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Nurse Perception Of Pain And Innovative Approaches To Pain Management, Tracey-Ann Nichole Knight

Walden Dissertations and Doctoral Studies

AbstractInsufficient assessment and management of pain among the patient population during their hospital stay may result in ineffective delivery of care, increased length of stay, poor clinical outcomes, and decreased patient satisfaction. The quality report at a local facility showed compliance scores of 78% for administration of pain medication and 79% for reassessment of pain. These scores and the weekly patients’ satisfaction survey results suggested a substandard adherence to the facility’s pain management guidelines. One identified barrier to properly managing patients’ pain was nurses’ lack of knowledge and understanding of the theoretical foundation of pain management. The purpose of this …

Strategies For Outsourcing Manufacturing In The Caribbean, Cindy Labossiere-Auguste

Walden Dissertations and Doctoral Studies

Ineffective outsourcing strategies fail to overcome cultural challenges. Outsourcing apparel industry leaders who fail to overcome cultural barriers negatively impact the organization's financial growth and trajectory. Grounded in the theory of constraints, the purpose of this qualitative single case study was to explore the strategies apparel industry leaders use to overcome cultural barriers when outsourcing internationally. Participants comprised 3 North American apparel company leaders who successfully implemented strategies to overcome outsourcing challenges in the Caribbean. Data were collected using semistructured interviews and reviewing company documents. Yin’s 5-step approach, methodological triangulation, and thematic analysis were used to analyze the data. Three …

Vicarious Bullying And Career Progression: Narratives From African American Women Academics, Laurenda Mckinney

Walden Dissertations and Doctoral Studies

Intersectionality scholars have indicated that a literature gap exists in workplace bullying research on the implications of vicarious bullying on African American women's career progression. The purpose of this qualitative, narrative inquiry study was to explore African American women academics' stories of daily work experiences with vicarious bullying and how these experiences may interfere with their career progression. Narrative inquiry is a qualitative research approach conceived to honor a person's lived experiences as a source of valuable knowledge. Data were collected through in-depth storytelling from 5 African American women academics. Three key concepts frame this study: Miller et al.'s concept …

The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik

Walden Dissertations and Doctoral Studies

Research studies have shown that organizational leadership and support affect organizational outcomes in many sectors, including healthcare. However, less is known about how organizational leadership influences the quality of patient care by physicians. This study was guided by the perceived organizational support theory and leader-member exchange theory that provide general understanding of how supportive leadership influences staff wellbeing and productivity. Ninety-five resident physicians residing in Lebanon participated in this cross-sectional study and completed an online survey, which consisted of demographics and five tools, namely, the Leader-Member Exchange 7, Perceived Organization Support 8, Maslach Burnout Inventory 7, Utrecht Work Engagement 9, …

Nonprofit Arts Programs As Professional Development Experiences In Rural West Virginia, Ariel Mcgill Price

Walden Dissertations and Doctoral Studies

Public educators in West Virginia are required to take 18-hours of professional development learning annually. The professional development opportunities offered are not varied, inclusive of all content areas, and have been found by the state’s Department of Education to lack in application and effectiveness. This study examined the benefits of living laboratory professional development experiences, utilizing Howard Gardner’s theory of multiple intelligence, with educators that volunteer with fine arts community-based nonprofit organizations, as a possible alternative to the professional development policy requirements by the state. The study’s key research questions were about the recognition and enhancement of intrapersonal and interpersonal …

Staff Education Program For Nurses Caring For Patients With Medical Decline On A Geriatric Psychiatric Unit, Portia Denise Risper

Walden Dissertations and Doctoral Studies

AbstractElderly patients admitted to psychiatric units are a vulnerable population, some may have mental disorders, physical decline, cognitive challenges; along with other comorbidities in addition to their mental illness. However, their physical health needs may be overlooked due to the presenting behaviors mimicking mental health behaviors. The nurses working in the local hospital facility’s geri-psych unit failed to recognize signs and symptoms of physical decline in their severely mentally ill (SMI) patients. Not recognizing and reporting acute changes resulted in patients’ prolonged hospitalization, decreased quality of life, and increased cost to the facility. The purpose of this DNP project was …

