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Improving Intake Efficiency In Inpatient Behavioral Health Facilities To Reduce Delays In Care, Lakisha Brown
Improving Intake Efficiency In Inpatient Behavioral Health Facilities To Reduce Delays In Care, Lakisha Brown
Walden Dissertations and Doctoral Studies
Delays in inpatient psychiatric admissions represent a significant and persistent challenge within U.S. behavioral health systems, contributing to emergency department boarding, reduced quality of care, increasing risk, resource strain, and inefficiencies. The purpose of this integrative review was to examine evidence-based operational strategies that improve intake efficiency and reduce admission delays in inpatient behavioral health facilities. The Lean Healthcare Framework was used, which emphasizes eliminating waste, improving workflow efficiency, and enhancing value. The review question focused on what operational and systems-management evidence-based strategies are most effective in improving intake efficiency. The Johns Hopkins Evidence-Based Practice appraisal tool was used to …
School Counselor Preparedness With Mass School Shootings, Lidia Oviedo
School Counselor Preparedness With Mass School Shootings, Lidia Oviedo
Walden Dissertations and Doctoral Studies
Mass school shootings represent a significant threat facing K–12 schools, yet the lived experiences of school counselors as they engage in prevention efforts and prepare to respond to and recover from these incidents remain unexplored. This study addressed the discrepancy between the increasing prevalence of mass school shootings and the limited understanding of school counselors' preparedness. The purpose of this qualitative study was to explore the experiences of school counselors regarding their preparedness to prevent, respond to, and recover from mass school shootings. This study was grounded in Giorgi's descriptive phenomenological method and informed by the U.S. Department of Education's …
Secondary Special Education Teachers’ Perspectives On Professional Socialization In A Maryland School District, Darice Mattie Holmes
Secondary Special Education Teachers’ Perspectives On Professional Socialization In A Maryland School District, Darice Mattie Holmes
Walden Dissertations and Doctoral Studies
The problem addressed in this study was the insufficient professional socialization of novice secondary special education teachers (SSETs), undermining their ability to adapt to school culture in a Maryland school district (MSD, a pseudonym). Grounded in Mayo's theory of human relations, the purpose of this study was to explore novice SSETs' perceptions of professional socialization through peers, professional development, or mentoring to adapt to the school culture at MSD. For this basic qualitative design, semistructured interviews were conducted with seven novice SSETs. The data were analyzed using Braun and Clarke's thematic analysis with Saldaña's coding strategies, yielding four themes: (a) …
Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth
Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth
Walden Dissertations and Doctoral Studies
Hospice patients experiencing uncontrolled pain, dyspnea, agitation, anxiety, delirium, or other severe symptoms may require General Inpatient (GIP) hospice care for intensive symptom management. However, inconsistent recognition of symptom crises can delay escalation to the appropriate level of care, contributing to unnecessary patient suffering, caregiver distress, and avoidable emergency department or hospital utilization. This Doctor of Nursing Practice executive leadership project evaluated the implementation of an educational framework designed to improve clinician recognition and timely escalation of patients who may be appropriate for GIP hospice care. Education emphasized early identification of uncontrolled symptoms, interdisciplinary communication, documentation, and escalation for clinical …
Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol
Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol
Walden Dissertations and Doctoral Studies
Visceral leishmaniasis, a severe parasitic disease that is invariably fatal, is characterized by frequent outbreaks, and is associated with poverty. South Sudan is among the countries with the highest burden of visceral leishmaniasis. However, few studies have investigated factors associated with visceral leishmaniasis in the country. This study investigated demographic (age, gender, marital status, education level and occupation) and socioeconomic factors (transport, access to health services and residence) that may be associated with visceral leishmaniasis infection in South Sudan. The study was anchored on the socioecological model conceptual framework, which describes the interaction between individual and their social environment and …
Staff Education To Improve Geriatric Mental Health Screening And Pharmacotherapy, Andy Wu
