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Strategies To Improve Patient Satisfaction And Organizational Performance In Health Care, Leanne Fay Heppell

Walden Dissertations and Doctoral Studies

Walden University

College of Management and Technology

This is to certify that the doctoral study by

Leanne Heppell

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Carol-Anne Faint, Committee Chairperson, Doctor of Business Administration Faculty

Dr. Rocky Dwyer, Committee Member, Doctor of Business Administration Faculty

Dr. Kenneth Gossett, University Reviewer, Doctor of Business Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2016

Ninth Grade Student And Teacher Perceptions Of Teacher-Student Relationship, Lynda Rose Huggins

Walden Dissertations and Doctoral Studies

The challenge of transitioning into high school is associated with social anxiety, decreased grades, increased absences, and overall motivation to learn. Based on anecdotal evidence from 9th grade teachers in the Ohio School District, teachers had poor rapport with some of their students, and 9th graders were being retained more often than were students in any other grade. Grounded in Noddings's care theory, the purpose of this mixed methods sequential case study was to explore perceptions of rapport between 9th graders and their teachers. Guiding research questions were used to discover student and teacher perceptions about their relationship as it …

Caregivers' Perceptions Of An Early Diagnosis Of Alzheimer's Disease In African Americans, Stanita Jackson

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is significantly more prevalent among African Americans than within the general population, but rates of early detection are lower in the African American community. Researchers have demonstrated that both pessimistic Alzheimer's-directed health beliefs, and negative perceptions of the effectiveness and the accessibility of medical care act as barriers to care seeking by African American family members of individuals with the disease. Recent research into causal judgments made by potential caregivers about individuals with undiagnosed AD suggests that gender bias and errors in attribution may constitute covert barriers to both lay and professional interpretations regarding the need for …

Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik

Walden Dissertations and Doctoral Studies

Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement …

Federal Health Care Fraud Statute Sentencing In Georgia And Florida, 2011-2012, Lisa Walker Johnson

Walden Dissertations and Doctoral Studies

The financial costs of U.S. federal health care fraud continue to increase, and as health care payments due to fraudulent claims increase, the portion of The Medicare Trust Fund available to pay for legitimate health care expenses decreases. Prosecution is one of several fraud management life cycle components that contributes to and can alter the course of increasing health care fraud; however, despite this recognition, there is a gap in the literature regarding the consistency of prosecution for federal health care fraud across different judicial districts. The purpose of this qualitative, exploratory multiple case study was to explore the federal …

The Relationship Between High School Culinary Curriculum And Culinary Arts College Student Achievement And Completion, Emily Knight

Walden Dissertations and Doctoral Studies

There is a lack of persistence and completion of students enrolled in a local college culinary arts program, a problem also evident in national data. Some students entering the college program have participated in a defined high school curriculum focused on culinary arts, such as the National Restaurant Association Education Association's ProStart curriculum. The purpose of this study was to determine if participation in the ProStart program was related to the mean grade point average (GPA) and time to completion in the college culinary arts program. Dewey's theory of experience provided the theoretical framework. Participants from 2 cohorts at the …

Perceptions And Behaviors Of Caribbean And South American Women Of Color Living In The United States Towards Breast Cancer, Bernadette Serena Loncke

Walden Dissertations and Doctoral Studies

Breast cancer is a global public health issue, and even though the incidence and mortality rates for this disease have declined, a substantial gap in mortality rates between U.S. women of color and European American women remains. Strategies have been initiated to decrease this gap, but they have not addressed the special needs of women of color residing in the United States, who tend to be diagnosed only after they have developed late-stage breast cancer. The purpose of this phenomenological study was to understand the perceptions and behaviors of 20 first-generation Caribbean and South American-born women of color living in …

Executive Compensation, Firm Performance, And Net Community Benefits Within Nonprofit Urban Hospitals, Terry Deshawn Long

Walden Dissertations and Doctoral Studies

Nonprofit hospitals are under increased pressure to maintain financial stability and compliance with Internal Revenue Service (IRS) net community benefit requirements. Boards of directors are not always confident that the compensation packages awarded to executives stimulate them to act in the organization's best interest. The principal-agent theory formed the basis of this correlational study. Archival data from National Center for Charitable Statistics, Guidestar, and the Center for Medicare & Medicaid Services were collected from 117 nonprofit urban hospitals for the fiscal year 2013. Regression analysis was used to determine the significance of relationships between return on assets (ROA), change in …

Development And Content Validation Of An Emergency Department Ehr Safety Educational Program, Ursula Renee Jernigan