A Retrospective Program Evaluation Of Existing Quality Improvement Project Colorectal Cancer Screening, Laveda Lynn Roberts

Walden Dissertations and Doctoral Studies

The United States Preventive Services Task Force (USPSTF) makes recommendations on preventive health screenings based on the level of evidence. Colorectal Cancer is the third most commonly diagnosed cancer. The practice problem for this DNP QI project, is that providers are not following the USPSTF Guidelines on colorectal cancer screening with the FQHC scores below the HRSA expectation of 80% showing only a 43% screening compliance rate for patients age 50 -75 years. The purpose of this DNP QI project was to evaluate the effectiveness of the existing QI initiative for provider colorectal screening of patients age 50-75 years, then …

Examining The Efficacy Of A School-Based Mental Health Program In Iowa, Karen A. Rodriguez

Walden Dissertations and Doctoral Studies

Evidence shows that treating mental health issues positively impacts academic and other life outcomes for students. However, there remains a gap in knowledge specific to academic outcomes and to rural school districts. It is important for mental health providers, educators, and third-party payers to gain an understanding of how treating mental health in the school setting affects student performance. The purpose of this quantitative study, which had contribution analysis as its theoretical framework, was to examine the academic and behavioral outcomes of participating in a school-based mental health (SBMH) program in rural school districts in Iowa. The specific focus was …

Effects Of Ethnicity And Type Of Crime On Juvenile Offenders’ Recidivism Risk, Larry E. Taylor

Walden Dissertations and Doctoral Studies

Juvenile crime in the United States has been a persistent social problem that has reached epidemic proportions. The purpose of this between-subjects, comparative quantitative study was to examine the relationship between recidivism risk and the type of crime, ethnicity, and race of the juvenile. Social learning theory was used to guide the study. Archival data of 59,653 cases were collected from Inter-University Consortium Political and Social Research. Correctional Offender Management Profiling for Alternative Sanctions was used to assess the dependent variable recidivism risk. The independent variables were ethnicity and type of crime of the offender reported in the Transcript of …

Leadership Techniques To Catalyze Organizational Productivity In Small Consulting Firms, Benjamin Philip Zapien

Walden Dissertations and Doctoral Studies

AbstractSmall business owners employ 47% of the U.S. labor force, yet 50% of small businesses do not survive beyond 5 years. This failure can impact approximately 29% of the U.S. workforce. Therefore, this study is important to small business owners because the research and findings may help them evaluate their leadership techniques, which may help them improve their organizational productivity and survive. Grounded in the vertical dyad linkage theory, the purpose of this multiple case study was to explore effective leadership strategies small business firm leaders used to maintain a steady growth of their organizations past the initial 5-year life …

Cognitive Effects Of Concussions In Collegiate Athletes, Brandon Anthony Campo

Walden Dissertations and Doctoral Studies

AbstractThere are approximately 1.6 and 3.8 million sports-related concussions each year in the United States (Langlois, et al. 2006). However, there are few studies examining the impact of multiple concussions among collegiate athletes, especially female athletes. Over the past decade, there has been a paradigm shift with the ImPACT neuro-battery assessment tool, which is administered to athletes’ pre-season as a baseline test and then re-administered upon a possible concussion, thus, comparing the two results. For this study, the focus was on the biological and psychological aspects of the Biopsychosocial Model. Secondary data from 49 college athletes was examined. The results …

Emotional Intelligence, Turnover Intention, And Commitment Among Nonprofit Employees, Tabitha Brewster

Walden Dissertations and Doctoral Studies

Employee turnover is a persistent problem contributing to financial issues and declining

productivity in nonprofit organizations. Nonprofits cannot fulfill their core missions of

providing services to people in need when managing staffing disruptions. Measuring

employee turnover intention can determine the probability of employee turnover, and a

potential predictor of turnover intention is emotional intelligence, an area unstudied in the

nonprofit sector. This study was designed to explore this relationship, in addition to the

employee's commitment to the organization. The population consisted of 273 nonprofit

employees older than 18 years, working in a nonsupervisory capacity. They completed an

online survey consisting …

Exploring The Competencies Of Educators Who Serve Transgender Learners In Secondary School, Genevieve C. Godin

