Digital Commons Network^™

Improvement Of Hpv Vaccination Rate In Pediatric Patients In A Clinic Through Implementation Of A Bundle, Macalah Jenschke

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Human papillomavirus (HPV) is a major cause of several cancers, and vaccination is a highly effective preventive measure. However, HPV vaccination rates remain suboptimal, particularly in rural pediatric populations. This quality improvement (QI) project aims to enhance HPV vaccination rates through the implementation of a comprehensive vaccination bundle targeting provider education, patient and parent education, appointment reminders, and the use of a vaccine waiver when needed.

Method: This QI project was conducted over twelve weeks in a rural pediatric clinic with approximately 130 patients seen daily. The intervention bundle included provider education on effective communication regarding HPV vaccination, educational …

Multidisciplinary Approach To Reduce The Heart Failure Readmission Rate, Nisha Thekkedam

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States, 6.7 million adults have been diagnosed with heart failure (HF), a number projected to rise to 8.5 million by 2030. National data indicate a 30-day readmission rate of 18.2% among HF patients from 2010 to 2017. In Texas, around 12% of the Medicare population in Texas, and specifically 11% of the Medicare population in North Texas County, have been treated for HF. A North Texas hospital reports an 18-20% HF readmission rate over the past several years. Purpose: This EBP project included the implementation of a care bundle using the Dutch Heart Failure …

Implementing The Tips Toolkit To Prevent Falls In Hospitalized Older Adults: A Rural Hospital Approach, Viridiana G. Gonzalez Msn, Rn

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Falls remain the leading cause of injury-related deaths among hospitalized older adults, contributing to significant morbidity, extended hospital stays, and increased healthcare costs. Implementing effective fall prevention strategies is especially challenging in rural hospitals due to staffing shortages, limited funding, and variability in clinical practice.

Local Problem: A 30-bed Medical-Surgical Unit in a rural Southwest Texas hospital experienced a rise in patient falls among older adults aged 65 and older, including several incidents requiring advanced medical treatment and one resulting in serious injury. A gap analysis revealed inconsistent implementation of tailored fall prevention strategies.

Methods: A quality improvement (QI) …

Implementing The Gad-7 Screening Tool In An Adult Outpatient Psychiatric Clinic, Elizabath George

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Anxiety disorders are among the leading causes of disability worldwide and the most prevalent mental illness in the United States. Despite affecting 6.8 million adults annually, fewer than half with Generalized Anxiety Disorder (GAD) receive treatment. Many patients present with somatic complaints, leading to underdetection. Standardized screening tools such as the Generalized Anxiety Disorder-7 item (GAD-7) can improve identification and outcomes.

Purpose: This quality improvement (QI) project implemented the GAD-7 screening tool in an adult outpatient psychiatric clinic in North Texas and evaluated its impact on identifying patients with GAD, compared to the prior year without structured screening. …

Analysis Of Technology Skill Requirements For Entry-Level Accountants, Jiane Louella Tolentino Rabara

Theses and Dissertations

This study examines the evolving impact of emerging technologies on skill requirements for entry-level accountants. Using a mixed-method approach that combines literature review and quantitative analysis of 2,257,082 job postings from 2021 to 2024 provided by the Butler Center for Research and Economic Development, the study evaluates trends in employer expectations across firm sizes and time. Chi-square tests revealed significant changes in the proportion of postings requiring technological skills (χ² = 117,672, df = 3, p < .001), indicating a shift in how technology-related competencies are presented in job ads. Specifically, while previous job postings often included general technical skills alongside traditional accounting tasks, recent job postings increasingly emphasize advanced or specialized technologies—such as ERP systems, cloud accounting platforms, and automation tools. This shift suggests that employers are moving away from broad technical expectations toward more targeted skill sets, reflecting the evolving technological demands of the profession. A separate chi-square test found a significant relationship between technological skill requirements and job ad duration (χ² = 2,309.57, df = 4, p < .001). However, no consistent pattern of longer posting duration was observed for technology-oriented roles. Literature-based synthesis further showed that large accounting firms continue to demand more advanced technological competencies than smaller firms. Overall, while traditional accounting skills remain predominant, the findings indicate a transition toward more specialized technological expectations in the entry-level accounting role.

