Digital Commons Network^™

Wisconsin's Quality Improvement Initiative For Childcare Programs: A Case Study, Betty Jane Bohleber

Walden Dissertations and Doctoral Studies

Wisconsin's Quality Rating and Improvement System (QRIS) was implemented in 2010 to improve quality of care for young children enrolled in childcare programs. Due to the recent initiation of the state's QRIS, empirical evidence on the effectiveness of the initiative to improve quality care for young children is limited. This qualitative case study explores childcare stakeholders' perceptions on the effectiveness of Wisconsin's QRIS as a quality improvement program. Bronfenbrenner theorized that exosystems such as state governments impact early childhood environments and the development of young children through initiation of programs. The research questions address the efficiency of the state's QRIS …

Retaining Behavioral Healthcare Employees Of The Millennial Generation, David W. Gomel

Walden Dissertations and Doctoral Studies

As a result of the passage of the Affordable Care Act, the behavioral healthcare field is experiencing an increased demand for services. This increase is based on the availability of healthcare coverage to an estimated 13.4 million previously uninsured individuals. To meet this demand for treatment, the workforce of behavioral health therapists must grow. The largest generation entering the workforce, the Millennial Generation - those born after 1980 - is believed to lack commitment to their employers, frequently vacating their positions for the next best offer. The purpose of this case study was to determine factors that both affect retention …

Personality Factors And Nuclear Power Plant Operators: Initial License Success, Cynthia Catherine Devita-Cochrane

Walden Dissertations and Doctoral Studies

Commercial nuclear power utilities are under pressure to effectively recruit and retain licensed reactor operators in light of poor candidate training completion rates and recent candidate failures on the Nuclear Regulatory Commission (NRC) license exam. One candidate failure can cost a utility over $400,000, making the successful licensing of new operators a critical path to operational excellence. This study was designed to discover if the NEO-PI-3, a 5-factor measure of personality, could improve selection in nuclear utilities by identifying personality factors that predict license candidate success. Two large U.S. commercial nuclear power corporations provided potential participant contact information and candidate …

Daily Calendar Group Time And The Mathematical Skills Of Preschoolers, Deborah Ann Lavine

Walden Dissertations and Doctoral Studies

The evidence supporting the common instructional method of daily calendar group time to teach math skills to prekindergarten children has been inconclusive. The purpose of this study was to examine the effect of exposure to daily calendar group time on prekindergarten children's math score gains in a private early-childhood program located in the suburban Southeast. Vygotsky's sociocultural theory guided this quantitative, causal comparative design wherein archival data from 104 prekindergarten students' pre- and posttest numeracy skill scores on the Young Children's Achievement Test were analyzed. Data from 6 classrooms over 2 school years were compared using multiple linear regression. Four …

Educating Medical-Surgical/Staff Nurses To Improve Nursing Knowledge Of Patient Education, Focusing On Health Literacy, Justin Thomas Loew

Walden Dissertations and Doctoral Studies

A primary problem faced by a majority of medical-surgical nurses is a lack of knowledge and skills necessary to improve health literacy among patients. This inadequacy among medical-surgical nurses is often linked to insufficient training on how to identify and interact with patients with lower health literacy. Improvement of patient health literacy can be realized through proper training, education, and a better application of communication strategies. The aim of this project was to improve current medical-surgical nurses' practice guidelines via the use of educational programs. The project developed pilot protocols and policies in order to improve its practical applications. The …

Strategies Healthcare Leaders Use For Leadership Development, Julie Hunt

Walden Dissertations and Doctoral Studies

Education and training of potential leaders are essential, and chief executive officers (CEOs) need to identify effective leadership development (LD) programs that foster successful leaders within the healthcare industry. The purpose of this multiple, exploratory case study was to explore LD strategies used by CEOs in hospitals in Central Florida, United States. The overarching research question investigated what executable LD strategies healthcare leaders needed to ensure sustainable growth and successful leaders. The human capital theory and the concepts of emotional intelligence and spiritual leadership guided this study. A purposive sample of 8 CEOs participated in semistructured face-to-face interviews to elicit …

Underserved Patients' Perspectives On How The Ehr Impacts Their Health, Marie Mirna Lexima

Walden Dissertations and Doctoral Studies

Our modern health care system requires technology that can deal with multidisciplinary and complex processes, operations, and situations. The EHR, by far, is one of the greatest health information technology innovations that satisfy these requirements because of its efficiency and the effectiveness of its features. This study sought to develop an in-depth understanding of how underserved patients' perspectives about their health and illness, can contribute to greater use of the EHR. It also sought to improve their health outcomes and maintain sustainable change in the lives of the underserved. A quantitative non-experimental design study was conducted over a 6-week period …

Predictors Of Condom Use Among Middle-Income, African American Women, Yvonne Maire Reed

