Digital Commons Network^™

The Impact Of Staffing Level On Patient Care In Behavioral Health Care Settings, Sheuness Cuthbertson

Walden Dissertations and Doctoral Studies

In many behavioral health care organizations, adequate staffing represents a key challenge that can compromise the workforce and cause detrimental outcomes for patients. The purpose of this qualitative study was to understand how inadequate staffing shapes the environment of one behavioral health care organization. A case study design was used, with the Baldrige Excellence Framework serving as the conceptual guide to understand how the organization's leadership performed and addressed important organizational challenges. The participant, a leader in the organization who oversaw program services, operations, policies, and procedures, answered interview questions about inadequate staffing and its impact on patient care and …

Nurses’ Perception Of Facilitators And Barriers To The Community College Faculty Role, Hallie Roselie Coppi

Walden Dissertations and Doctoral Studies

There is an increased nursing faculty shortage throughout the United States (U.S.) which can have a significant impact on student enrollment in nursing programs. The purpose of this descriptive qualitative study, which was guided by Herzberg’s two-factor theory, was to explore perceptions of nursing faculty about their role in community college associate degree nursing (ADN) programs in the western U.S. Data were collected via in-depth semi-structured interviews with 14 nurse educators to gain insights regarding experiences with role transition, work expectations, and plans in academia. Transcribed interview data were thematically analyzed to reveal seven overarching themes which were motivation, role …

Construction Industry: Profitable Corporate Sustainability Strategies And Processes Achieve Competitive Advantage, Chad Justin Czelusniak-Serviss

Walden Dissertations and Doctoral Studies

Some construction industry managers lack strategies to integrate corporate sustainability strategies and processes for competitive advantage, which causes limited profitability. Grounded in the general systems theory, the purpose of this multiple case study was to explore corporate sustainability strategies and processes senior and mid-level construction industry managers use to achieve competitive advantage in the United States. The participants were eight senior/mid-level construction industry managers from eight different construction industry organizations with at least five years of experience in the construction industry who utilized corporate sustainability strategies and processes. Data were collected using semistructured interviews. Three themes emerged using thematic analysis: …

Effect Of Drug Medi-Cal Organized Delivery System Access To Substance Use Disorder Treatment, Ana Y. Davies

Walden Dissertations and Doctoral Studies

Drug addiction, mental health disorders, and homelessness has impacted communities nationwide increasing mortality and morbidity and is a public health threat. But access to substance use treatment has been a problem due to the lack of the ability by many to pay for services. This observational quantitative research design utilized administrative secondary data collected between July 2017 and June 2022. The key variables are Insurance Status, Number of Admissions, and Successful Discharges in outpatient substance use treatment. The purpose of the study and research questions involved evaluating the effects Drug Medi-Cal (DMC) Organized Delivery System program by analyzing program admissions …

Identifying And Examining Key Themes Emanating From The U.S. Legislative Tobacco Policy Subsystem, Arnon Dayak

Walden Dissertations and Doctoral Studies

Americans’ continuously increasing tobacco use in the form of smoking presents an ongoing and rising negative health impact on this leading cause of preventable death. Despite existing U.S. federal level tobacco regulation through the Family Smoking Prevention and Tobacco Control Act (FSPTCA), U.S. tobacco use remains ubiquitous demonstrating existent ineffectiveness of tobacco control legislation. Unknown underlying attributing factors present critical information gaps which, when exposed, could improve tobacco regulation. Using a case study approach, the question, “What key themes are aligned with legislative subsystem actors when voting on the FSPTCA” was examined. Multi-source data streams using existing secondary datasets including …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Resiliency Perceptions Of Women In Organizational Management, Brandi Dehart

Walden Dissertations and Doctoral Studies

Exploring the perceptions of women managers involving effective strategies to remain within their roles is essential to further understand resiliency. A literature gap exists regarding the resilience strategies of women managers to stay in leadership roles. The purpose of this qualitative single case study with embedded units was to explore perceptions of women managers with at least five years of experience in management regarding how they remained resilient throughout their careers. The overarching research question was developed to address the purpose of this qualitative single case study with embedded units. Qualitative data were collected from semistructured interviews with nine women …