Fighting The Hypothetical: Why Law Firms Should Rethink The Billable Hour In The Generative Ai Era, Nancy B. Rapoport, Joseph R. Tiano Jr.

Scholarly Works

“Fighting the Hypothetical: Why Law Firms Should Rethink the Billable Hour in the Generative AI Era” analyzes how the emergence and adoption of generative artificial intelligence (GenAI) will fundamentally disrupt the traditional billable hour model that has dominated the industry since the 1960s. Professor Rapoport and Mr. Tiano contend that GenAI’s ability to perform routine legal tasks quickly and accurately will force law firms to shift away from billing structures based primarily on time spent (or inputs) and toward models that better reflect client value (or outputs).

The authors interviewed law firm leaders to gain an “in the trenches” view …

Change Is People: How Faculty, Staff, And Administrators Engage With And Shape A Substantive Organizational Change Process, Karen Bellnier

Open Access Dissertations

Creating substantive organizational change (SOC) in higher education can face numerous challenges including navigating complex sets of rules and relationships, negotiating potentially conflicting perspectives, and balancing the motivations and goals of peers (Engeström, 2018b; Kezar, 2018). Each SOC change agent brings a unique perspective, identity and motivation (Eteläpelto et al., 2013; Gess-Newsome et al., 2003) to their conception of and relationship to the planned change (Hay et al., 2021; Weick, 1995). This dynamic nature makes SOC difficult to conceptualize as a whole - either as a researcher or a change agent - and therefore difficult to understand how change processes …

Either At The Table Or On The Menu: Strategies For Enabling Practitioner-Led Policy Co-Creation In Education Systems, Robert Reyes

Theses and Dissertations

Demands for educational transformation present unparalleled challenges for practitioners, as successive reform initiatives often exclude their voices and discount their expertise. Despite empirical evidence recognizing educators as key agents of change, systemic barriers continue to hinder their participation in policy-centered decision making. This study underscores the urgent need for education systems to invest in practitioner capacity-building, structural enablement, and cross-sector collaboration to create a more equitable and responsive future for education governance. A qualitative phenomenological approach was employed to explore how best to prepare and enable PK-12 practitioners to co-create education policy at the state level, aiming to empower them …

When Purpose Isn’T Enough: Adapting For-Profit Retention Practices To Support Early-Career Professionals In Youth- Serving Nonprofits, Brittany Erway Soto

Theses and Dissertations

This comparative qualitative study explored how nonprofit and for-profit organizations approach the retention and development of early-career professionals aged 18 to 25. Drawing on Jay Galbraith’s (1995) STAR model of organizational design—encompassing strategy, structure, process, people, and rewards—the study investigated what practices are currently in place and which strategies nonprofits might adopt from for-profit organizations to improve employee engagement and retention. Data were collected through 10 semi-structured interviews with senior leaders from five large, youth-serving nonprofit organizations and five for-profit companies with strong employee retention reputations. The findings revealed six core differences between sectors, with for-profit organizations demonstrating more consistent …

Practitioner Perspectives On Barriers And Opportunities Shaping Contemporary Dei, Carlen Arima

Theses and Dissertations

This study examined the lived experiences of diversity, equity, and inclusion (DEI) practitioners to understand the barriers and opportunities shaping their work in the current landscape. The study identified conditions for success, including two organizational conditions (authentic leadership commitment and strategic business alignment), three practitioner-driven strategies (human resource operations and systemic integration, use of data and metrics, and adaptive framing to increase adoption), and three persistent barriers (leadership support without operational follow-through, funding and time constraints, and structural marginalization of DEI). A central finding revealed that leadership commitment was both the most cited enabler of success and, when lacking operational …

Minimizing Hotel Employees’ Negative Responses To Adverse Change Practices: The Application Of Attribution Theory, Zhengmin, Kelly Peng

