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Walden Dissertations and Doctoral Studies

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Patient Education Brochure On Diabetic Foot Care In A Primary Care Setting, Trinitas (Nitas) Duru Oha Feb 2026

Patient Education Brochure On Diabetic Foot Care In A Primary Care Setting, Trinitas (Nitas) Duru Oha

Walden Dissertations and Doctoral Studies

This Doctoral Nursing Practice (DNP) project was an evidence-based quality improvement (QI) initiative. The practice problem was the absence of expert-validated diabetic foot care education materials, insufficient and inconsistent patient education, and patients' limited knowledge of self-care for diabetic foot care, all of which led to the persistence of diabetic foot complications in primary care settings. Due to the organization’s identified lack of patient education materials, an evidence-based diabetic foot care brochure for diabetic self-foot care education was developed. The patient education materials assessment tool (PEMAT) was used to evaluate the brochure's efficacy. The practice question was designed to determine …


Strategies To Recruit And Retain Imaging Ancillary Staff For Healthcare Organizations, Stephania Poveromo Feb 2026

Strategies To Recruit And Retain Imaging Ancillary Staff For Healthcare Organizations, Stephania Poveromo

Walden Dissertations and Doctoral Studies

Hospitals and healthcare facilities in the United States continue to face persistent shortages of ancillary imaging technologists, creating significant challenges for hospital administrators. The purpose of this integrative review was to identify effective strategies for recruiting and retaining imaging staff in hospitals. The review question concerned what best practices and strategies healthcare administrators can use to improve the recruitment and retention of ancillary imaging staff. The theoretical frameworks for this research, strategic human resource development and Maslow’s theory of human motivation, provided a lens for understanding organizational enhancement and employee engagement, respectively. Following the application of inclusion and exclusion criteria, …


Upper Elementary Teachers' Experiences In Teaching Narrative Writing In Title I Classrooms, Courteney O. Manning Feb 2026

Upper Elementary Teachers' Experiences In Teaching Narrative Writing In Title I Classrooms, Courteney O. Manning

Walden Dissertations and Doctoral Studies

The problem that was addressed in this study is that third through fifth grade students continue to score below district expectations on the Georgia Milestones Assessment System in narrative writing. Guided by the Ofsted inspection framework, the purpose of this basic qualitative study was to understand the experiences of upper elementary teachers teaching writing in Title I classrooms. Data were collected through semistructured interviews with 10 participants who taught upper elementary grades. Through thematic coding, four themes emerged outlining (a) the instructional success teachers experienced teaching narrative writing, (b) the instructional challenges of teaching narrative writing, (c) teachers’ beliefs about …


Law Enforcement Officers’ Experiences With Secondary Traumatic Stress And Coping While Working With Child Molesters, Aaliyah Blanding Feb 2026

Law Enforcement Officers’ Experiences With Secondary Traumatic Stress And Coping While Working With Child Molesters, Aaliyah Blanding

Walden Dissertations and Doctoral Studies

This study was focused on law enforcement officers’ experiences with secondary traumatic stress and coping while working with child molesters. Lazarus and Folkman’s cognitive model of stress and coping were used to examine how law enforcement officers manage stress, focusing on their cognitive processes and thought patterns. Using a basic qualitative approach, eight law enforcement officers who work with child molesters in the state of South Carolina were interviewed to hear their personal experiences. Interviews were semi-structured interview questions via a video-conferencing platform. The data were analyzed and coded using Braun and Clarke’s six-step thematic analysis. The study’s findings confirmed …


Leadership Styles And Safety Climate In An Integrated Healthcare System In Northern California, Darshan Kaur Grewal Feb 2026

Leadership Styles And Safety Climate In An Integrated Healthcare System In Northern California, Darshan Kaur Grewal

