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Level Of Stroke Center Designation And The Association With Hcahps Nurse Communication Scores And Hcahps Discharge Instruction Scores In North Carolina Hospitals In 2023, Donna Lee Frederick
Level Of Stroke Center Designation And The Association With Hcahps Nurse Communication Scores And Hcahps Discharge Instruction Scores In North Carolina Hospitals In 2023, Donna Lee Frederick
Walden Dissertations and Doctoral Studies
Strokes are costly and the leading cause of disability and a leading cause of death in the United States. Stroke management has improved through a partnership between The Joint Commission and The American Heart Association, which established stroke care center certifications for hospitals nationwide. Despite this progress, North Carolina (NC) remains within the Stroke Belt due to the high prevalence of stroke there. In some areas of NC, the stroke mortality rate is 40% higher than the national average. Guided by the Donabedian model, this quantitative correlational study investigated the association between stroke center designation levels and the Hospital Consumer …
Clinical Supervision In Local County Jails: The Descriptive Experiences Of Mental Health Supervisors, Vanessa Qualls
Clinical Supervision In Local County Jails: The Descriptive Experiences Of Mental Health Supervisors, Vanessa Qualls
Walden Dissertations and Doctoral Studies
The overrepresentation in correctional settings of persons who are seriously mentally ill and/or challenged with addiction has necessitated the presence of qualified mental health professionals. Implementation of quality mental health treatment in correctional settings has been met with various barriers, such as limited resources, physical space constraints, and safety concerns. While these barriers are present in most correctional settings, jails are more likely to encounter individuals who are experiencing acute symptoms related to mental illness and addiction, aggression, and crisis. Mental health counselors make up a significant portion of the mental health workforce in jail settings and may assume clinical …
Navigating Sexuality In Therapy: Counselors Lived Experiences Of Initiating Conversations With Clients, Sandra Mireles
Navigating Sexuality In Therapy: Counselors Lived Experiences Of Initiating Conversations With Clients, Sandra Mireles
Walden Dissertations and Doctoral Studies
Gaps in counselor education leave many counselors inadequately prepared to initiate sexuality-related conversations with clients. This qualitative hermeneutic phenomenological study was an exploration of the lived experiences of independently licensed mental health counselors and the personal, cultural, and professional meanings they constructed around initiating conversations related to sexuality. Guided by hermeneutic phenomenology and social constructivism, semistructured interviews were conducted with six independently licensed mental health counselors who had practiced independently for at least 5 years and primarily worked with adult clients. Data were analyzed using interpretative phenomenological analysis (IPA). Three overarching themes emerged: (a) societal and religious influences and misconceptions …
The Lived Experiences Of Workplace Discrimination Of Transgender People In Mississippi, Wendy Mann
The Lived Experiences Of Workplace Discrimination Of Transgender People In Mississippi, Wendy Mann
Walden Dissertations and Doctoral Studies
In recent years, transgender people have been more open to living as the gender they believe they were meant to be, instead of the gender they were born as. With this decision, they are more susceptible to mistreatment and discrimination in the workplace. The purpose of this qualitative study was to explore and understand the experiences and perceptions of discrimination of transgender individuals within workplaces in the U.S. state of Mississippi. Transgender identity development (TID) and social identity theory provided a theoretical framework for examining participants’ lived experiences of perceived transgender workplace discrimination, navigation of this discrimination, and the role …
Relationship Between Financial Performance And Healthcare Quality Outcomes, Ela C. Lena
Relationship Between Financial Performance And Healthcare Quality Outcomes, Ela C. Lena
Walden Dissertations and Doctoral Studies
Hospital leaders face increasing pressure to improve quality outcomes while controlling costs. The evidence is limited on whether hospital financial performance predicts overall quality star ratings. Grounded in the general contingency theory, this quantitative, correlational project examined the predictive relationship between operating margin, current ratio, and a composite of quality metrics represented by the overall hospital Quality Star Rating (QSR). Data included the population of acute care hospitals in Massachusetts with 25 or more beds, yielding a final analytic sample of 54. Four year-specific multiple linear regression models were performed from 2021 through 2024. The analyses did not indicate a …
Principals’ Experiences With Implementation Practices For School Board Policies In An Urban School District, Andrea J. Richardson
Principals’ Experiences With Implementation Practices For School Board Policies In An Urban School District, Andrea J. Richardson
Walden Dissertations and Doctoral Studies
