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Walden Dissertations and Doctoral Studies

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Influence Of Psychological Evaluators’ Demographics, Perceptions Of Bias, And Juvenile Defendants’ Race On Competency Decisions, Elizabeth Zaito Jan 2025

Influence Of Psychological Evaluators’ Demographics, Perceptions Of Bias, And Juvenile Defendants’ Race On Competency Decisions, Elizabeth Zaito

Walden Dissertations and Doctoral Studies

Recent large-scale studies and reviews have revealed inconsistent findings regarding the role of evaluator characteristics, bias, and characteristics of juveniles in judging competency to stand trial as adults in juvenile cases using Dusky standards. The purpose of this study was to examine the influence of psychological evaluators’ education and experience, cognitive bias, and race of juveniles on decisions involving competency to stand trial. The attribution theory was used as the theoretical framework to explain how internal years of education and experience as well as beliefs about bias can influence decision-making. Data were collected from 84 forensic and clinical professionals and …


Factors Associated With Parental Substance Use And Child Welfare In Nevada 2019-2021, Lisa Christine Lee Jan 2025

Factors Associated With Parental Substance Use And Child Welfare In Nevada 2019-2021, Lisa Christine Lee

Walden Dissertations and Doctoral Studies

Substance use is a growing public health concern that is adversely impacting reproductive-aged individuals and families (Bruzelius & Martins, 2022). Parental substance use is increasingly driving family separation through the child welfare system. Substance use and family separation intersect with trauma and adverse childhood experiences in a variety of ways. Risk factors and race/ethnicity may contribute to family surveillance, bias, and disproportionality in child welfare and impact reunification and cause further trauma. This study explored associations between household characteristics and risk factors and services provided to families with reunification goals for families with child welfare involvement due to substance use …


Influence Of Psychological Evaluators’ Demographics, Perceptions Of Bias, And Juvenile Defendants’ Race On Competency Decisions, Elizabeth Zaito Jan 2025

Influence Of Psychological Evaluators’ Demographics, Perceptions Of Bias, And Juvenile Defendants’ Race On Competency Decisions, Elizabeth Zaito

Walden Dissertations and Doctoral Studies

Recent large-scale studies and reviews have revealed inconsistent findings regarding the role of evaluator characteristics, bias, and characteristics of juveniles in judging competency to stand trial as adults in juvenile cases using Dusky standards. The purpose of this study was to examine the influence of psychological evaluators’ education and experience, cognitive bias, and race of juveniles on decisions involving competency to stand trial. The attribution theory was used as the theoretical framework to explain how internal years of education and experience as well as beliefs about bias can influence decision-making. Data were collected from 84 forensic and clinical professionals and …


Staff Education Project Assessing Pediatric Sepsis, Michelle Louise James Jan 2025

Staff Education Project Assessing Pediatric Sepsis, Michelle Louise James

Walden Dissertations and Doctoral Studies

Pediatric sepsis is a leading cause of death globally, affecting over 25 million children annually. In the United States, it results in over 75,000 inpatient admissions and approximately 3.4 million deaths each year. Evidence from multiple studies supported the existing recommendations for early recognition and management of pediatric sepsis, emphasizing that comprehensive vital sign assessments, clinical practice guidelines, standardized protocols, and continuous monitoring align to improve patient outcomes. Three clinical experts reviewed the evidence-based educational program developed for this project. Nineteen participants completed a pre- and post-education program survey assessing their knowledge and perceived competence in early recognition and assessment …


Human Resource Managers’ Perceptions Of Vocational Readiness Among Post-Secondary School Students In Antigua, Renee J. Smith Jan 2025

Human Resource Managers’ Perceptions Of Vocational Readiness Among Post-Secondary School Students In Antigua, Renee J. Smith

Walden Dissertations and Doctoral Studies

Vocational readiness for the global workforce requires the development of both academic and nonacademic skills. Antiguan education has focused primarily on the teaching of academic skills. Grounded in Holland’s theory of career choice and Wigfield and Eccles’s interpretation of expectancy-value theory, the purpose of this generic qualitative study was to explore perceptions of Human Resource Managers (HRMs) in Antigua on the vocational readiness of post-secondary school graduates. Research questions asked about the perceptions of HRMs in Antigua regarding the vocational readiness of post-secondary school graduates, offerings of tertiary institutions to address the vocational readiness of their students, and the type/quality …