Staff Education To Improve Geriatric Mental Health Screening And Pharmacotherapy, Andy Wu
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) quality improvement project addressed the lack of standardized workflows and clinical confidence regarding geriatric mental health screening and safe antidepressant initiation at a rural primary care clinic. Utilizing the FOCUS-PDSA framework, a 15-minute staff education module and a clinical pocket guide were implemented to train Medical Assistants (MAs) on integrating PHQ-9 and GAD-7 screenings during triage, and to equip providers with EHR SmartPhrases and 2023 AGS Beers Criteria prescribing guidelines. A pre- and post-intervention 5-point Likert scale survey evaluated the knowledge and clinical confidence of the clinic staff (n = 12). Results demonstrated a …
Effective Techniques In Equine Assisted Therapies From The Facilitators Perspective, Emily Dolezal
Effective Techniques In Equine Assisted Therapies From The Facilitators Perspective, Emily Dolezal
Walden Dissertations and Doctoral Studies
Equine assisted therapies have been shown to be an effective treatment approach for individuals experiencing mental health issues. However, there have been rising challenges in standardization and nomenclature throughout the field. Current research supporting the benefits of equine assisted therapies is often from the client perspective. There is a gap in understanding what occurred in session that made it beneficial to their mental health. The purpose of this phenomenological study was to describe the lived experiences of equine assisted therapy facilitators in terms of mechanisms that produce positive changes in their clients. The theories and concepts that ground this study …
Imposter Syndrome And Self Determination In Clinical Social Work Supervision, Alexis Tarr
Imposter Syndrome And Self Determination In Clinical Social Work Supervision, Alexis Tarr
Walden Dissertations and Doctoral Studies
This doctoral project is focused on the social work practice problem of limited understanding of how social workers experience clinical supervision in the context of imposter syndrome. Imposter syndrome can affect confidence, decision making, and overall wellbeing, making it an important issue in clinical social work practice. The purpose of this study was to explore how social workers describe and make meaning of their supervision experiences involving feelings of imposter syndrome. Guiding practice-focused research questions were used to examine how social workers experienced clinical supervision and described autonomy, competence, and relatedness. This study was informed by the self-determination theory, which …
From Fields To Flu: Mapping H5n1 Zoonotic Risk In California Rice Fields, Mariati Messinger
From Fields To Flu: Mapping H5n1 Zoonotic Risk In California Rice Fields, Mariati Messinger
Walden Dissertations and Doctoral Studies
Highly Pathogenic Avian Influenza (HPAI) H5N1 threatens agriculture, wildlife, and public health in California, where flooded rice fields in the Central Valley provide surrogate wetland habitat for migratory waterfowl and may create ecological interfaces for viral spillover into poultry systems. This quantitative ecological study examined whether county-level rice acreage, Lesser Snow Goose activity, and their interaction were associated with poultry HPAI H5N1 outbreak incidence during complete winter seasons available for analysis. Guided by One Health and disease ecology frameworks, secondary data from USDA, eBird, PRISM, and public surveillance sources were analyzed for 36 county-winter observations using negative binomial regression, logistic …
Staff Education To Improve Nurse Competency In Phq-9 And Gad-7 Screening Using A Standardized Behavioral Assessment In An Outpatient Mental Health Setting, Ernest Ogbeide
Walden Dissertations and Doctoral Studies
Evidence-based practice was the basis for this quality improvement project, which involved developing and implementing a staff education program to enhance nurses' competency in administering, scoring, and interpreting behavioral health screening tools (PHQ-9 and GAD-7) for outpatient mental health services. Variability in competency amongst clinical staff to use these standardized screening tools for evaluating anxiety and depression was identified as a problem, as there was no structured, evidence-based education and competency validation process for clinical staff to use, which has the potential to decrease early identification of anxiety and depression among patients and impact clinical assessment and decision-making. The practice …
Marketing Strategies To Enhance Awareness And Attract International Patients In The Medical Tourism Industry Of Trinidad And Tobago, Natasha Rachel Rochford-Chance
Marketing Strategies To Enhance Awareness And Attract International Patients In The Medical Tourism Industry Of Trinidad And Tobago, Natasha Rachel Rochford-Chance
Walden Dissertations and Doctoral Studies
