Digital Commons Network^™

Effectiveness Of Guardrails At Reducing Medication Errors Indrug Administration, Teresa Mosley

Walden Dissertations and Doctoral Studies

Medication errors during drug administration are an issue in the nursing profession. The errors that occur due to intravenous vein infusions pose threats to patients due to the mode of administration and the risk of occurrence. Strategies such as guardrails have been implemented to reduce the rate of such errors. Despite these guardrails, facilities record mixed results on the effectiveness of infusion pumps in reducing medication errors. The project was designed as a quantitative study to evaluate the effectiveness of guardrails in reducing medication errors at the facility. Data analysis included error reports from the facility before and after the …

Portuguese-American Parents' Knowledge Of Attention Deficit Hyperactive Disorder, Debbie Shrimatie Persaud

Walden Dissertations and Doctoral Studies

According to recent studies, there is an interethnic research gap that exists regarding Portuguese-American parents' knowledge of Attention Deficit Hyperactive Disorder (ADHD). The purpose of this study was to explore Portuguese-American parents' knowledge of the symptoms and diagnosis of ADHD, how they think it impacts their children's education, learning, behaviors, and what interventions they use to address the behavioral issues and learning disabilities that result from ADHD. Guided by family systems theory, with the premise that children are an integral part of the family and cannot be understood in isolation from the family, this qualitative, phenomenological study used semi-structured interviews …

Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip

Walden Dissertations and Doctoral Studies

Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …

Leadership Styles And Competencies Of Project Managers In Successful Projects, Monica Senthill

Walden Dissertations and Doctoral Studies

Leadership style and competency are relevant to the failure or success of a project. The purpose of this single case study was to explore the leadership styles and competencies that project managers possess to improve information technology (IT) project outcomes. The targeted population included 5 project managers from an organization headquartered in the mid-Atlantic region of the United States who have successfully managed U.S.-based IT projects and improved the project outcomes. The 3 traditional leadership styles (transformational, transactional, and participatory) were the conceptual framework for this study. Data collection included review of archival organizational documents and semistructured interviews with 5 …

Experiences Of Parenting For African American Female Survivors Of Childhood Sexual Abuse, Chelsea Sharpe

Walden Dissertations and Doctoral Studies

Childhood sexual abuse (CSA) has been linked to a number of adverse effects in adulthood including higher levels of depression, shame, guilt, self-blame, somatic concerns, anxiety, dissociation, repression, denial, relationship problems, and sexual problems. Little is known, however, about the influence CSA has on parenting, specifically among African American mothers, as previous researchers have primarily focused on the trauma experienced by survivors. Examining the impact of CSA on African American mothers' parenting is important as those children of survivors will often also experience the impact of the long-term sequelae associated with CSA. Guided by womanist theory, the purpose of this …

Discriminant Profile Of Dimensions Of Acquired Disability On Domains Of Posttraumatic Growth, Linda Denise Portis

Walden Dissertations and Doctoral Studies

The transformative process of personal growth following suffering and challenges, or posttraumatic growth (PTG), is limited in persons with acquired disability. The dimensions of acquired disability, as outlined by the World Health Organization, include impairments in body functions, body structures, and growth restrictions in activities and participation. The 5 domains of PTG include personal strength, new possibilities, relating to other people, appreciation of life, and spiritual change. Using discriminant function analysis, the purpose of this quantitative study was to identify a discriminant analysis of the dimensions of acquired disability on the domains of posttraumatic growth. The first research question focused …

Strategies For Hiring Skilled Furniture Manufacturing Workers, Michael L. Simmons

Walden Dissertations and Doctoral Studies

In April 2013, the U.S. unemployment rate was 7.6% and did not drop as quickly in the recent recession as in past recessions. The Unemployment and Job Creation Program study informed readers that many employers could not find qualified workers. The purpose of this qualitative multiple case study was to explore hiring managers' strategies to locate and hire skilled workers in the furniture manufacturing industry. The target sample included 3 furniture manufacturers located in Huntsville, Alabama who have successfully developed and implemented strategies for hiring skilled workers. The skill shortage theory was the conceptual framework for this study. In the …

Quantitative Analysis Of Differences Between Adaptors And Innovators For Decriminalization Attitudes, Aaron Solomon

