Digital Commons Network^™

Assessing Clinical Software User Needs For Improved Clinical Decision Support Tools, Kimberly B. Denney

Walden Dissertations and Doctoral Studies

Consolidating patient and clinical data to support better-informed clinical decisions remains a primary function of electronic health records (EHRs). In the United States, nearly 6 million patients receive care from an accountable care organization (ACO). Knowledge of clinical decision support (CDS) tool design for use by physicians participating in ACOs remains limited. The purpose of this quantitative study was to examine whether a significant correlation exists between characteristics of alert content and alert timing (the independent variables) and physician perceptions of improved ACO quality measure adherence during electronic ordering (the dependent variable). Sociotechnical theory supported the theoretical framework for this …

Analysis Of Telephonic Pharmacist Counseling, Katherine N. Swift

Walden Dissertations and Doctoral Studies

Medication complexity and nonadherence are significant risk factors for avoidable hospitalizations and health care spending for older adults in the United States. However, limited empirical research has investigated pharmacist-run telephonic medication management programs as a potential solution to the problem of reducing medication complexity while improving medication adherence. This quantitative study employed the behavioral change model to analyze archival data from a sample of 1,148 participants, examining the relationship of a pharmacist-run telephonic consulting program on medication adherence and medication complexity for one pharmacy benefit management firm's Medicare Part D recipients. The primary research questions investigated the relationship of medication …

Relationship Between Community Violence Exposure, Gender, And Social Information Processing, Yvonne Twana Bell

Walden Dissertations and Doctoral Studies

Violent behaviors among adolescents serve as a disruption to many aspects of society. If these behaviors remain uncorrected, there is increased potential for serious self-harm, harm to others, incarceration, and escalation of violence into homicide or suicide. The purpose of this study was to examine the relationship between youth exposure to community violence and adolescents' social information processing underlying aggressive responses, as well as the potential role of gender in moderating this relationship. A sample of 160 male and female 18-year-olds from the Midwestern United States completed an online survey, which included the Things I Have Seen and Heard (TISH) …

Teacher Perceptions About Sustaining A Successful School-Within-Aschool, Edward Meidhof

Walden Dissertations and Doctoral Studies

Attempts to restructure public high schools by establishing separate school-within-a-school (SWS) models have not endured beyond 3 to 5 years. This qualitative case study examined a SWS that has thrived for more than 12 years. The study investigated how teachers at the school explained the success of the SWS, their experience of working at the SWS, and their resilience in addressing the challenges that led to the lack of success of other SWS schools. The theories and models of educational change developed by Fullan, Hargreaves, and Giles and Hord provided a conceptual framework for the study. Data were collected through …

A Proposal For The Development Of An Exercise Program To Treat Post Thrombotic Syndrome, Christy Jean Hansen

Walden Dissertations and Doctoral Studies

Healthcare costs continue to escalate and hospitals need to use programs that encourage cost effectiveness, reduce resources and staffing, and increase patient accountability for their own healthcare risk factors, comorbidities, and participation in their healthcare decisions. Post Thrombotic Syndrome (PTS) is a debilitating disease with few treatment options. Allowing patients to have shared decision making in a care plan for this disease process that involves an exercise program may be a significant factor in the success or failure of their own healthcare goals and outcomes. The development of a proposal for an exercise program for PTS should provide patients with …

Governmental Procurement Restrictions, Deficit Reductions, And The Sustainability Of Alaska Native Corporations, Paul O. Fondren

Walden Dissertations and Doctoral Studies

Alaska Native Corporations (ANCs) came under political scrutiny in the United States in 2009 during a climate of economic recession and governmental spending reductions. Since then, ANCs have faced increased governmental regulations that immediately changed the ways that their leaders previously achieved growth and success. The purpose of this explanatory case study was to identify elements of ANC strategic plans that lead to success and growth when operationally implemented. The central research questions investigated what executable strategic plans ANC leaders need to ensure sustainable business growth and what practices have led to success and failures. Data were collected from interviews …

