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Emergency Nurses' Perceptions Of Interpersonal Empathy When Caring For Department Superusers, Makeba K. Cavette
Emergency Nurses' Perceptions Of Interpersonal Empathy When Caring For Department Superusers, Makeba K. Cavette
Walden Dissertations and Doctoral Studies
Compassion fatigue syndrome (CFS) is a significant challenge for healthcare professionals, particularly nurses in the emergency department (ED), due to the demanding, high-pressure nature of their work environment and their increased exposure to human suffering. The purpose of this qualitative phenomenological descriptive study, guided by Nursing Theory of Personal Empathy, was to describe the meaning of ED nurses' interactions with superuser patients and how these interactions affect ED nurses' empathy and susceptibility to developing CFS. A purposive sample of 8 ED nurses with at least 3 years of experience as ED staff nurses working with superuser patients participated in semistructured …
Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad
Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad
Walden Dissertations and Doctoral Studies
Lyme disease (LD), a tick-borne illness, has been a growing concern in the state of Tennessee. Studies have established environmental concerns regarding a growing tick population and identified a gap between reported cases and disease burden in Tennessee. Despite this information, it remains classified as a low-incidence reporting state, raising concerns about underreporting that indicate an ineffective current surveillance system. Because the public perception regarding surveillance of LD is unknown, the purpose of this qualitative study was to explore how adults in Tennessee perceived LD as a credible public health threat within the context of the current surveillance system. Guided …
Improved Depression Screening In An Outpatient Mental Health Clinic Using The Phq-9, Meghan Rey Young
Improved Depression Screening In An Outpatient Mental Health Clinic Using The Phq-9, Meghan Rey Young
Walden Dissertations and Doctoral Studies
Depression is a common mental health disorder in the United States that places significant burden on the individual, the community, and the country. It is estimated that 7.8% of adults in the U.S. experienced major depression in 2019. Having a depression diagnosis places the individual at increased risk for suicide by 31%. Therefore, it is important to screen for depression. In a small outpatient mental health clinic, a gap in practice was identified as a lack of depression screening at patient encounters. The question was asked: In the outpatient clinical setting, what is the impact of improved use of the …
Early Childhood Teachers’ Perceptions Of Early Childhood Teacher Leadership, Their Leadership Experiences, And Teacher Leadership Skill Development, Danyle Watkins
Walden Dissertations and Doctoral Studies
The problem that was addressed in this study is that research into early childhood leadership has focused on early childhood directors and programs for leadership, but little research has been conducted on early childhood teachers’ (ECTs’) perceptions of the ECT leadership. Guided by the McCormick Center Whole Leadership Framework, the purpose of this basic qualitative study was to explore ECTs’ perceptions on characteristics of teachers as leaders, their leadership experiences, and their leadership skill development in a Midwestern U.S. state. Data were collected through semistructured interviews with 10 ECTs employed in licensed early childhood centers serving children from birth through …
Consistent Phq-9 Administration At Mental Health Watch Initiation And Discharge In A Correctional Setting, Gouni Aicha Bouraima
Consistent Phq-9 Administration At Mental Health Watch Initiation And Discharge In A Correctional Setting, Gouni Aicha Bouraima
Walden Dissertations and Doctoral Studies
This staff education project addressed inconsistent Patient Health Questionnaire-9 (PHQ-9) administration and documentation at mental health watch initiation and discharge in a correctional setting. A baseline audit showed 42.1% PHQ-9 documentation compliance (8 of 19 charts), below the 90% organizational benchmark, limiting objective depression severity data needed for clinical decision-making and safe transitions. The practice-focused question was: Among nurses working with incarcerated individuals at mental health watch initiation and discharge, what is the impact of staff education on nurses’ knowledge of PHQ-9 screening protocols? The purpose was to implement structured staff education to improve nurses’ knowledge of PHQ-9 trigger points, …
Improving Suicide Risk Identification Through Standardized Implementation Of The Columbia–Suicide Severity Rating Scale (C-Ssrs) In An Adult Outpatient Behavioral Health Setting, Mirabel Ngwe Boma
Walden Dissertations and Doctoral Studies
