Digital Commons Network^™

Impact Of Sepsis Order Set Optimization On Sep-1 Compliance And Clinical Outcomes: A Retrospective Data Analysis, Janelle Harding

West Chester University Graduate Theses, Dissertations, and Final Projects

Sepsis remains a leading cause of mortality, morbidity, and healthcare expenditure in the United States, with national SEP-1 compliance rates persistently near 60%. This quality improvement project evaluated whether optimizing sepsis order sets within a large, urban, Magnet-designated hospital improved adherence to the CMS SEP-1 quality measure and associated patient outcomes. Guided by the Donabedian Model, a multidisciplinary sepsis workgroup redesigned emergency department and inpatient sepsis order sets to streamline evidence-based care, enhance workflow alignment, and reduce variation in treatment. A retrospective analysis of 158 adult SEP-1 cases, with 67 cases in the preintervention group and 91 cases in the …

Human Resources Representation Models And Municipal Employee Outcomes: A Quantitative Study Of Small Pennsylvania Municipalities, John W. Crouser

West Chester University Graduate Theses, Dissertations, and Final Projects

Small municipalities operate in resource-constrained environments that shape how human resource management (HRM) is organized and experienced. This study examines whether HR representation models (in-house, delegated, outsourced, and hybrid) differ in association with employee job satisfaction and manager-reported turnover trends (RQ1), and whether delegating HR responsibilities to non-HR managers is associated with outcomes differently than other models (RQ2). Grounded in Strategic Human Capital Management, the Resource-Based View, and contingency theory, the study assesses whether HR information system (HRIS) capability is associated with turnover trends or employee satisfaction (RQ3) and whether Strategic Human Capital Management (SHCM) alignment is associated with manager-reported …

Rooted In Relationships: How Personal And Workplace Social Capital Help Sustain Principal Leadership, Megan Scelfo

West Chester University Graduate Theses, Dissertations, and Final Projects

It takes five or more years to fully realize a vision for change in any organization (Fullan, 2002; Snodgrass Rangel, 2018), yet the average tenure for a public-school principal in their same school is 4.5 years (National Center for Education Statistics [NCES], 2023). This work adds to our understanding of what factors may improve principal longevity to positively impact school effectiveness. This multiple-case study (Yin, 2018) incorporated a survey and interviews to determine how components of social capital (Bourdieu,1986; Coleman, 1988; Tsounis 2022, Wang et al., 2014) may impact the retention of Pennsylvania public school principals. The survey asked about …

A Pull Toward Independence: Improving Pessary Removal Ease And Patient Independence Using Dental Floss, Stephanie Haly

West Chester University Graduate Theses, Dissertations, and Final Projects

Pelvic Organ Prolapse and Stress Urinary Incontinence are the most common medical conditions for prescribing a vaginal pessary. Treating these conditions is vital to improve patient outcomes and quality of life. Treatment options vary from surgical options to less invasive alternatives. Due to various reasons, a patient might opt to avoid surgical management which leaves a vaginal pessary as the next best treatment option. Barriers to pessary self-management are seen frequently and can reduce patient independence and compliance. This quality improvement project sought to answer the following research question: In women using vaginal pessaries for pelvic organ prolapse or stress …

Using Text Messages To Reduce Pediatric No-Show Rates In Primary Pediatric Care, Kelly A. Rexford-Hudson

West Chester University Graduate Theses, Dissertations, and Final Projects

Pediatric appointment no-show rates lead to fragmented care, missed preventative services, delayed immunizations, and reduced clinic efficiency. Children who miss well-child and follow-up visits are at increased risk for unmanaged chronic conditions and gaps in developmental surveillance. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether bilingual text message reminders would decrease no-show rates in a pediatric primary care clinic. Led by the Plan-Do-Study-Act framework and Bronfenbrenner's Ecological Model, this intervention consisted of two manual text message reminders, delivered in English and Spanish, at 7 days and 2 days before scheduled appointments during a …

Poct Hgb A1c And Patient Satisfaction In Adult Patients With Diabetes, Kelly Galvin