Behavioral Operations Management In Federal Governance, Frederick Leonard Mobley

Walden Dissertations and Doctoral Studies

The environmental uncertainty of federal politics and acquisition outsourcing in competitive markets requires an adaptive decision-analysis structure. Practitioners oriented toward exclusively static methods face severe challenges in understanding qualitative aspects of organizational governance. The purpose of this grounded theory study was to examine and understand behavioral relationship attributes within intuitive, choice, judgment, or preference decision-making processes. The problem addressed in this study was the detrimental effects of organizational citizenship behavior (OCB), compulsory citizenship behavior (CCB), and social exchange theory (SET) on the acquisition management relationship The OCB, CCB, SET dictates that sound business development, relationship acumen, emotional intelligence and perceptiveness …

Examining The Impact Of Collaboration Between Probation, Victim Services, And Offender Treatment Providers On Domestic Violence Offender Outcomes, Cedar Stagner

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), continues to be an issue in the United States, despite various intervention approaches and efforts to improve them over the past 40 years. Even if IPV offenders attend treatment and pursue rehabilitation, current efforts appear marginally effective in reducing its reoccurrence. The purpose of this ex-post facto, comparative, quantitative study was to determine whether there was a significant difference in outcomes between male offenders (N = 126) who attended treatment programs that participated in a tripartite collaboration with probation and victim services versus offenders (N = 126) who did not. Bronfenbrenner's …

The Association Between Core Science Course Timing And Completion Of An Associate Degree Nursing Program, Patricia Ann Pfeiffer

Walden Dissertations and Doctoral Studies

The aging population in the United States has led to an increased demand for registered nurses. Nursing program administrators must examine ways to increase nursing program completion, which will increase the supply registered nurses. The purpose of this study was to determine the associations among length of time between core science course completion and nursing program admission, on-time completion, and National Council Licensure Examination for Registered Nurses (NCLEX-RN) success for students at a southeastern community college. A convenience sample of 288 community students admitted to an associate degree level nursing (ADN) program between 2007 and 2012 was selected. The guiding …

Stigmas Associated With Black American Incarceration Through An Afrocentric Lens, Wylie Jason Tidwell

Walden Dissertations and Doctoral Studies

Although extensive quantitative research has been conducted on Black American incarceration rates, to date, there has not been a study from an Afrocentric (Black American) perspective in the field of public policy. Using Dillard's conceptualization of Afrocentric theory, this study added to the field of public policy by examining how the stigmas associated with mass incarceration have reduced political and economic opportunities for Black Americans born 1965 - 1984. The purpose of this ethnographic study was to provide an Afrocentric voice by which the members of the Black American community are the center of the data collection on the stigmas …

Factoring As A Financing Alternative For African Small And Medium-Sized Enterprises, Robert Lumbuye Tomusange

Walden Dissertations and Doctoral Studies

Small and medium-sized enterprises (SMEs) are the main drivers of economic growth and employment. African SMEs are constrained by a lack of access to finance. In line with the pecking order theory, capital-constrained SMEs are expected to seek external finance. However, due to credit rationing, African SMEs have limited success raising finance. Factoring could enable African SMEs to gain access to finance, as underwriters mainly place the risk on the receivables as opposed to the firm itself. Despite its benefits, factoring has not taken root in sub-Saharan Africa. The purpose of this phenomenological study was to explore the obstacles and …

Elementary School Teacher Perceptions Of Factors Influencing Teacher Morale, Dyna M Chambers

Walden Dissertations and Doctoral Studies

The 28th annual MetLife survey of 1,001 American teachers in the United States indicated that low teacher morale is a common problem faced by many public schools. In one public elementary school located in a Southern state, the teacher attrition rate increased from 30% to 40% within 2 years. The purpose of this mixed method study was to investigate teachers' perceptions of morale and their perceived factors that influence low morale at the school. Maslow's theory of motivation was used to understand the impact of teacher satisfaction on teachers' morale and self-motivation for leading change. The research questions were focused …