Gendered Racial Microaggressions’ Cumulative Effects On Black Women’S Psychological Well-Being, Melva Dorsey

Walden Dissertations and Doctoral Studies

Black women living in North America experience gendered racial microaggressions injurious confrontations in every social setting due to simultaneous discrimination involving race and gender. This basic qualitative research study aimed to explore the perceptions of Black women in this society with gendered racial microaggressions to discover how they perceive the cumulative effects of this phenomenon on their psychological well-being by utilizing intersectionality as the study's conceptual framework. Data collection occurred via interviews with a sample size of five Black women ages 51 and older who were born and raised in North America that self-reported experiencing gendered racial microaggressions. Participants were …

Thematic Analysis Of Online Predatory Grooming Behavior Among Male Offenders, Ryan Christopher Dronek

Walden Dissertations and Doctoral Studies

Social media sites, gaming platforms, and online communication tools have been integrated into children’s everyday lives. This has created a new avenue for child predators to identify, communicate, and victimize children. Just as the internet and the ability to communicate online have evolved, predatory grooming behavior has evolved as well. This qualitative study aimed to identify predatory grooming themes and the thematic stage progression for online male offenders who target child victims using online chat rooms. O’Connell’s typology of cyber sexploitation and online grooming practices was used to explore online child predators’ grooming themes and stage progression. Nine male Wisconsin …

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

Perceptions Of Female Naval Officers On Combat Role Policy And Career Advancement, Cheryl Dudley

Walden Dissertations and Doctoral Studies

Women were officially allowed to serve in combat positions when the 1993 Combat Exclusion Policy was lifted in 2013. There was little research to date on how these changes may have influenced the recruitment, retention, and promotion of female naval officers. The purpose of this study was to explore female naval officers' perceptions on how lifting the combat exclusion policy impacted the factors of recruitment, retention, and promotion within the military. A generic qualitative study supported exploring perceptions of female naval officers who experienced combat duty regarding these issues. Using feminist security studies as the conceptual framework, this study focused …

Retention Rate Factors Of Junior Enlisted Females In The U.S Marine Corps, Iris I. Esquilin

Walden Dissertations and Doctoral Studies

The modern United States Armed Forces is the largest and most powerful military force the world has ever experienced, and the U.S. Marine Corps represents the most elite members thereof, claiming the iconic tagline “The Few, The Proud.” However, while the Marine Corps expends considerable effort in recruiting excellent personnel, the branch also faces a high turnover rate, with 75.0% of first-year enlistees choosing not to continue their service for a subsequent term. This retention problem is especially pronounced with respect to female Marines, who only make up 8.0% of the Marine force, the lowest of any U.S. military branch. …

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Non-Nightmare Recurring Dreams And Trauma, Asmai Fathelbab

Walden Dissertations and Doctoral Studies

This study examined the relationship between trauma and non-nightmare recurrent dreams (NNRD). Although there is extensive literature on the psychological consequences, diagnosis, and treatment of trauma, studies on the role of sleep processes have focused almost exclusively on nightmares. The potential relationship between NNRD and traumatic experiences has been overlooked by researchers. The purpose of this study was to assess if history of trauma and NNRD were correlated. More specifically, using Revonsuo’s threat simulation theory as a framework, the study evaluated if gender, quality of sleep, depression, anxiety, stress, and history trauma predicted NNRD. A cross-sectional correlational survey design was …

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …

Improving Staff Knowledge Of The Value Of Hourly Rounding, Dr. Melissa Gagliano, Dnp, Nea-Bc

Walden Dissertations and Doctoral Studies

Research has shown that consistent hourly rounds improve patient satisfaction and quality of care. Successful implementation and maintenance of this patient-centered practice hinges on nursing knowledge and proper training in the processes and procedures that support timely, purposeful, and effective hourly rounds. The purpose of this doctoral project was to implement a staff education project to improve staff perception of the value of hourly rounding on an inpatient orthopaedic unit. Project materials supplemented the hourly rounding program already in place at the facility. Following an in-depth literature search, pre-intervention multiple-choice knowledge assessment questionnaires were distributed to staff who volunteered to …