Disseminating inadequate service information can limit a business's market appeal and hinder its growth. Business leaders must include comprehensive service information in their marketing strategies, as inadequate service information can make a business seem unappealing to potential clients, undermine competitive position, reduce market share, and diminish profitability. The purpose of this qualitative pragmatic inquiry was to explore the marketing strategies used by medical tourism business leaders in Trinidad and Tobago to attract international patients and increase profitability. The participants were eight medical tourism business leaders with experience in implementing marketing strategies. McCarthy's marketing mix theory of product, price, place, and …
Strategies Managers Used To Mitigate Constraints For Project Success, Teela Washington
Strategies Managers Used To Mitigate Constraints For Project Success, Teela Washington
Walden Dissertations and Doctoral Studies
Persistent project failures result in significant financial losses and reduced project management efficacy. Project managers who struggle to complete projects to scope, on time, and on budget risk reducing business performance and organizational value. Grounded in change management theory and theory of constraints, the purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies project managers employ to mitigate constraints and improve project success. Participants were 10 project managers who effectively mitigated constraints. Data were collected using semistructured interviews and publicly available documents. Thematic analysis yielded four key themes: leadership, resource management, stakeholder engagement, and …
Enhancing Surgical Team Readiness: Simulation Training For Power Failure Response In Robotic Procedures, Heather Marie Sorton
Enhancing Surgical Team Readiness: Simulation Training For Power Failure Response In Robotic Procedures, Heather Marie Sorton
Walden Dissertations and Doctoral Studies
In this Doctor of Nursing Practice (DNP) project, I used a quality improvement design to implement and evaluate a simulation-based education aimed at improving perioperative staff knowledge related to robotic power-loss events. A practice gap was identified in staff preparedness for robotic system failures due to limited education on emergency protocols, communication, team roles, and Association of PeriOperative Registered Nurses (AORN)-aligned response processes, impacting patient safety during robotic-assisted procedures. I examined whether implementation of a simulation-based educational intervention improved staff knowledge related to robotic power-loss management. The purpose of the project was to improve staff knowledge and standardize responses to …
Medical Recommendations And Bmi Among Black And Hispanic Adolescent Females, Dorothea Polk
Medical Recommendations And Bmi Among Black And Hispanic Adolescent Females, Dorothea Polk
Walden Dissertations and Doctoral Studies
Adolescent obesity persists as a critical public health challenge in the United States, with Black and Hispanic adolescent females experiencing elevated rates. Adolescent obesity contributes to serious long-term health risks, but provider counseling may support body mass index (BMI) management. Guided by the social-ecological model, this study examined whether receiving medical recommendations to control or lose weight was associated with BMI among Black and Hispanic adolescent females aged 16–19 years and whether meal preparation habits and food security status moderated this association, controlling for age, household income, and race/ethnicity. This quantitative, cross-sectional secondary analysis used multiple linear regression analyses to …
Strategies For Effectively Socializing Remote Workers, Emily Dahlen
Strategies For Effectively Socializing Remote Workers, Emily Dahlen
Walden Dissertations and Doctoral Studies
Improper socialization of remote workers into the organization can increase employee turnover and create an unstable remote workforce. Business leaders who fail to effectively socialize remote workers in ways that strengthen organizational identification and reduce turnover risk may create workforce instability that exposes the organization to additional business risks. Grounded in the theory of organizational socialization, the purpose of this qualitative pragmatic inquiry research project was to identify and explore the effective strategies some business leaders use to socialize remote workers and increase employee retention. The participants were eight business leaders who had implemented effective socialization strategies to remote employees. …
Staff Education To Address Medication Nonadherence Among Patients With Mental Health Challenges, Almena Ilis Huggins
Staff Education To Address Medication Nonadherence Among Patients With Mental Health Challenges, Almena Ilis Huggins
Walden Dissertations and Doctoral Studies
