencing a prolonged length of hospital stay (LOS) in the post-total knee and hip replacement surgery population that was causing system-wide patient flow issues. The purpose of this quality improvement project was to educate patients through an established education class on pain expectations, strategies on managing pain, discharge planning, and physical therapy expectations with a goal of reducing pain and LOS. The health belief model was used as a guide to incorporate new content into the educational program that addressed patient knowledge on pain, …

Second Grade Teachers' Perspectives On Differentiated Instruction, Alyssa Simmons

Walden Dissertations and Doctoral Studies

Despite various instructional efforts, the second grade students in a mid-sized Southwestern school district failed to progress in reading. Although differentiated instruction has been shown to improve literacy skills for young readers, many teachers at the study site did not differentiate instruction for all students. Grounded in theories of social constructivism and differentiated instruction, the purpose of this study was to investigate second grade teachers' perspectives about using differentiated literacy instruction and the effect of their teaching experience and participation in professional development on those perspectives. Data for this nonexperimental, causal-comparative study were collected from 93 second grade teachers via …

Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain …

Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley

Walden Dissertations and Doctoral Studies

Adult Type II diabetes is an increasing public health problem, particularly among very low-income minority populations. The purpose of this study was to create a nutritional guide for a diabetic specific meal plan with an accompanying food pantry nutrition packet for very low-income Type II diabetic patients at a rural Mississippi Free Clinic. The practice-focused question is: Will a nurse-prepared nutritional guide with supplemental food packets improve the glucose control in low income diabetic patients? The gap in practice is that there has been no structured nutrition education guide and no food pantry support plan for Type II adult diabetics. …

Exploring Value Of Perceived Problem Resolution In Success Of Online Doctoral Students, Vanessa S. O'Neal

Walden Dissertations and Doctoral Studies

How doctoral students view their institution's ability to resolve problems may be directly related to their overall satisfaction of the institution. Challenges such as barriers to communication could have a negative effect on the students' ability to be retained by the institution. Policies to address issues relating to retention; high default rates on student loans and student services are increasing and more constraining. While the literature indicates the formation of federal policies to monitor recruitment practices of for-profit online institutions, it is not known to what extent these policies have influenced the quality of postrecruitment services. Using the theoretical framework …

Successful Climate Change Strategies In Corporate Farming In North America, Deann Renee Reaves

Walden Dissertations and Doctoral Studies

The impact of climate change on agriculture is evident in changing growing seasons, crop yield, crop quality, and even complete crop losses. Changing climate conditions negatively affect the profitability of agricultural organizations. This study was a single descriptive case of one agricultural corporation in the western United States. The purpose was to identify and explore successful climate change-based sustainability strategies. The conceptual framework for this study was legitimacy theory. The data collection methods consisted of a semistructured interview of a corporate exectutive and obtaining corporate documents, including the annual report from the company's website. Data were analyzed using content analysis …

Perceptions Among African American Women Welfare Recipients In Advocating For Welfare Reform, Linda Denise Scope

Walden Dissertations and Doctoral Studies

The 1996 Personal Responsibility and Work Opportunity Act (PRWORA) significantly affected many families by changing public assistance from an entitlement program to a work program for recipients and imposing a 60 month maximum period for receiving assistance. Unanticipated outcomes created deleterious results for many single parents. This multiple case study explored the experiences of four African American single mothers in the mid-Atlantic region of the United States receiving assistance regarding welfare reform, the welfare system and their perceptions of welfare advocacy. Black feminist and empowerment theories framed the study to examine how welfare policy changes affected African American women's families …

Health Literacy Best Practices In Policy Development, Stacie Lee Trueheart

Walden Dissertations and Doctoral Studies

Low health literacy is a problem the U.S. faces and, like health care itself, is a complex issue stemming from patient demographics and the healthcare providers being very diverse. Tools have been developed to mitigate the risks of low health literacy, however, without formal policy. The purpose of this qualitative case study was to explore and compare commonalities in health literacy best practices of organizations that are recognized as leaders in health literacy and are addressing low health literacy in their communities. By comparing the organizations' abilities to implement standards of plain language and health literacy tools/guidelines, best practice and …

