Digital Commons Network^™

Security Strategies For Hosting Sensitive Information In The Commercial Cloud, Edward Steven Forde

Walden Dissertations and Doctoral Studies

IT experts often struggle to find strategies to secure data on the cloud. Although current security standards might provide cloud compliance, they fail to offer guarantees of security assurance. The purpose of this qualitative case study was to explore the strategies used by IT security managers to host sensitive information in the commercial cloud. The study's population consisted of information security managers from a government agency in the eastern region of the United States. The routine active theory, developed by Cohen and Felson, was used as the conceptual framework for the study. The data collection process included IT security manager …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

Advanced Triage Protocols In The Emergency Department, Lijuan Zhao

Walden Dissertations and Doctoral Studies

Overcrowded emergency departments (EDs) are a major problem in the United States resulting in inefficiency in operation and performance. A Southern California hospital ED was the site for this project because it had operated over its maximum capacity during the last decade. Advanced triage protocols integrating standard order sets were implemented to improve quality of care; however, no evaluation of the protocols had been done. The purpose of this project was to evaluate the effect of the advanced triage protocols. Two project questions determined whether advanced triage protocols reduced ED length of stay (LOS), number of patients who left without …

Strategies That Logistics Leaders Use For Achieving Successful Process Improvement, Henry Childs Childs

Walden Dissertations and Doctoral Studies

The successful implementation of process improvement (PI) could reduce operating costs of the Department of Defense, which could lessen the impact of budget reductions and the mounting costs of the expanding global mission requirements. Organizations fail to achieve the return on investment for PI and expected savings because of leaders' inabilities and experiences in integrating critical success factors into PI to improve processes. The purpose of this single case study was to explore the strategies that logistics leaders use to implement PI in the military aviation industry. Six purposively selected group and squadron civilian leaders with over 10 years of …

Information Technology Training To Promote Collaboration Among Multiple Generations, Gregg Foster

Walden Dissertations and Doctoral Studies

The decision to implement information technology (IT) initiatives to enhance collaboration among veterans, baby boomers, Generation X, Generation Y, and Fifth Generation employees continues to challenge organizational leaders. The purpose of this nonexperimental study was to identify how the implementation of information technology initiatives, coupled with the knowledge of learning styles, might enhance collaboration among generational cohort employees. The generational cohort theory, Maslow's hierarchy of needs theory, and the technology acceptance model were the theoretical frameworks used to develop an understanding of the relationships among the cohorts and the acceptance of technology to enhance collaboration. Data were collected from a …

Working Mothers, Work-Life Balance, Locus Of Control, And Perceived Supportive Factors, Natashia Gridiron

Walden Dissertations and Doctoral Studies

From 1948 to 2015, there was a dramatic increase of mothers in the workforce. The literature demonstrates that mothers tend to work outside of the home while also maintaining most of the domestic roles. However, the literature does not address how these women are able to balance their roles. There is a gap in the literature concerning the relationship between locus of control, perceived supportive factors, income size, and work-life balance for working mothers. The purpose of this cross-sectional quantitative study was to fill that gap as measured by Rotter's Internal- External Control Scale, Satisfaction with Work and Family Balance …

Strategies For Minimizing Defects In Offshore-Outsourced Products, More Layen-Layeni

Walden Dissertations and Doctoral Studies

Business leaders increasingly grapple with longer and more complex supply chain nodes wrought by the globalization of corporate manufacturing processes. The flow of outsourced materials is also more vulnerable to high-profile product-harm crises, sabotage, product defect, and recall problems. The purpose of this single case study was to explore manufacturing strategies used by business leaders of an original equipment manufacturer (OEM) in the United States to minimize the defects in offshore-outsourced products. The sample was 2 OEM business leaders who have successfully reduced the defects in offshore-manufactured products in their Michigan facility. The conceptual framework was agency theory. Data were …

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan

Walden Dissertations and Doctoral Studies

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, few studies have examined hypertension in the Armenian American population in the Los Angeles area, one of the most concentrated Armenian American communities in the United States. The purpose of this study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. The theoretical basis for this study was Pender's health promotion model and the health promoting lifestyle profile (HPLP-II), …