Walden Dissertations and Doctoral Studies

Abstract

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and …

Addressing Higher Education Issues Of Latino Students In Greenville County, South Carolina, Sandra Elizbeth Portillo De Yúdice

Walden Dissertations and Doctoral Studies

Latino college enrollment rates in South Carolina do not reflect the overall increase in the Latino population in the state, which suggests that schools, colleges, and universities may be unprepared to serve the unique needs of Latino students. Consequently, Latino students are less likely to pursue opportunities in higher education than their non-Latino counterparts, which raises significant public policy concerns about equity and the potential economic contributions of the Latino communities. The purpose of this narrative policy analysis (NPA), based upon critical race theory, was to explore the perceptions of Latino students, parents, and advocates related to opportunities in pursuing …

The Cost Of Workplace Bullying In Irish Universities, Patrick Pearse Rockett

Walden Dissertations and Doctoral Studies

Employees who demean and degrade coworkers cost organizations billions of dollars every year. Workplace bullying is a business problem that affects up to 15% of employees, and little empirical research is available to establish the extent of bullying in academia. Bullies flourish in decentralized structures, and universities can be particularly susceptible to bullying behavior because of their decentralized structures of teaching and research that promote the growth of microclimates in segregated silos, from laboratories to small departments. The purpose of this multiple-case, census sample study was to explore the cost-reduction strategies that university human resource (HR) leaders use to manage …

Assessing The Impact Of Major Health Policies On Provider Practice, Nadine Josephs

Walden Dissertations and Doctoral Studies

Many health care stakeholders have expressed concerns with the distribution and availability of primary care physicians (PCP) across the United States. Despite programs such as Healthy People 2010 and 2020 Initiatives, statewide and local health care expansion efforts and policies; access to PCP remains a challenge for health care consumers. The purpose of this mixed method research study was to evaluate the impact of several health care access policies on the practices of primary care providers and assess their perspectives regarding disparities in access. Patton and Sawicki's policy analysis and evaluation process was the framework used in this study as …

Diabetes Among Hispanic Immigrants: The Impact Of Age At Migration, Nancy Hahn

Walden Dissertations and Doctoral Studies

Diabetes is a disease that affects the Hispanic population in disproportionate numbers. With larger numbers of immigrants coming to the United States who are of Hispanic origin, the individual risk and health burden of this disease will have a major impact on the quality of life and the health care system. Research into the influence of the timing of changes in lifestyle suggested an association between specific levels of socioecological exposures and certain health conditions. This study examined that possibility. The use of the National Health Interview Survey, 2005-2011, provided adequate data for examining whether age at migration was associated …

The Effects Of Frequent Exposure To Violence And Trauma On Police Officers, Ternarian A. Warren

Walden Dissertations and Doctoral Studies

Police officers who maintain negative or traumatic information in long-term memory are vulnerable to mental illness, unstable emotional and behavioral responses, interpersonal problems, and impaired social relationships. The cognitive theory suggests that police officers externalize various negative or maladaptive behaviors as a result of frequent exposure to traumatic events. Researchers have found that police officers tend to either not seek mental health treatment, try to fix their own mental health problem, or if in treatment will not be forthcoming with internalized thoughts of psychological distress. The intention of this research was to examine the relationship between police officers' frequent exposure …

Climate Change Implications For Health-Care Waste Incineration Trends During Emergency Situations, Emilia Mmbando Raila

Walden Dissertations and Doctoral Studies

Healthcare waste (HCW) incineration practices in the global South countries are among the major sources of black carbon (BC) emissions or smoke. This study analyzes HCW incineration trends during emergency situations and smoke from HCW incineration processes in Haiti. The study was prompted by the current arguments about the climate change and the growing health effects associated with BC emissions. The conceptual framework was based on both adverse health effects from BC emissions exposure and climate change potential of BC emissions. Therefore, the goal was to determine whether cardboard HCW sharps containers emit lower BC emissions to the atmosphere during …

Financial Statement Disclosure Of Carbon Footprint Costs In The Airline Industry, Carol Anne Tuck-Riggs

Walden Dissertations and Doctoral Studies

Unaccountable corporate polluters profit short term at the expense of global economic sustainability. The purpose of the study was to determine if carbon dioxide (CO2) penalties on the airline emissions would result in financial statement disclosure and emission mitigation. Contributing to environmental accounting, the study was based in corporate social responsibility with a conceptual framework based on economically-centered CO2 studies. A random sample of 69 global airlines, taken from the International Air Transport Association (IATA) and the International Civil Aviation Organization (ICAO) memberships, was stratified between EU bound and non-EU bound airlines. The research questions explored (a) the frequency mean …

Success Factors For Women Of Color Information Technology Leaders In Corporate America, Annette Skervin

