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Managerial Strategies to Increase Employee Retention in the Health Care Industry
Get PDFEmployee turnover remains a significant business concern for Hawaiian health care organizations. Health care organization leaders are concerned about employee retention because of its implications for organizational effectiveness and the continuity of customer care. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative pragmatic inquiry was to identify and explore successful strategies used by eight purposively selected health care leaders in Hawaii to improve employee retention. Thematic analysis of semistructured interview data and public organizational documents revealed six themes: (a) competitive compensation and benefits, (b) professional development and training, (c) recognition and rewards, (d) work–life balance and flexibility, (e) effective leadership and communication, and (f) employee engagement and support systems. A key recommendation for health care organization leaders is to implement an integrated retention framework that aligns compensation equity, leadership development, and structured growth opportunities. The implications for positive social change include the potential to enhance the workforce stability of health care organizations, which can potentially lead to improved patient outcomes, particularly for patients, their families, and underserved populations
K-8 School Administrators\u27 Implementation of Positive Behavior Intervention and Support Systems to Reduce Out-of-School Suspensions in a Southeastern U.S. School District
Get PDFThe problem that was addressed through this study is that the implementation of positive behavior interventions and supports (PBIS) has not resulted in a consistent reduction in the use of out-of-school suspensions as a disciplinary consequence in K–8 schools in a Southeastern U.S. school district. Grounded in Horner and Sugai’s PBIS, the purpose of this qualitative study was to explore K–8 school administrators’ perceptions of their implementation of PBIS in a Southeastern U.S. school district. For this basic qualitative design, semistructured interviews were conducted with three principals and three assistant principals in the local school district. Thematic analysis using inductive coding revealed five themes: (a) the level of training provided to principal and assistant principals was inconsistent; (b) the different challenges administrators faced implementing PBIS on their school campus; (c) the different approaches administrators used to discipline students; (d) the effect PBIS had on out-of-school suspensions; and (e) the need for district-wide training to improve PBIS implementation. Results indicated that the study district should provide professional development to school administrators to address the inconsistent implementation of PBIS in their schools. Based on these results, a 3-day professional development program was developed for school administrators. This study may promote positive social change by enabling school administrators to better manage student behavior while teachers and students concentrate on teaching and learning
Staff Education on Medication Adherence
Get PDFSummary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice without training. The project involved designing, implementing, and evaluating a staff education program, utilizing pre- and post-tests to measure changes in staff confidence and understanding. Findings showed that education improved nurses’ awareness of adherence challenges, ability to identify barriers, and skills in providing patient-centered education and collaboration. The average percentage increase was 88.89%, suggesting that nurses achieved a better understanding of the evidence-based practice strategies to improve medication adherence. The primary outcome was a reusable staff education module, and the project concludes that ongoing staff education is a practical and sustainable approach to strengthening nursing practice, promoting culturally sensitive and equitable care, reducing health disparities, and improving medication adherence and outcomes for underserved mental health populations
Teacher Perspectives of their Challenges in Supporting K-3 Students in Mathematics Proficiency
Get PDFThe problem for this study was that mathematics preparation for students in K–3 classrooms often does not lead to mathematics proficiency for third grade students. Guided by Wigfield’s expectancy value theory, the purpose of this qualitative study was to explore teachers’ perspectives of children’s expectations and values related to mathematics and challenges teachers describe in supporting children’s mathematics achievement. Data were collected through 12 semistructured interviews with K–3 teachers in in a public school district in the eastern United States. Thematic analysis using open coding resulted in six themes which indicated that teacher beliefs and expectations are associated with mathematics knowledge; students hold beliefs, experiences and expectations associated with mathematics knowledge and ability levels; students\u27 mathematics challenges affect their ability to achieve mathematics proficiency within grades K–3 ; classroom measures are in place to help students better understand the subject of mathematics; family influences are associated with students’ behaviors and success in mathematics; and teachers have expertise and knowledge regarding mathematics. Results of this study revealed that teachers are aware of motivational factors affecting students’ beliefs and expectations in mathematics. Further study is recommended to determine levels of achievement expectancy among students in 4th to 8th grade. Positive social change may result when teachers’ perspectives of students’ mathematics challenges are understood, and teachers use motivational strategies to help students achieve mathematics proficiency which will enable them to be successful and productive citizens throughout life
Perspectives of EFL Teachers Toward the Influence of AI Writing Tools on Students\u27 Writing Content and Organization
Get PDFObjectives: This study investigated Vietnamese English as a foreign language (EFL) teachers’ perspectives on the influence of artificial intelligence (AI) writing tools on students’ writing content and organization, examining tool selection patterns and effectiveness relationships through a mixed-methods approach.