Department of Hospitality and Business Management

Hospitality organizations need to make changes from time to time, which usually result in adverse human

resource (HR) practices, such as readjustments to job duties or salary cuts. To reduce negative employee responses to these adverse practices, scholars suggest the important role of change communication. However, it

remains unclear how change communication can alter employees’ cognition to minimize their negative responses. Drawing on the HR attribution theory, we hypothesize that high-quality change communication can

reduce employees’ turnover intentions through well-being attribution. We further argue that this indirect effect

depends on the seriousness of the negative impact on employees. We test …

Leadership In Behavioral Health, Rebecca Mccoy

School of Business Student Theses and Dissertations

Abstract

Leadership in healthcare is difficult when dealing with human contact in its most raw and vulnerable way. Leadership in behavioral health is just as challenging as direct practice practitioners tend to be the ones who move up into these roles. This study will exam “Identifying factors that promote successful leadership and challenges that cause barriers to having successful leadership in behavioral health.” This includes soft and hard skill knowledge, growth opportunities and the strengths and struggles in moving into leadership roles in this industry.

The study is based on phenomenological research to gain an understanding of the individual experience …

When Coalitions Do Not Form: The Disability Movement And The Sustainability Movement In Congressional Hearings, Samantha Lavenhagen

American Studies Honors Papers

This thesis examines why and how the disability issue network has traditionally been excluded from the legislative process. The integration of the disability issue network into congressional hearings demonstrates larger themes of power and respect in politics and society. Whether through quotes, statements for the record, or testifying as a witness, issue networks influence lawmakers and lawmaking, building and maintaining relationships with Congress Members and other issue networks. This integration of the disability issue network into congressional hearings reveals larger themes of power and respect in politics and society. More specifically, this thesis investigates the absence of disability organizations from …

Examining The Impact Of Conceptual Mathematics Instructional Practices On Middle School Achievement For Low-Income Public-School Students, Tracy L. Donath

Theses and Dissertations

This dissertation in practice investigates the persistent decline in mathematics proficiency between the fourth and fifth grades, particularly among low-income compared to high-income students in a large, urban public school district in central Illinois. Using Mintrop’s Cycle of Inquiry and the CPED framework in a 90-day intervention, seven fifth-grade teachers implemented small group lessons designed to build students’ conceptual understanding of grade level mathematics. This data-driven intervention encouraged the teachers to use a variety of manipulatives and visual representations to improve students’ mathematics proficiency on four grade level Common Core standards. Data collected through classroom pretests, posttests, and exit tickets, …

“That Class Changed My Life”: Using Transformative Learning Theory To Teach Leadership, Mitchell, Jane

Santa Clara Law Review

Since the country’s founding, the legal profession has served as a springboard for some of society’s greatest leaders. But by and large, lawyers were not trained to lead—until recently. Over the last fifteen years, law schools have become increasingly intentional about leadership development. Leadership programs in law schools have proliferated, as has a growing body of scholarship on lawyer leadership.

Surprisingly, the literature on lawyer-leader development has neglected adult learning theories. This Article addresses that gap and grounds the teaching of leadership in a well-established theoretical tradition. It presents the results of a design-based research study that applies Mezirow’s transformative …

An Examination Of Athletics Department Culture And Job Satisfactory Of Executive Staff Members In Division I Ncaa Athletics Departments, Kyle Moyer

Master of Education in Applied Human Development Graduate Projects

College athletics has undergone some of the biggest changes in our society over the past decade. The experiences of fans and student-athletes have changed drastically. But how does that impact the experiences of athletic administrators working in sport? The ever-changing landscape means that employees must adapt to meet the current needs of the industry. Adaptation often involves discomfort, requiring time, energy, and resilience from those in the profession.

Legal Practice 2.0: Emerging Technology And The Law, John Haried

Western New England Law Review

This article examines the legal profession's transition into "Legal Practice 2.0," where lawyers maintain the same fundamental goals and requirements but conduct business through emerging technologies that affect every aspect of legal practice. This piece was written by Attorney John Haried specifically for publication following his presentation at the 2024 Western New England Law Review Symposium.

2025-2026 Undergraduate Catalog And Course Descriptions, Rochester Institute Of Technology

Undergraduate Catalog and Course Descriptions

No abstract provided.