Walden Dissertations and Doctoral Studies

The 2013 United States Census data documents the significant underrepresentation of women of color in the information technology (IT) field. Women of color (Black, Hispanic, Asian or self-classified as non-White) represent an untapped resource in an industry with a low unemployment rate, high starting salaries, and a projected 18% growth rate by the year 2022. Prior researchers have studied White women in IT and have not provided a voice to women of color leaders. The specific problem addressed was the under-representation of women of color IT leaders in corporate America. The purpose of this phenomenological study was to investigate the …

Exploring Strategies For Implementing Barcode Medication Administration Systems, Julie A. Frederick

Walden Dissertations and Doctoral Studies

The number of medication errors associated with preventable deaths in healthcare facilities remains at a high rate for healthcare leaders. Practices of medication delivery remain similar to those 10 years ago. Hospitals that have implemented barcoding medication administration systems have reported a decrease in medication errors ranging from 60% to as high as 93%. Despite this utility of barcoding, only 50% of U.S. hospitals have implemented barcode medication administration. This comparative case study explored the strategies hospital leaders used to implement barcode medication administration systems, utilizing the sociotechnical theory for a conceptual framework. Face-to-face, semistructured interviews were used to identify …

Perceptions Of Home And Small Business Owners On Insurance In Accra, Ghana, Helen Stevens-Benefo

Walden Dissertations and Doctoral Studies

Insurance is a prudent option to mitigate business risk and property loss caused by natural disasters. The current study took place in Accra, Ghana, and was prompted by the low adoption of insurance and limited understanding by home and small business owners of its risk mitigation value. The purpose of this multiple-case study was to explore information insurance companies' need to motivate investment in weather-related insurance. The interview questions of the study served to explore the reasons business owners and homeowners purchase or decline insurance, including their understanding of and receptivity to insurance. The theoretical underpinning of this study included …

The Distribution Of Type 1 Diabetes Onset In The United States By Demographic Factors, Margaret Beckstrand

Walden Dissertations and Doctoral Studies

Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene …

Health Literacy And The Level Of Hypertension In Urban Latinos, Marlene Rosetta Glashen

Walden Dissertations and Doctoral Studies

Health literacy (HL) plays a significant role in health care communication and patient compliance. Low health literacy leads to noncompliance with health instructions, poor health choices, failure to participate in recommended health screenings, frequent hospitalizations, and higher health care costs. Using the health belief model (HBM) as the conceptual framework, this quantitative, cross-sectional study addresses a gap in the literature related to the research questions of this study. The research questions are: (a) Is there a relationship between HL and the level of hypertension (HTN) in hypertensive urban Latinos?, and (b) Will HL predict the level of control of HTN …

An Examination Of Tribal Nation Integration In Homeland Security National Preparedness, Donald J. Reed

Walden Dissertations and Doctoral Studies

Research has established that national homeland security policy requires a whole community or all-of-nation approach to national security preparedness. What is less clear is whether all stakeholders are integrated into or benefit from this collective effort. This narrative policy analysis examined the relationship between a federally-recognized group of Native American tribal nations and homeland security national preparedness to explore whether tribal nations are effectively integrated with the collective effort for national preparedness. The theoretical framework stemmed from a convergence of social contract theory and conflict theory. Interviews (n = 21) were conducted with preparedness authorities from government agencies, and from …

Medical Academia Conflict Of Interest Policy And Potential Impact On Research Funding, Michael Keith Maahs

Walden Dissertations and Doctoral Studies

The partnership between medical academia and the pharmaceutical industry has been scrutinized for issues associated with research bias. As a result of this scrutiny, the Institute of Medicine (IOM) issued policy recommendations in 2009 directing academia to adopt comprehensive conflict of interest (COI) policies. During the same time, a slowdown of funded research into academia occurred, and it is not clear whether the IOM recommendations contributed to this problem. The purpose of this case study was to determine the extent to which compliance with the IOM policy resulted in a reduction in funded research. The Advocacy Coalition Framework (ACF) was …

The Relationship Between Middle School Configurations And Student Success, Asia Ali-Hawkins

Walden Dissertations and Doctoral Studies

Public schools have used varying school configurations for middle grades-typically K-8 or traditional middle school arrangements-to improve students' academic outcomes. A small Northeastern school district was experiencing problems with student achievement, suspensions, and truancy, and was considering school configuration as a potential method of improving student performance. The purpose of this quantitative study was to explore the associations between school configuration and student achievement, suspensions, and truancy. Erikson's psychosocial theory of development and Dickinson's middle school philosophy guided this study since both address the needs of adolescents. Five years of archival data were collected from 2 demographically comparable Northeast school …

Systematic Review Of Retention Of Direct-Care Workers In Long-Term Care Facilities, Regina Evonne Goins