Effective policy implementation is crucial for improving educational outcomes and ensuring equitable learning environments. While existing literature has shown that policy implementation is influenced by factors such as leadership capacity, stakeholder engagement, communication, resource availability, organization context, and accountability, there is little known about how K-12 urban principals narrate, interpret, and make meaning of their experiences to implementing board-mandated policies. This study addressed this gap by exploring how principals in an urban school district in Ohio navigated the complexities of implementing school board policies amid resource limitations, stakeholder resistance, and accountability pressures. The purpose of this qualitative narrative inquiry study …
Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi
Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi
Walden Dissertations and Doctoral Studies
The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …
The Impact Of Inclusive Leadership And Leader Cultural Intelligence On The Work Engagement Of Migrant Employees, Dena Semonia Whittle
The Impact Of Inclusive Leadership And Leader Cultural Intelligence On The Work Engagement Of Migrant Employees, Dena Semonia Whittle
Walden Dissertations and Doctoral Studies
With the rise of globalization and the growing demand for skilled workers, the number of foreign-born employees in the American workforce has grown significantly over the last 20 years. These numbers continue to grow, as the upward trend of foreign-born employees has been even more significant over the last 5 years. However, despite having a now more diverse workforce, there are still signs of discrimination and unequal treatment of migrants in the workplace. Such mistreatment has been linked to health-related, occupational, and psychological consequences and has been negatively associated with work engagement. The purpose of this quantitative study was to …
Revictimization Of Female Sexual Assault Survivors During Cross-Examination From The Perspective Of Criminal Prosecutors, Robyn Fuchs
Walden Dissertations and Doctoral Studies
Sexual assault is a heinous crime that remains one of the most underreported crimes. Victims of sexual assault face scrutiny for reporting and may be revictimized by the process. The intent of this study was to examine how cross-examination has the potential to revictimize female sexual assault survivors from the perspective of criminal prosecutors. This study may provide insight on whether defense attorneys intentionally cause harm to victims or if there is an automatic level of trauma in testifying. Ten interviews were conducted with criminal prosecutors across the United States. After the interviews, the transcripts were manually analyzed to identify …
Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah
Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah
Walden Dissertations and Doctoral Studies
Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …
Optimizing Advanced Ehr And Enhanced Data-Sharing And Reporting In Rural Health Clinics, Adaeze Honesta Duru
Optimizing Advanced Ehr And Enhanced Data-Sharing And Reporting In Rural Health Clinics, Adaeze Honesta Duru
Walden Dissertations and Doctoral Studies
Rural clinics continue to face several barriers in utilizing advanced electronic health record (EHR) features, including interoperability, data sharing, and care coordination. The purpose of this integrative review was to investigate strategies to overcome barriers to the use of advanced EHRs and enhance data-sharing and reporting capabilities in rural clinics. The review question emphasized viable strategies for overcoming barriers to advanced EHR utilization and enhancing data-sharing and reporting capabilities in rural clinics. The consolidated framework for implementation research provided a conceptual model for understanding the various facets of EHR optimization. A literature search initially resulted in 135 relevant articles. After …
Staff Education On Teach- Back Communication Method For Psychiatric Nursing Staff, Adanma Violet Ebere
Staff Education On Teach- Back Communication Method For Psychiatric Nursing Staff, Adanma Violet Ebere
Walden Dissertations and Doctoral Studies
Summary Patient education delivered without a standardized communication protocol for patients with serious mental illness (SMI), especially for those who face disproportionate health literacy deficits, cognitive challenges, and stigma, may increase the risk of medication misunderstanding and non-adherence. An outpatient psychiatric practice lacked a standardized patient education protocol. This quality improvement staff education initiative equipped all clinical nursing staff with the 5Ts for Teach Back framework, an evidence-based, five-step method endorsed by the Agency for Healthcare Research and Quality (AHRQ), The Joint Commission (TJC), and the American Hospital Association (AHA), and grounded with evidence in 13 sources at Levels I …
Navigating Trauma And Scarcity: A Phenomenological Inquiry Into Well-Being Among Black Adult Males In Ohio Valley, Devron Demont Hobbs
Navigating Trauma And Scarcity: A Phenomenological Inquiry Into Well-Being Among Black Adult Males In Ohio Valley, Devron Demont Hobbs
Walden Dissertations and Doctoral Studies