Methods: An exploratory sequential mixed-methods design was employed, combining semi-structured interviews and classroom observations with six EFL teachers, followed by a survey of 52 teachers from various Vietnamese universities. Data analysis integrated thematic analysis of qualitative data with correlation and regression analyses of survey responses to examine relationships between usage patterns, institutional factors, and effectiveness ratings.
Results: Teachers strategically combined multiple AI platforms (ChatGPT, Grammarly, and QuillBot) to support different aspects of writing development. Statistical analysis revealed strong correlations between AI tool usage frequency and effectiveness ratings for both content and organization. Regression analysis indicated that usage patterns and institutional factors significantly predicted organizational effectiveness. While AI tools enhanced students’ idea generation and organizational coherence, they showed limitations in supporting sophisticated argument development. Significant disparities in implementation effectiveness existed between private and public institutions, with guided instruction approaches demonstrating superior outcomes compared to independent AI tool usage.
Conclusions: AI writing tools function effectively as scaffolding mechanisms in EFL writing instruction when implemented within structured pedagogical frameworks, with effectiveness determined by implementation strategies and institutional support rather than technological capabilities alone. Statistical validation confirms that guided integration approaches yield significantly better outcomes than independent usage.
Implications: These findings inform the development of balanced integration approaches that combine technological support with traditional pedagogy while highlighting the need for institutional support to address implementation disparities in different educational contexts
Uncertainty in Cervical Cancer Screening: Age and Implications for Shared Decision-Making in Resource-Limited Settings
No full textPersistent high-risk human papillomavirus (HPV) infection causes cervical cancer. Age-related changes at the cervical squamocolumnar junction (SCJ) can compromise screening accuracy in older women, risking missed precancerous or invasive lesions. Informed by risk-based management and shared decision-making (SDM) frameworks, this study examined the relationship between age and SCJ visibility (controlling for parity, HIV status, reviewer, and study site) and explored experts’ and women’s perspectives on communicating SCJ visibility-related uncertainty and SDM. Contingency tables and logistic regression were used to analyze 5,992 cervical images from countries participating in the HPV-Automated Visual Evaluation (PAVE) Consortium. Qualitative thematic synthesis drew on 14 interviews with PAVE scientific experts and 4 focus group discussions with 25 women in the PAVE study, Ikire, Nigeria. Results were indicative of higher odds of nonvisible SCJ among women aged 30–34 (OR = 1.6, 95% CI [1.0, 2.5], p = .042); 35–39 (OR = 2.9, 95% CI [1.8, 4.6], p \u3c .001); 40–44 (OR = 4.7, 95% CI [3.0, 7.4], p \u3c .001); and 45–49 (OR = 6.8, 95% CI [4.3, 10.7], p \u3c .001), compared with those aged 25–29. Experts described an ethical tension in disclosing SCJ visibility uncertainty—balancing respect for autonomy with perceived beneficence. Women reported navigating uncertainty through faith, trust in clinicians, and seeking reassurance. Respectful, transparent communication tailored to local norms and contexts can facilitate understanding of screening strategies and support women’s participation in cervical screening and SDM. Implementing these findings may strengthen cervical cancer screening programs as countries pursue cervical cancer elimination
Exploring Parenting Experiences: Fathers and Mothers Raising a Child With Autism
Get PDFThe experiences of parenting a child with autism spectrum disorder (ASD) have been widely studied in Western contexts. Still, limited research has explored how sociocultural factors shape these experiences in India. This qualitative study aims to address this gap by exploring and comparing the lived experiences of mothers and fathers raising a child with ASD in Kerala, India. The purpose of this study was to investigate how gender roles, cultural expectations, and social structures impact parental adaptation, coping, and caregiving practices. Bronfenbrenner’s ecological systems theory and Crenshaw’s ideas of intersectionality provide the conceptual framework of this study. Using an interpretative phenomenological analysis design with reflexive thematic analysis, semistructured interviews were conducted with 12 participants (i.e., six couples, comprising six mothers and six fathers, who were interviewed independently) who are parenting children diagnosed with ASD. The findings indicated that mothers primarily managed emotional and physical caregiving responsibilities, including therapy coordination and educational support, whereas fathers assumed supportive, yet secondary roles focused on financial and practical needs. These gendered caregiving patterns reflect Kerala’s sociocultural norms that valorize maternal sacrifice and paternal provision. Parents demonstrated resilience despite experiencing stigma, isolation, and inadequate institutional support. The implications for positive social change include promoting culturally responsive, gender-sensitive, and family-centred interventions that strengthen community awareness and improve access to coordinated autism services in India