Walden Dissertations and Doctoral Studies

Turnover among direct-care workers in long-term care (LTC) facilities is high, and has a significant impact on residents, leaders, and owners of LTC facilities. The overall turnover costs are also substantial and constitute a significant financial burden in LTC facilities. This systematic review of the literature examined, retention strategies for direct-care workers in the LTC workforce. The information may be used to develop and provide practice recommendations that will help improve retention rates among direct-care workers in LTC facilities. The project design involved a systematic examination of English-only studies from 2001-2004, retrieved from 3 major databases: CINAHL with Medline simultaneous, …

Multiple Regression Analysis Of Factors Concerning Cardiovascular Profitability Under Health Care Reform, Gordon Brian Wesley

Walden Dissertations and Doctoral Studies

Cardiovascular (CV) patients receive one-third of the care and account for $444 billion of the health care costs in the United States. The cardiovascular service line (CVSL) in hospitals contributes to the profitability influenced by elements of resource dependence theory (RDT). The purpose of this study was to understand whether the regression model of hospital characteristics and outcomes would predict profitability in a CVSL through the cost-to-charge ratio (CCR). The use of a general linear model and multiple regression analysis to examine the 2012 National Inpatient Sample from the Healthcare Cost and Utilization Project allowed estimates from a weighted sample …

Investigating The English Language Arts Placement Of Struggling High School Freshmen, Pamela Burke-Haug

Walden Dissertations and Doctoral Studies

This qualitative case study addressed a suburban school district's placement of academically at-risk English language arts (ELA) 9th graders as the district transitions from the New Jersey Assessment of Skills and Knowledge (NJASK) to use of the unfamiliar and controversial Partnership for Assessment of Readiness for College and Careers (PARCC). Based on the theoretical frameworks of the zone of proximal development, cognitive apprenticeship, and Bandura's model of self-efficacy, the purpose was to understand the characteristics of struggling (labeled 'academic') ELA students, placement practices and perceptions of these practices, and placement improvements. A purposeful sample was recruited of 7 staff members …

Marketing Strategies For Profitability In Small Independent Restaurants, Wanda Y. Jenkins

Walden Dissertations and Doctoral Studies

The restaurant industry is the second largest employer in the United States; however, only 33% of restaurants are successful during the first 3 years of operation. The purpose of this exploratory multiple case study was to determine what marketing strategies small independent restaurant owners need for profitability. Aaker's brand equity model was the conceptual framework used to ground this study. Using a purposeful criterion sampling technique and semistructured interviews, 12 individuals (2 managers and 2 employees from 3 restaurants in Philadelphia) participated in the study. Data collected from interviews and archival business records were analyzed to generate themes, also allowing …

Inflammatory Markers Associated With Disease Progression Of Cardiorenal Syndrome, Srikanta Banerjee

Walden Dissertations and Doctoral Studies

An increase in cellular inflammatory biomarkers directly increases the risk of cardiovascular disease (CVD). Using the social ecological and biomedical theories, the study examined quantitatively how specific inflammatory biomarkers are associated with cardiorenal syndrome (CRS), a potential complication of hypertension and diabetes, and how sociodemographic factors modify this association in the U.S. adult population. A retrospective secondary data analysis of the data collected from National Health and Nutrition Examination Survey (NHANES) 1999-2010 was utilized to evaluate these hypotheses. High sensitivity C-reactive protein, homocysteine (hcy), and fibrinogen had a modifying effect on Type 4 (chronic reno-cardiac etiology), Type 2 CRS (chronic …

A Policy Guide To Decrease The Use Of Continuous Passive Motion Machines, Rosa M. Cooper

Walden Dissertations and Doctoral Studies

A Policy Guide to Decrease the Use of Continuous Passive Motion Machines

by

Rosa M. Cooper

MSN, Walden University, 2009

BSN, Immaculata University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

This project was conducted at a post-acute rehabilitation hospital that served post-acute orthopedic, stroke, brain injury, cardiac, and skilled nursing patients. On the orthopedic unit, there were 5 practicing physicians, 3 of whom consistently used continuous passive motion (CPM) therapy on total knee arthroplasty (TKA) and 2 of whom did not. As a result of discussions …

Exploring The Meaning Of School Bullying Among Parents Of Victimized Children, Mildred Peyton

Walden Dissertations and Doctoral Studies

Bullying in American schools has increased to what some have considered an epidemic and is a major problem among youth. Bullied youth experience poorer mental health and lower school performance, in comparison to those who are not bullied, and the growth of bullying has raised concerns from parents, schools, policy makers, and human-services professionals interested in prevention and intervention of bullying behaviors. The purpose of this study was to explore how parents whose children experienced school bullying perceived school administrators, teachers, antibullying school policies or programs, and their family's dynamics, to better understand the parents' internal experiences. The theoretical framework …