Walden Dissertations and Doctoral Studies

The majority of transgender youth have learning experiences in school that are less than optimal; however, there is a paucity of research on the competencies of educators of transgender learners that could ameliorate the comorbidities and adversities they endure in secondary school. The purpose of this study was to explore what knowledge, attitudes, and skills educators apply to serve transgender learners in secondary school. The conceptual framework of servant leadership was used in this inquiry. A single case study design was used to examine a secondary school participating in the Alberta Sexual Orientation and Gender Identity Educator Network that serves …

Measuring Levels Of Posttraumatic Growth In Firefighters, Anna Lisa De Lima

Walden Dissertations and Doctoral Studies

Firefighters provide essential lifesaving services to the community. They are at high risk for mental health issues due to their exposure to trauma in the line of duty. Moreover, adverse effects on mental health can affect their ability to provide appropriate care to the community resulting in a serious social problem. Researchers have explored the concept that individuals can also experience growth from trauma. However, there are few studies that explore the factors that can predict growth in firefighters. The purpose of this quantitative study was to examine the degree to which selected variables such as the level of posttraumatic …

The Predictive Ability Of Self-Efficacy On Recidivism Among Adult Male Offenders, Marianne Kelly

Walden Dissertations and Doctoral Studies

With crime rates high and increasing numbers of offenders receiving community-based corrections sentences, factors related to risk of recidivism should be a high priority for researchers. The impact of crime on offenders, victims, and communities is costly. Traditional punishment has done little to reduce crime, particularly among repeat offenders. The purpose of this study was to examine the predictive ability of self-efficacy on recidivism, based on social cognitive theory. The research design was quantitative and nonexperimental, using regression analyses. The nonrandomized sample consisted of adult males incarcerated on felony charges at a large urban jail in the Midwest of the …

Education Toolkit On Restraint Reduction In The Intensive Care Unit, Sharon Watkins

Walden Dissertations and Doctoral Studies

The use of physical restraints in hospitals has been in practice for the better part of a century despite the many adverse effects it can have on patients. Socially, restraint use can strip the patient of their dignity in addition to their freedom. This evidence-based project was to build a toolkit to educate intensive care unit (ICU) nurses regarding the negative effects physical restraint use can have on their patients and to present alternatives to their use. Tools developed from prior research were included in the toolkit, and the Neuman systems model was applied to the overall education project. The …

Factors Associated With Prostate Cancer Screening Among African American Men In California, Frank Ibe Agodi

Walden Dissertations and Doctoral Studies

In Los Angeles County, California, prostate cancer (PC) is the second primary cause of cancer-related death in men. Previous studies have focused on sociodemographic factors influencing racial and ethnic inequalities in health in the United States. However, research was lacking regarding if and to what extent social-ecological factors predict PC screening, specifically among African American men residing in Los Angeles County. The purpose of this quantitative study, using a cross-sectional design, was to identify the factors that may align with PC screening among African American men living in Los Angeles. African American men aged 45 and older were the targeted …

Decision Making Process And Contralateral Prophylactic Mastectomy, Hala Alameddine

Walden Dissertations and Doctoral Studies

The increased rate of contralateral prophylactic mastectomy (CPM) among women with early stage unilateral breast cancer has raised concerns particularly with the lack of evidence for a survival benefit related to the CPM procedure and with the low risk of developing contralateral breast cancer among women with early stage sporadic breast cancer. The purpose of this quantitative cross-sectional study, using normative decision theory as the framework, was to assess the influence of the partner, physician, and media on the decision of women with unilateral breast cancer who decided to undergo CPM. Women with stage 0 to III early stage unilateral …

Reduce Postpartum Complications By Improving Postpartum Care Appointment Attendance, Shayla Tennille Buckler