Walden Dissertations and Doctoral Studies

Preventable medical errors continue to challenge healthcare systems and highlight the critical role of leadership in shaping organizational safety climates. Healthcare leaders need to understand this dynamic as a primary indicator affecting patient outcomes. The purpose of this quantitative correlational cross-sectional study was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and the safety climate within an integrated healthcare system in Northern California. Avolio and Bass’s full range leadership model and Neal and Griffin’s organizational safety climate theory grounded this study. The participants comprised 2,352 clinical and nonclinical staff who completed the safety attitudes questionnaire and the …


A Nurse-Led Staff Education Program To Prevent And Detect Elder Abuse By Caregivers In The Home, Nicola Violet Brown-Walters Feb 2026

A Nurse-Led Staff Education Program To Prevent And Detect Elder Abuse By Caregivers In The Home, Nicola Violet Brown-Walters

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a nurse-led, evidence-based staff education initiative designed to improve the prevention and detection of elder abuse in the home by caregivers within an outpatient primary care setting. Elder abuse places older adults at risk for physical harm, neglect, medication mismanagement, and violations of autonomy and patient rights. Elder abuse remains a pervasive and underrecognized problem in nursing practice, often resulting from limited staff education, inconsistent screening practices, and uncertainty regarding mandatory reporting requirements. The practice-focused question examined whether implementing a nurse-led targeted education program guided by the ADDIE instructional design model and …


Turn Teams, Ashley Johnson Feb 2026

Turn Teams, Ashley Johnson

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure injuries (HAPIs) are recognized as a prominent cause of patient morbidity and mortality, affect lengths of stay, and are one of the most costly and chronic adverse events in healthcare. A structured Turn Teams program with enhancements was evaluated in a novel unit within a healthcare organization that had implemented the approach on another unit as the focus of this Doctor of Nursing Practice project. The guiding question was, Does implementing Turn Teams as a quality improvement measure improve pressure injury rates in patients with a Braden Score of 18 or lower and enhance staff compliance with the …


Colorism And The Black Family: Effects Of Colorist Messages Among Black Women, Carolyn Frink Feb 2026

Colorism And The Black Family: Effects Of Colorist Messages Among Black Women, Carolyn Frink

Walden Dissertations and Doctoral Studies

The problem examined in this study is how colorism affects Black families. The purpose of this qualitative case study was to explore the lived experiences of Black women and the colorist messages they received from family members, how those messages were internalized, and the messages perceived effects. The conceptual framework for this study was based on the colorist-historical trauma framework, and data were obtained through individual interviews with Black women ages 22–70, from various socioeconomic backgrounds and selected through purposeful sampling. A multiple case study approach was used to examine similarities and differences among the participants. A thematic analysis was …


An Exploration Of The Site Supervision During Internship Experience For Clinical Mental Health Counseling Students, William Thomas Zaffiro Feb 2026

An Exploration Of The Site Supervision During Internship Experience For Clinical Mental Health Counseling Students, William Thomas Zaffiro

Walden Dissertations and Doctoral Studies

The purpose of this interpretive phenomenological analysis (IPA) study was to understand how CMHC students experience and create meaning of site supervision during internship under the new CACREP (2024) Standards. The bulk of the literature on this topic comes from allied social sciences and little research is available in the clinical mental health discipline. As such, there is a need to better understand this experience from the perspective of CMHC students. The study was grounded in interpretive phenomenology and used the rigorous IPA process to explore students’ lived experiences of supervision. I conducted a study using semi-structured interviews with eight …


The Impact Of Cultural Competence On Patient Outcomes In The Bahamas, Erinique Denise E. Ingraham Feb 2026

The Impact Of Cultural Competence On Patient Outcomes In The Bahamas, Erinique Denise E. Ingraham

Walden Dissertations and Doctoral Studies

In The Bahamas, the quality of care received by culturally diverse patients remains generally poor, highlighting an inability to adapt to the changing climate and adopt culturally responsive practices. The purpose of this quantitative causal-comparative study was to examine the relationship between perceived cultural competence of healthcare providers in The Bahamas and its impact on patient outcomes for the non-Bahamian patients they treat. The tripartite model of cultural competence grounded this study. The participants comprised 49 non-Bahamian patients from the public and private sectors. They completed the patient-reported physician cultural competency measure, self-efficacy for managing medications and treatments, and the …