Walden Dissertations and Doctoral Studies

Kirton's adaption-innovation theory suggests adaptors and innovators have different approaches to decision-making. The relationship between thinking styles in conjunction with decriminalization has not been investigated thoroughly, and this study addressed the relationship based on thinking styles and 6 demographics (race, age, gender, religion, education, and geographical location). The main research question examined whether innovators and adaptors have different attitudes about decriminalization. The hypotheses were tested with: (a) t tests to compare responses, (b) analysis of variance for comparing multiple groups and investigating moderator effects, and (c) correlation tests to determine whether Kirton's adaption-innovation inventory scores are associated with decriminalization attitudes. …

Effect Of Socioeconomic And Neighborhood Factors On Stroke Hospitalization Rate In Virginia, Esther Musu Stephens

Walden Dissertations and Doctoral Studies

The stroke rate in Virginia is above the national rate. Stroke results in poor quality health, morbidity, and mortality. This quantitative epidemiological study was conducted to investigate whether a significant association exists between stroke and (a) socioeconomic and (b) neighborhood factors among people who were admitted to Virginia hospitals between 2010 and 2015. An ecological design, including ecosocial theory, was used to examine associations between environmental factors and stroke. Data (746 census output areas) were acquired using patients' billing zip codes from the Virginia Health Information System in combination with socioeconomic and neighborhood data by Zip Code Tabulation Area from …

Organizational Strategies To Reduce Hospital Readmissions, Steven Warchol

Walden Dissertations and Doctoral Studies

Reducing hospital readmissions is critical to the success and sustainability of both hospitals and the communities in which they reside. The purpose of this multiple case study was to explore organizational strategies hospital leaders use to reduce hospital readmissions. The study was limited to hospitals in Southwest Missouri with readmission rates below the state average. Complex adaptive systems was the conceptual framework for the study because of the complex nature and numerous stakeholders of the healthcare system. Data were collected from a purposive sample of 15 hospital leaders via semistructured interviews and an analysis of organizational artifacts. Member checking was …

Assessing Racial Differences In U.S. Prenatal Care, Gestational Weight Gain, And Low Birthweight, Tiffany James

Walden Dissertations and Doctoral Studies

The benefits of prenatal care (PNC) are extensively documented; however, controversy surrounds the extent to which benefits are experienced among different racial groups. Determining whether PNC influences positive birth outcomes and if advantages differ by race is pertinent to attaining positive health outcomes. The purpose of this study was to examine the relationship between gestational weight gain (GWG), low birthweight (LBW), and PNC while weighing racial differences. The theoretical foundation was the motivation-facilitation theory of PNC access. Research questions were designed to (a) determine if there was a significant association between GWG and LBW, (b) determine if PNC had a …

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …

College Instructors' Perceptions On Coteaching, Theresa Da Costa

Walden Dissertations and Doctoral Studies

Coteaching is a teaching strategy that requires 2-teachers to collaborate in developing a course syllabus, selecting materials, and assessing students' work. The research problem, addressed in this study, was an appeal to educate the diverse adult population whose needs could not be addressed through traditional instructions at Rex College. Because of a high number of enrolled adult students, coteaching at Rex College was used to improve student success for academically underprepared students in a Set for Success program. The purpose of this study was to examine the coteaching strategies used at Rex College so that teaching guides and/or professional training …

Opportunity And Sex Offending By International Peacekeepers In The Central African Republic, Musa Yerro Gassama

Walden Dissertations and Doctoral Studies

Despite their peacekeeping role in the management of internal armed conflicts, some military peacekeepers have sexually exploited local populations in host countries, resulting in dire social and health consequences and threats to the success of international peace operations. Although researchers have examined sexual violence committed by peacekeepers, few researchers, if any, have used routine activities theory to examine sex offending by peacekeepers. The purpose of this study was to explore the extent to which situational opportunities influenced international military peacekeepers' engagement in the sexual exploitation of civilians in the Central African Republic, a peacekeeping host country. Data were collected from …

Perceived Factors That Influence Adult Learners' Persistence And Retention In Adult Basic Education, Evelyn Idoko