African American Women Caring For Loved Ones With Alzheimer's Disease And Dementia, Lisa M. Forbes

Walden Dissertations and Doctoral Studies

Abstract

In 2016, a dramatic shift occurred in demographics in the United States because the oldest people in the baby boomer generation, which consists of people born between 1946 and 1964, reached age 65. The larger aging population and longer lifespans have produced an increased need for care and services. There are an estimated 5.4 million Americans of varying ages living with a diagnosis of dementia or Alzheimer's disease. Diagnoses of Alzheimer's disease are more prevalent among African Americans than other ethnicities. With little research found on culturally appropriate interventions for specific ethnic groups, a more detailed review of the …

Government And Nongovernmental Collaboration To Build Community Resiliency Against Terrorism In Oklahoma City, Kimberly K. Heltz

Walden Dissertations and Doctoral Studies

The way communities build resiliency and prepare for acts of terrorism is ambiguous in the United States; best practices remain unclear. Due to mobility and advancements in communication technologies, individuals and organizations share information, incite anger, recruit, and act on ideological grievances with ease. Such grievances are bolstered by the political and social exclusion of disparate groups through poorly designed policies and ineffective government structures. Using a combination of social constructivism and systems thinking theories, this case study explored collaboration efforts between government agencies and nongovernment experts in Oklahoma City, OK, identifying best practices as a result of lessons learned …

Evaluating A Discharge Bundle For Chronic Obstructive Pulmonary Disease, Sharon Scardina Jones

Walden Dissertations and Doctoral Studies

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital readmissions within 30 days. Frequent readmissions negatively affect hospital reimbursements and patient outcomes. Creative strategies, such as COPD care bundles, have been shown to reduce readmission rates according to existing studies. A COPD discharge bundle was developed and implemented at 1 community hospital in response to an identified problem with COPD readmissions. Evaluation of this quality improvement initiative was the purpose of this project study. The practice-focused question was: Have 30-day readmission rates changed following the implementation of a COPD discharge bundle prior to …

Meeting Learning Needs Of Children With Autism Spectrum Disorder In Elementary Education, Sally Partlo

Walden Dissertations and Doctoral Studies

In a southeast school district, students with autism spectrum disorder (ASD) are taught by elementary general education teachers despite their lack of training to meet the needs of such students. To provide effective education that supports the learning needs of students with ASD, exploration of the problem was needed. The intended outcome of this qualitative case study was to provide information to district administrators that could be used to develop interventions to help general education teachers meet the learning needs of students with ASD. The Iovannone, Dunlap, Huber, and Kincaid model of effective educational practices for students with ASD grounded …

Challenges Of Aging With The Hiv Virus And Comorbidities, Rommie Navylia Abele

Walden Dissertations and Doctoral Studies

Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists demonstrated that the introduction of antiretroviral therapy led to an increased life expectancy yet early onset of comorbidities; however, they failed to address the challenges that people 50 years old or older face, as …

The Lived Experience Of Daughters Who Have Absent Fathers: A Phenomenological Study, Sibhon Jolette Brown

Walden Dissertations and Doctoral Studies

The problem that this study focused on was the difficulties and challenges experienced by daughters who had absent fathers. The purpose of this qualitative phenomenological study was to explore the lived experiences of daughters who grew up with absent fathers, and the effects on them as adults at home, in school, in their neighborhoods, and in their decision-making processes. The sample consisted of 20 daughters who grew up with absent fathers. Data were collected using face-to-face semi-structured interviews, and analyzed using 5 phases of Hycner's (1999) phenomenological research. Results indicated that participants' lived experiences of home life were characterized by …

What Matters Most To Mayors Making Interlocal Agreement Decisions, Douglas C. Haney