Effect Of Mental Distress And Functional Impairment On Mental Health Service Use By Filipino Americans In California, Marieann R. Brill Jan 2025

Effect Of Mental Distress And Functional Impairment On Mental Health Service Use By Filipino Americans In California, Marieann R. Brill

Walden Dissertations and Doctoral Studies

Mental health conditions are a significant global public health issue. Research shows that while Filipino Americans frequently experience mental distress and functional impairment, they are hesitant to use mental health services. In this quantitative study, the association between mental distress and functional impairment on mental health service utilization of prescription medication use, visits to primary care providers, and visits to mental health professionals was explored in adult Filipino Americans residing in California. Control variables included age, gender, marital status, education, employment, and income. This study was based on Andersen's behavioral model of healthcare use. Secondary data from the 2021-2022 California …


Improving Staff Knowledge Regarding Culturally Competent Care And Implicit Bias, Angela Woodfaulk-Trent Jan 2025

Improving Staff Knowledge Regarding Culturally Competent Care And Implicit Bias, Angela Woodfaulk-Trent

Walden Dissertations and Doctoral Studies

Mental health staff in the project site outpatient office lacked knowledge of cultural competence and the risk for implicit biases. This staff education project was implemented to improve their knowledge related to cultural competence and implicit bias in an outpatient mental health setting. Nursing theories and frameworks are imperative for bettering the health outcomes of diverse patient populations, and the nursing theory that informed this project was Leininger’s transcultural nursing framework. This Doctor of Nursing Practice (DNP) project addressed staff knowledge regarding cultural competence specifically implicit bias towards diverse mental health populations in an outpatient setting. The project was designed …


Staff Education To Improve Knowledge Regarding Fall Prevention In Long-Term Care, Molly Salmonsen Jan 2025

Staff Education To Improve Knowledge Regarding Fall Prevention In Long-Term Care, Molly Salmonsen

Walden Dissertations and Doctoral Studies

Falls in residents at long-term care facilities result in increased hospitalizations and healthcare-associated costs, as well as increased morbidity and mortality, which can significantly decrease quality of life. To help prevent falls for long-term care residents, nurses must be knowledgeable regarding fall risk precautions and fall safety as these are the first-line defenses in fall prevention. This doctoral staff education project focused on improving fall-risk reduction and prevention education in nurses of a 125-bed long-term care facility and aimed to answer the practice-focused question: Does implementation of a standardized education program related to fall-risk reduction in the elderly increase nurse’s …


Teachers' Perspectives Of Mandated Health Education Curriculum Goals In Grades K-3, Ashley Baker Jan 2025

Teachers' Perspectives Of Mandated Health Education Curriculum Goals In Grades K-3, Ashley Baker

Walden Dissertations and Doctoral Studies

This study addressed the challenges faced by many Grades K–3 teachers in north central Georgia in consistently implementing mandated health education curriculum goals (Villegas et al., 2021). The purpose of this basic qualitative study was to explore teachers’ perspectives on the barriers to consistent health education delivery in elementary schools. The study was guided by the concerns-based adoption model, which provided a framework for understanding how teachers navigate changes in curriculum and instruction. The key research questions focused on identifying the specific challenges teachers encounter in implementing health education and their perceived needs for support. Semi structured interviews were conducted …


Staff Education To Improve Knowledge Regarding Fall Prevention In Long-Term Care, Molly Salmonsen Jan 2025

Staff Education To Improve Knowledge Regarding Fall Prevention In Long-Term Care, Molly Salmonsen

Walden Dissertations and Doctoral Studies

Falls in residents at long-term care facilities result in increased hospitalizations and healthcare-associated costs, as well as increased morbidity and mortality, which can significantly decrease quality of life. To help prevent falls for long-term care residents, nurses must be knowledgeable regarding fall risk precautions and fall safety as these are the first-line defenses in fall prevention. This doctoral staff education project focused on improving fall-risk reduction and prevention education in nurses of a 125-bed long-term care facility and aimed to answer the practice-focused question: Does implementation of a standardized education program related to fall-risk reduction in the elderly increase nurse’s …


Leadership Implications Of Exploring Educator Perceptions About The Use Of Pbis And Cultural Responsiveness To Promote Equitable Discipline Practices For Black Students, Onika L. Stjames Jan 2025