Walden Dissertations and Doctoral Studies

Emergency Department (ED) providers and staff experience challenges with using electronic health record (EHR) software to document and communicate about patient care. These difficulties are often caused by inadequate training in the use of the organization's EHR system. Challenges with EHR use have been linked to increased ED patient wait times, which impacts patient safety by delaying care and increasing the potential for medication errors. Providing education that addresses EHR software; EHR usability; and collaboration among staff, providers, and EHR system managers has been shown to reduce ED wait times and decrease the risk of medication errors. The purpose of …

Maternal And Child Health Access Disparities Among Recent African Immigrants In The United States, Bakali Mukasa

Walden Dissertations and Doctoral Studies

Health care disparities are U.S. national public health concerns that disproportionately affect minority populations. The focus of published studies on the health of larger immigrant populations from Europe, Asia, South America, and the Caribbean has revealed a knowledge gap on the health of African and other minority immigrants. The purpose of this phenomenological study was to explore disparities in access to maternal and child health (MCH) care as well as the causes and effects of such disparities to care-seeking experiences of recent African immigrants. Andersen's behavioral model of health services use provided the theoretical lenses to interpret study findings. Eleven …

Water Management Efficiency In The Food And Beverage Industry, Maria Del C Reyes Torres

Walden Dissertations and Doctoral Studies

Water is critical for food production, food security, and health. Water quality management influences freshwater sustainability, land, and energy administration. Global agriculture accounts for more than 70% of all water consumption; the fertilizer, manure, and pesticide overspills are chief sources of water pollution worldwide. On a global scale, food-related waste directly impacts local food production and water resource management. The purpose of this multiple-case study on the food and beverage (FB) industry in the State of Georgia was to identify successful strategies for improving water management efficiency. The concepts of systems thinking, adaptive resource management, and integrated water resource management …

The Key Components Of A Highly Effective Title I Reading Program, George Spalaris

Walden Dissertations and Doctoral Studies

In a suburban school district in the northeastern United States, 10% to 15% of students at an elementary school received Title I reading services resulting in a low performing school designation. The purpose of this intrinsic case study was to complete a process-based evaluation identifying key instructional components of a high performing Title I reading program. Using data-based decision making theory as the conceptual framework, the goal of this study was to examine key instructional components of a highly effective Title I reading program in a school consistently scoring in the 90th percentile or higher on the state reading test. …

Effect Of Class Size On Student Achievement In Secondary School, Christopher Eric Uhrain

Walden Dissertations and Doctoral Studies

The school board of a school district in South Carolina has proposed to increase class size in all schools due to mandatory budgetary reductions. However, at the secondary school level, the literature on the effect of larger class size on student achievement is conflicting. The theoretical framework by Lazear suggested that the minimization of negative externalities (i.e., problematic behavioral and academic characteristics of students) achieved through the mechanism of smaller class size impacts student learning. Reducing the number of students in a classroom alters the entire classroom environment, creating a more positive learning environment in which students are able to …

The Relationship Between Suicide Ideation And Adult Support Among African American Adolescent Lesbians, Latonya Jill Watters

Walden Dissertations and Doctoral Studies

The suicide rate among African-American youths has significantly increased in recent years. Studies have indicated that racism, sexism, and homophobia put African-American adolescent lesbians (AAALs) at high risk for suicide. Earlier studies recognized the importance of adult support for adults, but the relationship between the AAAL suicide rate and the level of adult support has never been formally studied. Based on social support theory, this survey study examined the relationship between adult social support and attitudes toward homosexuality (as the independent variables) and suicidality and hopelessness (as the dependent variables) in a convenience sample of 200 self-identified 13-to-19-year-old AAALs. Data …

An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore

Walden Dissertations and Doctoral Studies

Seasonal influenza, or the flu, impacts over 3 million people each year. Within the health sector, nosocomial infection and absenteeism are frequently associated with the flu. The Centers for Disease Control and Prevention (CDC) recommend flu vaccination for all eligible individuals, especially health care workers (HCWs). Interventions associated with increased HCW vaccination include educational programs and occupational health campaigns to address misconceptions regarding vaccine safety and efficacy. This project evaluated the impact of a voluntary, web-based education module to encourage registered nurse (RN) vaccination. The logic and health belief models served as the theoretical frameworks. In a nonequivalent group design, …

Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling

Walden Dissertations and Doctoral Studies

The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease …

Nurses' Knowledge Of Pain Assessments And Reassessments Impacts Hospitalized Patients' Reporting Of Pain, M. Michele Potter Williams Williams