Lived Experiences Of Stress And Burnout Among Pediatric Home Care Nurses, Johane Garcon-Paul

Walden Dissertations and Doctoral Studies

Abstract

Research shows that healthcare providers encounter stress in their workplaces whether in a home or a healthcare facility that results in reduced job satisfaction, burnout, and inadequate care of patients. There is a gap in the literature regarding the lived experiences of nurses caring for children in all work settings, including the home care setting, regarding stress and burnout. The lived experiences of pediatric nurses working in home care settings were explored to discover conditions that contribute to their occupational stress and burnout. The occupational stress model with a major focus on the job demands-resources occupational stress model was …

Small Retail Business Strategies Used To Prevent Employee Fraud In North Carolina, Jourdan Mariah Gayden

Walden Dissertations and Doctoral Studies

Fraud could result in adverse business outcomes for small business owners. Small business owners are concerned with preventing fraud to increase the financial stability of small businesses. Grounded in the fraud triangle theory, the purpose of this qualitative multiple-case study was to explore strategies small business owners use to prevent and detect fraud in their businesses. Participants included five small business owners in North Carolina who successfully implemented strategies to prevent and detect fraud. Data were collected using semistructured interviews and a review of company documents. The data were analyzed using thematic analysis, which yielded four themes: monitoring, contractual agreements, …

Impacts Of White Privilege And Implicit Bias On Treatment Implementation With Black Pediatric Patients, Tara Geer-Leiker

Walden Dissertations and Doctoral Studies

White privilege and implicit bias are known contributing factors to the racial health inequities that exist in the treatment of Black children in U.S. hospitals. There is limited research, however, on the potential for White nurses to engage in self-examination related to either concept. The purpose of this basic qualitative inquiry was to understand how White privilege and/or implicit bias shapes the lived experiences of White nurses as they treat and interact with Black pediatric patients. The conceptual framework included a modified model comprised of Hobbs’s concept of White privilege and Blair et al.’s model of influences of implicit bias …

The Relationship Between Customers’ Satisfaction And Trust In The Global Supply Chain And Profitability, Azeal Gilham

Walden Dissertations and Doctoral Studies

The inability to meet customer demands and expectations impacts an organization’s profitability. Understanding and meeting customer needs are critical for the financial success of business owners. Grounded in the theory of constraints, the purpose of this quantitative ex post facto study was to examine the relationships between customers’ satisfaction and trust in the supply chain and profitability. Secondary data (n = 121) were collected from the Elsevier Research Database using archival data collected from an automotive factory. Data were analyzed using multiple linear regression, and the results were statistically significant, F (2, 118) = 264.347, p < .001, R2 = .90. In the final model, both predictor variables were significant, customers’ satisfaction: mean wait time (t = 22.991, p < .001, β = 16.23); and customers’ trust: minimum stock level (t = 7.306, p < .001, β = .118). A key recommendation is for business leaders to satisfy customers and gain their trust by creating sufficient inventory stocking levels and improving replenishment timeframes that meet customers’ supply chain demands. The implications for positive social change include the opportunity for supply chain managers to develop an effective supply chain that may contribute to the quality of service that promotes success in regional markets, sustain growth, and allows for social development among the local community workforces.

The Experiences Of Successful Formerly Incarcerated African American Males, Bernice Gordon-Young

Walden Dissertations and Doctoral Studies

African American men are incarcerated at alarming rates and often recidivate at high rates within 3 years. Researchers have demonstrated that recidivism rates last through years 4 and beyond. There is limited qualitative data to provide strategies from formerly incarcerated African American males who have been successful at not recidivating for 10 or more years after their release. The purpose of this Afrocentric-hermeneutic phenomenological study was to bridge the gap in the literature and explore the lived experiences of African American males who were formerly incarcerated and have positively changed their lives to avoid further criminality. A purposeful and snowball …