Black adult males in resource-scarce Ohio Valley communities have historically experienced trauma that disrupted their well-being. The purpose of this qualitative phenomenological study, grounded in developmental trauma disorder (DTD) theory, was to explore how Black adult males understood and sustained well-being while living with DTD in resource-scarce environments. The participants comprised six Black adult males who resided in Ohio Valley communities and experienced trauma during childhood and adulthood. Data were collected through confidential, semi-structured, face-to-face interviews and analyzed using interpretative phenomenological analysis (IPA). Five themes emerged: healing through connection and role-modeling, historical and systemic trauma as a daily barrier, navigating …
Personal Experiences With Remarkable Outcomes Of Stage 4 Cancer: A Phenomenological Study, Gail Firman Porter
Personal Experiences With Remarkable Outcomes Of Stage 4 Cancer: A Phenomenological Study, Gail Firman Porter
Walden Dissertations and Doctoral Studies
Prayer as a source of improved physical outcomes for individuals with medically diagnosed Stage 4 cancer has not been thoroughly addressed in recent academic literature, despite an increase in individual reporting within nonacademic sources.. The purpose of this phenomenological study was to explore the lived experiences of individuals in the United States who experienced remarkable healing from Stage 4 cancer after receiving Christian prayer for healing. Using the biopsychosocial-spiritual model as the conceptual framework, this study investigated the lived experiences of participants regarding their decision to seek prayer to heal their Stage 4 cancer, and its subsequent effects on their …
Staff Education To Enhance Clinical Staff Knowledge Of Medication Adherence Strategies In Bipolar Disorder, George Niyi Ojewale
Staff Education To Enhance Clinical Staff Knowledge Of Medication Adherence Strategies In Bipolar Disorder, George Niyi Ojewale
Walden Dissertations and Doctoral Studies
Medication nonadherence in bipolar disorder is a significant contributor to relapse, hospitalization, and functional decline. This doctor of nursing practice (DNP) staff education project addressed a practice gap at the project site involving inconsistent clinician knowledge and absence of a standardized approach to adherence education. The practice-focused question for this project was: How does implementing an evidence-based staff educational program improve clinical staff knowledge in supporting medication adherence in patients with bipolar disorder? The purpose of this project was to implement a structured, evidence-based educational intervention to improve clinician knowledge related to medication adherence strategies. The intervention consisted of a …
Workplace Loneliness And The Impact Of Social Connections In Distributed Teams, Belkys Stallings
Workplace Loneliness And The Impact Of Social Connections In Distributed Teams, Belkys Stallings
Walden Dissertations and Doctoral Studies
Workplace loneliness is a growing organizational challenge as the rise of distributed teams reshapes opportunities for social connection and engagement. Business leaders need to understand this challenge because it is associated with reduced belonging, lower job satisfaction, diminished productivity, and increased turnover intentions. The purpose of this quantitative correlational study was to examine the extent to which distributed team environments (remote, hybrid, or flexible) impacted workplace loneliness and whether social connectedness moderated this relationship. Social exchange theory, self-determination theory, and Weiss’s concept of loneliness grounded this study. The participants comprised 84 adults working full-time in distributed team environments across the …
Socioeconomic Determinants Of Malaria Infection Among Pregnant Women In Cameroon, Sub-Saharan Africa, Arnold Akosah Muluh
Socioeconomic Determinants Of Malaria Infection Among Pregnant Women In Cameroon, Sub-Saharan Africa, Arnold Akosah Muluh
Walden Dissertations and Doctoral Studies
Malaria during pregnancy is a significant public health issue in Cameroon, affecting maternal health and birth outcomes. Despite preventive measures, disparities exist among socioeconomic groups and between urban and rural areas. The study was guided by the social-ecological model and explored how socioeconomic factors and geographic location influence malaria infection in pregnant women. Specifically, the impact of wealth index, maternal education, and healthcare access on infection rates, considering maternal age, parity, and residence, was examined. Quantitative data from the Cameroon DHS Phase 8 were used (N=1204). The sample included pregnant women with valid malaria test results. Chi-Square tests and binary …
The Relative Strength Of Compulsive Reward-Driven Eating, Weight Self-Efficacy, And Physical Appearance Comparison In Predicting Feelings Of Self-Worth, Kathleen Rowe
Walden Dissertations and Doctoral Studies
Walden University College of Psychology and Community Services This is to certify that the doctoral dissertation by Kathleen Rowe 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. Hedy Dexter, Committee Chairperson, Psychology Faculty Dr. Medha Talpade, Committee Member, Psychology Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2026
Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh
Reducing Inpatient Falls Through Staff Education, Courage Duin Chiangeh
Walden Dissertations and Doctoral Studies