Increase Successful Outcomes With Technology-Driven Mergers And Acquisitions : Prioritize Post-Merger Integration Risk Mitigation, Kingsley Eromosele Usianeneh

Dissertations

In the post-COVID-19 era, accelerated engineering advances including Artificial Intelligence (AI) have increased firm’s reliance on technology-driven mergers and acquisitions (M&A) as an expedient strategy to bolster their technological innovation capabilities, retain competitive advantage and ensure sustainability. However, many M&As fail to achieve their strategic goals because of persistent challenges during post-merger integration (PMI). This dissertation adopts and integrates chapter 2 – chapter 4 to identify, theorize, and proactively mitigate the primary recurring PMI challenges that impede successful technology-driven M&A outcomes. Chapter 2 adopts PRISMA guidelines, conducts a systematic literature review, identifies, and synthesizes four persistent PMI risk categories: (1) …

Public University Gift Management Policies: Building A Best Practice Guide, Cristin Costello

MPA/MPP/MPFM Capstone Projects

Currently, no consistent standards exist for how institutions of higher education should manage their non-endowed gift revenue. Good stewardship of gift funds is vital to ensuring the maintenance of donor relationships to create unions that bring further financial opportunities to universities for years to come. Public institutions, as recipients of government dollars, are especially vulnerable to the negative repercussions that could come with the scandal of misappropriated gift dollars. Overall cash donations to higher education have significantly increased in the past few decades as state appropriations fall short and the need to keep tuition rates stable increases. It is more …

Challenges And Effects: A Qualitative Analysis Of The Unique Challenges Faced By Black Male Care Givers In Long-Term Care, Qudrat Oluwatimilehin Olufemi-Dirisu

All Graduate Theses, Dissertations, and Other Capstone Projects

The existing literature on caregivers working in long-term care focuses on the challenges ranging from being overworked, mental stress, low wages, and abuse. However, little is known about the unique intersectional experiences of Black male caregivers, particularly regarding how race and gender shape their professional encounters, societal perceptions, and coping strategies. The present study analyzed unique stressors of Black male care givers in long term care using their personal experiences and how these stressors impact their mental health. The effects of societal expectations, client biases, and workplace stereotypes significantly affect Black male caregivers are also examined against the background that …

Introducing A Paper Communication Alternative For Emergency Department Nurse-Technician Delegation To Promote Workflow Efficiency: A Quality Improvement Project, Grant Quinn

Master's Theses and Capstones

Background: Efficient and high quality communication is paramount in the emergency department setting, especially between registered nurses (RNs) and emergency department technicians. In a fluid and high-octane microsystem, poor communication can lead to missed or delayed delegated tasks, which harm teamwork and patient safety and outcomes.

Purpose: By introducing a low-cost, paper-based communication alternative to this microsystem into the workflow it is expected that perceived ease of use and communication quality will both increase when surveying department staff. This intervention offers an alternative means of communicating with the goal of improving communication overall in the microsystem.

Methods: Through use of …

The Relationship Between Deans’ Transformational Leadership And Teachers’ Work Engagement In Higher Education Institutions In Inner Mongolia, China, Lingbo Han

Graduate Student Theses, Dissertations, & Professional Papers

This study was designed to investigate the relationship between deans’ transformational leadership and teachers’ work engagement in Chinese higher education institutions, with a specific focus on Inner Mongolia. Against the backdrop of China’s ongoing higher education reforms and increasing emphasis on faculty development, understanding how leadership styles influence teacher motivation has become crucial for institutional advancement.

A quantitative, non-experimental causal-comparative design was employed to examine how four dimensions of transformational leadership - charisma, vision, individualized consideration, and intellectual stimulation - relate to teachers’ work engagement. Using multiple analytical approaches including correlation analysis, regression modeling, and comparative statistical tests, the study …

The Effects Of An Organizational Shift To Pay Transparency On Employees’ Justified Under-Met Pay Standing Expectations And Turnover Intentions, Heather Godsey

Industrial-Organizational Psychology Dissertations

Pay transparency is becoming more commonplace within U.S. organizations, due to the enactment of state pay transparency laws attempting to reduce the gender wage gap and broader calls for greater transparency in organizations. While transparency may be ideal, its effects on employee attitudes and behaviors are unclear. This study explored a potential unintended outcome of pay transparency, employee turnover, by examining how fairness perceptions mediate the justified under-met pay standing expectations and employees’ turnover intentions relationship, while investigating gender and justice sensitivity as moderators. A sample of 426 participants experienced an organizational shift from pay secrecy to pay transparency and …