Walden Dissertations and Doctoral Studies

Local governmental units in the United States are struggling to cope with dwindling public resources and surging public demands. They often turn to interlocal agreements (ILAs) as a collaborative means by which to more effectively serve their constituents. Unfortunately, many ILAs never materialize or fail prematurely. The purpose of this qualitative, phenomenological study was to explore the experiences of 13 purposefully selected mayors in the State of Indiana to discover what factors they considered important when making their ILA entry and continuation decisions. It utilized a conceptual framework based on the transaction costs theory, as informed by the utility maximization, …

Perceived Usefulness And Perceived Ease Of Use Impact On Patient Portal Use, Dasantila Sherifi

Walden Dissertations and Doctoral Studies

Patient portals are web-based tools that provide patients with access to their health records and enhance communication with providers. Despite the efforts in expanding their use and patients interest in using them, patient portal usage remains low. Higher use of portals is associated with greater patient engagement and better healthcare quality and outcomes. This study investigated the impact of perceived usefulness (PU) and perceived ease of use (PEU) on patient portal usage. The conceptual framework was based on the Technology Acceptance Model, which suggests that PU and PEU of a system affect attitude and behavioral intention toward using the system, …

Kansas City, Missouri, Inner City Schools' Parent Involvement Policy, Practices, And Accreditation Problems, Gena L. Ross

Walden Dissertations and Doctoral Studies

In 2012, the Missouri Board of Education took away Kansas City Public Schools (KCPS) accreditation status. For over 40 years, KCPS has struggled with poor academic achievement, decreased enrollment and budget, and numerous leadership turnovers. Although KCPS regained provisional accreditation in 2014 and earned enough points on the annual performance report for consideration to become a fully accredited school system, state education officials first want to ensure that the district can sustain its new performance level before granting full accreditation. The purpose of this phenomenological research study was to explore parents' perceptions about how the KCPS' parent involvement policy and …

Does Cybersecurity Law And Emergency Management Provide A Framework For National Electric Grid Protection?, Matthew Ryan Ziska

Walden Dissertations and Doctoral Studies

The U.S. government is responsible for protecting the country's energy and technology infrastructure. Critics argue the United States has failed to prepare, protect and respond to incidents involving the national electric grid leaving communities vulnerable to prolonged power outages. Protection of investor owned utilities' critical infrastructure is vulnerable to cyber and physical harm from the absence of criminalizing the intrusion of private sector computer networks, the lack of cybersecurity threats in emergency management, and the absence of cyber-intelligent leadership supports this argument. The purpose of this study was to introduce an electric grid protection theoretical concept, while identifying whether cybersecurity …

Nursing Faculty Perspectives On Support In Technology, Learning Management Systems, And Self-Efficacy, Diane Burling

Walden Dissertations and Doctoral Studies

Past literature has shown that nursing programs reported educators were at the novice or beginner level regarding use of technology and that there was a critical need for faculty development. There was a lack of current information on the perspectives of nurse faculty utilizing learning management systems. Learning management systems are being used within nursing education, faculty should be proficient implementing the technology, if not, students and faculty suffer. The purpose of this study was to understand how nursing faculty perceive the use and support for integrated online Learning Management System (LMS) technology, along with levels of self-efficacy, at the …

Self-Disclosure Of Human Immunodeficiency Virus Status In Personal Relationships: Perceptions Of South Africans Living With Human Immunodeficiency Virus, Delile Gertrude Langeni

Walden Dissertations and Doctoral Studies

Despite enormous research on the experience of living with HIV, many questions remain regarding self-disclosure of HIV status to sexual partners by people living with HIV (PLWHIV), which is essential to reducing further infection. In this study, a phenomenological approach captured the experience of self-disclosure among South Africans living with HIV in Louwsburg, South Africa. The health belief model served as a theoretical framework, and in-depth interviews were conducted with 12 PLWHIV (8 women, 4 men) who self-disclosed their HIV status to their sexual partners. Their experiences were explored, discovering their illness, motives for self-disclosure, feelings regarding disclosing, responses of …