Impact Of Career And Technical Education Programs, Bradley Eric Gogan

Walden Dissertations and Doctoral Studies

Autism spectrum disorder rates are climbing in the United States. Because this population is growing, research is needed to understand how to assist these individuals in pursuit of postsecondary educational and employment opportunities. The purpose of this qualitative study, as reflected in the central research question, was to investigate how a career and technical education program impacted the preparedness of students diagnosed with autism spectrum disorder for educational and employment opportunities beyond high school. The conceptual framework was based on Bronfenbrenner's ecological perspective of human development, Zhao and Frank's ecological perspective of technology, and Song's research about distributed cognition. This …

Factors Affecting Student Loan Default In Proprietary Non-Degree Granting Colleges, Samuel Hanson Kelley

Walden Dissertations and Doctoral Studies

The significant problem addressed in this research was the increasing default rate among federal student loan borrowers who attended non-degree-granting proprietary colleges in Florida (i.e., career and technical colleges). The purpose of this study was to identify, better understand, and predict which borrower characteristics increased the likelihood of student loan default at proprietary non-degree-granting colleges. The research was based on the structural-functional and planned behavior theories and utilized a quantitative, non-experimental, cross-sectional design to explore the relationship between academic success, age, college graduation status, ethnicity, gender, high school class ranking, and federal student loan default. Self-reported data were obtained from …

Perceived Job Stress And Life Style Behaviors' Effects On The Quality Of Life Of Registered Nurses, Jennifer Rose Limongiello

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine to what extent work demands as measured by perceived job stress affected the health-related quality of life (HRQOL) as determined by the number of unhealthy days of registered nurses in the United States. This study was also an investigation of the extent to which other variables such as body-mass index (BMI) and certain lifestyle behaviors affected the HRQOL (number of unhealthy days). The independent variables were perceived job stress, weight (BMI), and lifestyle factors such as tobacco and alcohol use, physical inactivity, and the mindful eating score, and the dependent variable …

Standardized Communication At The Bedside: A Review For Reimplementation, Eunice Rosas

Walden Dissertations and Doctoral Studies

This paper discusses a developmental, interdisciplinary quality improvement project that seeks to improve healthcare communication by standardizing clinician communication across all levels of care. The purpose of this project was to develop an organizational policy and interdisciplinary practice guidelines to standardize the patient handoff at the bedside. The initiative intended to use processes already in place in the organization and to integrate the knowledge from a literature review to plan the implementation of bedside handoff procedures. The quality improvement project process included assembling an interdisciplinary committee; reviewing relevant peer-reviewed literature; and developing policy, relevant guidelines, as well as long-term plans …

Ptsd With Substance Use Disorders Female Versus Male Veterans: An Archival Study, Geri Cribbs

Walden Dissertations and Doctoral Studies

The present study examined men and women veterans diagnosed with posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Women in the general public have been found to be at greater risk for a diagnosis of PTSD with life-long symptoms. Current literature involving military men and women veterans is at odds over which gender is more likely to have both PTSD and SUD. This study assessed the variables of gender and diagnosis. It also studied whether the age of female veterans affects their likelihood of having both PTSD and SUD. Archival data were gathered from the Veterans Administration (VA) for …

Relationship Between Mental Health Facilities' Pre-Intake Practices And Children's First Appointment Attendance Rates, Christine Marie De Santis-Collis

Walden Dissertations and Doctoral Studies

Between 20% and 57% of patients at community mental health centers miss their first mental health appointment, resulting in wasted resources and longer wait times for other patients. To date, only one peer-reviewed quantitative study examined the relationship between appointment reminder practices and children's and adolescents' first appointment attendance rates for community mental health centers. The purpose of this quantitative study was to examine the relationship between first appointment wait times, electronic appointment reminders, phone appointment reminders, and first appointment attendance for U.S. community mental health centers, along with the potential moderating effects of age, ethnicity, and gender. Blumer's symbolic …

The Development Of Narcissism Among Lawyers And Farmers: A Quantitative Study, Steve Murdock Murdock

Walden Dissertations and Doctoral Studies

Narcissism has been identified as a threat to society and the individual. Individuals with high levels of narcissism (narcissistic personality disorder) struggle to maintain jobs, stable relationships, and healthy life perspectives. Without knowledge about the origins of narcissism, mental health professionals may only be treating the symptoms of narcissism and not the factors that perpetuate its development. The purpose of this study was to measure narcissism in farming and law careers and to determine whether career is a factor in the development of narcissism. It was predicted that career would be an important developmental event and process that would have …