West Chester University Graduate Theses, Dissertations, and Final Projects

Point-of-care testing (POCT) is used to measure a variety of healthcare data rapidly at the bedside. It can be particularly useful when laboratory data is not available at the time a patient sees their healthcare provider (HCP). Patients living with diabetes frequently do not obtain laboratory data prior to their visit with their HCP. This quality improvement projected aim to assess if use of POCT to measure an Hgb A1c level in patients with diabetes affected patient satisfaction in an endocrinology clinic. Eligible participants were asked to complete an anonymous survey, with three questions asking if having their Hgb A1c …

Social Dirt Or Fertile Soil: A Phenomenological Study Of Contingent Faculty, Ann M. Hiloski-Fowler

West Chester University Graduate Theses, Dissertations, and Final Projects

The experiences of contingent or adjunct faculty affect their professional identity development. Contingent faculty use has increased since the 1970s. By 2013, two-thirds of U.S. higher education faculty were contingent (Finkelstein et al., 2016). While institutions use contingent faculty to fulfill their educational missions (Haviland et al., 2017; Kezar & Sam, 2011; Kimmel & Fairchild, 2017), their status as academic laborers stigmatizes them in academia, developing what Levin and Shaker (2011) term a “hybrid identity” (p. 1479), as both professionals and laborers, professors and temporary employees. Historically, the professional status of the professoriate has been defined on the tenure track …

Factors That Impact K-6th Grade Teachers’ Sense Of Self-Efficacy: A Mixed Methods Study, Becky A. Eckburg

West Chester University Graduate Theses, Dissertations, and Final Projects

Although there have been efforts to narrow the "achievement gap," research shows that the academic achievement levels of students in low socioeconomic school settings are likely to be significantly lower than the academic achievement levels of students in higher socioeconomic school settings (Babayiğit et al., 2021; Rahman et al., 2024). Studies also show that teachers have a significant impact on their students' growth, no matter what their academic setting may be (Petek & Pope, 2023), and that collective teacher self-efficacy is a significant factor in positive student achievement (Hattie, 2008). If targeted professional development could support teachers' self-efficacy, student achievement …

Retrospective Analysis Of Calcium Administration In Patients Undergoing Massive Transfusion Protocol (Mtp), Chrissy Unton

West Chester University Graduate Theses, Dissertations, and Final Projects

Unintentional injuries have remained the third leading cause of death in the United States since 2015, with the exception of 2020. Of those deaths resulting from traumatic injury, 40% result from hemorrhage and uncontrolled blood loss. Current treatment efforts focus on early, balanced transfusion of blood products and aim to correct metabolic derangements/coagulopathies, while minimizing crystalloid administration. As such, the role hypocalcemia plays in the injury process and the importance of calcium administration in resuscitation efforts has gained traction over recent years. The aim of this retrospective analysis was to assess calcium supplementation in relation to current facility protocol for …

Urban Megaregions In The United States: A Gis-Based Approach To Defining A New Regional Geography, Jonas Rugys

West Chester University Graduate Theses, Dissertations, and Final Projects

This study investigates urban megaregions in the United States. The regional concept is examined from its origins in the geographic tradition as well as its transformation in the twentieth century to its current state. A GIS-based methodology for defining urban megaregions is presented and discussed. The results challenge existing assumptions of population and employment growth in the United States.

Improving Scoliosis Screening Protocol And Outcomes, Beverly R. Jordan

West Chester University Graduate Theses, Dissertations, and Final Projects

The purpose of this Quality Improvement (QI) project was to address outdated scoliosis screening protocols and guidelines by identifying barriers and improving outcomes. Current protocols and guidelines are not current with evidence-based practices. School nurses are mandated to conduct scoliosis screening on 6^th & 7^th graders annually using Adam’s forward bend test and a second screener for failed screens. Although this guideline attempts to use a 2^nd screener as another tool to reduce false positives, it does not address the barriers school nurses may have with these older guidelines and protocols. Scoliosis screening has fallen out of …

College Students’ Use Of Cell Phones And Their Level Of Attention To Academics, Social Relationships, And Health, Nicole L. Istvan

West Chester University Graduate Theses, Dissertations, and Final Projects

This research utilized a single case study design to examine how college students, ages 18–24, perceive their attention in relation to cell phone use within academic, social, and health-related contexts. The case was bound by undergraduate students enrolled at a public university in the northeastern United States, referred to as Tapaton University. The study employed multiple sources of data to support triangulation and credibility, while providing an in-depth exploration of a complex, real-world phenomenon.