Suicide risk may fluctuate throughout treatment, making ongoing assessment essential for timely identification and intervention. At the project site, an adult outpatient behavioral health practice, the Columbia–Suicide Severity Rating Scale (C-SSRS) was administered consistently at intake but inconsistently at follow-up visits, creating gaps in suicide risk reassessment and documentation. The purpose of this quality improvement project was to evaluate the effect of standardized implementation of the C-SSRS during intake and follow-up visits on suicide risk screening compliance over a 9-week period. The practice-focused question asked how standardized implementation of the C-SSRS, compared with current practice, affected suicide risk screening compliance …
Social Workers’ Lived Experiences Of Trauma-Informed Training, Ashley Ann Johnson
Social Workers’ Lived Experiences Of Trauma-Informed Training, Ashley Ann Johnson
Walden Dissertations and Doctoral Studies
Social workers report limited formal training in trauma-informed approaches, and implementation of trauma-informed care varies widely across settings, with inconsistent training uptake and organizational support for sustained practice change. The purpose of this qualitative phenomenological study was to explore the lived experiences of social workers in trauma-informed training. The study was guided by trauma-informed care principles and an experiential learning framework. The research question examined how social workers develop trauma-informed competence and how systemic factors influence practice. Data were collected through 11 semi structured interviews with social workers and analyzed using thematic analysis. Three key themes emerged: (a) trauma-informed competence …
Effective Strategies For Accessing Capital For Startup Agricultural Entrepreneurs In St. Vincent And The Grenadines, Tonya Pompey
Effective Strategies For Accessing Capital For Startup Agricultural Entrepreneurs In St. Vincent And The Grenadines, Tonya Pompey
Walden Dissertations and Doctoral Studies
Limited access to capital is a significant barrier to market entry and long term sustainability in the agricultural industry. Agricultural business owners consistently identify capital constraints as the leading predictor of startup failure. Grounded in institutional theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies that agricultural startup business owners used to access capital for market entry and business sustainability. The participants were six agricultural startup entrepreneurs in St. Vincent and the Grenadines (SVG) who used effective strategies to access capital for market entry and sustained business operations for at least 2 years. Data …
Effective Strategies To Improve Ai Governance And Regulatory Compliance, Mursal Haroon
Effective Strategies To Improve Ai Governance And Regulatory Compliance, Mursal Haroon
Walden Dissertations and Doctoral Studies
Senior business leaders across sectors face increasing risks because many organizations lack effective strategies to ensure transparency and regulatory accountability in artificial intelligence (AI) governance. This problem is critical for industry leaders who rely on transparent and compliant AI systems to protect consumers and maintain operational stability. Grounded in the ethical usage of AI systems, the purpose of this qualitative pragmatic study was to explore effective strategies senior business leaders use to improve transparency and regulatory accountability in AI governance. The participants were six senior business leaders in the United States who successfully implemented such strategies. Data were collected through …
Staff Education To Improve Provider Knowledge Of Marijuana Use And Mental Health In A Community Mental Health Setting, Kalubi Florence Muganguzi
Staff Education To Improve Provider Knowledge Of Marijuana Use And Mental Health In A Community Mental Health Setting, Kalubi Florence Muganguzi
Walden Dissertations and Doctoral Studies
This staff education doctoral project addressed a practice gap in provider knowledge, confidence, and consistency when assessing, educating, and documenting marijuana use among patients receiving mental health services. The practice-focused question was the following: For staff in a community mental health setting, does a structured staff education intervention on marijuana use and mental health improve knowledge and confidence related to assessment, patient education, documentation, and psychotropic treatment monitoring? The purpose was to translate current evidence into a practical education session, screening guidance, patient counseling points, and documentation prompts. The evidence base included 10 peer-reviewed articles addressing cannabis use, mental health …
Staff Education On The Implementation Of An Evidence-Based, Suicide-Risk-Assessment Education Program For Psychiatric Staff, Yemurai Emily Dzikiti
Staff Education On The Implementation Of An Evidence-Based, Suicide-Risk-Assessment Education Program For Psychiatric Staff, Yemurai Emily Dzikiti