Perspectives Of Early Childhood Degree Students, Mentors, And Faculty On Quality Field Experiences, Carmen Cook Feb 2026

Perspectives Of Early Childhood Degree Students, Mentors, And Faculty On Quality Field Experiences, Carmen Cook

Walden Dissertations and Doctoral Studies

There is a need for high-quality practice-based field experiences as a component of early childhood teacher preparation programs. This need had been deemed critical and was prioritized by both national and local organizations in a Midwest state. Little research had focused on the quality of field experiences. Guided by Dewey’s progressive education and Vygotsky’s social cultural theory, the purpose of this basic qualitative study was to explore the perspectives of students, mentor teachers, and faculty on what constitutes high-quality field experiences and what components of the field experience are most important. Semistructured interviews were conducted with 16 early childhood degree …


The Relative Importance Of Cultural Competence And Compassion Fatigue In Predicting Nurse Prescribing Self-Efficacy, Debarah Lane Jowett-Gordon Feb 2026

The Relative Importance Of Cultural Competence And Compassion Fatigue In Predicting Nurse Prescribing Self-Efficacy, Debarah Lane Jowett-Gordon

Walden Dissertations and Doctoral Studies

As a result of the growing diversity among citizens requiring medical care, there has been a substantial increase in immigrants globally and in the United States. In the U.S. healthcare system, nurse practitioners (NPs) have been facing increased cultural challenges. The purpose of this quantitative study was to determine the relative importance of cultural competence and compassion fatigue in predicting nursing prescribing self-efficacy. Cultural competence served as the theoretical framework, as it focuses on how NPs can effectively communicate with patients from diverse backgrounds by understanding and respecting cultural differences, thereby building trust, improving patient outcomes, and providing quality healthcare. …


School Administrators’ Perspective On Juvenile Delinquency, Ebonee Thomas Feb 2026

School Administrators’ Perspective On Juvenile Delinquency, Ebonee Thomas

Walden Dissertations and Doctoral Studies

This qualitative study explored the lived experiences of school administrators in Maryland public schools regarding the implementation of discipline policies and their impact on juvenile delinquency. Prompted by rising concerns about delinquent behavior and inconsistent consequences for students, the research investigated how administrators perceive and navigate the challenges of enforcing discipline and the strategies they employ to foster safe, positive school environments. Grounded in defiance theory and social learning theory, the study used open-ended surveys to gather insights from 16 retired and current principals and assistant principals in Maryland public school systems. The findings reveal that while discipline policies provide …


Improving Clinical Staff Competence In Depression Screening Using Phq Tools: A Staff Education Initiative, Mwandu Chisanga Feb 2026

Improving Clinical Staff Competence In Depression Screening Using Phq Tools: A Staff Education Initiative, Mwandu Chisanga

Walden Dissertations and Doctoral Studies

This Doctoral Project was an educational project designed to improve standardized depression screening processes among the clinical staff of a behavioral health agency. This project addressed the gap of irregular implementation of the Patient Health Questionnaire-2 (PHQ-2) and PHQ-9 at this facility. The clinical practice issue being addressed by this project was, "Among clinical workers conducting depression screening, how does having a staff education program influence knowledge, confidence, and screening accuracy of the PHQ-2 and PHQ-9. Instructional intervention was developed based on the (Analyze, Design, Develop, Implement, Evaluate (ADDIE) model of instructional design. The program was delivered through standardized in-person …


Educator Retention And Director Practices In Early Childhood Education Settings, Katherine Williams Feb 2026

Educator Retention And Director Practices In Early Childhood Education Settings, Katherine Williams

Walden Dissertations and Doctoral Studies

Early childhood education (ECE) educators leave their profession at a rate 14% higher than K-12 educators, resulting in multisystemic issues that affect children, families, staff, and the ECE industry. Research has shown a connection between leadership practices and ECE educator turnover intentions; however, there is limited research on the relationship between the servant-leadership (SL) practices of ECE directors and ECE educators’ turnover intentions. Grounded in Greenleaf’s theory of servant-leadership, the purpose of this quantitative study was to explore the relationship between ECE director SL practices and its seven dimensions, measured using the SL scale, and ECE educator turnover intentions, measured …