Following Institutional Review Board approval, participants were recruited through community flyers, social media outreach, and snowball sampling. Data collection included observational field notes, a quantitative survey, …

Assessing The Mentorship Role In Neonatal Outcomes, Patricia Juhline Brunner

West Chester University Graduate Theses, Dissertations, and Final Projects

The complex environment of neonatal intensive care requires a skilled, engaged nursing workforce to maintain high‑quality outcomes. Structured mentorship is an evidence‑based strategy shown to enhance professional engagement and support improved clinical outcomes. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of a structured clinical mentorship program on evidence‑based practice beliefs, nurse engagement, and selected neonatal outcomes in a Level III academic intensive care nursery.

Guided by the Donabedian model, the project evaluated structure through mentorship design and preparation, process through mentor–mentee interactions and workflow integration, and outcomes through nursing and patient metrics. Lewin’s change …

Serenade No.2, James C. Mechem

West Chester University Graduate Theses, Dissertations, and Final Projects

Serenade No.2 is a seventeen minute composition for Wind Symphony, dedicated to each

of my mentors in classical composition during the past 10 years: John Carbon, Brian Norcross,

Samuel Andreyev, Jay Chadwick, Adam Silverman, Robert Maggio, Ari Sussman, and Mark

Rimple. Through this composition, my goal was to both pay homage to the individuals that

helped shape my artistic voice, and to additionally connote each movement with evocative

oceanic imagery, specifically through the title of each movement in the composition. I included

this latter detail in reference to a vacation that I went on in August of 2025 to Atlantic …

Modeling The Effects Of Subsurface Tile Drainage On Atrazine And Nitrate Transport In Till Soils Of Iowa, Madison Hobbs

West Chester University Graduate Theses, Dissertations, and Final Projects

Tile drainage design influences groundwater flow pathways, residence time, and agrochemical transport in agricultural soils. This study evaluates how differences in drainage design affect subsurface flow behavior and contaminant transport in glacial till soils. A groundwater model was developed to compare conventional and controlled drainage systems with a shallow drainage system, and particle tracking was used to examine flow paths and residence times.

The results show that tile drainage creates distinct shallow and deeper flow pathways. In the conventional and controlled model, 88% of particles were captured by drains, while 12% reached the general head boundary. The shallow system drains …

Beyond The Bedtime Story Beginnings: A Qualitative Study Exploring The Phenomenon Of Family Shared Reading With Middle-Grade Children, Kelly Rorvik

West Chester University Graduate Theses, Dissertations, and Final Projects

Literacy can serve as a critical outlet for children to develop empathy and academic success. However, substantial evidence suggests that by middle school, many students develop less positive attitudes and motivations for recreational and academic reading. The purpose of this asset-based phenomenological qualitative study, framed by Attachment and Socio-Critical Literacy theory, is to examine the parental experiences of shared reading with children between the ages of 10 and 15 to understand the perceived purpose and emotional impact it has on families. The 14 participants in this study were selected through a purposive interest survey. This asset-based phenomenological study seeks to …

Play Family, Andrea Grinwis

West Chester University Graduate Theses, Dissertations, and Final Projects

Play Family is a collection of lyrical essays, letters, photographs, and poems that examine grief, using form as a means to consider and recognize what is lasting amidst the lost. Play Family explores the emotions exposed by the indelible loss when a loved one passes and also the seemingly smaller losses as children take the first hesitant steps away from parents and then the more confident steps toward a life that places parents on the periphery. Using photographs of vintage Fisher Price Little People toys and engaging memories of play to forge a path to the past, Play Family uncovers …

Real-Time Isolated Asl Recognition: Evaluating Spatial-Temporal Networks And Multimodal Llms, Raga Mouni Batchu

West Chester University Graduate Theses, Dissertations, and Final Projects

This thesis investigates the deployment of high-accuracy Isolated ASL Recognition (ISLR) in resource-constrained edge environments. We train a lightweight Spatio-Temporal Attention Network (SSTAN,∼2.7 M parameters,∼10 MB) on the WLASL-100 benchmark, achieving 75.25% Top-1 and 88.24% Top-5 accuracy with 139 ms CPU-only inference. A systematic comparison against frontier multimodal LLMs (Gemini 3 Flash, Gemini 3.1 Pro, Qwen 3 VL) shows SSTAN outperforms the best LLM baseline by∼1.85×in accuracy while being 22–230×faster and up to 40×cheaper annually. The LLMs’ core limitation is a lack of fine-grained temporal perception; they impose English-language semantic priors rather than learning the articulatory distinctions that define ASL …