Towards More Effective Teacher Professional Development Initiatives, Laura Sebastian Hooks

Walden Dissertations and Doctoral Studies

The No Child Left Behind Act (2002) and Race to the Top (2009) legislation have forged new school accountability measures and led to a sharp increase in demand for teacher professional development (TPD). However, data revealed that there is a disconnection between the training that teachers receive and its implementation, limiting its impact on student achievement. This qualitative case study's purpose was to reveal major barriers to TPD implementation and provide suggestions for crafting more impactful TPD. Based on the social constructivist foundation, this study sought to address the factors that increase teachers' receptiveness to more effective teaching techniques. It …

The Perceptions And Lived Experiences Of Leaders Practicing Mindfulness Meditation: A Phenomenological Investigation, Denise A. Frizzell

Walden Dissertations and Doctoral Studies

Despite the gap between the demands of the global work environment and the maturity of its leaders, minimal research exists on the trend of the practice of mindfulness meditation and the developmental experiences of leaders, thereby resulting in a growing divide between theory and practice. Consequently, leadership scholars have little understanding of how an increasing number of leaders experience mindfulness meditation. The purpose of this phenomenological study was to understand the perceived impact mindfulness meditation had on leader development for 20 manager-leaders who had a regular (at least 3 days a week) mindfulness-meditation practice. The primary recruitment strategy included outreach …

Physician Participation In Crowdsourcing: Effect Of Intrinsic And Extrinsic Motivation, Rod Gene Brace

Walden Dissertations and Doctoral Studies

Physicians must participate in developing medical protocols to ensure that medical best practices are adopted for patients' social benefit. Healthcare leaders have struggled to gain sufficient physician participation in developing medical protocols. Using technology-based crowdsourcing to assimilate knowledge from physicians may help healthcare managers improve medical protocol development. Using self-determination theory, this quantitative causal-comparative design aimed to determine whether differences in intrinsic and extrinsic motivation existed among the 132 participating physicians who did or did not participate in developing medical protocols in a crowdsourcing environment. Participants were recruited by e-mail through an independent physician association. Motivation levels were measured by …

Communication Strategies To Generate Employee Job Satisfaction, Kenyatta Natasha Hills

Walden Dissertations and Doctoral Studies

Managers spend 75% of their time actively communicating with employees. Effective leadership communication is fundamental to employee job satisfaction. The purpose of this phenomenological study was to explore how communication strategies that government agency leaders use may motivate greater employee job satisfaction. Twenty employees of a government office in Florida were the general population sample. The motivational language theory helped explore the nature of job satisfaction by focusing on leadership and employee communication strategies. Leadership communication influences employee motivation through incorporating 3 categories of utterances: empathetic (illocutionary) language, direction-giving (perlocutionary) language, and meaning-making (locutionary) language. The Van Manen selective approach …

Resonating Personality Types For Couples: An Enneagram Application For Predicting Marital Satisfaction, Douglas George Carpenter

Walden Dissertations and Doctoral Studies

Over 50% of marriages in the United States end in divorce. Researchers have attempted to identify factors that help marriages endure by studying personality, attachment styles, and gender. However, few researchers have examined how dyadic interactions of personality types and attachment types influence marital satisfaction. The purpose of this study was to examine the effects of enneagram personality types on marital satisfaction within 3 groups of attachment types: couples who (a) both demonstrate a secure attachment style, (b) contain one member who demonstrates an insecure attachment style and the other who demonstrates a secure attachment style, and (c) both demonstrate …

Assessing The Significance Of Modularizing Contract Manufacturing Organizations, Christian Sampson Yorgure

Walden Dissertations and Doctoral Studies

Organizations are under constant threat from global competition, socioeconomic factors,

and political forces that are often unforeseen and dynamic. Consequently, decision

makers adopt strategies, some including the principles of modularity, as a

countermeasure. The problem addressed in this study was the lack of knowledge about

the significance of modularizing contract manufacturing organizations (CMOs). The

purpose of this quasi-experimental study was to assess the significance of modularizing