Staff Education To Prevent Falls Among Older Adults In Primary Care, Chioma Nwosu Feb 2026

Staff Education To Prevent Falls Among Older Adults In Primary Care, Chioma Nwosu

Walden Dissertations and Doctoral Studies

Falls are a significant health concern for the elderly population and a major cause of injury and functional decline among older adults, yet fall prevention practices are inconsistently applied in primary care. The purpose of this project is to evaluate the impact of staff education on fall risk screening and prevention for adults aged 65 years and older using the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) framework. This project employs a pre–post quality improvement design in a primary care clinic. Clinical staff received education on STEADI-based fall risk assessment, documentation, and evidence-based interventions. Data were collected through chart …


Risk Management Strategies For Project Efficiency, Paulisa Janel Scarlett Feb 2026

Risk Management Strategies For Project Efficiency, Paulisa Janel Scarlett

Walden Dissertations and Doctoral Studies

Ineffective risk management strategies negatively impact organizational leaders due to potential project failures, financial losses, and diminished stakeholder trust. Grounded in general systems theory, this qualitative pragmatic inquiry was to explore senior project managers’ risk management strategies for enhancing project outcomes, efficiency, and profitability. Nine senior project managers from construction, software development, marketing, mechanical engineering, and automotive manufacturing, all overseeing complex, high-risk projects, participated in the study. Data were collected through semistructured interviews, organizational reports, and project documents. Thematic analysis, using Braun and Clarke’s six-step process, was employed to identify patterns aligned with the research questions. Five major themes emerged: …


Staff Education To Improve Knowledge Of Nurse-Led Telemonitoring For Suicide Prevention, Finny Ngozi Rogers Feb 2026

Staff Education To Improve Knowledge Of Nurse-Led Telemonitoring For Suicide Prevention, Finny Ngozi Rogers

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a staff education initiative addressing a critical practice gap: clinical staff at a mental health facility lacked the practical knowledge to implement evidence-based telemonitoring protocols for suicide prevention, despite strong supporting research. High rates of suicide attempts and readmissions underscored the urgency for this intervention. The practice-focused question was: “Will a staff education program designed to educate healthcare providers on nurse-led telemonitoring protocols increase staff knowledge?” The purpose of this project was to develop, implement, and evaluate an educational program for providers to increase their knowledge on how a telemonitoring protocol can reduce …


Relationship Between Transportation Availability And Obstetric Access In Predicting United States Maternal Death Rates, Veronica N. Trueblood Feb 2026

Relationship Between Transportation Availability And Obstetric Access In Predicting United States Maternal Death Rates, Veronica N. Trueblood

Walden Dissertations and Doctoral Studies

Maternal mortality remains a significant challenge in the United States with substantial variation across counties reflecting differences in health care delivery systems and access to obstetric services. Fragmented obstetric care networks, hospital closures, and geographic barriers to care contribute to delays in prenatal and emergency obstetric services, increasing the risk of preventable maternal deaths. Guided by the social determinants of health (SDOH) framework, this quantitative cross-sectional health services study examined relationships between transportation availability, obstetric care access, and county-level maternal mortality in the United States. A national scope was required to achieve an adequate analytic sample size, as maternal mortality …


Exploring Strategies To Improve Turnover Staffing Shortages And Support For In-Home Family Caregivers, Katrina V. Tate Feb 2026

Exploring Strategies To Improve Turnover Staffing Shortages And Support For In-Home Family Caregivers, Katrina V. Tate

Walden Dissertations and Doctoral Studies

Home care workers play a vital role in supporting older adults, yet retaining staff in these positions can often be challenging. The purpose and review question for this integrative review concerned the strategies and best practices for home health agencies to retain formal caregivers and implement in-home/informal caregiving as an integral component of the caregiving team. Penchansky and Thomas’s theory of access supported this study by highlighting how the qualities and expectations of home care workers align with their patients. A comprehensive review of the literature resulted in 53 articles, which were screened for quality and relevance. Of these, 24 …