Patients’ non-adherence to prescribed medication regimens remains a significant challenge in healthcare. Patients often misuse or skip their medications, which undermines treatment outcomes. This was evident at a mental health medical practice located in a suburban area of the southeastern coast. To address this problem, I developed, implemented, and evaluated a staff education program on evidence-based strategies to improve medication adherence among individuals with mental illness. The practice question focused on whether staff knowledge increased following participation in the education program. Four nursing staff participated in the 2-hour education program. Pre- and posttest questionnaires consisted of 15 multiple-choice questions. The …
A Dynamic Web Design Strategy For Increased Customer Engagement And Sales, Sherline Jones
A Dynamic Web Design Strategy For Increased Customer Engagement And Sales, Sherline Jones
Walden Dissertations and Doctoral Studies
Nonprofit organizations risk losing customers, revenue, and mission impact when leaders fail to adapt digital strategies to evolving customer expectations. Nonprofit leaders are concerned because digital strategy adoption is essential to strengthening sustainability and expanding mission-centered services. Grounded in the Baldrige Excellence Framework, the purpose of this qualitative single case study research project was to explore effective strategies nonprofit business leaders use to leverage technology to attract new customers, retain existing customers, and increase sales. The participants were two senior leaders from a Florida nonprofit organization in the southern United States. Data collection included semistructured interviews, internal archival data, and …
Reducing Psychotropic Polypharmacy In Outpatient Mental Health Settings, Roseline Onyebuchi Okafor
Reducing Psychotropic Polypharmacy In Outpatient Mental Health Settings, Roseline Onyebuchi Okafor
Walden Dissertations and Doctoral Studies
Psychotropic polypharmacy in outpatient mental health settings is associated with increased adverse drug events, reduced adherence, and higher healthcare utilization. This Doctor of Nursing Practice project developed and evaluated an evidence-based clinical practice guideline (CPG) to reduce inappropriate psychotropic polypharmacy among adults receiving outpatient psychiatric care. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, a systematic literature review informed recommendations including structured medication reviews, standardized prescribing practices, interdisciplinary collaboration, and shared decision-making. The guideline was evaluated by a multidisciplinary expert panel using the AGREE II instrument. Mean domain scores ranged from 6.3 to 6.8 on a 7-point scale, indicating …
Childcare Center Administrators’ Leadership Practices To Foster Childcare Worker Retention In Non-Residential Childcare Centers, Rebecca Dececco
Childcare Center Administrators’ Leadership Practices To Foster Childcare Worker Retention In Non-Residential Childcare Centers, Rebecca Dececco
Walden Dissertations and Doctoral Studies
Though staff retention is essential for children's stability and security in childcare settings, there remains a gap in knowledge about the leadership practices in childcare that have implications for retaining staff. The problem addressed in this study was the need for information about the influence of leadership practices on childcare teacher retention in the United States. Grounded in Bandura’s social cognitive theory, the purpose of this basic qualitative study was to explore the leadership practices of childcare center administrators who retain childcare staff. For this basic qualitative design, semistructured interviews were conducted with 12 childcare center administrators who worked directly …
Effective Strategies For Hospital Leaders To Increase Employee Retention, Lionso Gomez
Effective Strategies For Hospital Leaders To Increase Employee Retention, Lionso Gomez
Walden Dissertations and Doctoral Studies
Employee retention remains a critical challenge for hospital leaders because high turnover can contribute to workforce instability, increased organizational costs, and poor patient care quality. The purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies that hospital leaders in Texas use to increase employee retention. The participants were six former hospital leaders in Texas's eastern and southern regions who had successfully implemented employee retention strategies. This research project was grounded in Herzberg’s two-factor theory. Data were collected through semistructured interviews and publicly available documents. The data were analyzed utilizing Braun and Clarke’s six-step thematic …
The Experiences Of Deaf American Muslims In Their Pursuit And Retention Of Employment, Shukry Mahmood
The Experiences Of Deaf American Muslims In Their Pursuit And Retention Of Employment, Shukry Mahmood
Walden Dissertations and Doctoral Studies