CMOs by statistically analyzing capacity utilization, efficiency, and profit margin

between modular and nonmodular departments in a focal CMO. This study was grounded

in the theory of modularity and the research question addressed what …

Qualitative Case Study Of Read-Aloud Expository Text Strategies In Kindergarten Through Grade 2, Mary Adeyemo

Walden Dissertations and Doctoral Studies

In an inner-city elementary school, students continue to lag in reading proficiency, and implementation of research-based, district-mandated teaching strategies is not well understood. The purpose of this case study was to explore teachers' perceptions of mandated, read-aloud expository text strategies in K-2 classrooms. The conceptual framework was Vygotsky's social constructivism model of learning, which envisions students learning by interacting with teachers and peers, in this case, using read-aloud strategies, until they become autonomous, expository readers. The research questions focused on benefits and challenges of the implementation of read-aloud expository text by K-2 teachers who were given a 5-year mandate by …

School Violence And Teacher Resiliency At A Midwest Elementary/Middle School, Jounice Blackmon Wright

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to investigate, from the perspective of teachers, the possible effect of school violence on teacher resiliency. School violence has been studied with respect to student behavior and academic success, as well as socioeconomic influences, but not with respect to teacher resiliency, as expressed by teachers themselves. Resiliency theory was the conceptual framework. Participants were all teachers of Grades 2-8 at an elementary/middle school in the Midwest. Twelve in-depth interviews were transcribed into text data and analyzed for common themes. Using NVivo, Version 10, I was able to more easily manage the volumes of …

Reducing Emergency Department Length Of Stay By System Change, Brian Dale Haybarker

Walden Dissertations and Doctoral Studies

Emergency departments (ED) are exceeding the Centers for Medicare and Medicaid Services and The Joint Commission's recommended 4-hour door-to-admission and 2-hour door-to-discharge for patients. The purpose of this project was to look for factors that decrease door-to-admission and door-to-discharge times and offer recommendations to the Patient Flow Committee (PFC) at the health care facility that may reduce overcrowding, diversion, and patient boarding. The 7-step Iowa model of evidence-based practice (EBP) was used to concentrate on problem-focused triggers that initiate the need for change. The project focused on decreasing door-to-admission and door-to discharge times: by opening an observation unit run by …

Strategies To Minimize The Impact Of Supply Chain Risk On Business Performance, Jonathan Opata

Walden Dissertations and Doctoral Studies

The exposure of companies to turbulence, uncertainty, and vulnerability in their supply chain results in supply chain disruption with an estimate cost of $10 million for each supply chain disruption. The purpose of this case study was to explore the strategies supply chain managers use to mitigate supply chain disruption on business performance in a pharmaceutical company in Maryland. Contingency theory of fit formed the conceptual framework for this study. Participant perceptions were elicited in interviews with 11 supply chain managers regarding strategies to mitigate risks associated with supply chain disruptions. Data from interviews and supporting documents were processed and …

Media Literacy Education Exposure Related To Self-Esteem, Body Esteem, And Sociocultural Ideals In College Students And Graduates, Tammy Stargardt

Walden Dissertations and Doctoral Studies

The prevalence of eating disorders (ED) in the United States has increased while the media consistently presents thinner representations of the body. Scholars have found media to negatively influence factors associated with the development of EDs. The purpose of this quantitative nonexperimental cross-sectional survey design study was to explore relationships between exposure levels to MLE and self-esteem, body esteem, and the internalization societal appearance ideals. Participants included undergraduate students or recent graduates majoring in either communications or an alternative major with comparatively less MLE curriculum. The Body Esteem Scale, Sociocultural Attitudes towards Appearance Questionnaire-3, and Rosenberg Self-Esteem Scale Surveys were …

Fukushima Nuclear Disaster Response Impact On Graduate Students, Sean Eric Kil Patrick Gay