Empowerment Vs. Oversight: Student Perspectives On Classroom Genai Policies, Jessica A. Drass

West Chester University Graduate Theses, Dissertations, and Final Projects

The widespread availability of generative artificial intelligence (GenAI) tools and their rapid evolution has prompted faculty and institutions to develop classroom policies in effort to manage use, yet little empirical research exists on how such policies impact students. This qualitative study sought to explore how higher education students define academic integrity and GenAI’s place within it, how they perceive and evaluate classroom GenAI policies, and how such policies shape their academic self-efficacy, motivation, and engagement. Semi-structured interviews were conducted with sixteen undergraduate and graduate students at a mid-sized public university located in the Mid-Atlantic region of the United States. Interview …

Beyond Superpowers And Stereotypes: Female High School Band Directors Navigating Gendered Expectations In Leadership, Rachael L. Urquhart

West Chester University Graduate Theses, Dissertations, and Final Projects

Female high school band directors (FHSBDs) are significantly underrepresented (approx. 25%) in a male-dominated field. This inequity is sustained by societal gender stereotypes that create a double standard for traits like assertiveness and empathy. This mixed-methods study examined the leadership perceptions and career aspirations of female music teachers and highlighted the career obstacles and encouragements of female high school band directors (FHSBDs) by applying feminist theory to gender roles, self-concept, and leadership conceptualization. A survey of female music teachers yielded 89 responses. Then, 10 FSHBDs participated in a narrative-mapping activity and follow-up interview.

Survey data confirmed that leadership is a …

Examining The Relation Between Cognitive Reflection And Directional Reasoning In The Context Of Political Affiliation, Ian Dargitz

West Chester University Graduate Theses, Dissertations, and Final Projects

The intent of the study was to examine contributing factors to political bias, in particular the role of cognitive reflection. I hypothesized that in an explicitly partisan context, cognitive reflection would be predictive of greater bias.

Participants completed the cognitive reflection test (CRT). They then read a prompt claiming that people with either conservative or liberal beliefs tended to score higher on the CRT, using either explicitly partisan (e.g., "Medicare for All") or relatively neutral language (e.g., "low-cost health insurance.") After reading this prompt, they were asked whether they believe the CRT is a valid measure of reflective ability. Participants …

Geriatric Trauma Care: Closing The Gap Between Current Practice And Evidence-Based Data, Coleen Dever

West Chester University Graduate Theses, Dissertations, and Final Projects

Trauma care for older adults, ages 65 and older, poses challenges for trauma centers and emergency departments. This age group accounts for nearly 20% of the population and is expected to continue growing, underscoring the need for rapid, efficient management after injury. Complex medical conditions and medications, such as anticoagulants, can worsen injuries even from low-energy mechanisms like a ground-level fall (GLF). As a result, trauma centers develop protocols to identify patients at the highest risk of serious injury and to allocate resources for assessment and treatment. Across the country, trauma centers have updated protocols to include anticoagulant use as …

Bridging Vision And Practice: A Case Study Of Educator Perceptions Within The Community School Model, Jessica M. Riedel

West Chester University Graduate Theses, Dissertations, and Final Projects

Guided by a qualitative collective case study employing two focus groups and six individual interviews, this dissertation in practice examined educator and community school specialist perceptions of the community school model and sought to understand how those perceptions inform the district’s approach to teaching and school operations. Findings indicated a genuine desire to make the community school model successful for students within the buildings but also emphasized a lack of role clarity and professional development opportunities, misconceptions around the model, and siloing within different programs in the schools. These results highlight the need for more communication within districts and schools …

Beyond Interests And Ideas: Institutions And The Persistence Of Trade Protectionism In Brazil, Samo Sérgio Gonçalves Tosatti

West Chester University Graduate Theses, Dissertations, and Final Projects

Despite decades of economic reforms and growing international integration since the 1990s, Brazil has remained one of the most protectionist large economies in the global trading system. Tariff levels remain relatively high, the country maintains a limited network of trade agreements, and non-tariff barriers play a significant role in shaping market access. Existing explanations for this persistence have focused primarily on the influence of organized interests, particularly import-competing industries, and the enduring influence of developmentalist ideas rooted in Brazil’s import-substitution industrialization (ISI) legacy.