Deaf American Muslims in the United States face high levels of unemployment. They often experience compounded marginalization at the intersection of disability, religion, and cultural identity, which often leads to exclusion and underrepresentation in employment contexts. The purpose of the study was to explore the lived experiences while pursuing and retaining employment in the United States of deaf Muslims in United States workplaces. In this qualitative study, a self-designed, semistructured interview protocol with open-ended questions was used to explore these experiences. The sample of 12 participants was selected based on their self-identification as deaf American Muslims with at least 30 …
Staff Education In An Outpatient Psychiatric Setting Using The Teach-Back Method To Improve Staff Knowledge Toward The Ultimate Goal Of Improving Medication Adherence, Laura Assanga Eyong
Staff Education In An Outpatient Psychiatric Setting Using The Teach-Back Method To Improve Staff Knowledge Toward The Ultimate Goal Of Improving Medication Adherence, Laura Assanga Eyong
Walden Dissertations and Doctoral Studies
For this doctoral project, I implemented a structured staff education intervention at an outpatient psychiatric clinic that required a practice change to address medication nonadherence among patients diagnosed with schizophrenia. The practice-focused question was: For staff in an outpatient psychiatric setting, will structured education on the use of the teach-back method improve staff knowledge toward the ultimate goal of improving medication adherence? The goal of this project was to conduct a rigorous education program using the analysis, design, development, implementation, and evaluation model to bridge the communication gap between staff and patients. Staff knowledge was evaluated via a pre-/posttest design …
Enhancing Chronic Kidney Disease Awareness And Early Identification Through Community Health Worker Education In Rural Arkansas, Samantha L.M. Smith
Enhancing Chronic Kidney Disease Awareness And Early Identification Through Community Health Worker Education In Rural Arkansas, Samantha L.M. Smith
Walden Dissertations and Doctoral Studies
The doctoral project was focused on improving staff education and development to prevent chronic kidney disease (CKD) through community health worker (CHW) education. The practice problem was the delayed identification of CKD risk factors and late referral to nephrology services, particularly among rural and underserved populations. Because CKD often progresses without symptoms, early education and awareness are critical to improving outcomes and reducing disease progression. The purpose of the project was to develop and implement a structured CKD educational curriculum for CHWs to improve their confidence in kidney health, CKD risk factors, prevention strategies, early identification, and referral awareness. The …
Time Series Analysis Of Temperature And Pollen Exposure On Asthma Outcomes In Atlanta, Georgia, Victoria Okereke-Viktorsson
Time Series Analysis Of Temperature And Pollen Exposure On Asthma Outcomes In Atlanta, Georgia, Victoria Okereke-Viktorsson
Walden Dissertations and Doctoral Studies
The effects of climate change contribute to volatile temperature changes, which coupled with pollen exposure pose a significant threat to asthmatic people, potentially impacting methods for asthma management. The purpose of this ecological time-series study was to use the carbon dioxide theory of climate change, Dutch hypothesis, and social ecological model to estimate the relationship between average temperature and average pollen concentrations on average asthma morbidity outcomes for adults living in metropolitan Atlanta from 2020 to 2022 (N = 37,913). Results varied in terms of years, socioeconomic status (SES) vulnerability, gender, and racial group. Overall, a linear regression model revealed …
Hospital-Acquired Infections Among Hispanic Diabetic Patients: Considering Geographic And Substance Use Factors In Southern Puerto Rico, Fabian A. Ramirez Rivera
Hospital-Acquired Infections Among Hispanic Diabetic Patients: Considering Geographic And Substance Use Factors In Southern Puerto Rico, Fabian A. Ramirez Rivera
Walden Dissertations and Doctoral Studies
Hospital-acquired infections (HAIs) remain a major cause of preventable morbidity, mortality, and healthcare utilization among hospitalized patients. Limited research has examined the relationship between diabetes and HAIs in Puerto Rican populations. The purpose of this quantitative cross-sectional study was to examine the prevalence of type 2 diabetes mellitus (T2DM) and its association with HAI characteristics and hospitalization outcomes among patients in southern Puerto Rico. The chronic care model provided a framework for evaluating whether diabetes status, geographic location, and substance use were associated with outcomes. Data were obtained through retrospective review of electronic health records from N = 846 patients …
Exploring Successful Change Strategies For Small Business Owners To Remain Competitive, Omari Akuamoah Boateng