Patient falls remain a major patient safety concern, particularly among hospitalized stroke patients who are at increased risk because of impaired mobility, neurological deficits, and cognitive changes. The inpatient stroke unit selected for this quality improvement project consistently reported the highest fall rates within the hospital system, highlighting the need for evidence-based interventions. The purpose of this project was to determine whether a structured fall-prevention education program incorporating evidence-based practices and the 4Ps of purposeful rounding (pain, potty, position, and possessions) would improve staff knowledge, increase compliance with fallprevention practices, and reduce patient falls over a 2-month period. Guided by …
Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu
Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu
Walden Dissertations and Doctoral Studies
This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …
Effective Strategies To Increase Employee Engagement Within Small And Medium Enterprise (Sme) Remote Workforces, Marion Catherine Hulse-Lawlor
Effective Strategies To Increase Employee Engagement Within Small And Medium Enterprise (Sme) Remote Workforces, Marion Catherine Hulse-Lawlor
Walden Dissertations and Doctoral Studies
The prevalence of remote work environments has created challenges for small and medium enterprise (SME) healthcare leaders who must sustain workforce productivity while increasing employee engagement. Declining employee engagement affects not only productivity but also organizational effectiveness and profitability. The purpose of this qualitative pragmatic inquiry research project was to identify and explore the effective strategies that some leaders of remote SME healthcare workforces use to improve employee engagement. Using engagement theory as the conceptual lens to guide the research project, six purposefully sampled United States business leaders who demonstrated successful engagement practices within remote SME healthcare workforces were studied. …
Inclusive Leadership And Employee Engagement In Multigenerational Nigeria’S Public Sector, Monday Kohwo Unurhiere
Inclusive Leadership And Employee Engagement In Multigenerational Nigeria’S Public Sector, Monday Kohwo Unurhiere
Walden Dissertations and Doctoral Studies
Ineffective leadership continues to engender disengaged employees whose work ethics contribute to inefficient and ineffective public service delivery across several African countries. The specific research problem is the inadequacy of knowledge about leadership behaviors that foster a sense of being valued among employees of different generational cohorts, leading to intellectual, social, and emotional engagement at work. The purpose of this quantitative correlational cross-sectional study was to investigate the influence of inclusive leadership (openness, availability, and accessibility) on employee engagement (intellectual, social, and affective) in the multigenerational Nigerian public sector. The theoretical framework included the constructs of inclusive leadership, employee engagement, …
How Non-Secular Leaders In Culturally Homogeneous Faith-Based Organizations Understand And Experience Cultural Intelligence Training, Marlon Anthony Ayers
How Non-Secular Leaders In Culturally Homogeneous Faith-Based Organizations Understand And Experience Cultural Intelligence Training, Marlon Anthony Ayers
Walden Dissertations and Doctoral Studies
Over the past five decades, shifts in U.S. immigration policy, demographic change, and civil rights reforms have increased cultural diversity across the U.S. workforce, while many faith based leaders lack the cultural intelligence (CQ) needed to navigate diverse interactions effectively. Non secular leaders in culturally homogeneous faith based organizations (FBOs) need to understand this concern as a leading indicator of challenges associated with cross-cultural engagement, organizational effectiveness, and community inclusion. The specific research problem is that it is unknown how non-secular leaders in culturally homogeneous FBOs understand and experience the challenges of managing cultural diversity in the absence of CQ …
The Effects Of Home Blood Pressure Monitoring And Hospital Readmission For Hypertensive Patients, Danielle Alston
The Effects Of Home Blood Pressure Monitoring And Hospital Readmission For Hypertensive Patients, Danielle Alston
Walden Dissertations and Doctoral Studies
Within this executive summary, the type of project discussed is an organization change project to address a health issue in chronic disease management, which is hypertension. Nearly 116 million American adults are affected by hypertension, which remains a leading force for preventable hospitalizations, emergency department visits, and cardiovascular-related mortality in the United States. Unexpected readmissions due to hypertension create system-wide strains, increased financial burden and decreased patient satisfaction. Hence, the question: In adults with hypertension, does remote home blood pressure monitoring, compared with standard office-based follow-up, reduce the rate of urgent care visits and hospital admissions over a 30-day period? …
The Individual And Combined Effects Of Individualism-Collectivism Orientation And Mental Health Stigma On Perceived Social Support In Firefighters, Emma Schafer Schutte
The Individual And Combined Effects Of Individualism-Collectivism Orientation And Mental Health Stigma On Perceived Social Support In Firefighters, Emma Schafer Schutte
Walden Dissertations and Doctoral Studies