This dissertation argues that these explanations are incomplete without accounting for a third explanatory dimension: institutions. It …

The Effect Of Social Buffering And Gender On Cortisol Response In Emerging Adults, Ashley G. Molchany

West Chester University Graduate Theses, Dissertations, and Final Projects

Abstract

Cortisol, the primary stress hormone in the body, is released in times of challenge, including challenges faced throughout the transition to college. The experience of acute stress can be assessed through cortisol measures. The present study involved a 60-minute lab assessment for first-year students to analyze their physiological response to stress. Previous research has illustrated factors which impact cortisol responses, two of which are social support and gender. In the current study, participants (n = 71) were assigned to work either by themselves (Student Alone Condition) or in a peer triad group (Peer Triad Condition). Additionally, participants identified …

Shrinking Attachment Spaces, Anastasia M. Clements

West Chester University Graduate Theses, Dissertations, and Final Projects

Gluing constructions such as pushouts and other colimits are often used to attach spaces to- gether in algebraic topology. The weak topology is a natural choice of topology for attachment spaces in the context of CW-complexes and simplicial complexes because of its universal property but is insufficient for gluing together infinitely many spaces and preserving topological properties like compactness or metrizability. In this thesis, we introduce a modification of the weak topology called the shrinking attachment topology, which is defined on a space Y constructed by attaching an infinite sequence of spaces B₁, B₁, B_{3 …}

Dual Language Learner Status In Relation To Cortisol For Children In Head Start Preschool, Keala Bratsch

West Chester University Graduate Theses, Dissertations, and Final Projects

Early childhood education (ECE) has well documented school readiness benefits, especially for children facing economic hardship. Yet preschool context poses challenges that are associated with elevated stress levels and potential long-term tax on physiological systems that respond to stress. The present study examined dual language learner (DLL) status in relation to levels of the stress hormone cortisol among low-income children attending Head Start Preschool programs. Participants included 207 children ages 3- 5 years who attended preschool in 2021-22 (60.9% attending a dual-language learning school, 39.1% attending an English-instruction-only preschool; all participants meeting the criteria for low-income), and their parents or …

The Evolution Of Ethical Conviction, Tracy Henry

West Chester University Graduate Theses, Dissertations, and Final Projects

There is a steady decline in public opinion polling when it comes to the public’s perspective of public officials. In 2023, the combined unfavourability rating of Congress was at 72%.  There are ongoing unfavorable ratings, by issue, for the judiciary, and by individual for the executive. The researcher went in search of the reasons behind the declining opinions. Semi-structured interviews were conducted to identify those reasons and to answer the research question: To what extent do the ethical philosophies of consequentialism, deontology, and virtue inform the perceptions of the American public when they scrutinize the decision-making and conduct of public …

School-Based Mental And Emotional Support For Urban Students Experiencing Traumatic Loss, Britney Daniel-Harris

West Chester University Graduate Theses, Dissertations, and Final Projects

This study explores the perception of educational staff members on school-based mental and emotional resources for urban students experiencing traumatic loss. With increased levels of research centered on enhancing training protocols to educate teachers on identifying, supporting, and guiding traumatic care through evidence-based resources, there is an opportunity to understand their experiences by hearing their voices through a narrative inquiry qualitative research design. The Substance Abuse and Mental Health Services Administration (SAMHSA) has six principles of a trauma-informed environment, which were utilized to analyze participant stories. Five teachers, one social worker, and one special education leader participated in one-on-one interviews …

Impact Of Childhood Trauma On Perceptions Of Health: Examining The Role Of Religiosity As A Protective Factor Among Black And African American Adults, Patrice Penrose

West Chester University Graduate Theses, Dissertations, and Final Projects

Purpose: Childhood trauma has detrimental immediate and lifelong impacts on health. Black and African Americans experience higher rates of potentially traumatic events (PTEs) than the general population. Religiosity, a common coping mechanism for many who experience trauma, could serve to moderate the impacts. This study examines whether the importance of religion buffers against the impact of childhood exposure to PTEs on adult perceptions of health and assesses whether social support and/or coping mediate the relationship between religiosity and perceived health.

Method: This study analyzed data from 2,537 Black and African American participants in the National Longitudinal Study of Adolescent to …