Exploring Successful Change Strategies For Small Business Owners To Remain Competitive, Omari Akuamoah Boateng
Walden Dissertations and Doctoral Studies
Small businesses are vital to the U.S. economy but face significant challenges in implementing organizational change to remain competitive due to resource constraints. This problem is important to small business owners because ineffective change strategies limit growth, sustainability, and broader economic contribution. Grounded in the resource-based view of the firm and entrepreneurship theory, the purpose of this qualitative pragmatic inquiry project is to explore the evidence-based organizational change strategies used by some small business owners in the United States to achieve and sustain a competitive advantage. The participants were 6 leaders from small businesses with fewer than 100 employees located …
Global Humanitarian Aid Sector Leaders’ Perceptions Of Leadership Development Programs To Support Humanitarian Aid Workers, Stephen J. Thomspon
Global Humanitarian Aid Sector Leaders’ Perceptions Of Leadership Development Programs To Support Humanitarian Aid Workers, Stephen J. Thomspon
Walden Dissertations and Doctoral Studies
The problem addressed through this study is that current leadership development programs for global humanitarian aid sector (GHAS) leaders fail to adequately address the unique circumstances of humanitarian aid work. Grounded in trauma-informed care and adaptive leadership, the purpose of this basic qualitative study was to explore GHAS leaders' perceptions of the essential components and opportunities for improving leadership development programs, as well as their recommendations on how to address the unique contexts of humanitarian aid workers. Semistructured interviews with eight GHAS leaders who had at least 10 years of sector experience were conducted. Through qualitative content analysis with a …
Identifying Symbolic Modeling Of Grooming Precursors In Social Media, Heath Landress
Identifying Symbolic Modeling Of Grooming Precursors In Social Media, Heath Landress
Walden Dissertations and Doctoral Studies
Short-form video platforms such as TikTok and Instagram Reels increasingly circulate dating and lifestyle advice that may normalize coercive relational scripts. A key challenge for preventing technology-facilitated child sexual exploitation is that early grooming precursors can be communicated through audiovisual design choices, such as tone, pacing, setting, and editing, that make manipulative narratives appear benign. The purpose of this qualitative multimedia content analysis was to identify recurring observable patterns that provide a form of symbolic modeling, through which relational and boundary-shaping cues associated with early-stage sexualized grooming are framed as ordinary dating or lifestyle advice in public TikTok and Instagram …
Risk Factors For Metabolic Syndrome Among U.S.-Born And Non-U.S.-Born Hispanics In The United States, Banessa Maldonado
Risk Factors For Metabolic Syndrome Among U.S.-Born And Non-U.S.-Born Hispanics In The United States, Banessa Maldonado
Walden Dissertations and Doctoral Studies
Current knowledge regarding risk factors for metabolic syndrome (METS) among Hispanic individuals of Mexican descent remains limited. Using data from NHANES 2017–2020, this study compared factors contributing to METS and included U.S.-born and non-U.S.-born Hispanic adults of Mexican descent aged ≥ 18 years living in the USA (N = 949) with assessed METS. Grounded in the social ecological model and social determinants of health, this research evaluated dietary habits, lifestyle patterns, and acculturation processes using multivariate logistic regression and stratified analyses. Educational attainment was associated with METS, but the association was not statistically significant in adjusted models p = 0.528. …
Strategic Organizational Growth In Nonprofit Organizations: A Swot-Based Change Management Analysis, Sharika Williams
Strategic Organizational Growth In Nonprofit Organizations: A Swot-Based Change Management Analysis, Sharika Williams
Walden Dissertations and Doctoral Studies
Nonprofit organizations often face operational and sustainability challenges. This study examined a nonprofit serving individuals with intellectual and developmental disabilities that was experiencing increased service demands, communication challenges, and workforce shortages. The purpose of this generic qualitative study was to develop a sustainable strategic change management approach to strengthen workforce development, financial stability, stakeholder collaboration, and strategic planning. Guided by the research question, "How can the client nonprofit organization implement a sustainable change-management approach that addresses internal communication challenges and resource constraints while maintaining mission alignment?" the study used a SWOT analysis and Kotter’s eight-step change model. Data were collected …