Ethical Decision-Making And Modification Of Service Delivery: Social Workers In Connecticut During Covid, Marie Elana Hollingsworth Feb 2026

Ethical Decision-Making And Modification Of Service Delivery: Social Workers In Connecticut During Covid, Marie Elana Hollingsworth

Walden Dissertations and Doctoral Studies

Social work professionals often experience demanding and intense situations while facing organizational restructuring during crisis situations. The purpose of this generic qualitative study was to explore the viewpoints of frontline social workers regarding their ethical decision-making processes in response to the mandatory modifications of the service delivery protocol during the COVID-19 pandemic. Enck’s biomedical and ethical decision-making framework grounded the study. Data were collected from semi-structured interviews with 10 frontline social workers in Connecticut who had been employed with a social service agency for at least 3 years, but no more than ten. Findings from coding and thematic analysis yielded …


Staff Education For Assessment Of Suicidal-Ideation In Patients Admitted With Mental-Illness, Sukhwinder Kaur Sangha Feb 2026

Staff Education For Assessment Of Suicidal-Ideation In Patients Admitted With Mental-Illness, Sukhwinder Kaur Sangha

Walden Dissertations and Doctoral Studies

This quality improvement project was focused on enhancing quality of nursing assessments for suicide risk among adults with psychiatric illnesses at a behavioral healthcare hospital. Inconsistencies involving assessing risks for suicide in patients who were treated in the facility led to inadequate treatment plans and missed opportunities for timely intervention, as well as potential risks for self-harm. Factors that were identified as relating to the gap in practice included inadequate knowledge or understanding of use of evidence-based suicide assessment rating scales, insufficient time that is dedicated to conducting thorough assessments, lack of standardized protocols for reinforcement, and limited resources for …


Lowering Morbidity And Readmissions Of Underserved Preterm Infants To Reduce Acute Care Hospital Spend, Adaugo Amuta Feb 2026

Lowering Morbidity And Readmissions Of Underserved Preterm Infants To Reduce Acute Care Hospital Spend, Adaugo Amuta

Walden Dissertations and Doctoral Studies

Neonatal readmissions remain a significant challenge in urban acute care hospitals serving indigent preterm infants. These readmissions impose substantial financial burdens, with high-cost conditions such as bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity driving recurring expenditures. This integrative review examined strategies that healthcare administrators can implement to reduce neonatal readmissions, improve care equity, and optimize healthcare spending in hospitals serving vulnerable populations in the Commonwealth of Virginia. A comprehensive literature search of empirical and non-empirical studies yielded 105 results for quality assessment using the Johns Hopkins appraisal tools. A total of 29 were included for thematic analysis. Five main …


Impact Of Suicide Literacy In Hispanic/Latinx Communities, Denisse Centeno Lamas Feb 2026

Impact Of Suicide Literacy In Hispanic/Latinx Communities, Denisse Centeno Lamas

Walden Dissertations and Doctoral Studies

No abstract provided.


The Relationship Between Social Determinants And Primary Care Utilization Among Medicaid Recipients In A Managed Care Community Health Worker Program, Rachel Elaine Rosensteel Feb 2026

The Relationship Between Social Determinants And Primary Care Utilization Among Medicaid Recipients In A Managed Care Community Health Worker Program, Rachel Elaine Rosensteel

Walden Dissertations and Doctoral Studies

Community health worker (CHW) programs are an increasingly important strategy for addressing social determinants of health (SDOH) within Medicaid systems. However, evidence on how specific SDOH impact healthcare utilization remains limited. In this quantitative, correlational study, the relationship between SDOH factors like housing instability, food insecurity, and transportation barriers, and primary care utilization among adult Medicaid recipients aged 18–65 who participated in a Medicaid managed care organization’s CHW program in Clark County, Nevada, during 2023 were examined. Retrospective administrative data from 441 participants were analyzed using negative binomial regression to assess associations between SDOH factors and postintervention primary care visits …