Exploring Frontline Management Strategies Used To Improve Employee Engagement, Michael P. Wise

Walden Dissertations and Doctoral Studies

Managers who foster at least 65% employee engagement, based on employee engagement surveys conducted by Hewitt Associates, Inc., provide a 19% higher return to shareholders than managers who do not foster a 65% or higher employee engagement level. The purpose of this single site case study was to identify strategies that frontline managers used to build employee engagement, leading to higher organizational performance. The transformational leadership theory was used as the conceptual framework for this study. Data were collected through semistructured interviews from a purposeful sample of 3 frontline managers at a beverage manufacturing facility in the Midwest of the …

Professionals' Perspective On Mental Health Courts, Martha M. Amos

Walden Dissertations and Doctoral Studies

In recent years, the percentage of incarcerated individuals with mental illness has dramatically increased. It is very hard to provide treatment and care for these defendants in jails or prisons. Currently, there are more mentally ill individuals incarcerated than in psychiatric hospitals. Furthermore, as budget cuts are being decided, urban and rural communities in America are looking at ways to help the mentally ill by initiating a mental health court (MHC) or continuing to fund an already existing MHC. Guided by the therapeutic jurisprudence theory, the purpose of this study was to elicit the opinions from MHC professionals regarding the …

Development Of A Transformational, Relationship-Based Charge Nurse Program, Kimetha D. Broussard

Walden Dissertations and Doctoral Studies

Leaders of a rural Southwest Oklahoma hospital requested the development of an evidence-based program that could transform unit charge nurses into effective leaders in order to improve the leadership of direct care nurses. Nursing executive leadership discovered staff members were demonstrating high levels of stress, dissatisfaction, and burnout. Press-Ganey survey results revealed that staff felt they were not supported and did not believe nurses cared for patients' or other co-workers' well-being or safety. The Hospital Consumer Assessment of Healthcare Providers and Systems outcome scores, which were below hospital and national desired benchmarks, revealed that patients were not satisfied with the …

A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy

Walden Dissertations and Doctoral Studies

Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …

How Women Experience And Respond To Singlism: Stereotyping And Discrimination Of Singles, Lisa Lynn Hancock

Walden Dissertations and Doctoral Studies

Society views and treats women who are single differently than women who are not single. This practice of stereotyping and discrimination towards singles is called singlism. The purpose of this qualitative study was to use grounded theory methodology to explore and explain how women experience singlism and what explains how women experience singlism. Social constructionism, cognitive dissonance theory, and social identity theory were used as conceptual foundations in explaining how society constructs the status of single women, how single women are viewed and treated, and how single women manage their single social identity. The participants of the study included women …

Nursing Staff Responsiveness To Patients And Hourly Rounding, Lucretia Wilson Wilson

Walden Dissertations and Doctoral Studies

The Center for Medicare/Medicaid Services reduced the hospital's reimbursement by $500,000 due to patient care linked to the poor outcomes of marginal fall rates and low patient satisfaction survey scores as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The scores for fiscal years 2013 and 2014 for the medical-surgical unit fluctuated between 40-42.9%, without significant improvement, while the house-wide scores were 63.17%. To address the problem, a quality improvement project (QIP) was implemented. An evidence-based (EB) hourly rounding intervention was initiated following an education program for nursing staff (n=47) tailored to enrich patient communication. The …

Care Coordination For Better Outcomes, Chad Dunavan

Walden Dissertations and Doctoral Studies

A deficiency of care coordination and delayed discharge planning has contributed to increased lengths of stay for telemetry patients and has pressed staff to discharge patients expeditiously, potentially leading to increased 30-day readmissions. Rushing the discharge process on the day of discharge has resulted in breakdowns in communication and lack of collaboration amongst the health care team of this study, contributing to extended lengths of stay, increased readmissions, and low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores. This project highlighted a patient-centered care coordination team approach with 2 clinical registered nurses and a social worker who coordinated …

The Survival Of Small Businesses In Northeastern Florida After A Natural Disaster, Harry Kemp