A Change In Climate: Inclusion And Menopause Experience At Work, Janie D. Stuart

Industrial-Organizational Psychology Dissertations

Inclusion within workplace environments is increasingly important as workforce diversity continues to expand. Despite anti-discrimination laws, women and other underrepresented groups often face exclusion in the workplace, which negatively affects their professional growth, health, and well-being. This research focused on how menopause, a natural biological transition, compounds workplace exclusion for women. Specifically, the study investigated the relationship between Menopause Experience and two workplace outcomes, Organizational Commitment and Turnover Intention, and assessed the moderating effects of Inclusion in organizations, teams, and non-gendered workplace cultures. There were strong positive relationships between all three dimensions of Inclusion with both Organizational Commitment and Turnover …

Leadership Communication And Symbolic Language In Organizational Change: A Study In Higher Education, Christine Fischer

Dissertations

Higher education institutions face growing pressures related to affordability, accessibility, and trust. In this environment, leadership communication, especially symbolic language that frames transformation as mission-aligned, plays a central role in shaping organizational change. This qualitative single-case study examined how leaders at a private Christian liberal arts college used metaphors, narratives, and values-based discourse to communicate an innovative tuition model and how this language influenced stakeholder perceptions, engagement, and resistance. Data included 26 leadership communication documents, a metaphor-based faculty and staff survey, and eight semi-structured interviews. Reflexive thematic analysis and metaphorical analysis were used to interpret symbolic language, meaning-making processes, and …

Healthcare Providers’ Lived Experiences During Pivotal Change, Lisa Raynelle Shelley

Dissertations

This phenomenological study examined healthcare providers’ lived experiences of psychological safety and administrative leader behaviors that influenced those experiences during pivotal change. While much research addressed psychological safety among frontline healthcare staff, a gap was noticed concerning providers. This study aimed to investigate the impact of psychological safety and administrative support on provider engagement, emotional response, and retention during periods of significant change. Data were collected via a survey containing multiple-choice and open-ended questions, followed by semi-structured interviews. Four findings emerged. First, the providers’ pivotal events generated themes of “workplace power dynamics,” “systemic and organizational change,” “transformational crisis,” and “physical …

An Introductory Guide To Trauma Informed Care, Isabella Fallon

Williams Honors College, Honors Research Projects

This project will consist of researching and analyzing at least 30 scholarly and government publications about trauma-informed care (TIC), resulting in a literature review at between 20-25 pages in length. TIC encompasses direct practice with clients, assessment tools, organizational structure and policy, as well as governing documents that impact service delivery. This literature review will build on the work of the Substance Abuse and Mental Health Services Administration's Concept of Trauma and Guidance for a Trauma-Informed Approach, focusing on providing practical examples of the physical and mental impacts of trauma, trauma-informed frameworks, trauma-informed tools/assessments, and trauma-informed policy, while analyzing and …

Internal Or External: An Exploration Of The United States Police Chief Hiring Process, Kayleigh Walker

Williams Honors College, Honors Research Projects

This paper explores the hiring processes of police chiefs across the United States, focusing on internal versus external hiring practices. The goal of this research was to identify common trends, legislative barriers, and the impact of leadership on the hiring process through historical context, legal analysis, and case studies. The findings suggest that internal hires dominate chief appointments, though external hires are often sought during crises. The paper concludes with recommendations for future research and highlights the need to more fully understand this phenomenon. Understanding the processes and limitations surrounding the appointment of new leadership is critical to reform and …

Organizational Culture Formation In Early-Stage, Mission-Driven Ventures, Janezee Bond

Theses and Dissertations

This research seeks to understand how organization culture is formed in early-stage nonprofit, mission-driven, and purpose driven organizations. Growth stage was determined by looking at Flamholtz and Randl’s “Growing Pains” stages of organizational growth and Cameron & Quinn’s Organizational Culture Assessment Instrument (OCAI) was utilized to identify the current organizational culture type. The research focused on the insights and experiences of founders of early-stage companies (defined as having been founded in the past 15 years). The research revealed that founders are integral in culture creation through their roles and especially through role modeling in the early stages. Additionally, one significant …