Walden Dissertations and Doctoral Studies

This evidence-based project (EBP) was developed to increase postpartum appointment attendance to improve maternal outcomes for postpartum women. The practice problem was that the postpartum women who received prenatal care failed to return for postpartum care at a community clinic in north east Texas. The practice-focused question explored whether an educational intervention with the nursing staff would increase postpartum appointment attendance. The framework used was Pender’s Health Promotion Model. The preintervention data were retrieved from an electronic medical record (EMR) generated report that provided the number of postpartum appointments attended 30 days before the intervention. The nursing staff received a …

Clinician Experiences With Religious, Spiritual, And Nonreligious Beliefs In Psychotherapeutic Interactions, Carolyn Rochelle Cowl-Witherspoon

Walden Dissertations and Doctoral Studies

Psychologists are ethically bound to respect the belief systems of their clients while practicing within appropriate boundaries of competence regardless of whether they hold different beliefs than their clients. Further, though there may be a disparity between clinicians’ and clients’ beliefs, most clients expect meaningful integrations of religious and spiritual beliefs, values, and traditions into psychotherapeutic interactions. To meet the needs and expectations of a religiously or spiritually oriented client base, psychologists must maintain appropriate levels of competency within this complex domain. But clinicians are hindered by inaccurate, incomplete, or inconsistent levels of education and training specific to the ethically …

Strategies Leaders In The Retail Industry Use To Increase Employee Engagement, Yvonne Nicole Crawford

Walden Dissertations and Doctoral Studies

Lack of employee engagement increases expenses for organizational leaders. Retail leaders struggle with identifying successful engagement strategies to achieve performance outcomes. Grounded by the motivation-hygiene theory, the purpose of this qualitative multiple case study was to explore strategies retail leaders used to increase employee engagement. The participants comprised 5 retail leaders in South Florida who experienced an increase in employee engagement. Data were collected from semi-structured interviews and documents that included publicly posted annual reports and strategic plans. The three themes that emerged using thematic analysis were employee incentives, effective communication, and affirmation from leaders. A key recommendation for business …

Experiences Of Ptsd Sufferers Who Participate In Internet-Based Virtual World Activities In Desktop Virtual Reality Environments, Colleen Margaret Crary

Walden Dissertations and Doctoral Studies

Treatments for posttraumatic stress have remained largely static for 3 decades, resulting in low recovery rates, high degrees of retrogression, and noncompliance by patients, calling for new approaches for posttraumatic stress disorder (PTSD) treatment. This qualitative phenomenological study explored the lived experiences of people with PTSD who participate in Desktop Virtual Reality Environments (DVREs). The research questions asked about the lived experiences of adults with PTSD who use the DVRE, and what they perceive as changes in their narratives about PTSD through their use of the DVRE. Twenty-three participants responded to a 10-item, open-ended questionnaire. Findings show that although each …

Successful Marketing Strategies For Small Business Sustainability, Jasmine Davis

Walden Dissertations and Doctoral Studies

Small businesses play a significant role in the health of the U.S. economy, but 50% of small businesses close before reaching 5 years of operation. Some small business owners do not utilize effective marketing strategies to guide them towards sustainability in business. Grounded in hybrid typology, the purpose of this qualitative multiple case study was to explore marketing strategies small business owners use for sustainability. The participants comprised three small business owners located in the Midwest Region of the United States, with a business in operation for at least 5 years. Data were collected from semi-structured interviews, public company documents, …

Information Technology Disaster Recovery Planning By Florida Nonprofit Organizations, Derek Keith Erfourth

Walden Dissertations and Doctoral Studies

Inadequate information technology (IT) disaster recovery planning (DRP) by nonprofit organizations could lead to organizational failure post-large-scale natural disasters. Without proper funding and planning, organizations may not be able to withstand the effects of a natural disaster resulting in the closure and the community losing a critical need service. Grounded in resilience theory, the purpose of this qualitative multiple case study was to explore strategies utilized by Florida-based nonprofit organization technology managers to adopt and implement an IT DRP to aid in post-natural disaster recovery efforts. The data collection included interviews with 5 IT managers and reviews of 4 business …