Walden Dissertations and Doctoral Studies
Suicide is a major public health concern, and consistent suicide risk assessment is essential for patient safety in psychiatric settings. This Doctor of Nursing Practice staff education project addressed a knowledge gap in evidence-based suicide risk assessment among psychiatric clinicians in an outpatient mental health setting. The practice-focused question examined whether an evidence-based suicide risk assessment education program would improve clinicians' knowledge from pre- to post-education. The educational intervention consisted of a 60-minute in-person training session on evidence-based suicide risk assessment using the Columbia-Suicide Severity Rating Scale (C-SSRS) and the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) framework. Ten psychiatric …
A Mindfulness-Based Stop Technique Training To Improve Nurses’ Knowledge And Self-Efficacy In Stress And Burnout Prevention, Rukiat Abolanle Afinni
A Mindfulness-Based Stop Technique Training To Improve Nurses’ Knowledge And Self-Efficacy In Stress And Burnout Prevention, Rukiat Abolanle Afinni
Walden Dissertations and Doctoral Studies
Nurse burnout and stress are well-documented occupational concerns in outpatient clinical settings, where high patient acuity and chronic staffing shortages leave nurses with little structured support for proactive self-care. To address this gap, a mindfulness-based STOP (stop, take a breath, observe, proceed) training program was developed and evaluated for outpatient nurses. The evidence-based practice question was: Among nurses in an outpatient clinical setting, what is the impact of a mindfulness-based STOP technique training on nurses' knowledge of stress and burnout prevention and self-efficacy in applying the technique? A one-group pretest-posttest design was used with eight participants. A project-developed questionnaire measured …
The Relationship Between Maintenance And Overhaul Employee Spending, Business Model, Geographic Region, And The Financial Performance Of Commercial Airlines, Naumaan Khalid Sheikh
The Relationship Between Maintenance And Overhaul Employee Spending, Business Model, Geographic Region, And The Financial Performance Of Commercial Airlines, Naumaan Khalid Sheikh
Walden Dissertations and Doctoral Studies
After nearly 5 decades of deregulation, commercial airline leaders still lack the capability to improve financial performance by structuring their maintenance operations to gain competitive advantages in highly competitive global markets. Without an effective strategy, airline maintenance affects service and financial performance. Framed with Porter’s competitive advantage theory, this quantitative nonexperimental correlational project was to examine the relationships between airline in-house maintenance and overhaul employee spending, business model, geographic region, and financial performance of global commercial full-service carrier (FSC) and low-cost carrier (LCC) airlines. Longitudinal panel data were collected from 121 LCCs and FSCs operating from 2001 to 2019 in …
Cultural Values, Norms, And Mental Health Service Utilization Among Young Adult Guyanese Immigrants, Rhonis Alfred
Cultural Values, Norms, And Mental Health Service Utilization Among Young Adult Guyanese Immigrants, Rhonis Alfred
Walden Dissertations and Doctoral Studies
Young adult Guyanese immigrants living in the United States often face cultural, familial, and social challenges that influence their perceptions of mental health and willingness to seek professional support. Despite growing attention to immigrant mental health, limited research has explored the experiences of this population. This qualitative study aimed to improve understanding of how cultural values, family dynamics, and acculturation stress influence mental health perceptions and help-seeking behaviors. The theoretical framework underpinning this study was acculturation theory. The research explored how participants navigated cultural identity, family expectations, and adaptation to life in the United States. A purposive sampling strategy was …
Exploring The Experiences Of Teacher Assistants Who Remain In A Rural Michigan Head Start Program, Melissa Thiebaut
Exploring The Experiences Of Teacher Assistants Who Remain In A Rural Michigan Head Start Program, Melissa Thiebaut
Walden Dissertations and Doctoral Studies
The problem addressed in this study was the approximately 35% attrition rate of teacher assistants (TAs) in a rural Head Start program. Grounded in Bakker’s job resources and job demands theory, the purpose of this basic qualitative study was to explore the experiences of TAs who chose to remain working in a rural Head Start program and the factors that influenced their decisions to stay. Data were collected by conducting semistructured interviews with 12 TAs from one Head Start program. Data analysis involved a deductive data analysis method with two categories, job resources and job demands, being predetermined by the …
Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele
Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele
Walden Dissertations and Doctoral Studies
Emerging infectious diseases continue to challenge national health systems, particularly in small island developing states with limited preparedness resources. Limited evidence comparing the International Health Regulations (2005) State Party Self-Assessment Annual Reporting (IHR SPAR) capacities of small island developing states with those of high-income countries limits efforts to identify preparedness gaps and strengthen health systems. The purpose of this quantitative comparative study was to evaluate Saint Lucia's preparedness using IHR SPAR indicators, compare its preparedness with the United States, and assess changes between 2023 and 2024. Guided by the World Health Organization Health System Framework, a quantitative cross-sectional design using …
Phenomenological Exploration Of The Military Veterans' Experiences Transitioning Into Civilian Workplace In Central Florida, James Wesley Shelton
Phenomenological Exploration Of The Military Veterans' Experiences Transitioning Into Civilian Workplace In Central Florida, James Wesley Shelton
Walden Dissertations and Doctoral Studies
Military veterans transitioning from military service to civilian employment frequently encounter challenges related to workforce integration, translating military-acquired skills, adapting to civilian workplace cultures, and employer perceptions of their qualifications. Organizational leaders need to understand these challenges as a key indicator of the factors that influence successful workforce integration, organizational commitment, and employee retention. Grounded in person-environment fit theory, the purpose of this qualitative study using an interpretative phenomenological analysis (IPA) approach was to explore the lived experiences of military veterans and how they make meaning of their transition to the civilian workplace. The participants comprised seven U.S. military veterans …
Improving Intake Efficiency In Inpatient Behavioral Health Facilities To Reduce Delays In Care, Lakisha Brown
Improving Intake Efficiency In Inpatient Behavioral Health Facilities To Reduce Delays In Care, Lakisha Brown
Walden Dissertations and Doctoral Studies
Delays in inpatient psychiatric admissions represent a significant and persistent challenge within U.S. behavioral health systems, contributing to emergency department boarding, reduced quality of care, increasing risk, resource strain, and inefficiencies. The purpose of this integrative review was to examine evidence-based operational strategies that improve intake efficiency and reduce admission delays in inpatient behavioral health facilities. The Lean Healthcare Framework was used, which emphasizes eliminating waste, improving workflow efficiency, and enhancing value. The review question focused on what operational and systems-management evidence-based strategies are most effective in improving intake efficiency. The Johns Hopkins Evidence-Based Practice appraisal tool was used to …
Mental Health Professional Preparedness To Address Mental Health Stigma And Challenges In Military Populations, Scott Martin Katzka
Mental Health Professional Preparedness To Address Mental Health Stigma And Challenges In Military Populations, Scott Martin Katzka
Walden Dissertations and Doctoral Studies
Veterans and service members often delay or avoid engaging in mental health services because of stigma experienced during military service and after transitioning to civilian life, contributing to worsening mental health outcomes. Although mental health professionals (MHPs) with military cultural competence can reduce stigma and improve engagement in care, little is known about how newly trained MHPs perceive their preparedness to effectively serve this population. The purpose of this hermeneutic, phenomenological study was to answer the question of what the lived experiences of new MHPs regarding their preparedness were to support veterans and service members experiencing mental health stigma. Seven …
The Impact Of Risk Management Strategies On Financial Forecasting In Small Businesses, Lakisha Hatcher
The Impact Of Risk Management Strategies On Financial Forecasting In Small Businesses, Lakisha Hatcher
Walden Dissertations and Doctoral Studies
Many small businesses are prone to fail because of ineffective or non-existing financial risk management practices. This problem is important to small business owners because ineffective risk management can hinder financial forecasting, decision-making, and long-term operational sustainment. The purpose of this qualitative pragmatic inquiry is to explore effective financial risk management strategies used by small business owners to identify and mitigate risk to improve financial risk management activities. The conceptual framework was enterprise risk management. The participants consisted of seven service-based small business owners located in Central Maryland who successfully implemented financial risk management practices. Data were collected through semistructured …