Leadership Implications Of Exploring Educator Perceptions About The Use Of Pbis And Cultural Responsiveness To Promote Equitable Discipline Practices For Black Students, Onika L. Stjames

Walden Dissertations and Doctoral Studies

School leaders and educators face challenges administering discipline equitably in school environments comprised of diverse student populations due to teachers’ potential inherent biases and lack of understanding and training about cultural responsiveness. To increase equity and reduce the disproportionality of discipline referrals issued to Black students, principals and assistant principals, district leaders, and other stakeholders need to acquire more knowledge about culturally responsive practices. The purpose of this basic qualitative study was to explore educator perceptions about the use of positive behavior interventions and supports (PBIS) and cultural responsiveness to reduce the disproportionality of discipline referrals issued to Black students …


Successful Strategies To Operate Profitably In Bottom Of The Pyramid Markets, Oluwasoromidayo George Jan 2025

Successful Strategies To Operate Profitably In Bottom Of The Pyramid Markets, Oluwasoromidayo George

Walden Dissertations and Doctoral Studies

In 2022, 133 million Nigerians were at the bottom of the pyramid (BOP), representing a large yet challenging market segment. Business leaders in the Nigerian fast moving consumer goods (FMCG) industry must develop strategies to operate profitably in this low income market to sustain their businesses and capture significant growth opportunities. Grounded in Prahalad’s BOP conceptual framework, the purpose of this qualitative multiple case study was to explore how four Nigerian FMCG leaders developed and implemented successful strategies to operate profitably in BOP countries. Data were collected through semistructured interviews and from company website documents. Using data triangulation and thematic …


Navigating The Burnout Crisis: Its Influence On Clinical Relationships And Treatment Efficacy, Jeremiah James Cleland Jan 2025

Navigating The Burnout Crisis: Its Influence On Clinical Relationships And Treatment Efficacy, Jeremiah James Cleland

Walden Dissertations and Doctoral Studies

A nonprofit behavioral health organization (XYZ) has experienced challenges related to staff burnout and high turnover rates. To evaluate and address these challenges, this research study explored the complex relationship between XYZ organizational leadership, workforce engagement, and employee retention. The study focuses on understanding how effective leadership, supportive supervision, and career development strategies can mitigate burnout, thus reducing turnover rates. Using the Baldrige Performance Framework, the study critically evaluated the role of leadership in fostering an environment that promotes staff well-being and operational excellence. Data were collected through interviews with employees and behavioral health leaders, offering insights into real-world challenges …


Leadership Implications Of Exploring Educator Perceptions About The Use Of Pbis And Cultural Responsiveness To Promote Equitable Discipline Practices For Black Students, Onika L. Stjames Jan 2025

Leadership Implications Of Exploring Educator Perceptions About The Use Of Pbis And Cultural Responsiveness To Promote Equitable Discipline Practices For Black Students, Onika L. Stjames

Walden Dissertations and Doctoral Studies

School leaders and educators face challenges administering discipline equitably in school environments comprised of diverse student populations due to teachers’ potential inherent biases and lack of understanding and training about cultural responsiveness. To increase equity and reduce the disproportionality of discipline referrals issued to Black students, principals and assistant principals, district leaders, and other stakeholders need to acquire more knowledge about culturally responsive practices. The purpose of this basic qualitative study was to explore educator perceptions about the use of positive behavior interventions and supports (PBIS) and cultural responsiveness to reduce the disproportionality of discipline referrals issued to Black students …


Effect Of Mental Distress And Functional Impairment On Mental Health Service Use By Filipino Americans In California, Marieann R. Brill Jan 2025

Effect Of Mental Distress And Functional Impairment On Mental Health Service Use By Filipino Americans In California, Marieann R. Brill

Walden Dissertations and Doctoral Studies

Mental health conditions are a significant global public health issue. Research shows that while Filipino Americans frequently experience mental distress and functional impairment, they are hesitant to use mental health services. In this quantitative study, the association between mental distress and functional impairment on mental health service utilization of prescription medication use, visits to primary care providers, and visits to mental health professionals was explored in adult Filipino Americans residing in California. Control variables included age, gender, marital status, education, employment, and income. This study was based on Andersen's behavioral model of healthcare use. Secondary data from the 2021-2022 California …