Walden Dissertations and Doctoral Studies

Retaining students, particularly in the 16- to- 24-year-old category, is a constant challenge for adult basic education programs nationwide. Educators need to understand factors that affect adult learners' experiences, have a better understanding of ways to motivate adult students in a nontraditional school setting to enhance their engagement, and apply research-based techniques and targeted, practical strategies to improve student persistence. The primary objective of this case study was to investigate the perceived factors that students considered influential on their persistence and retention in adult basic education programs. Knowles's andragogy theory and Tinto's persistence theory were the theoretical frameworks for this …

Therapists' Perceptions Of Eye Movement Desensitization And Reprocessing Treatment For Women Survivors Of Child Sexual Abuse, Annette Jones-Smith

Walden Dissertations and Doctoral Studies

Child sexual abuse is prevalent worldwide and can result in adverse psychological effects that persist into adulthood. Therapists must identify therapeutic treatments for adult survivors of child sexual abuse who continue to experience psychological difficulties, such as anxiety, depression, and PTSD. The purpose of this phenomenological qualitative study was to explore the perceptions of therapists about eye movement desensitization and reprocessing (EMDR) as a tool to assist adult women survivors of child sexual abuse through the healing process and to regain their abilities to function and behave appropriately. Data were collected through the Moustakas Theory (1994) with 10 therapists who …

Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck

Walden Dissertations and Doctoral Studies

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to …

Influence Of Leader Communication On Employee Motivation, Oke Obi

Walden Dissertations and Doctoral Studies

Ineffective communication is a chief contributor to business leaders' ineffective leadership. The purpose of this multiple case study was to explore the communication strategies that 4 business leaders in the retail industry used to improve employee motivation. The business leaders, including owners and senior leadership from 3 organizations in the retail industry in the Baltimore-Washington Metropolitan Area, were purposefully selected for study participation. Transformational leadership theory shaped the conceptual framework of this study. Transformational leaders use effective communication to influence employee motivation positively. Data were collected from semistructured interviews with the business leaders, public reports, organization documents, and text message …

Depression Management In Outpatient Settings: A Systematic Review Of The Literature, Modupe Mary Okonofua

Walden Dissertations and Doctoral Studies

Depression is a mental illness that requires prompt identification and treatment due to grave consequences if untreated. Depression can affect a person's level of functioning, lead to worsening health conditions, comorbid substance abuse, and suicide. Despite these facts, the current state of nursing practice includes an inadequate diagnosis of patients with depression, lack of guidelines for the use of assessment tools and diagnostic tests to identify depression, and insufficient information concerning the accuracy of depression assessment tools. This systematic literature review examined 6 depression assessment tools in regard to their accuracy as identified by specificity, sensitivity, reliability, and validity. This …

Perceptions Of Foster Care Providers' Implementation Of The Pstsfa Of 2014, Catherine Osilama

Walden Dissertations and Doctoral Studies

Youth in foster care encounter challenges during and after they transition from foster care to adulthood. To address these challenges and prepare these youth for transitioning into adulthood, U.S. Congress enacted the Preventing Sex Trafficking and Strengthening Families Act (PSTSFA) in 2014. The problem, which has received little attention in research, concerns the challenges that the implementers of this policy encounter as they provide services to foster youth. The purpose of this qualitative study was to better understand the challenges faced by foster care providers in their implementation of PSTSFA. Von Neumann and Morgenstern's game theory provided the theoretical framework …

Effects Of Race And Gender On Probability Of Juvenile Delinquency Leading To Recidivism, Britney Latoya Smith

Walden Dissertations and Doctoral Studies

Studies have shown that U.S. juvenile recidivism rates range from 50% to 80%, and many risk factors have been associated with adolescent delinquency and recidivism. The purpose of this cross-sectional correlational study was to evaluate the Future Generation mentoring program's effectiveness by examining the relationships between race and gender (independent variables) and youth progress (dependent variable). The Future Generation mentoring program is a pseudonym for the actual program to help protect confidentiality and anonymity of the organization. Juvenile progress was measured by how well a youth met their goals. Youth progress was classified as successful, progressing, or unsuccessful in relation …

Exploring Relationships Between Resilience, Thinking Styles, And Ptsd Scores In Women Veterans, Tanya Wilson