Assessing The Appropriateness Of Mental Health Patients For Telehealth Care, Jacquelyn Hamed Feb 2026

Assessing The Appropriateness Of Mental Health Patients For Telehealth Care, Jacquelyn Hamed

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project developed an evidence-based clinical practice guideline (CPG) to address the inconsistent selection of patients for telepsychiatry services. Using the Johns Hopkins evidence-based practice model and evaluated through the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, the project translated research findings into a practical tool for improving clinical decision-making. Telepsychiatry has been shown to produce outcomes comparable to in-person care for mild to moderate psychiatric conditions. However, without clear criteria, some patients with complex or high-acuity disorders are inappropriately scheduled for virtual visits, posing safety and quality risks. The CPG …


Educators Of Color’S Perceptions On The Influence Of Induction Practices, Malia Oshiro Lee Feb 2026

Educators Of Color’S Perceptions On The Influence Of Induction Practices, Malia Oshiro Lee

Walden Dissertations and Doctoral Studies

The problem addressed in this this study is the low retention of educators of color despite increased funding and resources aimed at supporting early career teachers in Washington State public schools. Elfers et al. noted that in Washington State over the course of 4 periods of time, early career educators of color are more likely to leave the profession than their White counterparts. Grounded in Holtom et al.’s job embeddedness theory, the purpose of this qualitative study was to explore educators of color’s perceptions about the usefulness of induction practices as it relates to their professional needs and career retention. …


Mitigating Vicarious Traumatization From Exposure To Human Trafficking For Human Services Professionals, Andrea T. Charles-Alleyne Feb 2026

Mitigating Vicarious Traumatization From Exposure To Human Trafficking For Human Services Professionals, Andrea T. Charles-Alleyne

Walden Dissertations and Doctoral Studies

Human trafficking is a devastating form of exploitation that not only has detrimental impacts to its victims but also the human services practitioners charged with and committed to their service provision. The secondary impact for professionals is not to be underestimated, as repeated exposure to the traumatic experiences of their clients can potentially lead to physical as well as emotional symptoms such as vicarious trauma, compassion fatigue, and burnout. Often, practitioners prioritize the needs of their clients with a relentless focus on advocacy and the overall well-being of those they serve. The purpose of this qualitative action research study was …


Secondary Students’ Mental Health And Absenteeism Post-Covid-19: School Social Workers’ Perspectives, Tiffany Hines Sutton Feb 2026

Secondary Students’ Mental Health And Absenteeism Post-Covid-19: School Social Workers’ Perspectives, Tiffany Hines Sutton

Walden Dissertations and Doctoral Studies

School social workers practice in a post-COVID-19 educational context where anxiety, depression, and emotional dysregulation are closely associated with chronic absenteeism among middle school students. This practice problem is central to clinical social work because distress-based avoidance is often misinterpreted as defiance, resulting in punitive responses that intensify disengagement. The purpose of this doctoral project was to explore how school social workers perceive and respond to the interconnected dynamics of student mental health and chronic absenteeism following COVID-19. Bronfenbrenner’s ecological systems theory guided the inquiry. A qualitative descriptive design was employed using semi-structured interviews with 10 middle school social workers …


Financial Stability Success Strategies For Nursing Homes, Jennifer Helene Garrison Feb 2026

Financial Stability Success Strategies For Nursing Homes, Jennifer Helene Garrison

Walden Dissertations and Doctoral Studies

Ineffective regulatory strategies can lead to reduced financial stability. Nursing home leaders who wrestle to improve regulatory practices may find their business facing reduced financial sustainability. Grounded in management by objectives theory, the purpose of this qualitative pragmatic inquiry research project was to identify and explore the effective strategies nursing home leaders used to implement regulatory compliance practices that increase financial sustainability. The participants were nine nursing home leaders who had successfully implemented regulatory compliance strategies within their organizations. Data was collected through semistructured interviews, public websites, and current and archival public documents. Through thematic analysis, three themes were identified: …