Factors Affecting Master's Counseling Students Pursuing Doctoral Degrees, Charity Ann Godfrey

Walden Dissertations and Doctoral Studies

Student leadership identity development is becoming one of the most critical challenges in preparing mental health counseling students for the professional world. Leadership aids in the development of counselor self-efficacy and counselor professional identity development. But the Council for Accreditation of Counseling and Related Educational Programs (CACREP) does not mandate master's level mental health counseling programs to incorporate leadership curriculum, although current research indicates that counselors demonstrate leadership skills with clients and within organizational roles. The purpose of this quantitative study was to investigate master's level mental health counselor leadership identity and determine whether Socially Responsible Leadership Scale (SRLS) scores …

Emotional Behavioral Disability Students: How Emotional-Social Intelligence Empowers Mainstream Elementary Teachers, Christopher J. Hanna

Walden Dissertations and Doctoral Studies

A district in Southwestern Pennsylvania was experiencing disruptive behaviors with students with emotional behavioral disabilities in the elementary mainstream classroom. Grounded in the Bar-On 10-factor structure emotional-social intelligence model, the purpose of the study was to gain understanding of how emotional-social intelligence competency empowered regular-education teachers to maintain positive relationships with students with emotional behavioral disabilities. The qualitative naturalist-constructionist research approach involved implementing the responsive interview technique for data collection. The study involved purposeful sampling for participant recruitment for 10 elementary regular-education teachers. The elementary teachers who taught first through fifth grades were observed by their building principals as maintaining …

Acknowledging And Addressing Adolescent Depression, Johnsie Burke Hughes

Walden Dissertations and Doctoral Studies

A family practice was found to inconsistently screen adolescents for depression even with the necessary Patient Health Questionnaire (PHQ) screening tools being readily available in their electronic medical record. The development of a practice guideline that offers a systematic approach to screening using the PHQ2 and the PHQ9 will potentially result in an increased guidance and provider willingness to screen for adolescent depression in the family practice setting. The purpose of this DNP project was to determine if an algorithmic practice guideline would increase provider willingness to assess for adolescent depression and identify any barriers to the use of the …

Hospital Nurses’ Perceptions Of Computer-Assisted Instruction For Professional Development, Katherine Irizarry

Walden Dissertations and Doctoral Studies

Computer-assisted instruction (CAI) is increasingly being used for professional development. However, at one hospital in the northeast region of the United States, it was observed that nurses were not completing their CAI professional development modules and were failing to meet continuous education requirements. This qualitative case study explored professional nurses’ perspectives regarding the usefulness of CAI as a mode of professional development. The conceptual frameworks used to guide this study were Davis’ theory of technology acceptance, and Knowles’s theory of andragogy. The research question explored how professional nurses perceived the usefulness of CAI to assimilate new learning. The participants in …

Preventing Aspiration Pneumonia Using An Aspiration Prevention Protocol, Lee James-Pettway

Walden Dissertations and Doctoral Studies

Hospital-acquired pneumonia, which includes aspiration pneumonia (AP), is a preventable condition that is costly to all healthcare institutions (more than $17,000 to $ 30,000 per episode), because insurance no longer covers the cost of hospital-acquired harms. Each episode in the hospital setting can lead to patient complications, increased use of antibiotics, patient mortality, as well as decreased patient survey scores. Several factors put patients at risk of developing AP, and screening for these risk factors on admission and implementing preventative nursing interventions can decrease the incidence. Based on an extensive literature review, an evidence-based, clinical practice guideline (CPG) was identified …

The Experience Of Being An Older Online Graduate Student, Shirley A. Losiewicz

Walden Dissertations and Doctoral Studies

The number of older adult online students (over age 30) has continued to grow over the past 10 years, but their perceptions of how the online experience affects their family and friendship relationships were unknown. The purpose of this qualitative phenomenological study was to examine the experiences of 6 graduate students over the age of 30 years enrolled in an online program, using the lens of Bowen’s family systems theory and Elder’s life course theory. The research questions focused on the experiences of being an older online graduate student, including motivation, factors that helped or hindered adjustment, perceived stress, social …