Improving Staff Knowledge Regarding Culturally Competent Care And Implicit Bias, Angela Woodfaulk-Trent Jan 2025

Improving Staff Knowledge Regarding Culturally Competent Care And Implicit Bias, Angela Woodfaulk-Trent

Walden Dissertations and Doctoral Studies

Mental health staff in the project site outpatient office lacked knowledge of cultural competence and the risk for implicit biases. This staff education project was implemented to improve their knowledge related to cultural competence and implicit bias in an outpatient mental health setting. Nursing theories and frameworks are imperative for bettering the health outcomes of diverse patient populations, and the nursing theory that informed this project was Leininger’s transcultural nursing framework. This Doctor of Nursing Practice (DNP) project addressed staff knowledge regarding cultural competence specifically implicit bias towards diverse mental health populations in an outpatient setting. The project was designed …


Teachers' Perspectives Of Mandated Health Education Curriculum Goals In Grades K-3, Ashley Baker Jan 2025

Teachers' Perspectives Of Mandated Health Education Curriculum Goals In Grades K-3, Ashley Baker

Walden Dissertations and Doctoral Studies

This study addressed the challenges faced by many Grades K–3 teachers in north central Georgia in consistently implementing mandated health education curriculum goals (Villegas et al., 2021). The purpose of this basic qualitative study was to explore teachers’ perspectives on the barriers to consistent health education delivery in elementary schools. The study was guided by the concerns-based adoption model, which provided a framework for understanding how teachers navigate changes in curriculum and instruction. The key research questions focused on identifying the specific challenges teachers encounter in implementing health education and their perceived needs for support. Semi structured interviews were conducted …


Navigating The Burnout Crisis: Its Influence On Clinical Relationships And Treatment Efficacy, Jeremiah James Cleland Jan 2025

Navigating The Burnout Crisis: Its Influence On Clinical Relationships And Treatment Efficacy, Jeremiah James Cleland

Walden Dissertations and Doctoral Studies

A nonprofit behavioral health organization (XYZ) has experienced challenges related to staff burnout and high turnover rates. To evaluate and address these challenges, this research study explored the complex relationship between XYZ organizational leadership, workforce engagement, and employee retention. The study focuses on understanding how effective leadership, supportive supervision, and career development strategies can mitigate burnout, thus reducing turnover rates. Using the Baldrige Performance Framework, the study critically evaluated the role of leadership in fostering an environment that promotes staff well-being and operational excellence. Data were collected through interviews with employees and behavioral health leaders, offering insights into real-world challenges …


Successful Strategies To Operate Profitably In Bottom Of The Pyramid Markets, Oluwasoromidayo George Jan 2025

Successful Strategies To Operate Profitably In Bottom Of The Pyramid Markets, Oluwasoromidayo George

Walden Dissertations and Doctoral Studies

In 2022, 133 million Nigerians were at the bottom of the pyramid (BOP), representing a large yet challenging market segment. Business leaders in the Nigerian fast moving consumer goods (FMCG) industry must develop strategies to operate profitably in this low income market to sustain their businesses and capture significant growth opportunities. Grounded in Prahalad’s BOP conceptual framework, the purpose of this qualitative multiple case study was to explore how four Nigerian FMCG leaders developed and implemented successful strategies to operate profitably in BOP countries. Data were collected through semistructured interviews and from company website documents. Using data triangulation and thematic …


Structured Staff Education On Incorporating Social Determinants Of Health Into Phq-9 Depression Screening For Improved Patient Outcomes, Gbemisola Elizabeth Mojelope Jan 2025

Structured Staff Education On Incorporating Social Determinants Of Health Into Phq-9 Depression Screening For Improved Patient Outcomes, Gbemisola Elizabeth Mojelope

Walden Dissertations and Doctoral Studies

This doctor of nursing (DNP) project addressed a significant practice gap in an outpatient community healthcare setting, where staff lacked knowledge related to patient health questionnaire (PHQ-9) depression screening. The project’s focus question addressed whether staff education increased knowledge pertaining to the PHQ-9 depression screening. The initiative aimed to equip healthcare providers with the skills needed to incorporate social determinants of health in routine depression screenings, enhancing early identification of depressive symptoms and supporting targeted interventions. Fifteen healthcare workers voluntarily participated in the education. The in-person education initiative highlighted the importance of integrating social determinants of health (SDoH) into PHQ-9 …