Walden Dissertations and Doctoral Studies

In 2013, military leadership took action to lift the ban on women participating in combat roles, thus creating a vital need to understand protective cognitive factors in women veterans exposed to combat. There is no prior research examining the relationship between resilience and thinking styles in this population. The purpose of this quantitative survey study was to examine the predictive relationship between resilience, measured with the Connor-Davidson Resilience Scale, and thinking styles, measured with the Thinking Styles Inventory-Revised 2, on posttraumatic stress disorder (PTSD) scores, measured by PCL-5, in women with combat exposure (CE). A cross-sectional design was used. A …

Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker

Walden Dissertations and Doctoral Studies

The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than …

Bleach-It-Away Clostridium Difficile, Kim Ione Hecker

Walden Dissertations and Doctoral Studies

Hospital-associated infections (HAIs) are infections patients contract as a result of being hospitalized. HAI rates decreased for almost all pathogens in the past few years, with the exception of Clostridium difficile infections (CDIs), which have been steadily climbing, placing hospital-acquired CDI at the top of the HAI list. The Center for Disease Control and Prevention reported in 2010 almost a half a million people were infected with CDIs yearly in the United States, and CDIs claimed the lives of approximately 29,000 people, representing a 4-fold increase from 1993. To address the problem in the local hospital, a quality improvement initiative …

Chronic Low Back Pain- A Needs Assessment For Practice Change, Chukwudi Oduah

Walden Dissertations and Doctoral Studies

There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for …

Educational Program For Parents Of Neonates On Nasal Continuous Positive Airway Pressure, Irina Sher

Walden Dissertations and Doctoral Studies

Parents in the neonatal intensive care unit (NICU) whose term or preterm infants are receiving nasal continuous positive airway pressure (NCPAP) experience stress. They often worry about being able to hold their child and possible complications of NCPAP, such as nasal deformities and compromised organ function. Lacking standard educational programming to provide parents information that they need to understand the care their infant is receiving, parents experience unnecessary stress that affects their capacity to care for their infants. A review of the literature suggested family-centered educational programs are able to decrease stress and increase parental confidence. The purpose of this …

Increasing Employee Retention Within The Georgia Division Of Family And Children Services, Santoria Lushell Williams

Walden Dissertations and Doctoral Studies

Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Santoria Lushell Williams

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Hilda Shepeard, Committee Chairperson,

Public Policy and Administration Faculty

Dr. Clarence Williamson, Committee Member,

Public Policy and Administration Faculty

Dr. Anne Hacker, University Reviewer,

Public Policy and Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2018

In Fulton County, Georgia, the Division of Family and Children Services (DFCS) child-welfare workers …

A Nutrition Education Program For Advanced Practice Registered Nurses Caring For Obese Patients, Kathy Lynn Wilson

Walden Dissertations and Doctoral Studies

Obesity is a major U.S. public health epidemic. A review of the current literature identified a lack of obesity counseling with individuals. The gap in practice was a lack of understanding of nutrition, nutrition labeling, and how foods affect health. The objective of this project was to identify the community assessment need related to obesity and then educate APRNs on ways to better communicate with obese patients. This project focused on an education program for advanced practice registered nurses (APRNs) on using the 5 A's framework for obesity counseling to improve their knowledge and skill in counseling their overweight and …

Organizational Information Security: Strategies To Minimize Workplace Cyberloafing For Increased Productivity, Hawazin Al Abbasi

Walden Dissertations and Doctoral Studies

Productivity loss occurs in organizations that experience high levels of personal Internet use by employees on company time, which includes employees using smartphones to surf without needing the firm's Internet connection. The purpose of this qualitative phenomenological study was to explore reliable ways for organizational leaders to monitor or limit their employees' use of smartphone technology for personal use (cyberloafing) while on the job to minimize wasted work time. Social cognitive theory, which includes an emphasis on human behavioral changes based upon the environment, people, and behavior, served as the conceptual framework. The general research question was as follows: How …

Correlating Residual Stress With Personal And Professional Characteristics In Aircraft Pilots, Erik Eckblad

Walden Dissertations and Doctoral Studies

Every day aircraft pilots must successfully resolve significant inflight situations and then manage the possibility of residual psychological and physiological stress. Previous research has shown primary attention is given to presignificant event training and stress management, however there remains an important gap in the current literature regarding postsignificant event stress within the aviation profession. The purpose of this cross-sectional quantitative study was to use the observational lens of stress theory and survey U.S. pilots who have experienced an inflight emergency, looking for correlation between factors such as age, gender, flight experience, and training against a pilot's self-reported level of residual …