Walden Dissertations and Doctoral Studies

Ineffective pain management can prolong a patient's length of stay and increase cost of care. Inadequate pain control decreases the patient's quality of life and contributes to poor health outcomes. A recent record audit showed that documentation of pain reassessments occurred only 20% of the time within an hour after administering pain medication. Furthermore, nurses may have insufficient knowledge regarding pain assessments and reassessments or hold irrational fears about addiction leading to inadequate treatment of pain. The purpose of this quality improvement project was to evaluate the effectiveness of an educational program for acute care nurses for the assessment and …

A Qualitative Evaluation Of Leader-To-Millennial Relationship Development, Tywana Williams

Walden Dissertations and Doctoral Studies

Generational conflicts affect socialization practices needed for knowledge transfer and Millennial retention. Because of failed socialization practices, organizations will face significant losses in knowledge capital as Boomers retire and Millennials began to take active roles within the workplace. This interpretative phenomenological study explored Millennials' perceptions of leader-to-employee relationship development that may influence organizational learning and retention practices. Millennial retention is a primary concern in that knowledge acquired is a result of longevity and work experience. The leader-to-member exchange theory was used to navigate this qualitative inquiry. The reflexive approach was implemented to explore 20 Millennial participants' experiences with their managers. …

Assessing The Level And Impact Of Financial Literacy On African Americans, Robert A. Amoah

Walden Dissertations and Doctoral Studies

Individuals are faced with making important economic decisions regarding retirement, savings, investing, and insurance. Across the globe, developed and emerging economies are experiencing growth in the sophistication of financial markets and products. Individuals require a greater degree of financial literacy to understand and explore these sophisticated and emerging financial markets and products. A review of literature revealed African Americans, however, lack the decision-making tools to function in the financial world. The purpose of this study was to assess the extent to which African Americans have financial knowledge. The sample size was 382 African Americans residing in Columbus, Ohio. The study …

Exploring Leadership Strategies To Maximize Profitability In The Nigerian Housing Sector, Babatunde Adesiyan

Walden Dissertations and Doctoral Studies

The collapse of construction companies in the Nigerian housing sector continues unabated, even in the face of 17 million housing deficits. Many construction company leaders believe that lack of business opportunities and the recent world economic decline have been responsible for the collapse. This situation has resulted in limited business activities for 80% of the Nigerian construction companies. This multiple case study explored the strategies used by leaders to maximize profitability in the Nigerian housing sector. The RBV and Porter's model of competition provided the conceptual framework for the study. Findings were based on detailed reviews of the policies and …

Nigerian Women's Empowerment Status And Its Influence On Access To Reproductive Health Services, Temi Aregbesola

Walden Dissertations and Doctoral Studies

Nigeria is a patriarchal society, which puts women in subordinate positions that may prompt gender-based discrimination. While evidence of this phenomenon has been investigated in Nigeria and other African countries, no such investigation has been conducted with immigrant and first-generation Nigerian women in the United States. The purpose of this study was to examine the role of a Nigerian woman's perceived empowerment and status on her willingness to access reproductive health services. The research questions examined views of Nigerian traditional beliefs' influence on status and how attitudes around traditional beliefs relate to access to reproductive health services and/or knowledge. Data …

Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr

Walden Dissertations and Doctoral Studies

Physical activity is associated with many health benefits to include weight management, lower risk for chronic diseases, and improved mental health and self esteem. The built environment has been linked to lower physical activity levels and overweight and obesity in children living in low income communities but the exact causes need further investigation. The purpose of this quantitative, cross sectional study was to examine the association between parents' perception of safety and body mass index (BMI) percentile and children's physical activity/ inactivity levels and children's BMI as measured by the National Survey of Children's Health (2011/12 NSCH). The sample consisted …

Predictors Of Stress Among Caribbean Community College Students, Jean Merle Da Silva

Walden Dissertations and Doctoral Studies

Research on North American and European students have reported moderate to severe levels of stress in more than 90% of students, which has been linked to negative health outcomes. However, there is a paucity of data on the stress of Caribbean students. Higher education in the Caribbean has undergone a transformation with wider access and higher enrollment; thus, it is important that the effects and characteristics of this transformation are researched and documented. Accordingly, the purpose of this quantitative study was to examine the experience of students in 2 year community colleges in the Caribbean. Using the theoretical foundation of …

Gender And Racial/Ethnic Differences In The Effects Of Child Sexual Abuse, Sandra Gray