Implementation Of Response To Intervention In An Urban Elementary School, Carla P. Graham

Walden Dissertations and Doctoral Studies

AbstractIn an urban Midwestern elementary school, the teachers and administrators were perplexed by the rise in special education referrals even with the implementation of response to intervention (RTI). The problem addressed in this study is the general education teachers’ implementation of RTI to identify if there were any gaps in practice and, if so, to create a plan that could correct those gaps and potentially decrease the number of special education referrals and students identified for special education services. The conceptual framework for this study was the multitiered system of support, of which RTI is one component. Four research questions …

Nurse Perceptions Of Nonacademic Factors That Influence Undergraduate Nursing Student Retention And Persistence To Graduation, Marianne Gray

Walden Dissertations and Doctoral Studies

Having an adequate supply of nurses is critical to maintaining the health care system. The problem for this study was that undergraduate nursing students were leaving a local Midwest community college’s nursing program before obtaining a degree. The purpose of this qualitative study was to explore the perceptions of the program’s recent graduates, regarding nonacademic factors that they believe helped to facilitate their success. Jeffreys’s nursing universal retention and success model served as the conceptual framework. The research question was focused on identifying nurse graduate perceptions of nonacademic factors that contributed to their success. A basic qualitative research design was …

Relationship Between African American Professionals’ Acculturation, Racial Identity, And Experienced Stereotype Threat, Erica Regina Griffin

Walden Dissertations and Doctoral Studies

There is considerable research on acculturation, identity formation, and stereotype threat experiences of African American children and college students. However, little research has been conducted exploring these factors once college graduates have entered the workforce. Furthermore, the previous research has treated these variables separately or combining no more than two at a time. The purpose of this quantitative, cross-sectional study was to learn more about African American professionals’ acculturation, racial identity, and stereotype threat experiences. Seller’s Model of Racial Identity, Berry’s acculturation theory, and Shapiro’s Multi-threat framework provided the basis of this study. The research question addressed whether the type …

Stressors And Depression Among Adolescents With Co-Rumination As A Moderator, Angela Grosso-Burke

Walden Dissertations and Doctoral Studies

Stress, depression, and co-rumination have been a focus of scholars in recent years. Although studies have considered the relationship among stressors, depression, and co-rumination, little is known about the moderating effects of co-rumination. This study aimed to address the gap in the literature by examining moderating effects of co-rumination on relations between stressors and depression, along with further moderating effects of sex, race, and grade. The current study examined mean-level race, sex, and grade differences in the relation among stressors (total, family, peer, physical appearance, sport/physical activity, school) and depressive symptoms in adolescents. Analyses were conducted to determine the relationship …

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …

Clinicians' Perceptions Of Telehealth Services During The Covid-19 Pandemic In Virginia, Johnetta Hill Guishard

Walden Dissertations and Doctoral Studies

The onset of COVID-19 introduced unprecedented changes to how U.S. public health services were delivered. Many public and private agencies faced mandatory closures, social distancing mandates, and rapid transitions to telehealth interventions and treatment. Mental health clinicians witnessed disruptions in continuity of care and an increase in mental health risks overall. Although some studies have been conducted to survey clinicians’ perceptions of the usefulness and ease of use of technology-based interventions, knowledge about mental health clinicians’ experiences and perceptions in Virginia was sparse. The purpose of this generic qualitative study was to explore how mental health clinicians in Virginia described …

The Effect Of Public Budgeting Decisions And Tuition Costs On Student Graduation Outcomes In Michigan, Travis Charles Hadden

Walden Dissertations and Doctoral Studies

AbstractTuition costs for U.S. public universities have steadily risen in response to decreased state funding in the aftermath of the 2008 Great Recession. Researchers have studied the relationship between public budgeting and higher education but have not established the direct effects of budgeting decisions on student graduation outcomes. The purpose of this quantitative study was to understand why state funding has not kept up with tuition prices and how that affects student graduation rates. The effect of (a) tuition costs and (b) Michigan state funding for public universities on student outcomes was examined. Punctuated equilibrium theory and policy feedback theory, …