Lived Experiences Of South Texas Police Officers After Completing Crisis Intervention Training, Lyna Yvette Campos Jan 2025

Lived Experiences Of South Texas Police Officers After Completing Crisis Intervention Training, Lyna Yvette Campos

Walden Dissertations and Doctoral Studies

This qualitative phenomenological study addressed the paucity of research on the experiences of police officers who have both completed crisis intervention team (CIT) training and interacted with people with mental illnesses (PwMI). To address the problem, I investigated police officers’ perceptions of PwMI and the pertinent CIT training information they found advantageous when interacting with a PwMI in crisis. Rogers’s protection motivation theory was the theoretical foundation for addressing the research questions. Interviews were conducted with 13 South Texas police officers who had completed CIT training. Data was collected through transcribed interviews and analyzed with an approach that included theme …


Lived Experiences Of South Texas Police Officers After Completing Crisis Intervention Training, Lyna Yvette Campos Jan 2025

Lived Experiences Of South Texas Police Officers After Completing Crisis Intervention Training, Lyna Yvette Campos

Walden Dissertations and Doctoral Studies

This qualitative phenomenological study addressed the paucity of research on the experiences of police officers who have both completed crisis intervention team (CIT) training and interacted with people with mental illnesses (PwMI). To address the problem, I investigated police officers’ perceptions of PwMI and the pertinent CIT training information they found advantageous when interacting with a PwMI in crisis. Rogers’s protection motivation theory was the theoretical foundation for addressing the research questions. Interviews were conducted with 13 South Texas police officers who had completed CIT training. Data was collected through transcribed interviews and analyzed with an approach that included theme …


Information Technology Management And Emotional Intelligence, Tina M. Muheim Jan 2025

Information Technology Management And Emotional Intelligence, Tina M. Muheim

Walden Dissertations and Doctoral Studies

Information technology (IT) employees often face high stress, burnout, and turnover, indicating a potential gap in IT leaders’ emotional intelligence (EI), which may hinder their ability to support and retain their teams effectively. Since IT plays a critical role in organizational performance and achieving strategic goals, addressing this gap is crucial for improving team well-being and organizational success. Grounded in EI theory, the purpose of this quantitative correlational study was to examine the relationship between IT managers’ EI subscales—assertiveness and interpersonal relationships—and their influence on the EI subscale, happiness/well–being indicator. The participants were 38 IT managers from U.S. organizations who …


Periodic Fever, Aphthous Stomatitis, Pharyngitis & Cervical Adenitis, Sonia P. Wheat Jan 2025

Periodic Fever, Aphthous Stomatitis, Pharyngitis & Cervical Adenitis, Sonia P. Wheat

Walden Dissertations and Doctoral Studies

The suffering of children with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is well documented and includes diminished quality of life (QoL), emotional/behavioral problems, fatigue, food avoidance and school absenteeism. As an example of childhood adversity, and because the model of pediatric medical traumatic stress demonstrates traumatic responses do not always subside over time, this study examined the psychosocial health of PFAPA survivors post resolution. Using a quantitative, cross-sectional study design, the psychosocial well-being of PFAPA survivors was compared to children with persistent asthma and children without chronic illness or a history of medical trauma. Two validated parent-completed …


Information Technology Management And Emotional Intelligence, Tina M. Muheim Jan 2025

Information Technology Management And Emotional Intelligence, Tina M. Muheim

Walden Dissertations and Doctoral Studies

Information technology (IT) employees often face high stress, burnout, and turnover, indicating a potential gap in IT leaders’ emotional intelligence (EI), which may hinder their ability to support and retain their teams effectively. Since IT plays a critical role in organizational performance and achieving strategic goals, addressing this gap is crucial for improving team well-being and organizational success. Grounded in EI theory, the purpose of this quantitative correlational study was to examine the relationship between IT managers’ EI subscales—assertiveness and interpersonal relationships—and their influence on the EI subscale, happiness/well–being indicator. The participants were 38 IT managers from U.S. organizations who …


Structured Staff Education On Incorporating Social Determinants Of Health Into Phq-9 Depression Screening For Improved Patient Outcomes, Gbemisola Elizabeth Mojelope Jan 2025