Repetitive trauma exposure predisposes firefighters to a variety of mental health issues. Despite efforts to expand mental health resources and peer support, stigma remains a significant barrier to formal (professional) and informal (peer) support-seeking within the fire service. According to social influence theory, firefighters may avoid using available support services because they perceive support-seeking as stigmatized by their peers and feel compelled to conform. Research across cultural groups suggests that individualism-collectivism orientation, which defines how individuals assign value to individual or group needs, has nuanced effects on perceptions of social support. However, the interplay of individualism-collectivism orientation, stigma, and perceived …
Mentor Evaluation Of A Black Male Youth Mentoring Program, Kenneth Brown
Mentor Evaluation Of A Black Male Youth Mentoring Program, Kenneth Brown
Walden Dissertations and Doctoral Studies
This study was an exploration of how Black male mentors perceived organizational practices, culturally responsive mentoring, relational safety, and systems level barriers shaping their effectiveness and continued participation. The purpose was to examine early mentor-mentee match dissolution and low mentor retention in a nonprofit youth mentoring through the lens of the ecological systems theory and program evaluation framework. The practice-focused research questions were: How do volunteer mentors and program staff perceive the organizational practices and culturally responsive strategies that influence mentor effectiveness and retention in youth mentoring programs, and what organizational and systemic challenges do Black male mentors encounter in …
Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu
Staff Education To Improve Staff Knowledge Regarding Candida Auris, Nkechinyere Ejelonu
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project was a staff education project regarding Candida auris, a multidrug-resistant fungus recognized by the Centers for Disease Control and Prevention (CDC) as an urgent global health threat due to its high mortality, environmental persistence, and resistance to common disinfectants. Staff play a crucial role in infection prevention; however, limited awareness and inconsistent knowledge of Candida auris contribute to potential transmission in skilled nursing home settings. The project question was as follows: Among staff members in a skilled nursing facility, does an evidence-based educational intervention improve knowledge of Candida auris infection prevention as compared pre- …
Strategies To Enhance Employee Retention Among Leaders In The U.S. Poultry Processing Industry, Gary Dale Sisson
Strategies To Enhance Employee Retention Among Leaders In The U.S. Poultry Processing Industry, Gary Dale Sisson
Walden Dissertations and Doctoral Studies
Employee turnover remains a persistent challenge in the U.S. poultry processing industry. Leaders in the U.S. poultry processing industry are concerned that high employee turnover increases operating costs, disrupts productivity, and contributes to workforce instability. Grounded in organizational support theory, this qualitative pragmatic inquiry research project explored successful strategies that leaders in the U.S. poultry processing industry use to enhance employee retention. The participants were six leaders from poultry processing facilities in the southeastern United States. Data were collected through semistructured interviews and supplemented with workplace observations and organizational records related to retention initiatives and turnover trends. Data were analyzed …
Staff Education To Improve Healthcare Staff Knowledge Of An Electronic Scheduling System In An Intensive Outpatient Program (Iop), Catherine Kinyili
Staff Education To Improve Healthcare Staff Knowledge Of An Electronic Scheduling System In An Intensive Outpatient Program (Iop), Catherine Kinyili
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice staff education project aimed to improve staff knowledge of the newly implemented electronic scheduling and booking kiosk system. A transition from a paper-based to an electronic scheduling system led to reduced staff efficiency, communication challenges, scheduling errors, and delays in patient care. An evaluation identified inconsistent staff knowledge of the newly implemented electronic scheduling system. The practice-focused question for the project was: Among healthcare staff in an intensive outpatient program, how does a one-time structured education and training session affect staff knowledge of a new electronic scheduling system? The purpose of this project was to …
Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson
Registered Nurses’ Perceptions Of Relational Service Behaviors In Nursing Practice, Dadakpoye Tina Johnson
Walden Dissertations and Doctoral Studies
Nurses play a central role in shaping patient experiences through clinical care and relational service behaviors. However, little is known about registered nurses’ perceptions and experiences of relational service behaviors in contemporary health care settings. The purpose of this interpretive description qualitative study was to explore registered nurses’ perceptions and experiences of relational service behaviors and their role in promoting patient-centered care. Herzberg’s two-factor theory provided the conceptual framework for examining how intrinsic motivators and extrinsic workplace factors influence relational engagement. Semistructured interviews were conducted with 11 registered nurses from diverse clinical practice settings. Interview data were analyzed using Braun …