Walden Dissertations and Doctoral Studies

The roles that universities played in the response to the Fukushima nuclear disaster were significant and varied; however, there was limited study on participating graduate students. The purpose of this study was to understand the impact of disaster response on graduate students' personal and academic development. This study examined research questions about the perceived impact on academic and personal identity development. Empowerment, cognitive content engagement, general systems theory, and utilitarianism formed the theoretical foundation. This study used a transcendental phenomenological approach to examine the subjects' experiences in the context of involvement in disaster response. The primary source of data was …

Engaged Scholarship Activities Among Tenure-Track And Tenured Faculty Members, Michelle Christine Watkins

Walden Dissertations and Doctoral Studies

Institutions of higher education are widely known to be places that help solve the problems of society; however, few college professors seem to practice engaged scholarship after receiving tenure. In a time of decreased funding for public higher education institutions and increased competition for students with private institutions, public higher education institutions would do well to maintain their images as community partners. In this regard, public institutions need to know whether engaged scholarship among the professoriate has decreased, why this may be occurring, and how to inspire professors to create positive social change. This qualitative case study applied Frederick Herzberg's …

Assessing Spirituality Among Hospice Patients: A Phenomenological Study Of Hospice Nurses, Isabel Esther Kaufman

Walden Dissertations and Doctoral Studies

The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when …

Fall Prevention Quality Initiative: Implementation Of A Unit Safety Champion (Usc), Susan Lynn Rednak

Walden Dissertations and Doctoral Studies

The literature supports that a Unit Safety Champion (USC) may reduce falls among hospitalized patients. The purpose of this project was to determine if the implementation of a USC would assist in reducing falls on an acute unit in an urban hospital environment. The frequency of patient falls on the unit was collected from the hospital's quality department 3 months before and 3 months after the implementation of the USC. The average number of falls for 3 months before implementation was 5.0 per month (SD = 2.65) and involved a total of 15 individual patients. The average number of falls …

Factors Affecting Emergency Manager, First Responder, And Citizen Disaster Preparedness, Tiffany Cooks

Walden Dissertations and Doctoral Studies

Despite the increased frequency of natural and man-made disasters, there is a problem in the level of preparedness of emergency managers, responders, and citizens to address them. The purpose of this grounded theory study was to explore the factors that affect these groups' preparedness to inform the development of better emergency plans to handle emergency incidences. The conceptual framework for the study was knowledge management, which was used with a grounded theory approach. The study was guided by primary research questions that focused on understanding psychological, material, temporal, organizational, and other factors that affect the preparedness of emergency managers, first …

Evidence-Based Mentorship Program: Overview, Review Of Evidence, And Approach, Elizabeth Villanueva

Walden Dissertations and Doctoral Studies

Nurses comprise the largest segment of the healthcare workforce. Adequate numbers of

nurses help to ensure sufficient and safe nursing care in all settings. The current nursing shortage poses a barrier to optimum nursing care, and the nature of recruitment and retention of nurses has generated research interest because of its association with the labor shortage. The purpose of the project was to develop a nurse mentorship program for possible adoption by a northern state correctional facility. Goals are to aid recruitment and improve retention of nurses in the facility. This quality improvement project was informed by Jean Watson's theory …

Independent Retail Business Owners' Perceptions Of The Patient Protection And Affordable Care Act., Bradley A. Hall

Walden Dissertations and Doctoral Studies

Passage of the Patient Protection and Affordable Care Act (PPACA) in 2010 prompted the question of how independent businesses may react to the employer mandate in the PPACA. The law is based on the theory of managed competition and it is more likely to affect businesses with fewer employees than to affect larger businesses that already offer health insurance. The purpose of this quantitative, pre-experimental study was to examine the strategic responses of independent retail business owners in Hillsborough County, Florida, regarding their perceptions of the employer mandate in the PPACA. Before 2014, there was a great deal of non-peer-reviewed …