Structured Staff Education On Incorporating Social Determinants Of Health Into Phq-9 Depression Screening For Improved Patient Outcomes, Gbemisola Elizabeth Mojelope

Walden Dissertations and Doctoral Studies

This doctor of nursing (DNP) project addressed a significant practice gap in an outpatient community healthcare setting, where staff lacked knowledge related to patient health questionnaire (PHQ-9) depression screening. The project’s focus question addressed whether staff education increased knowledge pertaining to the PHQ-9 depression screening. The initiative aimed to equip healthcare providers with the skills needed to incorporate social determinants of health in routine depression screenings, enhancing early identification of depressive symptoms and supporting targeted interventions. Fifteen healthcare workers voluntarily participated in the education. The in-person education initiative highlighted the importance of integrating social determinants of health (SDoH) into PHQ-9 …


Periodic Fever, Aphthous Stomatitis, Pharyngitis & Cervical Adenitis, Sonia P. Wheat Jan 2025

Periodic Fever, Aphthous Stomatitis, Pharyngitis & Cervical Adenitis, Sonia P. Wheat

Walden Dissertations and Doctoral Studies

The suffering of children with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is well documented and includes diminished quality of life (QoL), emotional/behavioral problems, fatigue, food avoidance and school absenteeism. As an example of childhood adversity, and because the model of pediatric medical traumatic stress demonstrates traumatic responses do not always subside over time, this study examined the psychosocial health of PFAPA survivors post resolution. Using a quantitative, cross-sectional study design, the psychosocial well-being of PFAPA survivors was compared to children with persistent asthma and children without chronic illness or a history of medical trauma. Two validated parent-completed …


Elementary School Leaders’ Perceptions Of Suspensions As A Disciplinary Approach With Students Of Color, A Whitney Jones Jan 2025

Elementary School Leaders’ Perceptions Of Suspensions As A Disciplinary Approach With Students Of Color, A Whitney Jones

Walden Dissertations and Doctoral Studies

The problem addressed in this study was that students of color were being suspended with great frequency in elementary schools at the study site. The purpose of this basic qualitative study was to explore perceptions of elementary school leaders regarding the use of suspensions as a disciplinary approach and how culturally responsive school leadership (CRSL) practices influence their decision-making processes with students of color in one southeastern U.S. school district. The conceptual framework used in this qualitative study included Bell’s critical race theory and Khalifa’s CRSL. For this basic qualitative study, semi-structured interviews were conducted with nine elementary school leaders …


Strategies For Patient-Centered Care Implementation In Independent Medical Practices, Jesse Otto Irvin Jan 2025

Strategies For Patient-Centered Care Implementation In Independent Medical Practices, Jesse Otto Irvin

Walden Dissertations and Doctoral Studies

Method: Qualitative Design: Pragmatic Inquiry Why the study is being done: Explore strategies some independent medical practice professionals used to implement patient-centered care, ensuring quality patient care and practice profitability. How the data was collected. Semistructured interviews, audio, and examining public records Identify the population from which the researcher will collect data: six professionals from six medical practices in the St. Louis MSA who implemented patient-centered care to improve patient care quality and practice profitability. How data was analyzed. Qualitative with Themes Communication Financial Consciousness Quality Patient Care Time Management How will data contribute to social change: Implementing best practices …


Education Of Nursing Staff On Management Of Aggression And Violence In Mental Health Patients Using Less Restrictive Measures., Irene Ozurumba-Omoregie Jan 2025

Education Of Nursing Staff On Management Of Aggression And Violence In Mental Health Patients Using Less Restrictive Measures., Irene Ozurumba-Omoregie

Walden Dissertations and Doctoral Studies

Mental health nurses frequently face physical and emotional challenges due to the high prevalence of violence in psychiatric settings. A 2023 survey by the American Nurses Association revealed that 62% of nurses reported abuse from patients, underscoring the need for improved training on managing violent behaviors without excessive reliance on restraint and seclusion. This project addressed a critical knowledge gap in de-escalation techniques among mental health nurses by developing and implementing an educational program for violence prevention. The training included de-escalation strategies and alternative management practices aimed at reducing patient aggression while enhancing nurse safety and confidence. Forty-five of sixty …