Walden Dissertations and Doctoral Studies

Child sexual abuse (CSA) has been linked to a number of adverse effects including hypersexuality (HYP), substance use (SUB), suicidality (SUI), and depression (DEP). Despite a plethora of research on CSA, little is known about how it affects adolescents and the cultural factors that influence their coping styles. This study was founded on social-cultural coping theory and the model of traumagenic dynamics of sexual abuse, suggesting that CSA consequences lead to maladaptive coping mechanisms influenced by sociocultural factors. Using archival data, log-linear analysis was conducted to examine gender differences within racial/ethnic groups in HYP, SUI, DEP, and SUB among adolescent …

Case Study Of Teen Mother Perceptions Of Their Influence On Preschoolers' Language Development, Mary Schmidt Duncan

Walden Dissertations and Doctoral Studies

Children born to teen mothers tend to score lower on language development assessments and to have school readiness delays. To support teen mothers and their children in improving language development, educators need information about mothers' daily interactions with their children and how they contribute to their children's language development. The purpose of this descriptive case study was to understand mothers'perceptions of how they influenced their children's language development through play, routines, and other informal interactions. Flavell, Vygotsky, and Bruner's views on how learners' construct knowledge informed the study. Research questions were focused on the mothers' perceptions regarding interactions during routines …

A Phenomenological Study Of Methadone Treatment By Opiate-Dependent Individuals Ages 50-55 Years, Lamart Hightower

Walden Dissertations and Doctoral Studies

Today's methadone patients differ from those of the past due to increases in polydrug use, mental health issues, and medical needs. Patients requiring methadone treatment for their opiate addiction are now older than those who initially presented for treatment when methadone treatment first started. The number of older opiate users will continue to grow as the population continues to age. Although previous studies on opiate addiction focused on using methadone in treatment of younger adults, this study used phenomenological methodology to explore the lived experiences of opiate addicted methadone users between the ages of 50 to 55, an understudied population. …

Perioperative Orientation, Education, And Mentoring (Poem) Program, Esther M. Johnstone

Walden Dissertations and Doctoral Studies

Perioperative registered nurses (RNs) are vital to the provision of safe patient care for those undergoing invasive and surgical procedures within acute care settings. Unrealistic transition-to-practice (T2P) expectations for novice RNs (newly licensed and experienced RNs new to perioperative nursing) have resulted in significant turnover and attrition rates as high as 45%. A T2P program, known as the Perioperative Orientation, Education, and Mentoring (POEM) program, was developed to address attrition and turnover through mentoring and professional development. The POEM program was a pilot program implemented at a large academic medical center. An evaluation tool known as the Surgical Skill Assessment …

The Relationship Between Increased Police Patrols And Violent Crime Rates In Seven United States Cities, Victor Sylvester Kabia

Walden Dissertations and Doctoral Studies

Large, metropolitan areas across the nation have experienced high rates of violent crime over the past 2 decades. As a consequence, law enforcement agencies have increased patrol efforts, but little is known about whether the decrease in violent crime rates was correlated to increased police patrols or to the economic variables of unemployment, inflation, level of education, unemployment compensation, and homeownership. The purpose of this non-experimental, correlational study was to examine the nature of the relationship between increased police patrols, the 5 economic variables, and violent crime rates in 7 large US cities for a 10-year period. The theoretical framework …

Predictors Of Influenza Vaccination Compliance Among Union And Nonunion Workers In A Pennsylvania Health Care System, Ericka Lynne Kalp

Walden Dissertations and Doctoral Studies

To improve U.S. residents' health, advocates are focusing their efforts on workplace health. Researchers have found that unionization is a positive influence on workers' participation in health promotion programs relating to smoking and obesity prevention. However, the effect of union membership on other health promotion initiatives, such as influenza vaccination compliance among health care workers, has not been examined. The purpose of this quantitative study was to address this knowledge gap between a union and a nonunion health care facility in the U.S. state of Pennsylvania. The health belief model was used to determine if different domains of influenza vaccination …

Establishing Mobile Financial Services In Ethiopia, James R. Kanagwa

Walden Dissertations and Doctoral Studies

Mobile phone service is increasing among low income populations; however, with over 1 billion mobile service users worldwide, many people still lack banking services. Banks do not reach out to the poor because of the high operational costs involved. Scholars and industry practitioners have indicated that mobile phones could be an alternative channel for delivering financial services to the less advantaged and unbanked, without requiring a traditional bank with a branch network. The purpose of this bounded case study was to explore the strategies bank managers used to implement the new mobile banking service to the Ethiopian community. The new …