School Counselor Preparedness With Mass School Shootings, Lidia Oviedo
School Counselor Preparedness With Mass School Shootings, Lidia Oviedo
Walden Dissertations and Doctoral Studies
Mass school shootings represent a significant threat facing K–12 schools, yet the lived experiences of school counselors as they engage in prevention efforts and prepare to respond to and recover from these incidents remain unexplored. This study addressed the discrepancy between the increasing prevalence of mass school shootings and the limited understanding of school counselors' preparedness. The purpose of this qualitative study was to explore the experiences of school counselors regarding their preparedness to prevent, respond to, and recover from mass school shootings. This study was grounded in Giorgi's descriptive phenomenological method and informed by the U.S. Department of Education's …
Secondary Special Education Teachers’ Perspectives On Professional Socialization In A Maryland School District, Darice Mattie Holmes
Secondary Special Education Teachers’ Perspectives On Professional Socialization In A Maryland School District, Darice Mattie Holmes
Walden Dissertations and Doctoral Studies
The problem addressed in this study was the insufficient professional socialization of novice secondary special education teachers (SSETs), undermining their ability to adapt to school culture in a Maryland school district (MSD, a pseudonym). Grounded in Mayo's theory of human relations, the purpose of this study was to explore novice SSETs' perceptions of professional socialization through peers, professional development, or mentoring to adapt to the school culture at MSD. For this basic qualitative design, semistructured interviews were conducted with seven novice SSETs. The data were analyzed using Braun and Clarke's thematic analysis with Saldaña's coding strategies, yielding four themes: (a) …
Strategies To Engage Volunteers For Financial Sustainability Within The Nonprofit Industry, Judith Walker
Strategies To Engage Volunteers For Financial Sustainability Within The Nonprofit Industry, Judith Walker
Walden Dissertations and Doctoral Studies
Nonprofit organizations experience significant challenges in recruiting, engaging, and retaining volunteers. The issue is critical for nonprofit leaders because insufficient volunteer support can undermine day-to-day operations and threaten long-term financial sustainability. Grounded in social exchange theory, the purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies that leaders in the nonprofit industry use to engage volunteers to increase financial sustainability. Data were collected through semistructured interviews with six nonprofit leaders in the northern United States, as well as public documents. Through thematic analysis, four themes were identified: (a) building relationships and personal connections, (b) …
Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth
Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth
Walden Dissertations and Doctoral Studies
Hospice patients experiencing uncontrolled pain, dyspnea, agitation, anxiety, delirium, or other severe symptoms may require General Inpatient (GIP) hospice care for intensive symptom management. However, inconsistent recognition of symptom crises can delay escalation to the appropriate level of care, contributing to unnecessary patient suffering, caregiver distress, and avoidable emergency department or hospital utilization. This Doctor of Nursing Practice executive leadership project evaluated the implementation of an educational framework designed to improve clinician recognition and timely escalation of patients who may be appropriate for GIP hospice care. Education emphasized early identification of uncontrolled symptoms, interdisciplinary communication, documentation, and escalation for clinical …
Artificial Intelligence And Autonomous Systems Adoption Strategies For Employees’ Jobs And Self-Worth In Nigerian Banks, Nnamdi Cyriacus Onyebuchi
Artificial Intelligence And Autonomous Systems Adoption Strategies For Employees’ Jobs And Self-Worth In Nigerian Banks, Nnamdi Cyriacus Onyebuchi
Walden Dissertations and Doctoral Studies
As the Nigerian commercial banking sector navigates rapid financial technology disruption and rising regulatory compliance demands, many institutions have accelerated the adoption of artificial intelligence (AI) and autonomous systems. Banking executives need to understand these concerns as a primary indicator of employees’ readiness to adapt to AI-enabled workplace changes, sustain their self-worth, and navigate evolving job roles. The purpose of this qualitative exploratory multiple-case study was to explore the understanding of the AI and autonomous systems adoption strategies bank executives may employ to enhance employees’ jobs and self-worth in Nigerian banks. Anchored in sociotechnical systems and stakeholder theories, purposive sampling …
Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol
Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol
Walden Dissertations and Doctoral Studies
Visceral leishmaniasis, a severe parasitic disease that is invariably fatal, is characterized by frequent outbreaks, and is associated with poverty. South Sudan is among the countries with the highest burden of visceral leishmaniasis. However, few studies have investigated factors associated with visceral leishmaniasis in the country. This study investigated demographic (age, gender, marital status, education level and occupation) and socioeconomic factors (transport, access to health services and residence) that may be associated with visceral leishmaniasis infection in South Sudan. The study was anchored on the socioecological model conceptual framework, which describes the interaction between individual and their social environment and …
Staff Education To Improve Geriatric Mental Health Screening And Pharmacotherapy, Andy Wu
Staff Education To Improve Geriatric Mental Health Screening And Pharmacotherapy, Andy Wu
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) quality improvement project addressed the lack of standardized workflows and clinical confidence regarding geriatric mental health screening and safe antidepressant initiation at a rural primary care clinic. Utilizing the FOCUS-PDSA framework, a 15-minute staff education module and a clinical pocket guide were implemented to train Medical Assistants (MAs) on integrating PHQ-9 and GAD-7 screenings during triage, and to equip providers with EHR SmartPhrases and 2023 AGS Beers Criteria prescribing guidelines. A pre- and post-intervention 5-point Likert scale survey evaluated the knowledge and clinical confidence of the clinic staff (n = 12). Results demonstrated a …
Effective Techniques In Equine Assisted Therapies From The Facilitators Perspective, Emily Dolezal
Effective Techniques In Equine Assisted Therapies From The Facilitators Perspective, Emily Dolezal
Walden Dissertations and Doctoral Studies
Equine assisted therapies have been shown to be an effective treatment approach for individuals experiencing mental health issues. However, there have been rising challenges in standardization and nomenclature throughout the field. Current research supporting the benefits of equine assisted therapies is often from the client perspective. There is a gap in understanding what occurred in session that made it beneficial to their mental health. The purpose of this phenomenological study was to describe the lived experiences of equine assisted therapy facilitators in terms of mechanisms that produce positive changes in their clients. The theories and concepts that ground this study …
Evaluation Of A Streamlined Insurance Advocacy And Pre-Authorization Process For Hormone Replacement Therapy, Ellison Edwards
Evaluation Of A Streamlined Insurance Advocacy And Pre-Authorization Process For Hormone Replacement Therapy, Ellison Edwards
Walden Dissertations and Doctoral Studies
This organizational process evaluation project addressed the high rate of insurance denials for hormone replacement therapy (HRT) for women with symptomatic menopause and "normal" laboratory values within a private primary care setting. The practice problem involved bureaucratic barriers in the front office and a lack of structured advocacy, which delayed patient access to evidence-based care. The purpose of this project was to evaluate the impact of a streamlined insurance advocacy and pre-authorization process on access to therapy. The project utilized a standardized "Insurance Advocacy Toolkit" and evidence-based templates aligned with the 2023 North American Menopause Society (NAMS) guidelines. Analytical strategies …
Improving Post-Rehabilitation Discharge Outcomes Through A Care Coordination Bundle, Cavene Facey
Improving Post-Rehabilitation Discharge Outcomes Through A Care Coordination Bundle, Cavene Facey
Walden Dissertations and Doctoral Studies
Hospital readmissions remain a significant quality and patient safety concern across the United States, particularly among patients transitioning from rehabilitation settings to home or community-based care. Ineffective care transitions, fragmented communication, inconsistent discharge planning, and inadequate follow-up contribute to preventable hospital readmissions, increased healthcare costs, and poorer patient outcomes. Evidence consistently demonstrates that structured transitional care interventions and standardized care coordination processes improve continuity of care while reducing readmissions and enhancing patient satisfaction The purpose of this Doctor of Nursing Practice (DNP) project was to develop an evidence-based Clinical Practice Guideline (CPG) designed to improve post-rehabilitation discharge outcomes through implementation …