Walden Dissertations and Doctoral Studies

Many small business owners lack strategies needed to prevent permanent business closure in the wake of extreme natural disaster situations. After a natural disaster, small businesses suffer financial losses in millions of dollars related to damage and destruction that disrupt their lives, families, and communities. This multiple case study explored strategies that 5 small business owners in northeastern Florida used to avoid permanent business closure in the aftermath of a natural disaster. The theory of planned behavior and vested interest theory were the conceptual frameworks used in this multiple case study. In-depth interviews with purposively selected small business owners were …

Association Between Physician Characteristics And Surgical Errors In U.S. Hospitals, Obumneke A. Amadi

Walden Dissertations and Doctoral Studies

The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home …

Using Music Intervention To Reduce Anxiety And Agitation For Dementia Residents In Long Term Setting, Sonia Brown

Walden Dissertations and Doctoral Studies

Abstract

Dementia is one of the degenerative conditions that present in old age with a decline in cognitive function resulting in changes in personality and the ability to carry out activities of daily living and social functions. Dementia is usually associated with behavioral disturbances that include anxiety and agitation that pose a challenge for family members or caregivers in an alternate home or care-related facility. The purpose of this project was to design and implement a quality improvement program to evaluate music therapy intervention for residents in a long-term care who have dementia. The aim was to evaluate if music …

Leadership Styles And Employee Motivation In Qatar Organizations, Anas Al Haj

Walden Dissertations and Doctoral Studies

Organizations in the public sector in Qatar have a reputation for delivering inefficient services. Leaders lack an understanding of motivational factors affecting public sector employee performance. The purpose of this correlational research was to examine the relationship between leadership styles and employee motivation in public companies in Qatar. The independent variables were the transformational, transactional, and passive-avoidant leadership styles. The dependent variable was employee motivation. The moderator variables were employee age and salary. A sample of 92 employees from 4 public sector organizations in Qatar responded to the online survey. The full range leadership theory served as the theoretical foundation …

Examining U.S. Policy Makers' Conceptions Of Liberty In Drafting The Affordable Care Act, Louis Altobelli

Walden Dissertations and Doctoral Studies

The U.S. legislators may have incorrectly incorporated outlooks on liberty and natural law associated with the Patient Protection and Affordable Care Act (ACA) of 2010. The purpose of this case study was to use Kersch's conceptualization of declarationism and Hayek & Kamowy's construct of socialism to examine whether the ACA incorporates principles associated with the natural right of liberty as promoted by the Founders of the United States. The central research question that guided this study investigated whether U.S. lawmakers followed the intentions of the Founders in passing the ACA, as demonstrated in the legislation, related bureaucratic reports, and court …

Generational Communications In The New York City Public Sector Workplace, Nathasha Anita Brooks-Harris

Walden Dissertations and Doctoral Studies

Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Nathasha Brooks-Harris

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. Mark Gordon, Committee Chairperson,

Public Policy and Administration Faculty

Dr. Michael Knight, Committee Member,

Public Policy and Administration Faculty

Dr. Michael Brewer, University Reviewer,

Public Policy and Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2017

There is a digital divide between Baby Boomers and Millennials in the way they communicate …

Introducing The Health Coach Method Of Motivational Interviewing To Medical Assistants To Improve The Patient Care Approach, Allison Marlene Souza

Walden Dissertations and Doctoral Studies

The emerging health care culture of accountability for patient outcomes compounds problems for already overwhelmed clinicians struggling to fit everything entailed in complicated office visits into 15-minute appointments. Unprocessed frustrations tempt clinicians to use ineffective and outdated methods for trying to get their patients to comply or adhere to their care plans, undermining effective health care management. The intention of this project was to evaluate whether educating medical assistants in the health coaching method of motivational interviewing can improve the patient care approach while simultaneously assisting clinicians struggling with insufficient time. Several individual scheduling conflicts limited the target population into …

Spiritual Leadership: Achieving Positive Health Outcomes In African-American Christian Churches, Cynthia Bracey

Walden Dissertations and Doctoral Studies

In the United States, African-American residents are an underserved population with evidence of higher health disparities than those associated with any other race, contributing to escalating health care costs. Despite the absence of health promotion and wellness training, pastors in predominately Black churches accept the responsibility for addressing more than the spiritual needs of their church members. The purpose of this qualitative grounded theory research study was to explore the perspectives of African-American Christian pastors on giving health guidance and their lived experiences as health promotion advocates. A total of 10 African-American Christian pastors were voluntarily recruited from 3 southern …