Streamlining Hospital Administrative Procedures To Reduce Costs, Dr. Claret Onukogu

Walden Dissertations and Doctoral Studies

Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. …

Complementary Infant Feeding Practices In Afghanistan, Hasibullah Na Niayesh

Walden Dissertations and Doctoral Studies

Children are at greater risk of malnutrition in Afghanistan than they are in many other countries. Malnutrition impairs the mental and physical growth of more than 50% of children in Afghanistan. It also exacerbates the risks of mortality by 45% in infants and children in Afghanistan. The purpose of this study was to determine the association between mothers' knowledge, attitudes, and practices regarding complementary feeding and malnutrition in children in Afghanistan. The precaution adoption process model served as a theoretical framework in this quantitative cross-sectional research study. Data analyzed were collected from 306 mothers and children at 6 randomly selected …

Management Of Chronic Kidney Disease By Advanced Practice Nurses, Anthony C. Amagwu

Walden Dissertations and Doctoral Studies

Despite best available care, uncontrolled chronic kidney disease (CKD) - a complex disease that impacts millions in the United States, will eventually progress to end stage renal disease which is associated with high morbidity and mortality. New evidence suggests management of earlier stages of CKD is effective in delaying disease progression. This project evaluated the impact of a CKD class, led by a nephrology nurse practitioner, on preventing disease progression in advanced CKD patients with diabetes and hypertension. The purpose of the class was to validate the need for the advanced practice nurse (APN) in the care continuum of CKD. …

Colorado Middle School Principals' Transformational Leadership Characteristics And Colorado's Standardized Test Scores, Wayne Wolf

Walden Dissertations and Doctoral Studies

Researchers have documented that high expectations do not always result in higher achievement, but the reason for varying results has not been clearly understood. This correlational study was done to find out if the degree of presence of principal leadership characteristics can predict when high expectations are effective and when they are not. Expectancy and transformational leadership theories provided the framework for identifying 9 principal leadership characteristics that might influence student scores on Colorado statewide testing. Existing student testing data were considered the dependent variable, while survey data on the leadership behaviors of Colorado middle school principals were used for …

Increasing Knowledge About Food Allergy Management In The Preschool Setting, Katherine Mizell Crow

Walden Dissertations and Doctoral Studies

The prevalence of food allergies is a growing concern in the United States. Approximately 8% of the pediatric population has some form of food allergy. Many of these children are either in the preschool and primary school setting, which is where the majority of allergic reactions occur. If the symptoms of a food allergy reaction are not treated within minutes of exposure, the results can be damaging or fatal. Evidence continues to demonstrate that preschool and school personnel do not feel trained or prepared should a severe reaction arise. The purpose of this evidence-based project was to determine if the …

Association Between Altitude And Bronchopulmonary Cancer, Hung Ching

Walden Dissertations and Doctoral Studies

As a validation study, this study addressed an under-researched area of bronchopulmonary cancer mortality and incidence. The association between altitude and bronchopulmonary cancer mortality and incidence was investigated using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research. The theoretical framework for my study was Bronfenbrenner's ecological model. This model emphasizes the relevance of social and physical environments that influence patterns of disease and injury and shape responses to these patterns of disease and injury. The age-adjusted bronchopulmonary cancer mortality and incidence rates per 100,000 people in the highest elevation and lowest elevation states …

Socioeconomic Status And Cancer Risks In Employer-Insured Cancer Survivors, Christine Clinton

Walden Dissertations and Doctoral Studies

Chronic illnesses such as cancer continue to be among the costliest for employers who provide health insurance to their employees. Despite efforts to incorporate health improvement programs in the workplace, there are concerns about the effectiveness of these programs that do not always deliver a positive return on investment. Little is known about the specific socioeconomic status of employees for whom these workplace health improvement programs are designed for. Guided by the social-ecological model, this study sought to understand the relationship between cancer health risks about socioeconomic factors among cancer survivors in the employer-insured population. Data were extracted from the …