Digital Commons Network^™

Use Of Physician Credentialing Standards By U.S. Medical Services Professionals, James Allen Reeder

Walden Dissertations and Doctoral Studies

Credentialing in hospitals is the first line of defense for improving patient safety and reducing medical errors by verifying a physician's medical knowledge and skills. There is no single set of standards for physician credentialing followed by all hospitals in the United States. Using May's normalization process theory, the purpose of this quantitative study was to survey medical services professionals (MSPs) to determine which physician credentialing standards were being used, the sources being used, and the frequency of standards used. The dependent variables in this study were the 13 ideal credentialing standards developed by the National Association of Medical Staff …

Retention Of The Experienced Nurse, Tina Melissa Brinegar

Walden Dissertations and Doctoral Studies

The nursing profession is facing a potentially devastating shortage of nurses by the year 2020. Contributing to the shortage is the retirement of experienced nurses who are over the age of 45, and an aging baby boomer population. The loss will place a considerable strain on the overloaded health systems. As a result, it is important to identify successful strategies for addressing the problem of experienced nurse retention. Therefore, the purpose of this project was to conduct a systematic review of literature to answer the question of what retention strategies have been used to prevent the loss of the experienced …

Strategies To Secure Sustainable Funding For Nonprofit Organizations, Jasmine Y. Hardy

Walden Dissertations and Doctoral Studies

There are 1.4 million active nonprofit organizations in the United States; however, funding sustainability often forces nonprofit senior leaders into closure, which can lead to increased unemployment and decreased services provided to local communities. Nonprofit senior leaders seek help from scholars, at times, to identify strategies to secure sustainable funding sources, improve the sustainability of funding, or prevent or reverse losses of funding to their organizations. Through the conceptual lens of the general systems theory, the 2015-2016 Baldrige Excellence Framework and Criteria, and single- and double-loop learning, this single-case study explored strategies used to secure sustainable funding for nonprofit organizations …

Government Rule Compliance, Safety, And The Influence Of Regulation On Railroad Trainmen, Carlos Mendoza, Phd

Walden Dissertations and Doctoral Studies

Operational testing of railroad trainmen on federal government safety rules is a daily occurrence on every railroad in the United States. This constant testing and resulting discipline distracts trainmen from the task at hand, causing a loss of focus which could lead to injury or accidents. Using the social construction framework, this research sought to gain an understanding of trainmen's perception on how operational testing impacts their workplace safety, as well as how they perceive the U.S. federal government influences regulation and discipline. This phenomenological study investigated a segment of railroad employees, the trainmen, because they are operationally tested more …

Media Coverage Of Domestic Extremists And The Influence On Police Emotions, Jamie Porter

Walden Dissertations and Doctoral Studies

The media have influenced domestic extremists who are targeting the police, and this is related to negative emotions among the police. These extremists are targeting police officers based on how events are framed by the media. In this way, the media have influenced domestic extremists' target selection and caused negative emotions among police officers because they are now the targets. The purpose of this qualitative narrative study was to understand the perceptions of police officers about how the media have influenced domestic extremists to target them. The narrative of this qualitative inquiry was guided by a semistructured interview sample consisting …

The Role Of Humility In Promoting Forgiveness Through Expressive Writing, Henrika M. Marshall-Youquoi

Walden Dissertations and Doctoral Studies

Forgiveness is an important characteristic of a healthy relationship. Several factors have been shown to be connected to forgiveness, but other factors may play a significant role in the forgiveness process. Little is known about how humility affects forgiveness in the context of an interpersonal conflict. Expressive writing, when combined with humility, may help counselors and other mental health providers in understanding how to better foster forgiveness among individuals and help them cope with stressful events and relational problems. The primary purpose of this study was to examine whether expressive writing involving humility regarding a minor offense leads to increased …

Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor

Walden Dissertations and Doctoral Studies

Job satisfaction and employee turnover affect the health care industry in the form of overworked staff, inadequate health care, and loss of profits. In 2015, the United States health care industry had a shortage of over 923,000 registered nurses. Health care organizations lose an estimated $1.4 to $2.1 billion each year because of registered nurse (RN) turnover. These factors indicate that some managers lack the strategies to increase job satisfaction and reduce RN turnover. The purpose of this single case study was to use the Herzberg 2-factor theory to explore strategies 5 health care leaders use to improve nurses' job …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …

Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech

Walden Dissertations and Doctoral Studies

People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which …

Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell

Walden Dissertations and Doctoral Studies

Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients …

Saudi Women's Experiences Of Control And Engagement As Employees In Private Universities, Kimberly Dawn Deatherage

Walden Dissertations and Doctoral Studies

Saudi women have higher rates of graduation from college than their male counterparts, but are underrepresented as employees in the private higher education sector. Saudi women working in higher education report a lack of involvement in the planning of their work, challenges in balancing family and career, and low wages. Yet, no research has explored how Saudi women in administrative support staff positions in private universities perceive control and how their perceptions of control affect their engagement in the workplace. Therefore, based on locus of control theory, the 2-process model of perceived control, and compensatory control theory, the purpose of …

Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan

Walden Dissertations and Doctoral Studies

Obesity is a risk factor for chronic diseases among the ethnic minorities for adult immigrants in the United States. There have been many research studies conducted to examine the relationship between the predictors and obesity in minority groups in the United States, that relationship was unknown in Meskhetian Turk (Ahiska) immigrant populations. Guided by social ecological model and acculturation theory, this study examined the predictors of obesity in the Meskhetian Turk (Ahiska) immigrant population in the western United States. Data were collected from 109 participants using CDC's Behavioral Risk Factor Surveillance System, Stephenson Multigroup Acculturation Scale, and Perceived Stress Scale. …

Strategies For Small Businesses To Win Federal Contracts, Fredrick Derell Murphy

Walden Dissertations and Doctoral Studies

Small businesses miss out on federal contracting opportunities because of the strategies they lack. Both large and small businesses provide supplies and services through contract awards to the U.S. government while spending over $300 billion annually. The purpose of this multiple case study was to explore the strategies of small business owners in the Clarksville, Tennessee and Hopkinsville, Kentucky region who have won federal contracts. Porter's competitive advantage theory grounded this study as the conceptual framework. The data collection process involved face-to-face, semistructured interviews and member checking with 3 small business owners to enhance credibility of data interpretation. Themes that …

Early Strategies Of Kindergarten Teachers And Administrators To Lessen The Literacy Gap, Kirstin A. Rossi

Walden Dissertations and Doctoral Studies

Proficiency in literacy is paramount during a child's education. Lacking proficiency can have lasting effects. At both the state and local level, continuing gaps in student achievement in literacy have been documented. The purpose of this qualitative case study was to focus on kindergarten teachers and administrators' early literacy strategies, specifically current practices in early literacy skills and possible resources needed in early literacy to lessen the gap between White students and ethnic minority and students who qualify for free/reduced meals. The constructivist framework was the platform used to investigate teacher and administrator understanding of the 6 early literacy skills, …

Students' Perceptions Of Persistence In A Florida Associate Degree Nursing Program, Shivanie Saith

Walden Dissertations and Doctoral Studies

At a community college in Florida, the associate of science in nursing (ASN) program has experienced low persistence rates especially after the first semester of study. Framed by Jeffreys's nursing undergraduate retention and success model, a mixed-method approach was used to investigate first-semester and final-year ASN students' perceptions of factors influencing persistence and successful persistence strategies. In the quantitative sequence, first-semester students (N = 95) completed the Student Perception Appraisal-Revised-2 (SPA-R2) survey measuring perceptions of 5 persistence factors (environmental, institutional integration, personal academic, college academic, and friend support persistence). ANOVA and t tests were conducted by age, gender, language, ethnicity, …

Impact Of Staff Education On Geriatric Polypharmacy, Valerie Ikemefuna

Walden Dissertations and Doctoral Studies

Polypharmacy, the simultaneous use of multiple drugs to treat a single ailment or condition, is a

major health problem among the elderly population that contributes to adverse drug side events,

health risks, hospital readmissions, morbidity, and mortality. Therefore, a staff education

program geared toward reduction of such adverse drug events was implemented at a single site.