Need for a Psychiatric Facility to Develop a Clinical Practice Guideline on Self-Care to Give to Patients Upon Discharge
Get PDFThe project is a Doctor of Nursing Practice (DNP) clinical practice guideline (CPG) on the need for a psychiatric facility to develop a CPG on self-care to give to patients upon discharge. The practice problem was a healthcare facility did not have guidelines to educate patients on self-care upon discharge. Addressing the problem within nursing practice can promote self-care practices and improve overall health outcomes for patients with mental illnesses. The practice-focused question that guided this project was: will a CPG potentially increase self-care among discharged patients? The purpose of the study was to develop a CPG on self-care for nurses to give to patients upon discharge. Panel members were invited and given information on how to appraise developed guidelines based on the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. Seven panel members rated 100% for all 23 items of the AGREE II tool, indicating the guideline comprehensively addressed essential elements, was clear, and had strong clinical applicability. Also, all reviewers rated 100% overall quality of guidelines as 100% and recommended their use in clinical practice. This project enhances nursing practice by empowering nurses to deliver evidence-based education that enhances patients’ self-care capacity, supports recovery, and prevents readmissions. The project contributes to positive social change by advancing health literacy, promoting self- management, and improving overall wellbeing. Additionally, this project supports diversity, equity, and inclusion by addressing unique needs of individuals with mental illnesses by improving equitable access to self-care education.
Multidisciplinary Approach to Reducing Healthcare-Associated Infections: A DNP Project
Get PDFHealthcare-associated infections are increasingly common in healthcare facilities due to multiple concerns, including negligence, human error, and poor conditions. According to Chuwa (2024), secondary infections are a significant threat to patient safety and wellness, reducing an organization’s ability to realize clinical objectives. The facility is a large healthcare provider operating numerous hospitals and care homes across the United States. The organization continues to report increased infection rates across its branches owing to a lack of standardized infection prevention and control protocols, reducing its efficiency and appeal. Internal audits point to inconsistencies in general sanitation, cleanliness, and hygiene. The organization also lags in antibiotic stewardship, routine checks, and postoperative care. External reports from the Centers for Disease Control and Prevention highlight that one in 30 hospitalized persons contracts secondary infections daily, further complicating the facilities’ functioning (Almeida, 2021). Such infections yield challenges, including more extended hospital stays, poor patient outcomes, and higher medical costs. The present analysis attempts to foster a systemic and comprehensive strategy to reduce secondary infections to bolster organizational operations and promote patient-centered care
Staff Education to Increase Knowledge and Awareness of Cultural Sensitivity Among Providers
Get PDFThis Doctor of Nursing Practice (DNP) project aimed to enhance cultural sensitivity among healthcare providers through an educational intervention in a local organization. With the U.S. foreign-born population exceeding 47 million, the need for culturally competent care has become paramount. The study involved nine participants who underwent a pretest and posttest assessment to evaluate their knowledge and awareness of cultural sensitivity. Results indicated a significant increase in knowledge, with pretest and posttest scores improving from a mean of 4.33 to 8.56 (p \u3c 0.01). Awareness in key areas such as patient-provider relationships, cultural beliefs, and language barriers also showed marked improvement. These findings further support the necessity of ongoing cultural sensitivity training to enhance patient care and outcomes, highlighting the potential for broader application across healthcare institutions