The purpose of the project was to determine if the staff education program would increase

knowledge of adverse drug events due to geriatric polypharmacy. The Orem theory provided the

theoretical support for the project, and the Iowa model guided the evidence-based practice

change process. …

A Case Study Of Student Success In Physical Therapist Assistant Programs: A Systems Approach, Penelope Lescher

Walden Dissertations and Doctoral Studies

Graduating sufficient numbers of healthcare providers to fill the needs of an aging population in the United States is a major social concern. To address this problem physical therapist assistant (PTA) programs need to improve their graduation rates to keep up with the demand for qualified personnel. Applying Senge's theory of effective systems, 1 medium-sized community college with an average pass rate of over 90% on the National Physical Therapist Assistant Examination (NPTAE) was selected to address the research question: What are the systems factors and how do they operate together to support student success in an associate degree PTA …

Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko

Walden Dissertations and Doctoral Studies

In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual …

Walkability Assessment To Reduce Childhood Obesity In Wilson County Kansas, Nancy Lee Carpenter

Walden Dissertations and Doctoral Studies

Promoting physical exercise is necessary to combat childhood obesity. Walking to school is an encouraged physical activity, but the feasibility of walking to school depends on the walkability of the environment. During the last 40 years, the number of U.S. schoolchildren who walk to school has declined. The purpose of this evidence-based practice project was to perform a walkability assessment of the 2 largest communities in Wilson County Kansas to identify and address walkability issues. Frameworks for this practice initiative were social cognitive theory and the Health Promotion model. Questions for the project addressed whether sidewalks along the main pedestrian …

Visually Impaired Individuals' Perspectives On Obtaining And Maintaining Employment, Nadine Donaldson

Walden Dissertations and Doctoral Studies

The employment rate among people with visual impairment is very low compared to sighted individuals. Negative attitudes, stereotypes, and misconceptions are held against people with visual impairment by employers, family members, and the general public. The purpose of this transcendental phenomenological study was to explore the lived experiences of 10 people with visual impairment regarding challenges in obtaining and maintaining employment. A transcendental phenomenological conceptual framework was used to guide the study. Data from semistructured interviews were coded and categorized to identify themes. Results revealed 5 essential themes, which showed to be barriers to employment. The themes are: travel difficulties, …

A Comparison Of Neuropathic Pain In Hiv Disease And Diabetes Mellitus, Mary Catherine George

Walden Dissertations and Doctoral Studies

Neuropathy is a nerve disorder found in HIV disease and diabetes mellitus that indicates damage in the peripheral nervous system. Burning, tingling, stabbing, shooting, and painful sensations in the hands and feet are common symptoms of this chronic disorder, and no treatments are available that repair the nerves. The approved pain treatments are few and only available for the diabetic neuropathy population. A mixed-methods study of archival data was performed to compare patients with painful neuropathy (PN) associated with 2 diseases: HIV (HIV-PN) and diabetes mellitus (DPN). This study examined the similarities and differences of the pain narratives and common …

The Effect Of Risk Factors On Recidivism Among Juveniles From The Perspectives Of Juvenile Justice Professionals, Diana R. Clarke

Walden Dissertations and Doctoral Studies

Within the Florida Department of Juvenile Justice system, juvenile delinquency referrals have decreased, yet at the same time, juvenile recidivism rates continue to challenge policy makers. Using Hirschi's social learning theory as the foundation, the purpose of this descriptive phenomenological study was to examine the perceptions of juvenile justice professionals about their experiences with youthful offenders in order to determine the causes of juvenile recidivism. Data came from in-depth interviews with 9 participants including state attorneys, judges, and mental health counselors from within the central region of the state of Florida. Data were analyzed and coded using Colaizzi's method. Two …

Assessing Provider Use Of Veterans Health Administration Tobacco-Cessation Guideline, Francisca Ogbonna

Walden Dissertations and Doctoral Studies

Cigarette use is more prevalent among veterans who have mental disorders than it is in the general population. Rates of tobacco use are also high among individuals who suffer from post traumatic stress disorder, addiction, and human immune deficiency disease. Approximately 22.7 million American veterans and their families are at risk of tobacco-related health problems. Concerned about heavy tobacco use among veterans, the U.S. Department of Veterans Affairs developed a Tobacco-Cessation Guideline to be used nationally. This guideline was updated in 2008 to include the '5A' mnemonic (ask, assess, advise, assist, and arrange) and is recommended for use by physicians, …

Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …

The Relationship Between Sustainable Supply Chain Management, Stakeholder Pressure, And Financial Performance, Zulfiya Tchaikovsky

Walden Dissertations and Doctoral Studies

Corporate sustainability confronts significant challenges when supply chain managers pursue short-term financial performance to meet stakeholders' expectations. To achieve sustainable economic success, organizational managers need to understand the relationship between corporate sustainability and long-term financial performance. Based on the resource dependence theory, the purpose of this correlational study was to examine the relationship between sustainable supply chain management (SCM), stakeholder pressure, and corporate sustainability performance. The population consisted of worldwide public organizations from Newsweek Global Green Ranking 2016 list engaged in sustainable SCM. The secondary data for the study were collected from databases hosted by Sustainalytics and Standard & Poor's. …

Perceptions Of Adolescents Suspended For School Drug Abuse, Katherine Bomba-Edgerton

Walden Dissertations and Doctoral Studies

School drug use has been attributed to the annual suspension of thousands of secondary adolescents, subsequently contributing to poor academics, low graduation rates, and continued school drug use. The purpose of this qualitative study was to examine the experiences of former adolescents who engaged in school drug use. Social learning theory suggests that behaviors observed from within the environment may later be modeled. Using Bandura's social learning theory, 10 participants, 18 years old and older responded to open-ended questions about how they processed school drug use. Using interpretative phenomenological analysis, the responses to the open-ended questions were coded and analyzed. …

Strategies Small Financial Business Owners Apply To Succeed Beyond Five Years, Tina M. Despin

Walden Dissertations and Doctoral Studies

Small businesses in the United States employ 98% of workers, yet approximately 47% of small businesses shut down in less than five years. Business leaders who fail to implement adequate strategic strategies experience reduced profits and sustainability challenges. These business closures cause unemployment rates to rise and inflict damages to the economic growth of economies in the United States. This multiple case study was grounded in the theory of transformational leadership. The purpose was to explore strategies used by small financial business owners to sustain their businesses beyond five years. The population consisted of 8small financial businesses in Southwest Florida; …

The Effects Of Transracial Adoption On Adjustment And Identity Development, Krystle Dandridge

Walden Dissertations and Doctoral Studies

A plethora of studies have focused on transracial adoption. While these studies have looked at identity development and/or adjustment, they lacked the investigation into some possible causes to include feelings of belongingness as well as socioeconomic status. The current study explored the lack of cultural socialization and belongingness of people adopted into an environment culturally dissimilar from their birth culture. The nonexperimental, correlational design study examined the relationship between adjustment and identity development, and the impact of transracial adoption when considering socioeconomic status and skin tone. The New Immigrant Survey Skin Color Scale, Multiethnic Identity Measure, and Measure of Psychosocial …

Perceptions, Thoughts, And Feelings, Of Women Who Stutter In Four Life Domains, Nancy Ann Georges

Walden Dissertations and Doctoral Studies

I explored how stuttering affects adult women in aspects of their life in 4 domains: social, occupational, academic, and financial. The literature contains few studies on adult women who stutter, and this research addressed these women regarding the kinds of problems they have encountered in their lives. The results of this phenomenological study identified the perceptions, thoughts, and feelings of adult women who stutter regarding how their speech disorder affected them in the 4 domains. The theoretical orientation used for this study was positive psychology. Positive psychology reflects how women who stutter used positive coping strategies to move forward, despite …

Nurse-To-Nurse End Of Shift Report, Winifred N. Nzeribe

Walden Dissertations and Doctoral Studies

Handing over patient care at the end of a shift is a complex part of nursing practice that is commonly fraught with challenges. Ineffective communication continues to be the leading cause of sentinel events in the hospital setting. In response to this practice problem, this project involved the implementation of a standardized bedside reporting protocol in a surgical unit in line with the best available evidence. The overarching goal of this project was to determine how an end of shift reporting tool would impact communication, involvement of patient in care provision, and continuity of care at the bedside. The protocol …